de Angelis Gian Luigi, Cavallaro Lucas Giovanni, Maffini Valentina, Moussa Ali Mahamat, Fornaroli Fabiola, Liatopoulou Stefania, Bizzarri Barbara, Merli Roberta, Comparato Giuseppe, Caruana Pietro, Cavestro Giulia Martina, Franzé Angelo, Di Mario Francesco
Department of Paediatrics, University of Parma, Parma, Italy.
Dig Dis. 2007;25(3):206-13. doi: 10.1159/000103886.
Non-invasive methods are advisable for the detection of Helicobacter pylori-related chronic gastritis in pediatric patients. Serum pepsinogens I and II (sPGII and sPGII), gastrin-17 (G-17) and anti-H. pylori antibodies (IgG-Hp) have been proposed as a 'serological gastric biopsy'.
To assess H. pylori infection and to evaluate gastric mucosa status in a pediatric population by means of serological parameters such as sPGI, sPGII, G-17 and IgG-Hp.
45 consecutively children evaluated for upper gastrointestinal symptoms were analyzed. All children were submitted to upper gastrointestinal endoscopy with biopsies. Serum samples were analyzed for IgG-Hp, sPGII, sPGI and G-17 (Biohit, Helsinki, Finland).
18 children had H. pylori-related mild or moderate non-atrophic chronic gastritis. They presented significantly higher mean levels of sPGII and of IgG-Hp than negative ones, either under or up to 10 years. sPGI showed significantly increased levels in H. pylori-positive patients only over 10 years. G-17 levels were not different between H. pylori-positive and -negative ones. The best cut-offs of IgG-Hp, sPGII and of product IgG-Hp x sPGII, to identify H. pylori infection, were 30 IU/l, 9 microg/l, and 241 IU/l x microg/l, respectively. The product IgG-Hp x sPGII identified H. pylori infection with a 100% sensitivity, 92% specificity, 90% positive predictive value and 100% negative predictive value. IgG-Hp and IgG-Hp showed a correlation (r = 0.94; p < 0.001).
Combined analysis of sPGII and IgG-Hp antibody levels could be recommended as a non-invasive panel for the assessment of H. pylori-related histological alterations of gastric mucosa in childhood.
对于检测儿童幽门螺杆菌相关慢性胃炎，非侵入性方法是可取的。血清胃蛋白酶原I和II（sPGI和sPGII）、胃泌素-17（G-17）和抗幽门螺杆菌抗体（IgG-Hp）已被提议作为一种“血清学胃活检”。
通过sPGI、sPGII、G-17和IgG-Hp等血清学参数评估儿童人群中的幽门螺杆菌感染情况并评价胃黏膜状态。
对45例因上消化道症状接受评估的连续儿童进行分析。所有儿童均接受了上消化道内镜检查及活检。对血清样本进行IgG-Hp、sPGII、sPGI和G-17检测（芬兰赫尔辛基Biohit公司产品）。
18例儿童患有幽门螺杆菌相关的轻度或中度非萎缩性慢性胃炎。无论年龄在10岁及以下还是10岁以上，他们的sPGII和IgG-Hp平均水平均显著高于检测结果为阴性的儿童。仅10岁以上的幽门螺杆菌阳性患者的sPGI水平显著升高。幽门螺杆菌阳性和阴性患者的G-17水平无差异。用于识别幽门螺杆菌感染的IgG-Hp、sPGII以及乘积IgG-Hp×sPGII的最佳临界值分别为30 IU/l、9 μg/l和241 IU/l×μg/l。乘积IgG-Hp×sPGII识别幽门螺杆菌感染的灵敏度为100%、特异性为92%、阳性预测值为90%、阴性预测值为100%。IgG-Hp和sPGII显示出相关性（r = 0.94；p < 0.001）。
sPGII和IgG-Hp抗体水平的联合分析可作为一种非侵入性检测方法，用于评估儿童期幽门螺杆菌相关的胃黏膜组织学改变。
