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[血清学方法在萎缩性胃炎诊断中的潜力]

[Potentialities of a serological method in diagnosis of atrophic gastritis].

作者信息

Pimenov S I, Makarenko E V

出版信息

Ter Arkh. 2008;80(2):15-21.

Abstract

AIM

To analyse diagnostic potential of "serological gastrobiopsy" in patients with various gastroduodenal diseases.

MATERIAL AND METHODS

A total of 244 patients with gastroduodenal pathology have been examined. The diagnoses made morphologically were compared with those made by the serological method. The diagnosis of duodenal ulcer, gastric ulcer, atrophic gastritis, nonatrophic gastritis was made in 155, 31, 43 and 15 patients, respectively. The type of chronic gastritis was diagnosed by the levels of gastrin-17, pepsinogen I, pepsinogen II and antibodies to Helicobacter pylori in blood serum. The diagnoses made serologically were compared with those made morphologically.

RESULTS

The highest accuracy of a serological diagnosis of mucosal atrophy of the antral stomach was observed in gastric ulcer (80.6%) and duodenal ulcer (71.6%) in high sensitivity and low specificity. The accuracy of the diagnosis of gastric body mucosa atrophy in atrophic gastritis was 60.5%, in gastric ulcer--51.6%, in duodenal ulcer 58.7% in high specificity and low sensitivity. Serological diagnosis of gastric atrophy was accurate in 71.7%. In weak morphological picture of gastric body atrophy false negative serological diagnosis is possible. No false positive results occurred in diagnosis of gastric body mucosal atrophy (specificity 100%). A negative correlation was found between the severity of gastric body atrophy and pepsinogen I serum level (r = -0.380), pepsinogen I to pepsinogen II in blood serum (r = -0.392). No differences were revealed in gastrin-17 levels in the serum in different atrophy severity in the antral mucosa.

CONCLUSION

"Serological gastrobiopsy"provides satisfactory accuracy of atrophic gastritis diagnosis in gastroduodenal diseases.

摘要

目的

分析“血清学胃活检”对各种胃十二指肠疾病患者的诊断潜力。

材料与方法

共检查了244例胃十二指肠病变患者。将形态学诊断结果与血清学诊断结果进行比较。分别对155例、31例、43例和15例患者做出了十二指肠溃疡、胃溃疡、萎缩性胃炎、非萎缩性胃炎的诊断。通过血清中胃泌素-17、胃蛋白酶原I、胃蛋白酶原II和幽门螺杆菌抗体水平诊断慢性胃炎类型。将血清学诊断结果与形态学诊断结果进行比较。

结果

在高敏感性和低特异性方面,胃溃疡(80.6%)和十二指肠溃疡(71.6%)中胃窦黏膜萎缩的血清学诊断准确性最高。萎缩性胃炎中胃体黏膜萎缩的诊断准确性为60.5%,胃溃疡中为51.6%,十二指肠溃疡中为58.7%,特异性高而敏感性低。胃萎缩的血清学诊断准确率为71.7%。在胃体萎缩的形态学表现不明显时,血清学诊断可能出现假阴性。胃体黏膜萎缩诊断中未出现假阳性结果(特异性100%)。发现胃体萎缩严重程度与血清胃蛋白酶原I水平(r = -0.380)、血清中胃蛋白酶原I与胃蛋白酶原II的比值(r = -0.392)呈负相关。胃窦黏膜不同萎缩严重程度的血清胃泌素-17水平未显示差异。

结论

“血清学胃活检”对胃十二指肠疾病中萎缩性胃炎的诊断具有令人满意的准确性。

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