血清胃蛋白酶原I和II、胃泌素-17及抗幽门螺杆菌抗体在萎缩性胃炎组织学诊断中的准确性

Accuracy of serum pepsinogens I and II, gastrin-17 and anti-helicobacter pylori antibodies in histological diagnoses of atrophic gastritis.

作者信息

Irvani S, Hashemi M R, Moghadam K G, Saeidee S, Khavaran K, Najari O, Ranavardi M, Nasiri S, Salmasian H, Rohanizadegan M

机构信息

Department of Gastroenterology, Army University of Medical Sciences, Tehran, Iran.

出版信息

Minerva Gastroenterol Dietol. 2010 Mar;56(1):13-7.

PMID:20190719

Abstract

AIM

Atrophic gastritis is defined as a chronic inflammatory process in gastric mucosa leading to loss of glandular cells. It is considered a precancerous condition, thus its early diagnosis is of importance. Although histo-pathologic studies remain as the gold standard of diagnosis, non-invasive methods suitable for screening purposes are being developed. This includes measurement of serum gastric profile.

METHODS

Two hundred and fifty 250 patients who were planned to undergo upper gastrointestinal endoscopy were randomly selected to be included in this study. Serum levels of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori (Hp) antibody were measured and the results were compared with that of histopathologic assessment of biopsy specimens obtained during endoscopy.

RESULTS

IgG anti-Hp, PGII and PGI/PGII ratio showed correlation with age. PGI/PGII ratio showed best sensitivity (96.1%) and negative predictive value (97.7%). PGI has the highest specificity (94.6%), and PGII also had a high negative predictive value (90.7%). IgG anti-Hp showed poor sensitivity and specificity (58.8% and 26.5%, respectively).

CONCLUSIONS

Pepsinogen I/II ratio appears to be the most suitable single measurement for screening purposes in atrophic gastritis.

摘要

目的

萎缩性胃炎被定义为胃黏膜的慢性炎症过程，导致腺细胞丢失。它被认为是一种癌前状态，因此其早期诊断至关重要。尽管组织病理学研究仍然是诊断的金标准，但适合筛查目的的非侵入性方法正在被开发。这包括血清胃蛋白酶原水平的检测。

方法

随机选择250例计划接受上消化道内镜检查的患者纳入本研究。检测血清胃蛋白酶原I、胃蛋白酶原II、胃泌素-17和抗幽门螺杆菌（Hp）抗体水平，并将结果与内镜检查时获取的活检标本的组织病理学评估结果进行比较。

结果

抗Hp IgG、胃蛋白酶原II及胃蛋白酶原I/胃蛋白酶原II比值与年龄相关。胃蛋白酶原I/胃蛋白酶原II比值显示出最佳敏感性（96.1%）和阴性预测值（97.7%）。胃蛋白酶原I具有最高特异性（94.6%），胃蛋白酶原II也有较高的阴性预测值（90.7%）。抗Hp IgG的敏感性和特异性较差（分别为58.8%和26.5%）。