Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan.
World J Gastroenterol. 2011 Nov 21;17(43):4793-8. doi: 10.3748/wjg.v17.i43.4793.
To evaluate the value of ABC (D) stratification [combination of serum pepsinogen and Helicobacter pylori (H. pylori) antibody] of patients with gastric cancer.
Ninety-five consecutive patients with gastric cancer were enrolled into the study. The serum pepsinogen I (PG I)/pepsinogen II (PG II) and H. pylori antibody levels were measured. Patients were classified into five groups of ABC (D) stratification according to their serological status. Endoscopic findings of atrophic gastritis and histological differentiation were also analyzed in relation to the ABC (D) stratification.
The mean patient age was (67.9 ± 8.9) years. Three patients (3.2%) were classified into group A, 7 patients (7.4%) into group A', 27 patients (28.4%) into group B, 54 patients (56.8%) into group C, and 4 patients (4.2%) into group D, respectively. There were only three cases in group A when the patients taking acid proton pump inhibitors and those who had undergone eradication therapy for H. pylori (group A') were excluded. These three cases had mucosal atrophy in the grey zone according to the diagnostic manual of ABC (D) stratification. Histologically, the mean age of the patients with well differentiated adenocarcinoma was significantly higher than that of the patients with poorly differentiated adenocarcinoma (P < 0.05). There were no differences in the pattern of atrophy in the endoscopies between the well differentiated and poorly differentiated groups.
ABC (D) stratification is a good method for screening patients with gastric cancers. Endoscopy is needed for grey zone cases to check the extent of mucosal atrophy.
评估 ABC（D）分层[胃蛋白酶原和幽门螺杆菌（H. pylori）抗体的组合]在胃癌患者中的价值。
纳入 95 例连续胃癌患者。检测血清胃蛋白酶原 I（PG I）/胃蛋白酶原 II（PG II）和 H. pylori 抗体水平。根据血清学状态将患者分为 ABC（D）分层的 5 组。还分析了萎缩性胃炎和组织学分化的内镜表现与 ABC（D）分层的关系。
患者的平均年龄为（67.9 ± 8.9）岁。3 例（3.2%）患者归入 A 组，7 例（7.4%）归入 A'组，27 例（28.4%）归入 B 组，54 例（56.8%）归入 C 组，4 例（4.2%）归入 D 组。当排除服用酸质子泵抑制剂的患者和已接受 H. pylori 根除治疗的患者（A'组）时，A 组中仅有 3 例患者。根据 ABC（D）分层的诊断手册，这 3 例患者的胃黏膜萎缩处于灰色区域。组织学上，分化良好的腺癌患者的平均年龄明显高于分化不良的腺癌患者（P < 0.05）。在分化良好和分化不良组之间，内镜下萎缩模式没有差异。
ABC（D）分层是筛选胃癌患者的一种较好方法。对于灰色区域病例，需要进行内镜检查以检查黏膜萎缩的程度。
