Gong Yuehua, Wei Wang, Yuan Yuan
Department of Tumor Etiology and Screening, Cancer Institute and General Surgery, the First Affiliated Hospital of China Medical University, and Key Laboratory of Cancer Etiology and Prevention, Liaoning Provincial Education Department, Shenyang 110001, China.
Health Examination Center, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang City, 110001, China.
Diagn Microbiol Infect Dis. 2014 Dec;80(4):316-20. doi: 10.1016/j.diagmicrobio.2014.09.009. Epub 2014 Sep 21.
Epidemiological studies found a significant correlation between Helicobacter pylori infection and elevated serum pepsinogen, especially pepsinogen II (PGII), and reduced pepsinogen I (PGI)/PGII ratio. The study aimed to evaluate the association between abnormal gastric function risk and H. pylori infection assessed by H. pylori IgG assay and (14)C-urea breath test (UBT).
A total of 1555 subjects who underwent a health check were enrolled. Serum PGI, serum PGII, PGI/PGII ratio, gastrin 17 (G17), H. pylori IgG antibody titer, and UBT results were collected.
Median PGII and G17 levels were higher, but PGI/PGII ratio was lower in H. pylori-seropositive compared with seronegative participants (P<0.001, respectively). Similar effects were demonstrated by UBT. The consistency between H. pylori IgG assay, and UBT results were 86.9%, 82.29%, and 84.64% in individuals with normal gastric function, but only 73.4%, 67.98%, and 74.6% in those with abnormal gastric function. The correlation coefficients for H. pylori infection and abnormal gastric function diagnosed by PGI/PGII <7 were 0.336 (P<0.001) by H. pylori IgG assay and 0.231 (P<0.001) by UBT, diagnosed by PGII ≥ 8.25 µg/L were 0.594(P<0.001) by H. pylori IgG assay and 0.493 (P<0.001) by UBT, diagnosed by G17 >3 pmol/L was 0.469 (P<0.001) by H. pylori IgG assay and 0.394 (P<0.001) by UBT. The odds ratios (ORs) (95% confidence intervals) of abnormal gastric function were 7.477 (5.278-10.594), 19.204 (14.526-25.387), and 7.921 (6.286-9.982) comparing positive versus negative by H. pylori IgG assay and 4.084 (2.98-5.598), 9.552 (7.494-12.174), and 5.402 (4.335-6.731) comparing positive versus negative by UBT.
H. pylori infection assessments by antibody-based or bacterial component-based detection are both related with abnormal gastric function. Moreover, serum H. pylori IgG assay was stronger associated with abnormal gastric function than UBT assay.
流行病学研究发现幽门螺杆菌感染与血清胃蛋白酶原升高，尤其是胃蛋白酶原II（PGII）升高以及胃蛋白酶原I（PGI）/PGII比值降低之间存在显著相关性。本研究旨在评估通过幽门螺杆菌IgG检测和碳-14尿素呼气试验（UBT）评估的幽门螺杆菌感染与胃功能异常风险之间的关联。
共纳入1555名接受健康检查的受试者。收集血清PGI、血清PGII、PGI/PGII比值、胃泌素17（G17）、幽门螺杆菌IgG抗体滴度和UBT结果。
与血清阴性参与者相比，幽门螺杆菌血清阳性参与者的PGII和G17水平中位数更高，但PGI/PGII比值更低（P均<0.001）。UBT也显示出类似的结果。在胃功能正常的个体中，幽门螺杆菌IgG检测与UBT结果的一致性分别为86.9%、82.29%和84.64%，但在胃功能异常的个体中仅为73.4%、67.98%和74.6%。通过幽门螺杆菌IgG检测，幽门螺杆菌感染与PGI/PGII<7诊断的胃功能异常的相关系数为0.336（P<0.001），通过UBT为0.231（P<0.001）；与PGII≥8.25μg/L诊断的胃功能异常的相关系数，幽门螺杆菌IgG检测为0.594（P<0.001），UBT为0.493（P<0.001）；与G17>3pmol/L诊断的胃功能异常的相关系数，幽门螺杆菌IgG检测为0.469（P<0.001），UBT为0.394（P<0.001）。通过幽门螺杆菌IgG检测，胃功能异常的比值比（OR）（95%置信区间）为7.477（5.278-10.594）、19.204（14.526-25.387）和7.921（6.286-9.982），阳性与阴性相比；通过UBT为4.084（2.98-5.598）、9.552（7.494-12.174）和5.402（4.335-6.731），阳性与阴性相比。
基于抗体或基于细菌成分的检测评估幽门螺杆菌感染均与胃功能异常有关。此外，血清幽门螺杆菌IgG检测与胃功能异常的关联比UBT检测更强。
