Tepes Bojan, Seruga Maja, Vujasinovic Miroslav, Urlep Dejan, Ljepovic Liljana, Brglez Jurecic Nataša, Forte Alenka, Anita Kek Ljubec, Skvarc Miha
Abacus Medico, Diagnostic Center Rogaška, Rogaška Slatina, Slovenia.
General Hospital Murska Sobota, Murska Sobota, Slovenia.
Radiol Oncol. 2017 Dec 7;52(1):7-13. doi: 10.1515/raon-2017-0054. eCollection 2018 Mar.
Gastric cancer is the fifth most common malignancy in the world with almost one million new cases annually. Helicobacter pylori infection causes 89% of all gastric cancers. Premalignant lesions (atrophy and intestinal metaplasia) develop after several decades of inflammation. Secondary prevention with gastroscopy is possible, but it is costly and has a low compliance rate. Alternative procedures like serology testing for pepsinogen I and II and pepsinogen I/II ratio are available to select patients for surveillance gastroscopies.
In seven outpatient endoscopic units, 288 patients (154 men; 53.5%), average age 60.68 years, tested positive in National colorectal cancer screening programme SVIT, were included in the study. Gastropanel (BioHit, Finland) was used as a serologic biopsy method.
We found 24 patients (12 men, mean age 63.7 years) with pepsinogen (pepsinogen I/II < 3 and/or pepsinogen I < 30 μg/L). Premalignant changes were found on gastric biopsies in 21 patients (7.3% incidence). Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) ≥ 1 was found in 20 patients; Operative Link for Gastritis Assessment (OLGA) ≥ 1 was found in 19 patients. Combined accuracy for preneoplastic lesions in Gastropanel positive patients was 87.5%. H. pylori seropositivity was found in 219 patients (76%). Only 24% of our population had normal results.
Gastropanel test has proven to be a reliable non-invasive test for advanced gastric preneoplastic lesions that can select patients for further gastroscopy. We found high H. pylori seropositivity in older age groups in Slovenia.
胃癌是全球第五大常见恶性肿瘤，每年新增病例近100万。幽门螺杆菌感染导致89%的胃癌。癌前病变（萎缩和肠化生）在数十年的炎症后发展而来。通过胃镜进行二级预防是可行的，但成本高昂且依从率低。像检测胃蛋白酶原I和II以及胃蛋白酶原I/II比值的血清学检测等替代方法可用于选择接受胃镜监测的患者。
在7个门诊内镜科室，纳入了288名在国家结直肠癌筛查项目SVIT中检测呈阳性的患者（154名男性；53.5%），平均年龄60.68岁。使用Gastropanel（芬兰BioHit公司）作为血清活检方法。
我们发现24名患者（12名男性，平均年龄63.7岁）胃蛋白酶原异常（胃蛋白酶原I/II<3和/或胃蛋白酶原I<30μg/L）。21名患者（发病率7.3%）的胃活检发现了癌前改变。20名患者的胃肠化生评估手术链接（OLGIM）≥1；19名患者的胃炎评估手术链接（OLGA）≥1。Gastropanel阳性患者癌前病变的综合准确率为87.5%。219名患者（76%）幽门螺杆菌血清学呈阳性。我们的人群中只有24%结果正常。
Gastropanel检测已被证明是一种可靠的用于检测晚期胃癌前病变的非侵入性检测方法，可用于选择患者进行进一步胃镜检查。我们发现在斯洛文尼亚老年人群中幽门螺杆菌血清学阳性率较高。
