Department of Gastroenterology, Nursing Section, West China Hospital, Sichuan University, Chengdu, China.
Department of Gastrointestinal Surgery & Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China.
Sci Rep. 2020 Mar 11;10(1):4523. doi: 10.1038/s41598-020-61472-7.
A hospital-based cross-sectional study in SIGES project was conducted during 2016.5-2017.5 in West China Hospital. It was aimed to observe the prevalence of atrophic gastritis (AG) in southwest China, and assess the diagnostic strength of serum gastrin-17 (G-17) in predicting AG in Chinese population. Asymptomatic healthy controls from health check-up, cancer-free patients with unspecific upper gastrointestinal symptoms, and histologically proven gastric cancer patients were eligible, if serum pepsinogen-I (PG-I), PG-II, and G-17 were detected. AG status was classified by the accredited cutoffs of PG-I (<70 ug/L) and PG-I/II ratio (<3). Totally, healthy controls (n = 9,425), symptomatic patients (n = 671) and gastric cancer patients (n = 305) were simultaneously observed, in which the prevalence of AG in southwest China were estimated as 15.9/1,000, 28.3/1,000, and 55.7/1,000 persons, respectively. The age-specific prevalence of AG in healthy controls showed a significantly uphill trend (p for trend <0.001). Higher level of serum G-17 was significantly associated with increased risk of AG in healthy population (15-30 pmol/L, aOR = 20.67, 95% CI 9.17-46.55; >30 pmol/L, aOR = 314.41, 95% CI 166.10-595.12). Throughout the progression of stomach diseases, the diagnostic strength of serum G-17 for AG showed a downhill trend across more advanced situations. In despite of that, serum G-17 displayed a good performance in predicting AG in the entire cross-sectional population (AUC = 0.92, 95% CI 0.89-0.94; SEN = 85.5%; SPE = 93.2%; LR+ = 12.55; LR- = 0.11). Population in southwest China had intermediate prevalence of AG, while the prevalence was increased over age or disease progression. High level of serum G-17 might be a reliable non-invasive measurement to predict AG in southwest Chinese population.
一项基于 SIGES 项目的华西医院横断面研究于 2016 年 5 月至 2017 年 5 月进行。旨在观察中国西南地区萎缩性胃炎（AG）的患病率，并评估血清胃泌素-17（G-17）在中国人群中预测 AG 的诊断强度。符合条件的研究对象为健康体检的无症状健康对照者、无特异性上消化道症状的癌症患者和经组织学证实的胃癌患者，如果检测血清胃蛋白酶原 I（PG-I）、PG-II 和 G-17。AG 状态通过 PG-I（<70ug/L）和 PG-I/II 比值（<3）的公认临界值进行分类。共同时观察了 9425 名健康对照者、671 名症状患者和 305 名胃癌患者，中国西南地区 AG 的患病率估计分别为 15.9/1000、28.3/1000 和 55.7/1000 人。健康对照组中年龄特异性 AG 患病率呈明显上升趋势（趋势检验 P<0.001）。健康人群中血清 G-17 水平升高与 AG 风险增加显著相关（15-30pmol/L，OR=20.67，95%CI9.17-46.55；>30pmol/L，OR=314.41，95%CI166.10-595.12）。随着胃病的进展，血清 G-17 对 AG 的诊断强度在病情加重的情况下呈下降趋势。尽管如此，血清 G-17 在整个横断面人群中预测 AG 仍具有良好的性能（AUC=0.92，95%CI0.89-0.94；SEN=85.5%；SPE=93.2%；LR+=12.55；LR-=0.11）。中国西南地区人群 AG 患病率处于中等水平，且随年龄或疾病进展而增加。高血清 G-17 水平可能是预测中国西南地区人群 AG 的可靠非侵入性测量方法。
