Mattar Rejane, Marques Sergio Barbosa, Ribeiro Igor Braga, Visconti Thiago Arantes de Carvalho, Funari Mateus, DE Moura Eduardo Guimarães Hourneaux
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Divisão de Gastroenterologia e Hepatologia Clínica, São Paulo, SP, Brasil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Divisão de Endoscopia, São Paulo, SP, Brasil.
Arq Gastroenterol. 2020 Apr-Jun;57(2):154-160. doi: 10.1590/S0004-2803.202000000-29.
It has been proposed that the combination of gastrin-17 (G-17), pepsinogens I and II (PGI and PGII), and anti-Helicobacter pylori (H. pylori) antibodies (GastroPanel®, BIOHIT HealthCare, Helsinki, Finland) could serve as biomarkers of atrophic gastritis.
This study aimed to ensure the diagnostic accuracy of GastroPanel® and evaluate the effect of proton pump inhibitors (PPIs) on these biomarkers.
Dyspeptic patients who underwent gastrointestinal endoscopy were enrolled in the present study. Histological findings, which were the gold standard to stratify groups, were as follows: no atrophy (controls); antrum atrophy; corpus atrophy; multifocal atrophy; and neoplasia. G-17, PGI, PGII, and anti-H. pylori immunoglobulin (Ig)G antibodies were assayed using commercially available kits. The ratio of PGI/PGII was calculated.
Among 308 patients, 159 (51.6%) were PPI users. The overall prevalence of atrophy was 43.8% (n=135). Ninety-two (29.9%) patients were H. pylori positive according to anti-H. pylori IgG levels. G-17 levels were not low in those with antrum atrophy but were high in those with corpus and multifocal atrophies. PGI levels were significantly lower in those with corpus and multifocal atrophies. The sensitivity of PGI <30 µg/L to detect corpus atrophy was 50% (95% CI 27.8-72.1%), with a specificity of 93.2% (95% CI 84.3-97.5%), a positive likelihood ratio of 7.4 (95% CI 2.9-19.2), and a negative likelihood ratio of 0.5 (95% CI 0.3-0.8). A small number of subjects (n=6) exhibited moderate to intense atrophy (4%), among whom 66.7% exhibited decreased PGI levels. PPI significantly increased the levels of G-17 and PGI, except in those with corpus and multifocal atrophies, in whom PGI levels were not increased by PPIs.
GastroPanel® (Gastrin-17, PGI, and PGI/PGII ratio) did not demonstrate high sensitivity for detecting gastric atrophy.
有人提出，胃泌素 -17（G -17）、胃蛋白酶原I和II（PGI和PGII）以及抗幽门螺杆菌（H. pylori）抗体（GastroPanel®，芬兰赫尔辛基BIOHIT医疗保健公司）的组合可作为萎缩性胃炎的生物标志物。
本研究旨在确定GastroPanel®的诊断准确性，并评估质子泵抑制剂（PPI）对这些生物标志物的影响。
本研究纳入了接受胃肠内镜检查的消化不良患者。组织学检查结果是分组的金标准，如下：无萎缩（对照组）；胃窦萎缩；胃体萎缩；多灶性萎缩；以及肿瘤形成。使用市售试剂盒检测G -17、PGI、PGII和抗H. pylori免疫球蛋白（Ig）G抗体。计算PGI/PGII的比值。
308例患者中，159例（51.6%）使用PPI。萎缩的总体患病率为43.8%（n = 135）。根据抗H. pylori IgG水平，92例（29.9%）患者H. pylori阳性。胃窦萎缩患者的G -17水平不低，但胃体和多灶性萎缩患者的G -17水平较高。胃体和多灶性萎缩患者的PGI水平显著较低。PGI<30μg/L检测胃体萎缩的敏感性为50%（95%CI 27.8 - 72.1%），特异性为93.2%（95%CI 84.3 - 97.5%），阳性似然比为7.4（95%CI 2.9 - 19.2），阴性似然比为0.5（95%CI 0.3 - 0.8）。少数受试者（n = 6）表现为中度至重度萎缩（4%），其中66.7%的受试者PGI水平降低。PPI显著提高了G -17和PGI的水平，但胃体和多灶性萎缩患者除外，在这些患者中PPI并未提高PGI水平。
GastroPanel®（胃泌素 -17、PGI和PGI/PGII比值）在检测胃萎缩方面未显示出高敏感性。
