Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
Clin Transl Gastroenterol. 2020 Sep;11(9):e00238. doi: 10.14309/ctg.0000000000000238.
Chronic atrophic autoimmune gastritis (CAAG) can lead to the development of gastric neuroendocrine tumors (gNETs) and can be accompanied by other autoimmune diseases. This study aimed to determine, in CAAG patients, the association of gNET development, the prevalence of autoimmune diseases other than CAAG, the association of autoimmunity, and gNET development with pepsinogen I, II, gastrin-17, and Helicobacter pylori infection analysis.
We determined the prevalence of gNETs and other autoimmune diseases and analyzed pepsinogen I and II, gastrin-17 serum levels, and H. pylori infection in all patients diagnosed with CAAG at our hospital between 2013 and 2017.
A total of 156 patients were studied and in 15.4% was observed concomitant gNET. Approximately 68.6% had at least 1 other autoimmune disease at diagnosis of CAAG. Approximately 60.9% had autoimmune thyroiditis, followed by diabetes (19.9%) and autoimmune polyendocrine syndrome (12.8%). CAAG patients with and without gNET had similar rates of comorbidity with other autoimmune diseases, but the pepsinogen I/II ratio was lower in patients with gNET (1.6 vs 4.5, P = 0.018). Receiver operating characteristic curve analyses identified a pepsinogen I/II ratio <2.3 and gastrin-17 levels >29.6 pmol/L as cutoffs distinguishing CAAG patients with gNET from those without. The combined use of these cutoff correctly identified 16 of the 18 CAAG patients with gNET (P = 0.007). H. pylori infection was observed in 28.7% of cases tested but did not associate with gNET.
This study suggests that a low pepsinogen I/II ratio and high gastrin-17 levels characterize patients with CAAG and gNET and confirms the frequent coexistence of CAAG with other autoimmune diseases.
慢性萎缩性自身免疫性胃炎（CAAG）可导致胃神经内分泌肿瘤（gNET）的发展，并可伴有其他自身免疫性疾病。本研究旨在确定 CAAG 患者中 gNET 发展的相关性、除 CAAG 以外的其他自身免疫性疾病的患病率、自身免疫与 gNET 发展的相关性以及胃蛋白酶原 I、II、胃泌素-17 和幽门螺杆菌感染分析。
我们确定了 gNET 和其他自身免疫性疾病的患病率，并分析了所有 2013 年至 2017 年在我院诊断为 CAAG 的患者的胃蛋白酶原 I 和 II、胃泌素-17 血清水平和 H. pylori 感染情况。
共研究了 156 例患者，其中 15.4%观察到同时存在 gNET。大约 68.6%的患者在诊断为 CAAG 时至少有一种其他自身免疫性疾病。大约 60.9%的患者患有自身免疫性甲状腺炎，其次是糖尿病（19.9%）和自身免疫性多内分泌综合征（12.8%）。患有和不患有 gNET 的 CAAG 患者的其他自身免疫性疾病的合并率相似，但 gNET 患者的胃蛋白酶原 I/II 比值较低（1.6 对 4.5，P=0.018）。受试者工作特征曲线分析确定胃蛋白酶原 I/II 比值<2.3 和胃泌素-17 水平>29.6 pmol/L 作为区分患有 gNET 和不患有 gNET 的 CAAG 患者的临界值。这些临界值的联合使用正确识别了 18 例 CAAG 患者中的 16 例（P=0.007）。测试的病例中有 28.7%存在 H. pylori 感染，但与 gNET 无关。
本研究表明，低胃蛋白酶原 I/II 比值和高胃泌素-17 水平是 CAAG 伴 gNET 患者的特征，并证实 CAAG 常与其他自身免疫性疾病共存。
