Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California.
Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California.
Clin Gastroenterol Hepatol. 2022 Apr;20(4):950-952.e3. doi: 10.1016/j.cgh.2021.01.009. Epub 2021 Jan 10.
Early identification of gastric precancerous lesions, including atrophic gastritis (AG) and intestinal metaplasia (IM), may improve gastric cancer detection and prevention. Because AG and IM are generally asymptomatic, many of the estimated 15 million Americans who carry these lesions remain undiagnosed. AG and IM are associated with either active or prior Helicobacter pylori (Hp) infection. Hp infection leads to perturbations in the serum concentration of gastric hormones pepsinogen I (PGI), pepsinogen II, the pepsinogen I/II ratio (PGR), gastrin-17 (G-17), and Hp IgG. In East Asia and other regions with high burden of Hp infection and gastric cancer, these biomarkers have been used as screening tools for AG and IM. However, there exists limited data on the sensitivity and discrimination of these serologic markers in low-Hp-prevalence populations, such as the United States.
早期识别胃癌前病变，包括萎缩性胃炎（AG）和肠上皮化生（IM），可能有助于提高胃癌的检出率和预防效果。由于 AG 和 IM 通常无症状，许多估计有 1500 万美国人携带这些病变，但仍未被诊断出来。AG 和 IM 与活动性或既往幽门螺杆菌（Hp）感染有关。Hp 感染导致胃蛋白酶原 I（PGI）、胃蛋白酶原 II、PGI/II 比值（PGR）、胃泌素-17（G-17）和 Hp IgG 等胃激素血清浓度发生改变。在 Hp 感染和胃癌负担较高的东亚和其他地区，这些生物标志物已被用作 AG 和 IM 的筛查工具。然而，在 Hp 感染率低的人群（如美国），这些血清标志物的敏感性和特异性数据有限。
