Kim Young Jung, Lee Sun-Young, Kim Jeong Hwan, Sung In-Kyung, Park Hyung Seok
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Chonnam University School of Medicine, Gwangju, Korea.
Clin Endosc. 2022 Jan;55(1):67-76. doi: 10.5946/ce.2020.299. Epub 2021 Apr 1.
BACKGROUND/AIMS: Helicobacter pylori (H. pylori) seroconversion may occur during screening for gastric cancer. Our study aimed to assess the number of seroconverted subjects with H. pylori and their results in follow-up tests.
Data were consecutively collected on subjects who were H. pylori-seronegative and presented for gastric cancer screening. Subjects who were followed up using the same serology test and pepsinogen (PG) assays on the day of endoscopy were included in the study.
During the follow-up of 57.7±21.4 months, 61 (15.0%) of 407 seronegative subjects showed seroconversion. H. pylori infection was detected in six (9.8%) of 61 seroconverted subjects. A diffuse red fundal appearance, with a significant increase in the Kyoto classification scores for gastritis, was observed in the infected subjects (p<0.001). Compared to the false-seropositive subjects, infected subjects showed higher serology titers (p<0.001) and PG II levels (p<0.001) and lower PG I/II ratios (p=0.002), in the follow-up tests.
Seroconversion occurred in 3.3% of seronegative subjects per year; however, only 9.8% had H. pylori infection. The majority (90.2%) of the seroconverted subjects showed false seropositivity without significant changes in the follow-up test results. The diffuse red fundal appearance could be an indicator of H. pylori infection.
背景/目的：胃癌筛查期间可能发生幽门螺杆菌（H. pylori）血清学转换。我们的研究旨在评估血清学转换的幽门螺杆菌感染患者数量及其后续检测结果。
连续收集幽门螺杆菌血清学阴性且前来进行胃癌筛查的受试者的数据。本研究纳入了在内镜检查当天使用相同血清学检测和胃蛋白酶原（PG）检测进行随访的受试者。
在57.7±21.4个月的随访期间，407名血清学阴性受试者中有61名（15.0%）出现血清学转换。61名血清学转换受试者中有6名（9.8%）检测到幽门螺杆菌感染。在感染受试者中观察到胃底弥漫性发红，胃炎京都分类评分显著增加（p<0.001）。在后续检测中，与假血清阳性受试者相比，感染受试者的血清学滴度（p<0.001）和PG II水平（p<0.001）更高，PG I/II比值更低（p=0.002）。
每年有3.3%的血清学阴性受试者发生血清学转换；然而，只有9.8%的受试者感染了幽门螺杆菌。大多数（90.2%）血清学转换受试者表现为假血清阳性，后续检测结果无显著变化。胃底弥漫性发红可能是幽门螺杆菌感染的一个指标。
