Wang Xiaoteng, Zhang Qiping, Han Feng, Wu Yiming
Department of Gastroenterology, The First Hospital of Jiaxing, Zhejiang, People's Republic of China.
Department of Infection Control and Public Health, The First Hospital of Jiaxing, Zhejiang, People's Republic of China.
Scand J Gastroenterol. 2023 Jan;58(1):34-37. doi: 10.1080/00365521.2022.2099761. Epub 2022 Jul 22.
To evaluate the value of new gastric cancer screening score system for risk assessment of gastric precancerous lesions. A total of 520 patients were enrolled after the examination of endoscopy at Endoscopy Center, Department of Gastroenterology, from June 2018 to December 2021. The patients were divided into three groups according to age, gender, serum helicobacter pylori antibody test, pepsinogen I (PGI), pepsinogen II (PGII), pepsinogen I/II ratio (PGR) and gastrin-17 test results before endoscopy: Group A defined as low-risk group (0-11 points), Group B defined as middle-risk group (12-16 points), Group C defined as high-risk group (17-23 points). The detection rates of gastric cancer and atrophic gastritis in three groups were analyzed. According to the range and degree of atrophy/intestinal metaplasia, patients were divided into five groups on the basis of OLGA/OLGIM staging system. The levels of PG I, PG II and PGR were compared between different groups, and the correlation between new gastric cancer screening score system and OLGA/OLGIM staging system were evaluated. Statistical analysis was accomplished by ANOVA, chi-square test and Gamma coefficient analysis. A total of 520 patients were enrolled. 268 patients were classified into group A,222 patients into group B and 30 patients into group C, respectively. According to the pathological results, 281 cases were non-atrophic gastritis, 230 cases atrophic gastritis and 9 cases gastric cancer. For OLGA staging system, 281 patients were divided into stage-0 group, 121 patients into stage-I group, 72 patients into stage-II group, 33 patients into stage-III group and 13 patients into stage-IV groups. The PGI and PGR level correlated inversely with the rising OLGA stages ( = 3.028, = .016, = 6.036, < .001). For OLGIM staging system, 252 patients were divided into stage-0 group, 137 patients into stage-I group, 80 patients into stage-II group, 36 patients into stage-III group and 15 patients into stage-IV group. The PGR level correlated inversely with the rising OLGIM stages ( = 3.466, =.007). The detection rates of gastric cancer and atrophic gastritis in Group C were much higher than other groups. ( = 14.727, < .001; = 51.280, < .001). Gamma coefficient analysis showed significant correlations between OLGA/OLGIM and the new gastric cancer screening score system ( < .001). The new gastric cancer screening score system is closely linked with histological OLGA/OLGIM staging system in the risk assessment of gastric precancerous lesions. The role of new gastric cancer screening score system in future gastric precancerous lesions screening and high risk population identifying was promising.
评估新型胃癌筛查评分系统对胃癌前病变风险评估的价值。2018年6月至2021年12月,共有520例患者在消化内科内镜中心接受内镜检查后入组。根据年龄、性别、血清幽门螺杆菌抗体检测、胃蛋白酶原I(PGI)、胃蛋白酶原II(PGII)、胃蛋白酶原I/II比值(PGR)及内镜检查前胃泌素-17检测结果,将患者分为三组:A组为低风险组(0 - 11分),B组为中风险组(12 - 16分),C组为高风险组(17 - 23分)。分析三组中胃癌及萎缩性胃炎的检出率。根据萎缩/肠化生的范围和程度,基于OLGA/OLGIM分期系统将患者分为五组。比较不同组间PG I、PG II及PGR水平,并评估新型胃癌筛查评分系统与OLGA/OLGIM分期系统的相关性。采用方差分析、卡方检验及伽马系数分析进行统计分析。共纳入520例患者,分别有268例患者归入A组,222例患者归入B组,30例患者归入C组。根据病理结果,非萎缩性胃炎281例,萎缩性胃炎230例,胃癌9例。对于OLGA分期系统,281例患者分为0期组121例,I期组72例,II期组33例,III期组13例,IV期组13例。PGI及PGR水平与OLGA分期升高呈负相关(= 3.028,= .016,= 6.036,< .001)。对于OLGIM分期系统,252例患者分为0期组137例,I期组80例,II期组36例,III期组15例,IV期组15例。PGR水平与OLGIM分期升高呈负相关(= 3.466,=.007)。C组中胃癌及萎缩性胃炎的检出率远高于其他组(= 14.727,< .001;= 51.280,< .001)。伽马系数分析显示OLGA/OLGIM与新型胃癌筛查评分系统之间存在显著相关性(< .001)。新型胃癌筛查评分系统在胃癌前病变风险评估中与组织学OLGA/OLGIM分期系统密切相关。新型胃癌筛查评分系统在未来胃癌前病变筛查及高危人群识别中的作用前景广阔。