Guo Xiaopei, Schreurs Marco W J, Marijnissen Fleur E, Mommersteeg Michiel C, Nieuwenburg Stella A V, Doukas Michail, Erler Nicole S, Capelle Lisette G, Bruno Marco J, Peppelenbosch Maikel P, Spaander Manon C W, Fuhler Gwenny M
Department of Gastroenterology and Hepatology, Erasmus MC, 3015 GD Rotterdam, The Netherlands.
Department of Immunology, Erasmus MC, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2023 Sep 23;12(19):6152. doi: 10.3390/jcm12196152.
: Autoimmune gastritis (AIG), characterized with the presence of anti-parietal-cell antibodies (APCA), is a risk factor for gastric cancer. However, AIG may go underdiagnosed, especially in the case of infection and the presence of gastric precancerous lesions (GPL), due to the ambiguous pathology and delayed symptom onset. : Investigate the prevalence and characteristics of AIG in GPL patients. Prevalence of AIG was determined with the presence of APCA in patients with GPL (n = 256) and the control group (n = 70). Pathological characteristics and levels of gastrin 17 (G17), pepsinogen (PG) I and II and anti- IgG were assessed in GPL cases, and the severity of intestinal metaplasia and gastric atrophy was scored by expert pathologists. : APCA positivity was observed in 18% of cases vs. 7% of controls ( = 0.033). Only 3/256 patients were previously diagnosed with AIG. The presence of APCA was associated with corpus-limited and extended GPL. A receiver operating curve analysis demonstrated that the G17 and PGI/II ratio could identify APCA-positive patients within GPL cases (AUC: 0.884). : The prevalence of AIG is higher in patients with GPL but goes undiagnosed. Using G17 and PG I/II as diagnostic markers can help to identify patients with AIG and improve surveillance programs for patients with GPL.
自身免疫性胃炎（AIG）以存在抗壁细胞抗体（APCA）为特征，是胃癌的一个危险因素。然而，AIG可能未得到充分诊断，尤其是在感染和存在胃癌前病变（GPL）的情况下，这是由于其病理不明确且症状出现较晚。：调查GPL患者中AIG的患病率和特征。通过检测GPL患者（n = 256）和对照组（n = 70）中APCA的存在来确定AIG的患病率。评估GPL病例的病理特征、胃泌素17（G17）、胃蛋白酶原（PG）I和II水平以及抗IgG水平，并由专家病理学家对肠化生和胃萎缩的严重程度进行评分。：18%的病例观察到APCA阳性，而对照组为7%（P = 0.033）。之前仅3/256例患者被诊断为AIG。APCA的存在与局限于胃体和扩展型GPL相关。一项受试者工作特征曲线分析表明，G17和PGI/II比值可在GPL病例中识别出APCA阳性患者（曲线下面积：0.884）。：GPL患者中AIG的患病率较高，但未得到诊断。使用G17和PG I/II作为诊断标志物有助于识别AIG患者，并改善GPL患者的监测方案。
