Kotelevets Sergey M, Chekh Sergey A, Chukov Sergey Z
Department of Therapy, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia.
Department of Mathematics, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia.
World J Gastrointest Endosc. 2024 Aug 16;16(8):462-471. doi: 10.4253/wjge.v16.i8.462.
New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.
To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity.
Of the 169 patients with atrophic gastritis, selected by the visual endoscopic Kimura-Takemoto method, 165 showed histological mucosal atrophy using the updated Kimura-Takemoto method. All 169 patients were examined for postprandial levels of gastrin-17 (G17) and pepsinogen-1 (PG1) using GastroPanel (Biohit Plc, Helsinki, Finland).
We used the histological standard of five biopsies of the gastric mucosa, in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy. We also compared the morpho-functional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1, as the markers of atrophic gastritis. The sensitivity of postprandial G17 was 62.2% for serological levels of G17 (range: 0-4 pmol/L) and 100% for serological G17 (range: 0-10 pmol/L) for the detection of monofocal severe atrophic gastritis. No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus. In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis, there is a pronounced positive long-term dynamics of the serological marker of atrophy - postprandial G17, after five months of rennet replacement therapy.
Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity. Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system. Therefore, postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.
需要新的标志物来提高萎缩性胃炎血清学筛查的有效性。
开发一种具有高灵敏度的、成本效益高的萎缩性胃炎血清学筛查方法。
通过内镜直视下的木村 - 竹本方法选取169例萎缩性胃炎患者，采用更新后的木村 - 竹本方法，其中165例显示组织学黏膜萎缩。使用GastroPanel（芬兰赫尔辛基Biohit Plc公司）对所有169例患者检测餐后胃泌素 - 17（G17）和胃蛋白酶原 - 1（PG1）水平。
我们依据木村 - 竹本分类系统，采用胃黏膜五处活检的组织学标准来评估G17检测胃黏膜萎缩的敏感性。我们还比较了检测到的胃黏膜萎缩组织学程度与作为萎缩性胃炎标志物的G17和PG1血清学水平之间的形态 - 功能关系。餐后G17对于血清学G17水平（范围：0 - 4 pmol/L）检测单灶性重度萎缩性胃炎的敏感性为62.2%，对于血清学G17水平（范围：0 - 10 pmol/L）的敏感性为100%。在通过木村 - 竹本分类系统确定胃体黏膜萎缩严重程度时，未发现PG1水平与组织学萎缩程度之间存在强相关性。在本临床病例中，一名63岁患有多灶性萎缩性胃炎的男性患者，在凝乳酶替代治疗五个月后，萎缩血清学标志物——餐后G17呈现出明显的长期正向动态变化。
通过评估餐后G17对多灶性萎缩性胃炎进行血清学筛查是一种具有高灵敏度的成本效益高的方法。餐后G17是萎缩性胃炎消退的比按照悉尼系统进行胃活检形态学检查更早的标志物。因此，建议使用餐后G17对萎缩性胃炎治疗后的情况进行动态监测。
