Papadia Cinzia, Marelli Laura, Wood Eleanor, Novelli Marco, Feakins Roger, Syrjänen Kari Juhani, Shidrawi Ray
Gastroenterology, Barts Health Trust, London, UK
Immunology, Barts and the London School of Medicine and Dentistry, London, UK.
BMJ Open Gastroenterol. 2025 Jan 6;12(1):e001559. doi: 10.1136/bmjgast-2024-001559.
Gastric adenocarcinoma (GAC) is the 17th most common cancer in the UK with a 5-year survival rate of 22%. GastroPanel (Biohit Oyj; Helsinki, Finland) is an ELISA kit that measures pepsinogen I (PGI); pepsinogen II (PGII); gastrin-17 (G-17); and Helicobacter pylori IgG antibodies (Hp IgG). PGI and the PGI/PGII ratio correlate inversely with the severity of chronic atrophic gastritis (AG). The aim of this study was to assess GastroPanel performance in the identification of moderate to severe AG in dyspepsia.
In this UK, single-centre, prospective diagnostic accuracy study, 324 patients [56.8% (n=184) female; median age 57 years (range 39-92 years)] were recruited for gastroscopy with biopsy and histology according to the updated Sydney System (USS). Blood (plasma) samples were collected for GastroPanel analysis. Paired samples were obtained from 268 patients [56.3% (n=151) female; median age=57 (range 39-92 years)]. GastroPanel results were interpreted using the GastroSoft app (Biohit).
Overall agreement between GastroPanel and the USS classification was 90% (95% CI=86.7 to 93.8%), with a weighted kappa (κw) of 0.828 (95% CI=0.781 to 0.865). In receiver operating characteristics (ROC) curve analysis, using moderate/severe atrophic gastritis of the corpus (AGC2+) as the endpoint, AUC=0.840 (95% CI 0.630 to 1.000) and 0.960 (95% CI 0.907 to 1.000) for PGI and the PGI/PGII ratio, respectively.
GastroPanel is a reliable dyspepsia triage test distinguishing patients who can be safely treated conservatively from those with moderate to severe corpus atrophic gastritis at high risk of developing GAC.
胃腺癌（GAC）是英国第17大常见癌症，5年生存率为22%。胃功能检测组合（芬兰赫尔辛基百得公司生产）是一种酶联免疫吸附测定试剂盒，可检测胃蛋白酶原I（PGI）、胃蛋白酶原II（PGII）、胃泌素-17（G-17）以及幽门螺杆菌IgG抗体（Hp IgG）。PGI和PGI/PGII比值与慢性萎缩性胃炎（AG）的严重程度呈负相关。本研究旨在评估胃功能检测组合在消化不良患者中识别中重度AG的性能。
在这项英国单中心前瞻性诊断准确性研究中，根据更新后的悉尼系统（USS），招募了324例患者[女性占56.8%（n=184）；年龄中位数57岁（范围39 - 92岁）]进行胃镜检查及活检和组织学检查。采集血液（血浆）样本进行胃功能检测组合分析。从其中268例患者[女性占56.3%（n=151）；年龄中位数 = 57（范围39 - 92岁）]获取配对样本。胃功能检测组合结果通过GastroSoft应用程序（百得公司）进行解读。
胃功能检测组合与USS分类之间的总体一致性为90%（95%置信区间 = 86.7%至93.8%），加权kappa值（κw）为0.828（95%置信区间 = 0.781至0.865）。在受试者工作特征（ROC）曲线分析中，以胃体部中重度萎缩性胃炎（AGC2 +）为终点，PGI和PGI/PGII比值的曲线下面积（AUC）分别为0.840（95%置信区间0.630至1.000）和0.960（95%置信区间0.907至1.000）。
胃功能检测组合是一种可靠的消化不良分诊检测方法，可区分出可安全进行保守治疗的患者与有中重度胃体萎缩性胃炎且发生GAC风险高的患者。
