Serological markers for gastric atrophy in asymptomatic patients infected with Helicobacter pylori

被引:33
作者
Ricci, C
Vakil, N
Rugge, M
Gatta, L
Perna, F
Osborn, JF
Russo, VM
Tampieri, A
Bernabucci, V
Miglioli, M
Vaira, D
机构
[1] Univ Bologna, S Orsola Hosp Nuove Patol, Dept Internal Med & Gastroenterol, I-40138 Bologna, Italy
[2] Univ Wisconsin, Sch Med, Milwaukee, WI 53201 USA
[3] Univ Padua, Dept Pathol, I-35100 Padua, Italy
[4] Univ Roma La Sapienza, Dept Publ Hlth Sci, Rome, Italy
关键词
D O I
10.1111/j.1572-0241.2004.40614.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVE: Atrophic gastritis is a precancerous condition that is commonly caused by chronic Helicobacter pylori (H. pylori) infection. This blinded, controlled study was designed to determine if serum gastrin and pepsinogens were reliable markers of atrophy in asymptomatic patients. METHODS: One hundred and forty-seven asymptomatic patients underwent endoscopy with multiple gastric biopsies obtained for histology, culture, and rapid urease test. Fasting serum gastrin (total and G-17) and serum pepsinogens (I-II) were determined by standard immunoassays. Gastric atrophy was histologically assessed in accordance with internationally accepted criteria; three main patterns of gastritis were distinguished: (a) nonatrophic gastritis, (b) atrophic antrum-restricted and antrum-predominant gastritis, and (c) corpus-restricted gastritis. Receiving operating characteristic (ROC) analysis was used to determine the best cut-off for each serum test in nonatrophic gastritis versus antrum-restricted/antrum-predominant atrophic gastritis. RESULTS: No significant differences in serum gastrin and pepsinogens I-II were detected in nonatrophic gastritis versus patients with antrum-restricted/antrum-predominant atrophic gastritis. The positive likelihood ratios for an abnormal serum test to detect antrum-restricted/antrum-predominant atrophy in the gastric body were total serum gastrin 2.13 (95% CI 0.99, 4.6), gastrin-17: 1.55 (95% CI 0.75, 36.17), pepsinogen I: 2.74 (1.4, 5.4), pepsinogen II: 1.74 (1.27, 2.39), and the ratio of pepsinogen I and II: 1.8 (1.2-2.8). Negative likelihood ratios ranged from 0.20 to 0.65. CONCLUSION: In an asymptomatic population, serum gastrin (total and G-17) and pepsinogens I-II (and their ratio) do not discriminate nonatrophic versus antrum-restricted/predominant atrophic gastritis.
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页码:1910 / 1915
页数:6
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