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BACKGROUND/AIM: To estimate the prevalence of autoimmune atrophic gastritis (AAG) in the Russian Federation, a systematic screening of asymptomatic healthy adults by non-invasive biomarker testing was conducted. The aim was i) To test the validity of non-invasive serological screening for AAG; ii) to establish the prevalence of AAG among asymptomatic adults. PATIENTS AND METHODS: Altogether, 1,283 asymptomatic, healthy adults (mean age: 38 years) were screened by GastroPanel® test. Those with a biomarker profile indicating AG (n=46) were invited for further examinations; 21 consented to gastroscopy with biopsies classified using the Updated Sydney System and Operative Link to Gastric Atrophy. Blood tests included parietal cell, intrinsic factor and thyroid peroxidase antibodies, and analysis of vitamin B12 and iron. RESULTS: Gastroscopy and biopsies confirmed AG in 20 of the individuals. Parietal cell, intrinsic factor and thyroid peroxidase antibodies were present in five, one and eight individuals, respectively. AAG-associated co-morbidities (iron deficiency and pernicious anemia) were diagnosed in 10 out of 21. The final diagnosis of AAG was made in 15 out of 1,283 subjects (1.2%), of whom four were Helicobacter pylori-positive. When corrected for verification bias (non-attendees in the confirmatory tests; n=25), the adjusted prevalence of AAG was 2.6% (33/1,283). CONCLUSION: AAG prevalence of 2.6% is among the highest reported using non-invasive tests. GastroPanel® is an optimal screening tool, providing the first link in the diagnostic protocol leading to the final diagnosis of this condition. The role of Helicobacter pylori as a trigger of AAG cannot be ruled out.
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Autoanticuerpos/sangre , Enfermedades Autoinmunes/diagnóstico , Gastritis Atrófica/diagnóstico , Pruebas Serológicas , Adulto , Anciano , Enfermedades Asintomáticas , Enfermedades Autoinmunes/sangre , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/patología , Biomarcadores/sangre , Biopsia , Ensayo de Inmunoadsorción Enzimática , Femenino , Gastritis Atrófica/sangre , Gastritis Atrófica/epidemiología , Gastritis Atrófica/patología , Gastroscopía , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Federación de Rusia/epidemiología , Adulto JovenRESUMEN
ABSTRACT: The study aimed to assess demographic, clinical, and endoscopic parameters in patients with predominant corporeal atrophic gastritis (CAG) and enterochromaffin-like cell hyperplasia suggestive for autoimmune etiology in comparison with patients presenting Helicobacter pylori atrophic gastritis limited to the gastric antrum (AAG).Demographical, clinical, and pathological data of consecutive patients who underwent an upper digestive endoscopy for bleeding screening risk, symptoms, or anemia in a single endoscopy unit were retrieved. The final study group included 63 patients with CAG and enterochromaffin-like cell hyperplasia on histology and a control group of 142 patients with AAG.Female patients were predominant in the group with CAG versus AAG (69.8% vs 46.4%, Pâ=â.002). Microcytic anemia (Pâ<â.001), but not macrocytic anemia (Pâ=â.14) was associated with CAG, the mean corpuscular volume of erythrocyte (MCV) (82.5 vs 86.5âfl, Pâ=â.01), the mean value of serum iron (11.8 vs 14.3âµmol/L, Pâ=â.02), and hemoglobin level (11.0 vs 12.7âg/dL Pâ<â.01) being significantly lower in patients with CAG versus AAG. Upper digestive endoscopies with no visible mucosal lesions (Pâ=â.01) were also more frequent in the patients with CAG, but there were not differences regarding digestive symptoms between groups. The linear regression models revealed that the low hemoglobin (Pâ<â.001) and low MCV (Pâ=â.03) are the independent variables that can predict CAG on histology, but not the serum iron level (Pâ=â.77)Consecutive patients investigated on endoscopy with CAG in comparison with those having AAG are more frequent female, they have microcytic anemia, and no mucosal lesions on endoscopy. The decreased hemoglobin level and low MCV, rather than the serum iron level are predictors for CAG versus AAG on histology in endoscopic population.
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Mucosa Gástrica/patología , Gastritis Atrófica/diagnóstico por imagen , Infecciones por Helicobacter , Helicobacter pylori/aislamiento & purificación , Hiperplasia/patología , Endoscopía Gastrointestinal , Femenino , Gastritis Atrófica/sangre , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/patología , Hemoglobinas , Humanos , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND/AIM: Prompted by the increasing demand of non-invasive diagnostic tools for screening of gastric cancer (GC) risk conditions, i.e., atrophic gastritis (AG) and Helicobacter pylori (Hp) infection, the GastroPanel® test (GP: biomarker panel of PGI, PGII, G-17, Hp IgG ELISA) that was developed in the early 2000's, was recently updated to a new-generation (unified GP) test version. This clinical validation study evaluated the diagnostic accuracy of the new-generation GP test in detection of AG and Hp among gastroscopy referral patients in a University Clinic. PATIENTS AND METHODS: Altogether, 522 patients were enrolled among the patients referred for gastroscopy at the Gastro Center, Oulu University Hospital (OUH). All patients underwent gastroscopy with biopsies classified using the Updated Sydney System (USS), and blood sampling for GP testing. RESULTS: Biopsy-confirmed AG was found in 10.2% (53/511) of the patients. The overall agreement between the GP and the USS classification was 92.4% (95%CI=90.0-94.6%), with the weighted kappa (κw) of 0.861 (95%CI=0.834-0.883). In ROC analysis using moderate/severe AG of the corpus (AGC2+) as the endpoint, AUC=0.952 (95%CI=0.891-1.000) and AUC=0.998 (95%CI=0.996-1.000) for PGI and PGI/PGII, respectively. Hp IgG antibody ELISA detected biopsy-confirmed Hp-infection with AUC=0.993 (95%CI=0.987-0.999). CONCLUSION: The new generation GastroPanel® is a precise test for non-invasive diagnosis of atrophic gastritis and Hp-infection in dyspeptic patients referred for diagnostic gastroscopy.
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Gastrinas/sangre , Gastritis Atrófica/diagnóstico , Gastroscopía , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/patogenicidad , Pepsinógeno A/sangre , Pepsinógeno C/sangre , Pruebas Serológicas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antibacterianos/sangre , Biomarcadores/sangre , Biopsia , Ensayo de Inmunoadsorción Enzimática , Femenino , Finlandia , Gastritis Atrófica/sangre , Gastritis Atrófica/microbiología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/microbiología , Helicobacter pylori/inmunología , Interacciones Huésped-Patógeno , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Derivación y Consulta , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Shidan granule (SDG), a traditional Chinese medicine in-hospital preparation, has been demonstrated to exert good effects on chronic atrophic gastritis (CAG) in clinics. However, the underlying mechanism of SDG against CAG is still unclear. This study utilized an untargeted plasma metabolomics approach to explore the potential mechanism of SDG in CAG rats using LC-MS and pattern recognition analysis. The results indicated that SDG could effectively improve the biochemical indexes and pathology features of CAG rats. Nineteen potential biomarkers (variable importance in projection > 1 and P < 0.05) contributing to CAG progress were identified. After SDG intervention, 17 biomarkers were obviously restored to normal levels. Further metabolic pathway analysis showed that aspartate and glutamate metabolism, arachidonic acid metabolism, arginine and proline metabolism, and TCA cycle were the most related pathways for SDG treatment. Based on these findings, the main mechanisms of SDG against CAG might be attributed to the regulatory effects of energy balance, inflammatory suppression, and improvement in disturbed amino acid and lipid metabolism. This study provided information for the mechanism research of SDG against CAG and would promote its clinical application.
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Medicamentos Herbarios Chinos , Gastritis Atrófica , Metaboloma/efectos de los fármacos , Metabolómica/métodos , Animales , Biomarcadores/sangre , Biomarcadores/metabolismo , Cromatografía Liquida/métodos , Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/farmacología , Gastritis Atrófica/sangre , Gastritis Atrófica/metabolismo , Masculino , Espectrometría de Masas/métodos , Ratas , Ratas Sprague-DawleyRESUMEN
INTRODUCTION: Chronic atrophic autoimmune gastritis (CAAG) can lead to the development of gastric neuroendocrine tumors (gNETs) and can be accompanied by other autoimmune diseases. This study aimed to determine, in CAAG patients, the association of gNET development, the prevalence of autoimmune diseases other than CAAG, the association of autoimmunity, and gNET development with pepsinogen I, II, gastrin-17, and Helicobacter pylori infection analysis. METHODS: We determined the prevalence of gNETs and other autoimmune diseases and analyzed pepsinogen I and II, gastrin-17 serum levels, and H. pylori infection in all patients diagnosed with CAAG at our hospital between 2013 and 2017. RESULTS: A total of 156 patients were studied and in 15.4% was observed concomitant gNET. Approximately 68.6% had at least 1 other autoimmune disease at diagnosis of CAAG. Approximately 60.9% had autoimmune thyroiditis, followed by diabetes (19.9%) and autoimmune polyendocrine syndrome (12.8%). CAAG patients with and without gNET had similar rates of comorbidity with other autoimmune diseases, but the pepsinogen I/II ratio was lower in patients with gNET (1.6 vs 4.5, P = 0.018). Receiver operating characteristic curve analyses identified a pepsinogen I/II ratio <2.3 and gastrin-17 levels >29.6 pmol/L as cutoffs distinguishing CAAG patients with gNET from those without. The combined use of these cutoff correctly identified 16 of the 18 CAAG patients with gNET (P = 0.007). H. pylori infection was observed in 28.7% of cases tested but did not associate with gNET. DISCUSSION: This study suggests that a low pepsinogen I/II ratio and high gastrin-17 levels characterize patients with CAAG and gNET and confirms the frequent coexistence of CAAG with other autoimmune diseases.
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Enfermedades Autoinmunes/diagnóstico , Gastritis Atrófica/diagnóstico , Infecciones por Helicobacter/diagnóstico , Tumores Neuroendocrinos/diagnóstico , Neoplasias Gástricas/diagnóstico , Adolescente , Adulto , Anciano , Enfermedades Autoinmunes/sangre , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/inmunología , Biomarcadores/sangre , Diagnóstico Diferencial , Femenino , Gastrinas/sangre , Gastritis Atrófica/sangre , Gastritis Atrófica/epidemiología , Gastritis Atrófica/inmunología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/inmunología , Helicobacter pylori/inmunología , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/sangre , Tumores Neuroendocrinos/epidemiología , Pepsinógeno A/sangre , Pepsinógeno C/sangre , Prevalencia , Curva ROC , Estudios Retrospectivos , Neoplasias Gástricas/sangre , Neoplasias Gástricas/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: Noninvasive assessment of corpus atrophic gastritis (CAG), a condition at increased risk of gastric cancer, is based on the measurement of pepsinogens, gastrin, and Helicobacter pylori antibodies. Parietal cell autoantibodies (PCAs) against the gastric proton pump (ATP4) are potential serological biomarkers of CAG. The purpose of this study was to compare the diagnostic performance of PCA and pepsinogen I tests in patients with clinical suspicion of CAG with the histopathological evaluation of gastric biopsies as reference standard. METHODS: A prospective case-finding study was performed on 218 naive adult patients (131 women, median age 65 years) who underwent gastric biopsies to confirm/exclude CAG. Patients with histopathological CAG were defined as cases, conversely as controls. Autoantibodies against the individual alpha (ATP4A) and beta (ATP4B) subunits of ATP4 were measured by luciferase immunoprecipitation, and global PCA and pepsinogen I by enzyme-linked immunosorbent assay. RESULTS: Histopathology classified 107 subjects (49%) as cases (CAG+, autoimmune 81.2%, and multifocal extensive 18.8%) and 111 subjects (51%) as controls (CAG-). In cases, ATP4A, ATP4B, and PCA titers were increased compared with controls, whereas pepsinogen I was reduced (P < 0.0001 for all). ATP4B, ATP4A, and pepsinogen I tests showed sensitivities of 77%, 75%, and 73% and specificities of 88%, 88%, and 80%, respectively. The receiver operating characteristic (ROC) area under the ROC curve (AUC) of these serological biomarkers confirmed their ability to discriminate cases from controls (ATP4B = 0.838, ATP4A = 0.826, pepsinogen I = 0.775, and PCA = 0.805), whereas the partial ROC-pAUC90 analysis showed that the ATP4B test had the best diagnostic performance (P = 0.008 vs ATP4; P = 0.0002 vs pepsinogen I). The presence of autoimmune or extensive gastritis was not significantly different between ATP4B positive or negative cases (P = 0.217). DISCUSSION: PCAs are promising serological biomarkers for the identification of CAG in high-risk individuals, particularly in an autoimmune pattern but also in an extensive-multifocal atrophy pattern.
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Autoanticuerpos/sangre , Gastritis Atrófica/diagnóstico , ATPasa Intercambiadora de Hidrógeno-Potásio/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Autoanticuerpos/inmunología , Biomarcadores/sangre , Biopsia , Estudios de Casos y Controles , Femenino , Mucosa Gástrica/diagnóstico por imagen , Mucosa Gástrica/inmunología , Mucosa Gástrica/patología , Gastritis Atrófica/sangre , Gastritis Atrófica/inmunología , Gastritis Atrófica/patología , Gastroscopía , Humanos , Masculino , Persona de Mediana Edad , Células Parietales Gástricas/inmunología , Pepsinógeno A/sangre , Estudios Prospectivos , Adulto JovenRESUMEN
1Department of General Surgery, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China.
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Gastrinas/metabolismo , Gastritis Atrófica/sangre , Microbioma Gastrointestinal/fisiología , Pepsinógeno A/metabolismo , Neoplasias Gástricas/sangre , Adulto , Anciano , Femenino , Gastritis Atrófica/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/patologíaRESUMEN
BACKGROUND: Autoimmune atrophic gastritis (AAG) diagnosis is based on specific histological findings and anti-parietal cell antibodies (PCA) considered the serological hallmark of AAG, although a subgroup of AAG patients may be seronegative. OBJECTIVES: To assess the occurrence and clinical features of seronegative compared to seropositive AAG. METHODS: This is a cross-sectional study including 516 consecutive adult patients (age 59.6⯱â¯12.8 years, F:Mâ¯=â¯2.2:1) with histologically proven AAG diagnosed in two Italian academic referral centers over the last 10 years. PCA were detected at AAG diagnosis. Variables related to the dependent variable of interest (i.e.PCA-negativity) were assessed by univariate/logistic regression analysis. RESULTS: 109/516 AAG patients were seronegative. The mean age of seronegative AAG patients was significantly higher compared to PCA-positive (65.9⯱â¯14.1vs57.9⯱â¯15.1 years; p<0.0001). The proportion of patients aged 70-79 and ≥80 years were, respectively, lower for PCA-positivity (5.1vs12.8%;21.3vs38.5%;p<0.005). Seronegativity was associated with age ≥50 years (OR2.4;95%CI 1.1-5.2), while for other variables (gender, comorbidities, anemia, atrophy severity) no association was found. In a sub-cohort of 101 AAG patients, PCA levels detected by ELISA were inversely correlated with age at AAG diagnosis (rho=-0.250;pâ¯=â¯0.0118). CONCLUSION: Roughly 20% of patients are seronegative at the time of AAG histological diagnosis and this is more common in elderly individuals.
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Autoanticuerpos/sangre , Enfermedades Autoinmunes/patología , Gastritis Atrófica/patología , Células Parietales Gástricas/inmunología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedades Autoinmunes/sangre , Estudios Transversales , Femenino , Gastritis Atrófica/sangre , Humanos , Italia , Modelos Logísticos , Masculino , Persona de Mediana EdadRESUMEN
Background: No data are available on the frequency of organ-specific humoral autoimmunity at diagnosis of adult celiac disease (CD).Aim: To evaluate the humoral immunoreactivities specific of type 1 diabetes (T1D), thyroid (THD), atrophic-gastritis (AG) and Addison's (AD) diseases in 92 adult CD patients at diagnosis and 237 adult healthy subjects (CTRL).Methods: T1D, THD and AD specific autoantibodies were analyzed by radioimmunoprecipitation assays. AG autoantibodies were detected by enzyme-linked immunosorbent assay.Results: Of 92 CD patients, 31.5% were positive for at least one of the organ-specific autoantibodies investigated (p < .0001 vs CTRL). Thyroid, diabetes, gastric and adrenal-autoantibodies, that increase with age at diagnosis, were detected in 12.0%, 10.9%, 10.9%, 2.2% of CD patients, respectively. Gastric- and diabetes- rather than thyroid- and adrenal-autoimmunity seem to be specifically related to presence of CD.Conclusions: One third of adult CD patients at diagnosis is target of at least one organ-specific autoantibody. A systematic organ-specific autoantibody screening in these patients might be of value to promptly identify, prevent or treat the relative diseases.
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Enfermedad de Addison/inmunología , Autoanticuerpos/inmunología , Enfermedad Celíaca/inmunología , Diabetes Mellitus Tipo 1/inmunología , Gastritis Atrófica/inmunología , Enfermedad de Addison/sangre , Adolescente , Adulto , Autoanticuerpos/sangre , Autoinmunidad , Estudios de Casos y Controles , Enfermedad Celíaca/sangre , Diabetes Mellitus Tipo 1/sangre , Femenino , Gastritis Atrófica/sangre , Humanos , Masculino , Persona de Mediana Edad , Glándula Tiroides/inmunología , Adulto JovenRESUMEN
Serum pepsinogens have been widely acknowledged as gastric mucosal biomarkers; however, a multicountry report on the benefits of pepsinogens as biomarkers has not yet been published. We analyzed 1,206 sera and gastric mucosal samples collected from Bangladesh, Bhutan, Indonesia, Myanmar, Nepal and Thailand then assessed the association between gastric mucosal changes and Helicobacter pylori infection. The new cutoff values for serum pepsinogen values were evaluated using a receiver operating characteristic analysis. The participants with H. pylori infection had significantly lower pepsinogen I and higher pepsinogen II values, but a lower pepsinogen I/II ratio than participants without the infection (all P < .001). The pepsinogen I and pepsinogen I/II values were significantly higher and lower, respectively, in individuals with atrophic gastritis than in those without (both P < .001). Among uninfected individuals, only the pepsinogen I/II ratio was significantly lower in atrophic individuals. Pepsinogen I/II ratio also were significantly different between disease among H. pylori-positive and H. pylori-negative individuals, suggesting the pepsinogen I/II ratio is a robust biomarker for determining both chronic and atrophic gastritis. The cutoffs for detecting chronic and atrophic gastritis for the pepsinogen I/II ratio were 4.65 and 4.95, respectively. In conclusion, pepsinogen levels are useful biomarker for both chronic gastritis and atrophic gastritis, but they should be used with caution. Population-based validation is necessary to determine the best cutoff values. Among all pepsinogen values, the pepsinogen I/II ratio was the most reliable gastric mucosal-change biomarker.
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Gastritis/sangre , Pepsinógeno A/sangre , Pepsinógeno C/sangre , Neoplasias Gástricas/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Asia , Biomarcadores/sangre , Enfermedad Crónica , Femenino , Gastritis Atrófica/sangre , Helicobacter pylori/patogenicidad , Helicobacter pylori/fisiología , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Factores de Riesgo , Factores de Virulencia/metabolismo , Adulto JovenRESUMEN
Aims: We aimed to explore diagnostic efficiencies of long noncoding RNAs (lncRNAs) adjacent to PGC combining with sPGC and anti-Helicobacter pylori IgG in identifying GC (gastric cancer) and precancerous disease. Patients & methods: A total of 265 patients with different gastric diseases were collected. ELISA was to detect sPGC and anti-H. pylori IgG. LncRNAs was determined by qRT-PCR. Results: The area under receiver operating characteristic curve of lncRNAs in discriminating GC+AG (atrophic gastritis) and superficial gastritis (SG) were 79.0, 68.1 and 75.9%. The diagnostic performance of lncRNAs with sPGC had increasing trends in distinguishing GC from non-GC, SG from GC+AG comparing with lncRNAs, with no statistic difference. Diagnosis efficacies of lncRNAs with anti-H. pylori IgG improved dramatically. Conclusions: Serum lncRNAs could distinguish GC, AG and SG. Diagnosis efficiencies of lncRNAs with sPGC and anti-H. pylori-IgG could be improved.
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Gastritis/diagnóstico , Pepsinógeno C/genética , ARN Largo no Codificante/sangre , Adulto , Anciano , Biomarcadores/sangre , Diagnóstico Diferencial , Femenino , Gastritis/sangre , Gastritis/patología , Gastritis Atrófica/sangre , Gastritis Atrófica/diagnóstico , Gastritis Atrófica/patología , Helicobacter pylori/inmunología , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Pepsinógeno C/sangre , Lesiones Precancerosas/sangre , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , ARN Largo no Codificante/genética , Sensibilidad y Especificidad , Neoplasias Gástricas/sangre , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologíaRESUMEN
A hospital-based cross-sectional study in SIGES project was conducted during 2016.5-2017.5 in West China Hospital. It was aimed to observe the prevalence of atrophic gastritis (AG) in southwest China, and assess the diagnostic strength of serum gastrin-17 (G-17) in predicting AG in Chinese population. Asymptomatic healthy controls from health check-up, cancer-free patients with unspecific upper gastrointestinal symptoms, and histologically proven gastric cancer patients were eligible, if serum pepsinogen-I (PG-I), PG-II, and G-17 were detected. AG status was classified by the accredited cutoffs of PG-I (<70 ug/L) and PG-I/II ratio (<3). Totally, healthy controls (n = 9,425), symptomatic patients (n = 671) and gastric cancer patients (n = 305) were simultaneously observed, in which the prevalence of AG in southwest China were estimated as 15.9/1,000, 28.3/1,000, and 55.7/1,000 persons, respectively. The age-specific prevalence of AG in healthy controls showed a significantly uphill trend (p for trend <0.001). Higher level of serum G-17 was significantly associated with increased risk of AG in healthy population (15-30 pmol/L, aOR = 20.67, 95% CI 9.17-46.55; >30 pmol/L, aOR = 314.41, 95% CI 166.10-595.12). Throughout the progression of stomach diseases, the diagnostic strength of serum G-17 for AG showed a downhill trend across more advanced situations. In despite of that, serum G-17 displayed a good performance in predicting AG in the entire cross-sectional population (AUC = 0.92, 95% CI 0.89-0.94; SEN = 85.5%; SPE = 93.2%; LR+ = 12.55; LR- = 0.11). Population in southwest China had intermediate prevalence of AG, while the prevalence was increased over age or disease progression. High level of serum G-17 might be a reliable non-invasive measurement to predict AG in southwest Chinese population.
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Biomarcadores , Gastrinas/sangre , Gastritis Atrófica/sangre , Gastritis Atrófica/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Gastritis Atrófica/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Pronóstico , Curva ROC , Adulto JovenRESUMEN
BACKGROUND: This study aimed to explore the diagnostic value of serum miR-101-3p combined with pepsinogen (PG) on early diagnosis of gastric cancer (GC). METHODS: A total of 61 atrophic gastritis (AG) and 86 GC patients, and 50 healthy volunteers were enrolled. The serum expression of miR-101-3p was measured by qRT-PCR. The serum content of carcinoembryonic antigen (CEA) was measured by Electrochemiluminescence immunoassay. The serum contents of PGI and PGII were measured by Enzyme linked immunosorbent assay. The diagnostic value of serum markers on AG and GC was analyzed by receiver operating characteristic (ROC) analysis. RESULTS: The expression of miR-101-3p, the content of PGI and the ratio of PGI/II were significantly decreased, and the content of PGII was significantly increased in AG patients compared with those in normal controls. The changes of the above serum indicators were more obvious in GC patients than those in AG patients. The content of CEA was significantly higher in GC patients than that in AG patients. In addition, the expression of miR-101-3p was negatively associated with the submucosal infiltration in GC patients. MiR-101-3p exhibited high diagnostic value on AG (AUC 0.8493, sensitivity 80.33%, specificity 80%) and GC (AUC 0.8749, sensitivity 72.09%, specificity 86.49%). MiR-101-3p + PGI + PGI/II (AUC 0.856, sensitivity 80.23%, specificity 77.05%) exhibited a high diagnostic value in distinguishing between AG and GC. CONCLUSIONS: MiR-101-3p was a potential diagnostic marker for AG and GC. MiR-101-3p + PGI + PGI/II was effective in distinguishing between AG and GC.
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Detección Precoz del Cáncer , Gastritis Atrófica/sangre , MicroARNs/sangre , Neoplasias Gástricas/sangre , Adulto , Antígeno Carcinoembrionario/sangre , Diagnóstico Diferencial , Femenino , Gastritis Atrófica/genética , Gastritis Atrófica/patología , Humanos , Masculino , Persona de Mediana Edad , Pepsinógeno A/sangre , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologíaAsunto(s)
Anemia Perniciosa/sangre , Anemia Perniciosa/diagnóstico , Homocisteína/metabolismo , Ácido Metilmalónico/metabolismo , Vitamina B 12/sangre , Anemia Perniciosa/tratamiento farmacológico , Femenino , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/tratamiento farmacológico , Gastritis Atrófica/sangre , Gastritis Atrófica/diagnóstico , Gastritis Atrófica/tratamiento farmacológico , Humanos , Hidroxocobalamina/uso terapéutico , Persona de Mediana Edad , Tetrahidrofolatos/uso terapéutico , Complejo Vitamínico B/uso terapéuticoRESUMEN
BACKGROUND: Serologic testing of anti-Helicobacter pylori antibody, together with testing of pepsinogen I and II, is now widely used to stratify groups at high risk of gastric cancer in Japan. Those with a negative anti-H. pylori IgG titer, especially "high-negative" (3-<10 U/mL), are speculated to have higher risk of gastric cancer. We aimed to evaluate the association between a high-negative anti-H. pylori IgG titer and the long-term risk of gastric cancer in the Japan Public Health Center-based Prospective Study (JPHC Study) Cohort II. METHODS: The study population consisted of 19,106 Japanese men and women who were followed from 1993 to 2013. A Cox proportional hazards model was used to assess the risk of gastric cancer for plasma anti-H. pylori IgG titers, together with the severity of atrophic gastritis by pepsinogen I and II levels. A total of 595 cases of gastric cancer occurred during an average of 18 years of follow-up. RESULTS: Compared with those with a low-negative anti-H. pylori IgG titer (≤3 U/mL), subjects with a high-negative titer (3-<10 U/mL) showed a significantly elevated risk of gastric cancer [HR = 2.81; 95% confidence interval (CI) = 1.62-4.89]. Among those with a high-negative titer, risk increase was observed under moderate or severe atrophic gastritis (HR = 18.73; 95% CI = 8.83-39.70). CONCLUSIONS: Our results suggest that those with a high-negative anti-H. pylori IgG titer and moderate and severe atrophic gastritis are at increased long-term risk of gastric cancer. IMPACT: Development of moderate or severe atrophic gastritis in subjects with high-negative anti-H. pylori IgG titer is suggested to increase risk of gastric cancer.
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Anticuerpos Antibacterianos/sangre , Gastritis Atrófica/diagnóstico , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/inmunología , Neoplasias Gástricas/epidemiología , Anciano , Anticuerpos Antibacterianos/inmunología , Femenino , Estudios de Seguimiento , Gastritis Atrófica/sangre , Gastritis Atrófica/microbiología , Gastritis Atrófica/patología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/aislamiento & purificación , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pepsinógeno A/sangre , Pepsinógeno C/sangre , Estudios Prospectivos , Medición de Riesgo , Pruebas Serológicas , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND/AIMS: The relationship between the serum pepsinogen (sPG) level and changes in gastric mucosa has been well studied. Here, we evaluated the usefulness of sPG (I, II, I/II ratio) and intragastric pH as a biomarker of severe gastric atrophy in gastric neoplastic lesions. METHODS: A total of 186 consecutive Korean patients with gastric neoplastic lesions underwent endoscopic submucosal dissection (ESD) in this study. The serologic atrophy group had sPG I level ≤ 70 ng/mL and an sPG I/II ratio ≤ 3.0. Before ESD, overnight fasting venous blood and gastric juice samples were collected to measure the sPG level and intragastric pH. The degree of gastric atrophy was estimated by endoscopy, and the rapid urease test was performed to investigate Helicobacter pylori infection. RESULTS: Patients who met the criteria of serologic atrophy showed more severe endoscopic atrophic changes (61% vs. 18%, p = 0.000). Older patients and those with more atrophic changes at the gastric upper body demonstrated both a lower sPG I level and a lower PG I/II ratio and more severe endoscopic atrophy. The sPG I/II ratio was the lowest in low grade dysplasia than in high grade dysplasia and early gastric cancer (EGC) (p = 0.015). In addition, patients who tested negative for serologic atrophy and H. pylori showed the lowest intragastric pH (p = 0.000). CONCLUSION: A low sPG I level and a low I/II ratio were correlated with the severity of gastric atrophy in gastric neoplastic lesions, thus indicating it to be a sensitive biomarker of gastric precancerous lesions or EGC.
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Gastritis Atrófica/epidemiología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Pepsinógenos/sangre , Neoplasias Gástricas/diagnóstico , Biomarcadores/sangre , Endoscopía , Femenino , Mucosa Gástrica/patología , Gastritis Atrófica/sangre , Gastritis Atrófica/diagnóstico , Gastritis Atrófica/patología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/patología , Helicobacter pylori , Humanos , Concentración de Iones de Hidrógeno , Masculino , Índice de Severidad de la Enfermedad , Neoplasias Gástricas/sangre , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
BACKGROUND: Atrophic gastritis is considered precursor condition for gastric cancer. There is so far limited evidence on the performance of pepsinogens for atrophy detection in Central Asia. The aim of our study was to detect the prevalence of atrophic gastritis in the asymptomatic adult population in Kazakhstan as well as address the accuracy of pepsinogen testing in atrophy detection. METHODS: Healthy individuals aged 40-64 were included. Upper endoscopy and pepsinogens (PG) evaluation were performed. PG were analysed in plasma by latex agglutination. Cut off values were used to define decreased PG values (PGR ≤ 3 and PG I ≤ 70 ng/mL); severely decreased PG values (PGR ≤ 2 and PG I ≤ 30 ng/mL). Biopsies were analyzed and obtained according to the updated Sydney System. PG test sensitivity, specificity and overall accuracy were assessed using the histological diagnosis as the "gold standard". RESULTS: Altogether 157 individuals - female 40,1% and male 59,9% were included. Histologically, moderate to severe corpus atrophy, was present only in 1,3% cases. From all study subjects, 26,8% had decreased plasma PG values with cut-off values PGR ≤ 3 and PG I ≤ 70 ng/mL. The sensitivity of the PG test with this cut-off values was 50,0%, specificity 73,5%, overall accuracy 73,2% for detection of moderate to severe atrophy in the corpus. The sensitivity of PG test with cut-off values PGR ≤ 2 and PG I ≤30 ng/mL was 50,0%, specificity 90,9% and overall accuracy 90,4%. CONCLUSIONS: The prevalence of gastric mucosal atrophy was low in the Kazakh population. Serological PG test screening nevertheless can play an important role in the diagnosis of gastric precancerous lesions. However, the diagnostic accuracy of the PG test is mainly dependent on the cut-off values for positive results.
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Mucosa Gástrica/patología , Gastritis Atrófica/epidemiología , Pepsinógeno A/sangre , Adulto , Atrofia/sangre , Atrofia/diagnóstico , Atrofia/epidemiología , Endoscopía , Femenino , Estudios de Seguimiento , Mucosa Gástrica/metabolismo , Gastritis Atrófica/sangre , Gastritis Atrófica/diagnóstico , Gastritis Atrófica/patología , Humanos , Kazajstán/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Curva ROCRESUMEN
BACKGROUND: Autoimmune atrophic gastritis (AAG) is an immune-mediated disorder characterised by destruction of gastric oxyntic mucosa AIM: To explore gastric histopathological evolution in a cohort of AAG patients over a prolonged follow-up METHODS: Single centre prospective study enrolling consecutive patients with histologically confirmed AAG between 2000 and 2018. All AAG patients undergoing endoscopic follow-up every 1-3 years were classified as having stages 1, 2 or 3 according to atrophy severity (mild, moderate and severe). AAG patients with either glandular or neuroendocrine dysplasia/neoplasia were classified as having stage 4. Disease stage progression, and changes in serum anti-parietal cell antibody (PCA), chromogranin A and gastrin-17 were assessed. RESULTS: In total, 282 AAG patients (mean age 60.3 years; F:M ratio 2.4:1; median follow-up 3 years, interquartile range 1-7) were enrolled. All patients with stages 1 or 2 progressed to stage 2 or 3 over time with a steady trend (P = .243) and regression from a severe to a milder stage was never noticed. Disease progression of patients with stages 1 or 2 occurred within the first 3 years. PCA positivity rate did not change over time. Stage 3 patients had higher gastrin-17 levels compared to patients with stages 1 and 2 (median 606 vs 295 pg/mL; P < .001). In stage 3, the hazard ratio for the risk of developing stage 4 was 6.6 (95% CI 1.5-29; P = .001). CONCLUSIONS: AAG is a steadily progressive disease, in which stages 1 and 2 always progress to stage 3. The risk of developing a complicated disease stage is greater in patients with more severe gastric lesions.
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Enfermedades Autoinmunes/patología , Gastritis Atrófica/patología , Adulto , Anciano , Enfermedades Autoinmunes/sangre , Progresión de la Enfermedad , Femenino , Mucosa Gástrica/patología , Gastrinas/sangre , Gastritis Atrófica/sangre , Humanos , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/patología , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Neoplasias Gástricas/patologíaRESUMEN
BACKGROUND: Persistent infections that induce prolonged inflammation might negatively affect the leukocyte telomere length (LTL); however, the role in LTL of Helicobacter pylori (H. pylori) infection, which persistently colonizes the stomach, remains unknown. The study objective was to examine associations of sero-prevalence of H. pylori immunoglobulin G (IgG) antibody and serum pepsinogens (PGs), as markers of atrophic gastritis, with LTL. A cross-sectional study was performed among 934 Arab residents of East Jerusalem, aged 27-78 years, randomly selected from Israel's national population registry. Sera were tested for H. pylori IgG and PG levels by ELISA. LTL was measured by southern blots. Multiple linear regression models were fitted to adjust for sociodemographic and lifestyle factors. RESULTS: LTL decreased significantly with age (p < 0.001) and was shorter in men than women (p = 0.032). The mean LTL was longer in H. pylori sero-positive persons than negative ones: mean difference 0.13 kb (95% CI 0.02, 0.24), p = 0.016. Participants with atrophic gastritis (PGI < 30 µg/L or a PGI: PGII < 3.0) had shorter LTL than did those without: mean difference - 0.18 (95% CI - 0.32, - 0.04). The difference was of larger magnitude between persons who had past H. pylori infection (sero-negative to H. pylori IgG antibody) and atrophic gastritis, compared to those who were H. pylori sero-negative and did not have atrophic gastritis: mean difference - 0.32 kb (95% CI - 0.55, - 0.10). This association remained significant after adjustment for age, sex, and religiosity: beta coefficient - 0.21 kb (95% CI - 0.41, - 0.001), p = 0.049. The results were similar after further adjustment for lifestyle factors. In bivariate analysis, mean LTL was longer in physically active persons than non-active ones, and shorter in persons with than without obesity; however, these differences were diminished and were not significant in the multivariable model. CONCLUSIONS: H. pylori IgG sero-positivity per se was not related to reduced LTL. However, persons with past H. pylori infection (i.e., lacking H. pylori IgG serum antibody) and with serological evidence of atrophic gastritis, had a significantly shorter LTL than did those without atrophic gastritis.
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Gastritis Atrófica/sangre , Infecciones por Helicobacter/sangre , Inmunoglobulina G/sangre , Pepsinógenos/sangre , Adulto , Anciano , Anticuerpos Antibacterianos/sangre , Árabes/genética , Biomarcadores/sangre , Femenino , Gastritis Atrófica/genética , Gastritis Atrófica/microbiología , Gastritis Atrófica/patología , Infecciones por Helicobacter/genética , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/patogenicidad , Humanos , Israel/epidemiología , Leucocitos/metabolismo , Leucocitos/patología , Masculino , Persona de Mediana Edad , Pepsinógenos/genética , Telómero/genética , Telómero/microbiologíaRESUMEN
BACKGROUND AND AIM: Helicobacter pylori (H. pylori) is closely associated with pre-neoplastic lesions such as atrophic gastritis (AG) and gastric intestinal metaplasia (GIM). The relationshionship between inflammation, hyperhomocysteinemia and arterial stiffness is of pathophysiological relevance for the development of cardiovascular disease. This study aimed to investigate the relationship between vitamin B12, folic acid, homocysteine (Hcy) and pulse wave velocity (PWV) levels in patients with GIM, AG and non-atrophic non-metaplastic chronic gastritis. PATIENTS AND METHODS: ninety-seven patients with GIM, 67 patients with AG and 69 patients with chronic gastritis were included in the study. Glucose, creatinine, total cholesterol, triglyceride, low-density lipoprotein, cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid and Hcy levels were measured by biochemical methods. PWV and other vascular parameters were measured using the Phsyio-port AS device. MAIN RESULTS: PWV was higher in patients with GIM and AG than in controls (p < 0.05 and p < 0.05, respectively). Vitamin B12 levels were significantly lower in patients with GIM and AG than in controls (p < 0.01 and p < 0.01, respectively). Folic acid levels were significantly lower in patients with GIM than in controls (p < 0.05). Hcy levels were significantly higher in patients with GIM and AG than in controls (p < 0.001 and p < 0.05, respectively). A logistic regression analysis showed that GIM, AG and vitamin B12 deficiency were predictors for arterial stiffness. CONCLUSIONS: PWV values increased in patients with GIM and AG compared to non-atrophic non-metaplastic chronic gastritis, without different conventional cardiovascular risk factors.