Increased Prevalence of Autoimmune Gastritis in Patients with a Gastric Precancerous Lesion

被引：13
作者：
Guo, Xiaopei [1 ]
Schreurs, Marco W. J. [2 ]
Marijnissen, Fleur E. [1 ]
Mommersteeg, Michiel C. [1 ]
Nieuwenburg, Stella A. V. [1 ]
Doukas, Michail [3 ]
Erler, Nicole S. [4 ,5 ]
Capelle, Lisette G. [6 ]
Bruno, Marco J. [1 ]
Peppelenbosch, Maikel P. [1 ]
Spaander, Manon C. W. [1 ]
Fuhler, Gwenny M. [1 ]
机构：
[1] Erasmus MC, Dept Gastroenterol & Hepatol, NL-3015 GD Rotterdam, Netherlands
[2] Erasmus MC, Dept Immunol, NL-3015 GD Rotterdam, Netherlands
[3] Erasmus MC, Dept Pathol, NL-3015 GD Rotterdam, Netherlands
[4] Erasmus MC, Dept Biostat, NL-3015 GD Rotterdam, Netherlands
[5] Erasmus MC, Dept Epidemiol, NL-3015 GD Rotterdam, Netherlands
[6] Meander Med Ctr, Dept Gastroenterol & Hepatol, NL-3813 TZ Amersfoort, Netherlands
来源：
JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 19期
关键词：
autoimmune gastritis; gastric precancerous lesions; gastrin; 17; pepsinogen; HELICOBACTER-PYLORI; INTESTINAL METAPLASIA; ATROPHIC GASTRITIS; PERNICIOUS-ANEMIA; FOLLOW-UP; DIAGNOSIS; CANCER; PEPSINOGEN; PATHOGENESIS; GASTROPANEL;
D O I：
10.3390/jcm12196152
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Background: 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 H. pylori infection and the presence of gastric precancerous lesions (GPL), due to the ambiguous pathology and delayed symptom onset. Aim: Investigate the prevalence and characteristics of AIG in GPL patients. Methods: 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-Helicobacter pylori IgG were assessed in GPL cases, and the severity of intestinal metaplasia and gastric atrophy was scored by expert pathologists. Results: APCA positivity was observed in 18% of cases vs. 7% of controls (p = 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). Conclusions: 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.
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页数：11
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