최신연구결과(해외)

General studySerum Pepsinogens Combined with New Biomarkers Testing Using Chemiluminescent Enzyme Immunoassay for Non-Invasive Diagnosis of Atrophic Gastritis: A Prospective, Multicenter Study

관리자
2023-10-05
조회수 572

Diagnostics (Basel). 2022 Mar 12;12(3):695. doi: 10.3390/diagnostics12030695. 


* 이번 연구는 serum pepsinogen과 atrophic gastritis 정도에 따른 혈청검사의 의미를 알아본 연구입니다. AIG 단독으로 시행하거나 비교 연구라기 보다는 AIG와 H.pylori associated gastritis가 함께 섞여 있고 구분되어 있지 않습니다. Atrophic gastritis의 경우는 update Sydney system을 이용하여 corpus 2곳, antrum 2곳에서 biopsy를 시행하여 조직소견을 중심으로 구분하여 나눠 분석한 결과 입니다. Cut-off value 는 PGI: <30 µg/L; PGII: <3 µg/L, PGI/PGII ratio: <3.0을 기준으로 시행하였습니다.  내용이 복잡하고 table, figure 모두 해석하기 힘든 내용으로 보입니다만, 강점으로 antrum atrophy 에 대해 IL-6, HE4 와 같은 새로운 serologic marker 를 사용하여 prospective disign으로 진행하였다는 점이며 pepsinogen 검사는 gastric atrophy와 function을 살피는 유용한 serologic test라는 점이 중요하겠습니다. 


Table 1. Serum levels of all the biomarkers in different patient groups according to histology results


Figure 1. Receiver operating characteristic curve of PGI, PGI/PGII ratio, HE-4, and IL-6 for thef PGI, PGI/PGII ratio, HE-4, and IL-6 for the detection of any atrophy (AGA or AGC or AGAC).  


Table 2. Diagnostic performance of different markers for the detection of AG: comparison between all patients with AG (AGA or AGC or AGAC, n = 152) and all control patients (N + NAG, n = 204), presented for all patients (white space, n = 152) and patients with moderate to severe atrophy (grey space, n = 54).


Figure 2. Receiver operating characteristic curve of PGI, PGI/PGII ratio, HE-4, and IL-6 for the detection of corpus AG (AGC + AGAC).


Figure 3. Receiver operating characteristic curve of PGI, PGI/PGII ratio, HE-4, and IL-6 for the detection of antrum AG (AGA).

Table 3. Diagnostic performance of different markers for the detection of corpus atrophic gastritis: comparison between the patients with AGC + AGAC (n = 80) and control patients (N + NAG, n = 204), presented for all patients (white space, n = 80) and patients with moderate to severe atrophy (grey space, n = 36).


Table 4. Diagnostic performance of different markers for the detection of antrum atrophic gastritis: comparison between the patients with AGA (n = 72) and control patients (N + NAG, n = 204), presented for all patients (white space, n = 72) and patients with moderate to severe atrophy (grey space, n = 18). 


Table 5. Diagnostic performance of different markers for the detection of pangastric (antrum and corpus) atrophic gastritis: comparison between the patients with AGAC (n = 38) and control patients (N + NAG, n = 204). 


Figure 4. Receiver operating characteristic curve of PGI, PGI/PGII ratio, HE-4, and IL-6 for the detection of extensive AG (AGAC).


<Abstract>

Background: Analysis of serum biomarkers for the assessment of atrophic gastritis (AG), a gastric precancerous lesion, is of growing interest for identification of patients at increased risk of gastric cancer. The aim was to analyze the diagnostic performance of serum pepsinogen testing using another method, chemiluminescent enzyme immunoassay (CLEIA), as well as of other new potential biomarkers. 

Material and Methods: The sera of patients considered at increased risk of gastric cancer and undergoing upper endoscopy collected in our previous prospective, multicenter study were tested for pepsinogen I (PGI) and II (PGII), interleukin-6 (IL-6), human epididymal protein 4 (HE-4), adiponectin, ferritin and Krebs von den Lungen (KL-6) using the CLEIA. The diagnostic performance for the detection of AG was calculated by taking histology as the reference. 

Results: In total, 356 patients (162 men (46%); mean age 58.6 (±14.2) years), including 152 with AG, were included. For the detection of moderate to severe corpus AG, sensitivity and specificity of the pepsinogen I/II ratio were of 75.0% (95%CI 57.8–87.9) and 92.6% (88.2–95.8), respectively. For the detection of moderate to severe antrum AG, sensitivity of IL-6 was of 72.2% (95%CI 46.5–90.3). Combination of pepsinogen I/II ratio or HE-4 showed a sensitivity of 85.2% (95%CI 72.9–93.4) for the detection of moderate to severe AG at any location. 

Conclusion: This study shows that PG testing by CLEIA represents an accurate assay for the detection of corpus AG. Additionally, IL-6 and HE-4 may be of interest for the detection of antrum AG. 

Mini-abstract: Pepsinogens testing by chemiluminescent enzyme immunoassay is accurate for the detection of corpus atrophic gastritis. IL-6 and HE-4 maybe of interest for the detection of antrum atrophic gastritis.

Keywords: atrophic gastritis; non-invasive markers; pepsinogens; diagnostic performance  

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대한자가면역성위염연구회

주소 : 경기도 용인시 기흥구 중부대로 579, 508-23호 (구갈동, 강남대프라자)

대표전화 : 070-8080-0453  이메일 : autogastritis@gmail.com 


Copyright (c)대한자가면역성위염연구회. All Rights Reserved. Design Hosting By 위멘토.