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Introduction: The mode of treatment of APD is changedradically ever since the role of H.pylori is proved for thiscondition. The study was aimed to detect the utility of antiH.pylori IgG estimation in the diagnosis of acid pepticdiseases.Material and methods: Endoscopic examination of stomachfollowed by Rapid Urease Test on the biopsy material andthe anti-Helicobacter pylori IgG quantitative estimation weredone in 85 patients with history suggestive of acid pepticdisease.Results: 46 (100%) patients with gastritis showed positiveRapid Urease Test within 30 minutes and had serum IgG >30IU/ml. 10 patients with peptic ulcer, 12 patients with non ulcerdyspepsia and 2 patients with carcinoma stomach gave positiveRapid Urease Test after 30minutes and serum IgG level was< 30 IU/ml for these patients. Of the 70 Rapid Urease Testpositive in the study, 2 of the 12 non ulcer dyspepsia patientswere negative for antibody. Endoscopy findings in 15 subjectswere normal and negative for Rapid Urease Test and antiHelicobacter pylori IgG antibody.Conclusion: Estimation of Serum anti-Helicobacter pyloriIgG may be useful as a non invasive method in the diagnosisof gastritis.
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Objective To compare the consistency and detection rate of early gastric cancer (EGC) of three different methods including anti-Helicobacter pylori (Hp) antibody combined with pepsinogen (PG) (ABC method),serum PG combined with gastrin-17 (G-17) (new ABC method) and the new scoring system.Methods Serological tests were performed in Zhejiang population,which divided the subjects into low risk,intermediate risk and high risk groups.High risk subjects were examined by endoscopic and pathological examination.SPSS19.0 were used to evaluate the consistency of three methods.According to the receiver operating characteristic (ROC) curve,the ratio of G-17 to PG (PGR) was calculated for the optimal diagnostic cut-off value of EGC.Results A total of 30 126 subjects were recruited.Based on the data of ABC method,the proportions of low risk,intermediate risk and high risk group were 15 368 (51.01％),13 246 (43.97％),and 1 512 (5.02％),respectively.These proportions by the new ABC method were 20 584 (68.32％),8 990 (29.84％),552 cases (1.83％),respectively.By new scoring system,these were 20 810 (69.08％),8 059 (26.75％),and 1 257 (4.17％),respectively.Among them,1 263 subjects underwent endoscopy and 22 cases (1.74％) were finally diagnosed as gastric cancer including 19 EGC (86.4％).There were 1 case (0.35％),14 cases (1.84％),and 7 cases (3.21％) with gastric cancer in low risk,intermediate risk,and high risk groups by ABC methods,respectively.Gastric cancer patients were 7 (1.68％),10 (1.38％),and 5 (4.10％) in three groups respectively by new ABC methods.Via new scoring system,gastric cancer were detected in 5 (0.66％),9 (2.22％),and 8 (7.84％) patients of three risk groups respectively.The consistency of three screening methods was poor.The detection rate of gastric cancer in high risk group was higher than that in the other two (P＜0.05).The area under the curve (AUC) for diagnosis of gastric cancer by G-17 and PGR was 0.588 and 0.729,respectively.According to the PGR cut-off value determined by the fitted model,the incidence of gastric cancer in the low,intermediate and high risk groups was 0.94％,1.97％,and 6.31％,respectively.When the cut-off value is PGR＜4.135,the sensitivity is 0.855 and the specificity is 0.545.Conclusion The new scoring system has a better predictive value in EGC screening.The detection rate of EGC in high risk group is higher than that in low and intermediate risk groups.
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Objective To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with Helicobacter pylori (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Methods Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. Results The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Conclusions Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.
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<p><b>Objective</b>Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.</p><p><b>Data Sources</b>The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords "Helicobacter pylori," "Pepsinogens," and "Stomach Neoplasms."</p><p><b>Study Selection</b>Original articles and reviews on the topics were selected.</p><p><b>Results</b>Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.</p><p><b>Conclusions</b>The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.</p>
Subject(s)
Humans , Antibodies, Bacterial , Blood , Allergy and Immunology , Gastroscopy , Helicobacter Infections , Blood , Allergy and Immunology , Helicobacter pylori , Allergy and Immunology , Mass Screening , Methods , Stomach Neoplasms , Blood , MicrobiologyABSTRACT
Objective To observe the distribution of different types of Helicobacter pylori (H.pylori)infection in non-atrophic gastritis,atrophic gastritis and intestinal metaplasia.Methods From January 2015 to January 2017,457 hospitalized patients with gastritis were collected.All the inpatients received 14C-urea breath test(14C-UBT), H.pylori antibody typing detection, anesthesia gastroendoscopy and pathological analysis of biopsies.According to the results of H.pylori antibody typing,all patients were divided into typeⅠ H.pylori infection group,typeⅡ H.pylori infection group and H.pylori negative group.The relation among different types of H.pylori infection,age and pathological type were analyzed.Analysis of variance and chi-square test were performed for statistical analysis.Results The mean age of patients in typeⅠH.pylori infection group(n=135),typeⅡ H.pylori infection group(n=98)and H.pylori negative group(n=224)in patients with non-atrophic gastritis was(47.5 ± 9.0),(49.0 ± 9.0)and(52.0 ± 11.0)years,respectively, which were lower than those of patients with atrophy gastritis((56.8 ± 10.3),(57.5 ± 12.4)and(62.6 ± 10.4) years,respectively)and patients with intestinal metaplasia((59.2 ± 11.1),(57.5 ± 12.6)and(57.8 ± 10.0)years,respectively),and the differences were statistically significant(F=17.90,6.82 and 18.30,all P<0.01).The proportion of patients with non-atrophic gastritis in H.pylori negative group,typeⅡ H.pylori infection group and typeⅠ H.pylori infection group decreased in turn(56.3%,126/224;40.8%,40/98 and 34.8%,47/135, respectively),and the differences were statistically significant(χ2 =18.44,P<0.01).The proportion of patients with intestinal metaplasia in H.pylori negative group,type Ⅱ H.pylori infection group and type Ⅰ H.pylori infection group increased in turn(23.2%,52/224;26.5%,26/98 and 42.2%,57/135),and the difference was statistically significant(χ2 =11.44,P=0.003).There was no significant difference in the proportion of patients with atrophic gastritis among H.pylori negative group,type Ⅱ H.pylori infection group and type Ⅰ H.pylori infection group(20.5%,46/224;32.7%,32/98 and 23.0%,31/135;χ2 = 5.60,P=0.061).Conclusions Gastric atrophy is easily induced in patients with H.pylori infection.In patients without symptoms,H.pylori should be eradicated before gastric atrophy,which can provide the greatest benefit to the patients.Different types of H.pylori infection have different role in the progress of atrophic gastritis.TypeⅠ H.pylori infection accelerate the progress of atrophic gastritis,especially from atrophic gastritis to intestinal metaplasia,which should be actively eradicated.
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Objective:To investigate the feasibility of detection of serum pepsinogen (PG),gastrin-17 (G-17) and Helicobacter pylori antibody (anti-HP)in the gastric cancer screening,and to elucidate its clinical value. Methods:A total of 208 patients with early gastric cancer were selected as observation group;at the same time, 208 healthy examinees were regarded as blank control group.The levels of PGⅠ,PGⅡ and G-17 of the subjects in two groups were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetry;the positive rates of anti-HP were detected by 13 C urea breath test;the serum levels of PG Ⅰ,PG Ⅱ and PG Ⅰ /PGⅡ ratio of the anti-HP positive subjects (anti-HP positive group)and anti-HP negative subjects (anti-HP negative group)were compared and analyzed.Results:Compared with blank control group,the serum PGⅠ / PGⅡ ratio and PGⅠ level of the subjects in observation group were significantly decreased (P <0.01),and the levels of PG Ⅱ,G-17 and the positive rate of anti-HP were increased (P <0.01).Compared with anti-HP negative group,the serum PGⅠ / PGⅡ ratio and PGⅠ level of the subjects in anti-HP positive group were significantly decreased (P <0.01).The levels of PGⅡ and G-17 were significantly increased (P < 0.01).Conclusion:The detection of positive rate of anti-HP combined with the ratio of PGⅠ /PGⅡ has important clinical significance in gastric cancer screening.The levels of G-17 and PG Ⅱ in the epithelial neoplasia lesion tissue can be used as indicators of gastric precancerous lesions.
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BACKGROUND: The etiology of chronic idiopathic urticaria (CIU) is not completely clear. There are a few antibodies were reported to correlate with CIU. OBJECTIVE: To investigate the correlation these antibodies and CIU. METHODS: The autologous serum skin test (ASST) and allergens were performed. Serum levels of immunoglobulin E (IgE), anti-FcepsilonRI and anti-IgE, anti-Helicobacter pylori (HP) antibodies and anti-thyroglobulin antibody (TGAb) were measured in 100 patients with CIU, acute urticaria (AU) and normal controls respectively. RESULTS: Eighty-six percent food or inhalant allergens were detected in AU patients, but no allergens were detected in CIU patients and normal controls. Serum anti-FcepsilonRI antibody and anti-IgE antibody levels were higher in the CIU than that in the AU patients and normal controls (p<0.05, respectively). IgE level was lower in the CIU patients (T=190.00, p< 0.05), but increased in the AU patients (T=226.00, p<0.05) compared with the normal controls. The ASST positive rates in the CIU and the AU patients were 53.4% and 12.6% respectively, but all normal controls were negative. The anti-FcepsilonRI antibody level was higher in the ASST-positive CIU patients than those negative ones (T=101.73, p<0.05). In anti-HP antibody positive and TGAb positive CIU patients, anti-FcepsilonRI antibody positive rate was higher than AU patients (p<0.01) and normal controls (p<0.01). CONCLUSION: The anti-FcepsilonRI and anti-IgE antibodies play a key role in CIU, but anti-HP antibody and TGAb have an indirect correlation with CIU.