The serological gastric biopsy: a non-endoscopical diagnostic approach in management of the dyspeptic patient - Significance for primary care based on a survey of the literature
The serological gastric biopsy: a non-endoscopical diagnostic approach in management of the dyspeptic patient - Significance for primary care based on a survey of the literature
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DOI：
10.1080/003655202320621418
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发表时间：
2002-01-01
影响因子：
1.9
通讯作者：
Lamers, CBHW
中科院分区：
文献类型：
--
作者：
Korstanje, A;den Hartog, G;Lamers, CBHW
背景：胃粘膜分泌产物胃蛋白酶原A（PgA）的血清浓度测定。胃蛋白酶原C（PgC）和胃泌素的血清学检查称为血清学胃活检。幽门螺杆菌抗体、壁细胞抗体和内因子抗体的额外测量支持血清市场的非侵入性诊断价值。在许多临床研究中。已经确定了血清标志物在预测胃粘膜疾病的形态和严重性方面的诊断潜力。目的是评估血清学胃活检的诊断价值的初级保健。方法：文献综述。结果如下：血清学胃活检的细胞生理背景，血清市场的结果和这些参数的各种胃粘膜疾病的关系的解释进行了说明。PgA测定是鉴别粘膜性胃炎和功能性消化不良的可靠方法。即使胃泌素正常，十二指肠溃疡、胃溃疡和幽门溃疡的PgA也升高。PgA和胃泌素都在肾功能不全和Zollinger-Ellison综合征中升高。低PgA是粘膜萎缩的指示，也是胃酸过少的良好指标。PgA：C比值降低提示萎缩性胃炎或胃广泛性肠上皮化生。低胃蛋白酶原血症也可能是胃癌的警报症状。低的PgA和高的胃泌素表明身体萎缩。结论：在初级保健，血清学胃活检可能是一个可行的和适当的诊断方法，消化不良患者的管理。在一般实践中，必须进行进一步的研究，以验证血清学胃活检的预测价值，并确定诊断策略。
Background: Measurement of the serum concentration of the secretory products of the gastric mucosa, pepsinogen A (PgA). pepsinogen C (PgC) and gastrin is called the serological gastric biopsy. Additional measurement of Helicobacter pylori antibodies and antibodies to parietal cells and intrinsic factor supports the non-invasive diagnostic value of the serum markets. In many clinical studies. the diagnostic potential of the serum markers in predicting the topography and severity of gastric mucosal disorders has been established. The aim was to assess the diagnostic value of the serological gastric biopsy for primary care. Method: Survey of the literature. Results: The cell-physiological background of the serological gastric biopsy the interpretation of the outcome of serum markets and the relation of these parameters to various gastric mucosal disorders are described. Measurement of PgA is a reliable way to discriminate between mucosal gastritis and functional dyspepsia. PgA is raised in duodenal, gastric and pyloric ulcer even though gastrin is normal. Both PgA and gastrin are raised in renal insufficiency and the Zollinger-Ellison syndrome. A low PgA is indicative of mucosal atrophy and a good indicator for gastric hypoacidity. An additional low PgA:C ratio is indicative of atrophic gastritis or extensive intestinal metaplasia of the stomach. A hypopepsinogenaemia can also be an alarm symptom for gastric cancer. A low PgA and a high gastrin is indicative of corpus atrophy. Conclusion: In primary care, the serological gastric biopsy might be a feasible and appropriate diagnostic method for management of the dyspeptic patient. Further research in general practice has to be done to validate the predictive value of the serological gastric biopsy and to define a diagnostic Strategy.