Predictors of Gastric Neoplasia in Cases Negative for Helicobacter pylori Antibody and with Normal Pepsinogen.
Predictors of Gastric Neoplasia in Cases Negative for Helicobacter pylori Antibody and with Normal Pepsinogen.
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发表时间：
2015-12
影响因子：
2
通讯作者：
H. Kishikawa;Kayoko Kimura;A. Ito;K. Arahata;S. Takarabe;S. Kaida;J. Miyauchi;S. Miura;J. Nishida
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文献类型：
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作者：
H. Kishikawa;Kayoko Kimura;A. Ito;K. Arahata;S. Takarabe;S. Kaida;J. Miyauchi;S. Miura;J. Nishida
背景/目的幽门螺杆菌抗体阴性且胃蛋白酶原试验正常的个体（A组）在称为ABC法的血清胃癌筛查中被认为是低风险的，并且不推荐内窥镜检查;然而，该组可能包括2-10%的胃癌病例。患者与方法345例接受上消化道内镜检查的患者，按ABC分类为A组（H组）。pylori抗体滴度70 ng/ml或I/II比值>3），并研究胃肿瘤的预测因子。结果10例胃肿瘤（胃癌和腺瘤）被纳入。多因素Logistic回归分析确定H. pylori抗体滴度≥3 U/ml（比值比=14.4，95%可信区间=2.7-76.9; p<0.01）和胃蛋白酶原I/II比值≤4.3 ng/ml（比值比=10.0，95%可信区间=2.1-47.9; p<0.01），但年龄不是肿瘤形成的独立预测因素。结论对H. ABC法判定A组pylori抗体滴度≥ 3U/ml，胃蛋白酶原Ⅰ/Ⅱ比值≤4.3。
BACKGROUND/AIM Individuals negative for Helicbacter pylori antibody and with a normal pepsinogen test (group A) are regarded as being at low risk in serum gastric cancer screening known as the ABC method, and endoscopy is not recommended; however, this group may include 2-10% of gastric cancer cases. PATIENTS AND METHODS A total of 345 individuals who underwent upper gastrointestinal endoscopy and were classified by ABC as group A (H. pylori antibody titer 70 ng/ml or I/II ratio >3) were enrolled, and predictors of gastric neoplasia were investigated. RESULTS Ten gastric neoplasia cases (gastric cancer and adenoma) were found to be included. Multiple logistic regression analyses identified H. pylori antibody titer ≥3 U/ml (odds ratio=14.4, 95% confidence interval=2.7-76.9; p<0.01) and pepsinogen-I/II ratio ≤4.3 ng/ml (odds ratio=10.0, 95% confidence interval=2.1-47.9; p<0.01), but not age as independent predictive factors of neoplasia. CONCLUSION Endoscopy should be considered in individuals with H. pylori antibody titer of ≥3 U/ml and a pepsinogen-I/II ratio of ≤4.3 in those classed as group A by ABC method.