Effects Of Histological Changes Of Chronic Atrophic Gastritis Based On OLGA Stages On Serum Pepsinogen And Gastrin Levels

Objective:To analyze the clinical value of serum pepsinogen(PG)and gastrin-17(G-17)in the diagnosis of pre-gastric cancer lesions.Methods:Collected 453 asymptomatic patients underwent a health check-up in hospital from September,2015 to September,2018.The patients underwent both serological tests and endoscopic examinations.The basic data were collected,including sex,age,height,weight,history of smoking,history of drinking,family history of gastric cancer(GC),history of infection and treatment of Helicobacter pylori(Hp),serological indicators,endoscopic diagnosis and histopathological diagnosis.Each biopsy specimen was scored,and then combined with the antral and gastric atrophy degree according to OLGA、OLGIM stage.The ANOVA and non-parametric tests were used to explore the factors affecting the stage of OLGA、OLGIM.Results:1.From 2015 to 2018,a total of 453 eligible subjects were included,of which 216 were male,ranging in age from 22 to 80 years,with an average age of 52.46±10.30 years.These included 230 atrophy,154 intestinal metaplasia(IM)and 66 dysplasia.Male PGI level is higher than female(P<0.05).2.The accuracy of EFB in 113 patients was 46.9%,including 8.0%,29.2% and 9.7% in LGIN groups,HGIN groups,and ECC groups.Kappa value was 0.175.The underestimation rate of EFB was 41.6% and the overestimation rate was 11.5%.2.Serum pepsin I and pepsin II levels gradually decreased with the degree of atrophy(P<0.01).The levels of serum pepsin I and pepsin II decreasd gradually with the increase of intestinal degeneration(P<0.01).The pepsin ratio was not exactly the same in different groups,among which the severe intestinal metathesis group was significantly lower than that in the mild and moderate group(P<0.01).Age in atrophy,intetinal and intraepithelial neoplasia group(P<0.05).3.Comparing the serological indexes of different OLGA stage patients,the ratio of serum pepsin I and pepsin I in stage IV was significantly lower than that in other stages(P<0.01).Compared with stage 0,stage III pepsin level decreased(P<0.05).Comparing the serological indexes of different OLGIM stages,the level of pepsin I gradually increased with the increase of stage.The pepsin levels of stage II and stage III were significantly lower than that of stage 0 and stage I(PComparing the serological indexes of different OLGIM stages,the level of pepsin I gradually increased with the increase of stage.The pepsin levels of stage II and stage III were significantly lower than that of stage 0 and stage I(P<0.01),stage III and IV pepsin ratio decreased compared with the previous three phases(P<0.05).4.Comparing the effects of HP infection on serum indicators and OLGA/OLGIM stage.The serum PG II and G-17 levels were significantly higher and PG I,PGR levels decreased in the HP positive group compared with those in the HP negative group(P<0.01).In the HP positive group,PG II levels of OLGA III and IV stage were significantly lower than that in loe risk stage(P<0.05).In the HP negative group,the levels of serum PG I in the stage of OLGA II,III and IV were lower than those in the stage of 0 and I(P<0.01).Both in HP positive and negative groups,the PGR of OLGA IV stage decreased compared with the previous three phases(P<0.05).The level of PG I in HP positive group was higher than that in stage 0(P<0.05).Comparing the PG I levels of different OLGIM stages in HP positive group,the PGI in IV phase was lower than that in 0 and I stage(P<0.01).The PG I levels of HP negative group were significantly lower in the latter three phases that in the first two phases(P<0.01).The PG II levels of HP positive group were lower than those of stage 0 and I(P<0.05),PG II level of stage III decreased compared with stage 0 in HP negative group(P<0.01).Both in the HP positive and negative groups,PGR levels of stage IV decreased compared with stage 0,I,II(P<0.05).5.Comparing the effects of age on serum indicators and OLGA stages.In the HP-positive group,although participants had no significant symptoms,OLGA stages increased with age(P<0.05).In the HP-negative group,different ages were not significantly associated with OLGA stage.HP infection rate was highest among people under 50.Serum PGI,PGI and G-17 levels gradually increased with age,but PGR was not affected by age.Conclusions: There were a total of 453 patients,the serum PG I levels of male were higher than female.With the increase of OLGA score,serum PG I,PG II and PGR levels were reduced.The serum PGI,PGII and G-17 levels in HP positive group were higher than those in HP negative group,while PGR levels were lower.Both in the HP positive group and negative group,the levels of serum PG I and PGR decreased in patients with high OLGA stage and high OLGIM stage,and the difference was statistically significant.Serum indicators and OLGA score increased as age increased.Serum levels of PG I,PG II and G-17 also gradually increased with age.