Correlation Of OLGIM Stage Of Chronic Gastritis And Gastric Mucosal Serology,Carcinoembryonic Antigen And Helicobacter Pylori Infection

Objective To explore the correlation between operative link on gastric intestinal metaplasia assessment（OLGIM）stage of chronic gastritis and gastric mucosal serology,carcinoembryonic antigen（CEA）and Helicobacter pylori（Hp）infection.To analyze the risk factors of chronic gastritis OLGIM stages III～IV,and to seek appropriate serological indicators and optimal cut-off values for the diagnosis of chronic gastritis of OLGIM stage III～IV.Methods Collect patients undergoing physical examination as well as gastroscopy at the Health Management Center of Provincial Hospital affiliated to Anhui Medical University from May 2015 to December 2017,then gather demographic information of each individual.Assays for serum pepsinogen（PG）,gastrin-17（G-17）,CEA detection and Hp-urea breath test（Hp-UBT）were performed,and the PGI/PGII ratio（PGR）was calculated.Analyze the differences in serological detection and Hp infection rate among patients of different genders and ages,and find out the effect of Hp infection status on serological indicators,and then compare the differences in serological detection,Hp infection and demographic information of patients with different OLGIM stages.Explore the correlation of OLGIM stage with gastric mucosal serology,CEA and Hp infection.Logistic regression model was constructed to analyze the risk factors of chronic gastritis OLGIM stage III～IV.According to different Hp infection status,receiver operating characteristics（ROC）curve was plotted to analyze the optimal cut-off value of PGR level for the diagnosis of chronic gastritis OLGIM stage III～IV.Results 1)1112 patients in all were included in this study,aged 18-78 years（47.52±9.91 years）,with 554 males（49.82%）and 558 females（50.18%）.The levels of serum PGI（P<0.001）,PGR（P=0.004）,G-17（P=0.011）,and CEA（P<0.001）of male individuals were higher than those of female ones,and the positive rate of Hp infection was lower than that of female ones（46.03% vs 52.15%,P=0.041）.2)The levels of serum PGI（P=0.004）,PGII（P<0.001）,G-17（P=0.002）,CEA（P<0.001）and Hp infection rate（P=0.018）in different age groups were statistically different significance.With the increase of patient ages,the levels of serum PGI,PGII,G-17,and CEA gradually increased,while PGR decreased.3)The Hp infection rate of the included patients was 49.10%（546/1112）.Compared with Hp infection-negative patients,the levels of serum PGI,PGII and G-17 of Hp infection-positive individuals were significantly higher,while PGR was lower（P all<0.001）.4)With the increase of OLGIM stages,the levels of serum PGII（P<0.001）and G-17（P<0.001）increased,while PGR（P<0.001）decreased.The higher the OLGIM stages was,the higher the ages（P<0.001）,the Hp infection rate（P=0.008）and family history of gastrointestinal tumors（P=0.048）were.Serum PGII（r=0.078,P=0.013）and CEA（r=0.067,P=0.032）were positively correlated with OLGIM stages and PGR was negatively correlated with OLGIM stages（r=-0.114,P<0.001）.The distribution of OLGIM stages in different age groups were different,and the proportion of patients with OLGIM stage III～IV in higher age groups is significantly higher.5)The risk factors of chronic gastritis OLGIM stage III～IV are age（P<0.001）,serum PGII（P<0.001）,PGR（P<0.001）,G-17（P<0.001）,Hp infection（P=0.020）and family history of gastrointestinal tumors（P=0.008）.Besides,low PGR（P=0.001;OR: 0.837;95%CI: 0.754-0.928）and advanced age（P=0.035;OR: 1.032;95%CI: 1.002-1.063）were independent risk factors of chronic gastritis OLGIM stage III～IV.6)For Hp infection-negative patients,Hp infection-positive patients and all patients,the optimal cut-off values of PGR for the diagnosis of chronic gastritis OLGIM stage III～IV were 9.64（sensitivity 64.7%,specificity 83.7%）,6.675（sensitivity 76.0%,Specificity 59.6%）and 8.065（sensitivity 73.81%,specificity 69.37%）.Conclusions Serum PG and G-17 are affected by various factors such as age,gender and Hp infection.The OLGIM stage of chronic gastritis is positively correlated with serum PGII and CEA levels,and negatively correlated with PGR.Low PGR and advanced age are independent risk factors of OLGIM stage III～IV of chronic gastritis.PGR can be used as a good serological index for screening OLGIM stage III～IV of chronic gastritis,and different optimal cut-off values should be used for PGR in patients with chronic gastritis according to different Hp infection status.