上海交通大学学报（医学版）2026，Vol.46Issue(8)：1101-1108,8.DOI:10.3969/j.issn.1674-8115.2026.08.010
血清胃泌素和胃蛋白酶原辅助诊断自身免疫性胃炎的临床价值
Clinical value of serum gastrin and pepsinogen in the auxiliary diagnosis of autoimmune gastritis
摘要
Abstract
Objective·To investigate the auxiliary diagnostic value of serum gastrin-17(G-17)and pepsinogen Ⅰ(PG Ⅰ)as biomarkers for autoimmune gastritis(AIG).Methods·A total of 100 patients suspected of AIG based on endoscopic screening were retrospectively enrolled.Clinical data were collected,including laboratory parameters such as parietal cell antibody(PCA)and intrinsic factor antibody(IFA).Based on serum antibody results,patients positive for either PCA or IFA were assigned to the confirmed AIG group(n=82),and those negative for both antibodies were assigned to the suspected AIG group(n=18).Serological parameters,including G-17,PG Ⅰ,PG Ⅱ,and vitamin B12,were compared between the two groups.Multivariable Logistic regression was employed to identify independent predictors of AIG.The diagnostic performance of serological markers and their combinations was assessed using receiver operating characteristic(ROC)curve analysis.Results·Serological analysis revealed significantly higher G-17 levels and significantly lower PG Ⅰlevels,PG Ⅰ/Ⅱ ratio,and vitamin B12 levels in the confirmed AIG group(all P<0.05).Multivariable Logistic analysis identified G-17 as an independent predictor of AIG(OR=1.09,95%CI 1.02 ‒1.16,P=0.009).ROC analysis showed that the combination of G-17>17.84 pmol/L and PG Ⅰ<12.69 ng/mL yielded the best diagnostic performance,with an area under the curve(AUC)of 0.883(95%CI 0.800‒0.967),sensitivity of 79.3%,and specificity of 83.3%.Among patients in the confirmed AIG group,34.1%(28/82)were IFA-positive.Age was identified as an independent predictor of IFA positivity(OR=1.05 ‒ 1.06,P<0.05),with age>55.5 years identified as an important risk threshold.A predictive model incorporating age(>55.5 years),G-17,and PG Ⅰ/Ⅱ ratio showed good predictive performance for IFA positivity,with an AUC of 0.72(95%CI 0.598‒0.835),sensitivity of 67.9%,and specificity of 70.4%.Conclusion·In settings where specific antibody(PCA/IFA)testing is unavailable,the combination of serum G-17 and PG Ⅰ measurements may serve as an effective auxiliary tool for diagnosing AIG.For AIG patients aged>55.5 years,attention to changes in G-17 levels and the PG Ⅰ/Ⅱ ratio may help identify individuals at high risk of IFA positivity.关键词
自身免疫性胃炎/内因子抗体/胃泌素/胃蛋白酶原Key words
autoimmune gastritis(AIG)/intrinsic factor antibody(IFA)/gastrin/pepsinogen(PG)分类
医药卫生引用本文复制引用
万芮铭,和春婕,周迪,施素凡,谢莉梅,张昱..血清胃泌素和胃蛋白酶原辅助诊断自身免疫性胃炎的临床价值[J].上海交通大学学报（医学版）,2026,46(8):1101-1108,8.基金项目
云南省消化系统疾病临床医学中心开放课题(2024YNLCYXZX0119) （2024YNLCYXZX0119）
云南省医学学科带头人项目(D-2024050) （D-2024050）
云南省中青年学术带头人后备人才项目(202205AC160070). Yunnan Provincial Clinical Medicine Center for Digestive System Diseases(2024YNLCYXZX0119) （202205AC160070）
Yunnan Provincial Medical Discipline Leadership Program(D-2024050) （D-2024050）
Yunnan Provincial Program for Young Academic Leaders(202205AC160070). （202205AC160070）
