Clinical study of serum gastric function and gastric neuroendocrine tumor in patients with chronic atrophic gastritis

Objective To observe and analyze serum gastric function indexes pepsinogen (PG) Ⅰ, PG Ⅱ, pepsinogen Ⅰ to pepsinogen Ⅱ ratio (PGR), gastrin-17 (G-17), atrophy range evaluation classification results and the detection rate of type 1 gastric neuroendocrine tumor (G-NET) in patients with chronic atrophic gastritis (CAG).

Methods Data of 95 high-risk patients with gastric cancer were retrospectively analyzed, 44 patients with chronic non-atrophic gastritis were included in chronic non-atrophic gastritis group, and 51 patients with CAG were divided into distal CAG group (n=30) and extensive CAG group (n=21) according to the atrophic range assessment results (endoscopy and histopathological findings). Baseline data, serum gastric function index levels, Helicobacter pylori (Hp) infection rate and detection rate of patients with type 1 G-NET in three groups were compared.

Results The serum PGⅠ levels of the distal CAG group and the extensive CAG group were lower than those of the chronic non-atrophic gastritis group, and the serum PGⅠ level of the extensive CAG group was lower than that of the distal CAG group (P < 0.001). In the extensive atrophic gastritis group, the serum PGⅠ level was significantly decreased, while the serum G-17 level was increased compared with the non-atrophic gastritis group and the distal atrophic gastritis group (P < 0.001). There was no significant difference in serum PGⅡ level among the three groups (P > 0.05). The detection rate of type 1 G-NET in the extensive CAG group was 14.29%(3/21), which was higher than 0% in the chronic non-atrophic gastritis group and the distal CAG group (P < 0.05).

Conclusion Serum PG combined with G-17 has significant diagnostic value for CAG. Patients with increase of G-17 accompanying by significant decrease in serum PGⅠ and PGR indicate that they occur extensive CAG mainly characterized by gastric atrophy. Patients with extensive CAG have a higher risk of developing type 1 G-NET, and the atrophy area should be evaluated during gastroscopy to improve the detection rate of type 1 G-NET.