Background Screening for chronic atrophic gastritis (CAG) is crucial for the prevention and early detection of gastric cancer. Endoscopy is the main method of CAG diagnosis, with high training requirements and limited accuracy, making it difficult to popularize. The study attempts to improve the positive rate and accuracy of CAG screening through non-invasive testing. Methods A total of 2564 patients who underwent gastroscopy were included in this study. The results of gastroscopic evaluation, histological biopsy results (including H. pylori biopsy), urea breath test (UBT) results, serum pepsinogen, and testosterone were statistically analyzed. Results We found significant differences in the diagnosis of CAG between endoscopy and histological biopsy. Pepsinogen II and pepsinogen I/II ratio were more useful for the diagnosis of CAG compared with pepsinogen I. The risk of CAG was increased when pepsinogen II exceeded 11.05 μg/L, and the pepsinogen I/II ratio was less than 3.75. CAG positivity was higher in patients with positive H. pylori infection on UBT screening. In addition, higher levels of testosterone, SHBG and HSD17B2, and lower level of GNRH1 were found in CAG mucosa. Patients with high serum testosterone had a higher risk of CAG. Conclusion CAG screening should be combined with endoscopic evaluation, biopsy, and other non-invasive tests. Non-invasive tests include the combination of serum pepsinogen II protein and pepsinogen I/II ratio and high level of serum testosterone. UBT combined with serum pepsinogen testing may improve the positive rate of CAG and reduce gastric mucosal damage from multiple biopsies.

中文翻译：

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慢性萎缩性胃炎高危因素分析[J].

背景 慢性萎缩性胃炎 (CAG) 筛查对于胃癌的预防和早期发现至关重要。内镜是CAG诊断的主要方法，培训要求高，准确性有限，难以普及。该研究试图通过无创检测来提高CAG筛查的阳性率和准确性。方法 共纳入2564例接受胃镜检查的患者。对胃镜检查结果、组织学活检结果（包括幽门螺杆菌活检）、尿素呼气试验（UBT）结果、血清胃蛋白酶原、睾酮进行统计分析。结果 我们发现内窥镜检查和组织学活检对 CAG 的诊断存在显着差异。与胃蛋白酶原I相比，胃蛋白酶原II和胃蛋白酶原I/II比值对CAG的诊断更有用。当胃蛋白酶原II超过11.05μg/L，胃蛋白酶原I/II比值小于3.75时，CAG的风险增加。UBT 筛查中幽门螺杆菌感染呈阳性的患者 CAG 阳性率更高。此外，在 CAG 粘膜中发现较高水平的睾酮、SHBG 和 HSD17B2，以及较低水平的 GNRH1。血清睾酮水平高的患者患 CAG 的风险更高。结论 CAG筛查应与内镜评估、活检等无创检查相结合。非侵入性测试包括血清胃蛋白酶原 II 蛋白和胃蛋白酶原 I/II 比率的组合以及高水平的血清睾酮。