Do serum biomarkers correlate to the risk of gastric lesions in patients with autoimmune gastritis༟—A systematic review and meta-analysis

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI:10.1016/j.clinre.2025.102722

Zijin Liu , Yingqi Wang , Jiayi Hong , Fang He , Lijie Hao , Linmin Liu , Huihong Zhai

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引用次数: 0

Abstract

Background & Aims

Current surveillance strategies for autoimmune gastritis (AIG) lack consensus, and the prognostic role of serum biomarkers remains unclear. This meta-analysis aimed to evaluate the correlation between serum biomarkers and the risks of gastric lesions in AIG patients.

Methods

Studies comparing serum biomarkers in AIG patients with versus without neuroendocrine tumor (NET), gastric polyp (GP), or gastric cancer (GC) were identified by searching PubMed, EMBASE, and Cochrane databases (up to March 2025). Basic studies, meta-analyses, reviews, case reports, or studies not published in English were excluded. Two investigators independently extracted data and quality-assessed using the Newcastle–Ottawa and AHRQ scales. Statistical analysis used Review Manager 5.4 and Stata MP18. Heterogeneity and publication bias were evaluated. Sensitivity analysis was used to manage heterogeneity and assess the stability of the result.

Results

Thirteen studies (10 for NET, 4 for GP, and 1 for GC) were included. Elevated serum gastrin correlated significantly with NET (MD: 519.05, 95% CI: 227.96∼810.13, P = 0.0005, I²=85%) and GP (MD: 70.54, 95% CI: 43.59∼97.49, P < 0.00001, I²=0%; weighted mean: 240.02 pg/ml). With a high heterogeneity in the NET group, we arranged sensitivity analysis and removed two studies that caused heterogeneity, the result consistently showed a statistical difference (MD: 196.62, 95% CI: 76.61∼316.64, P = 0.001, I²=22%; weighted mean: 811.53 pg/ml). Publication bias was found neither in NET (Begg’s test: P = 0.1078, Egger’s test: P = 0.3553) nor in GP (Begg’s test: P = 1.0000, Egger’s test: P = 0.4771) groups. Chromogranin A (CgA), vitamin B12, and parietal cell antibody (PCA) showed no consistent associations. For GC, limited data suggested milder gastrin elevation and higher Helicobacter pylori co-infection rates.

Discussion

Serum gastrin is correlated with NET and GP in AIG patients. The weighted mean serum gastrin level was 811.53 pg/ml in AIG patients with NET, and 240.02 pg/ml in those with GP. Non-enrollment of randomized controlled trials (RCTs), inconsistency in laboratory methods for biomarker detection and diagnostic criteria, and different units of biomarkers may cause limitations of the present study.

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血清生物标志物与自身免疫性胃炎患者胃病变风险相关༟-系统评价和荟萃分析

背景与目的：目前自身免疫性胃炎（AIG）的监测策略缺乏共识，血清生物标志物的预后作用仍不清楚。本荟萃分析旨在评估AIG患者血清生物标志物与胃病变风险之间的相关性。方法：通过检索PubMed、EMBASE和Cochrane数据库（截至2025年3月），对伴有神经内分泌肿瘤（NET）、胃息肉（GP）或胃癌（GC）的AIG患者的血清生物标志物进行比较研究（截至2025年3月）。基础研究、荟萃分析、综述、病例报告或非英文发表的研究被排除在外。两名研究者独立提取数据并使用Newcastle-Ottawa和AHRQ量表进行质量评估。统计分析使用Review Manager 5.4和Stata MP18。评估异质性和发表偏倚。敏感性分析用于管理异质性和评估结果的稳定性。结果：纳入13项研究（NET 10项，GP 4项，GC 1项）。血清胃泌素升高与NET （MD: 519.05, 95% CI: 227.96 ~ 810.13， P=0.0005, I2=85%）和GP （MD: 70.54, 95% CI: 43.59 ~ 97.49, P2=0%；加权平均值：240.02 pg/ml）显著相关。由于NET组异质性较高，我们安排了敏感性分析并剔除了两项引起异质性的研究，结果一致显示有统计学差异（MD: 196.62, 95% CI: 76.61 ~ 316.64， P=0.001, I2=22%；加权平均值：811.53 pg/ml）。NET组（Begg检验：P = 0.1078，Egger检验：P = 0.3553）和GP组（Begg检验：P = 1.0000，Egger检验：P = 0.4771）均未发现发表偏倚。嗜铬粒蛋白A （CgA）、维生素B12和壁细胞抗体（PCA）没有一致的相关性。对于GC，有限的数据表明胃泌素轻度升高和幽门螺杆菌合并感染率较高。讨论：血清胃泌素与AIG患者NET和GP相关。AIG合并NET患者加权平均血清胃泌素水平为811.53 pg/ml， GP患者加权平均血清胃泌素水平为240.02 pg/ml。未纳入随机对照试验（RCTs），生物标志物检测和诊断标准的实验室方法不一致，生物标志物单位不同可能导致本研究的局限性。

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.