A laboratory score in the diagnosis of autoimmune atrophic gastritis: a prospective study

J Clin Gastroenterol. 2015 Jan;49(1):e1-5. doi: 10.1097/MCG.0000000000000101.

Abstract

Background: Several biomarkers have been proposed for the diagnosis of autoimmune atrophic gastritis (AAG), but at the present there is no appropriate testing strategy for the disease.

Goals: The aim of this study was to develop and validate a laboratory score able to address the diagnosis of AAG in a general practice setting.

Study: We prospectively evaluated a number of serum biomarkers (vitamin B12, mean corpuscular volume, hemoglobin, gastrin, and chromogranin A levels) in a case-control population and built 2 biochemical scores, the first with all the parameters [Global Score (GS)], and the second as the best statistical combination of them [Simple Score (SS)]. In the second phase we validated the score that proved to be more efficient on a random population referred to our center (Gastroenterology Outpatient Clinic).

Results: Both models turned out to be reliable in detecting patients with suspected AAG, showing excellent accuracy [area under the receiver operating curve (AUC-ROC) 0.94; 95% confidence interval (CI), 0.91-0.97 for GS and AUC-ROC 0.93; 95% CI, 0.89-0.86 for SS]. The SS proved to be more convenient because of its accessibility and availability in a general setting and its low cost. The validation of the SS showed a sensitivity of 85.7% (95% CI, 57.2-98.2) and a specificity of 83.7% (95% CI, 74.2-90.89).

Conclusions: Herein, we describe 2 nonexpensive and reliable score models, particularly the SS, that can be applied in daily medical practice for identifying patients potentially affected by AAG.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / pathology
  • Biomarkers / blood
  • Case-Control Studies
  • Chromogranin A / blood
  • Erythrocyte Indices
  • Female
  • Gastrins / blood
  • Gastritis, Atrophic / blood
  • Gastritis, Atrophic / diagnosis*
  • Gastritis, Atrophic / pathology
  • Hemoglobins / metabolism
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Vitamin B 12 / blood

Substances

  • Biomarkers
  • Chromogranin A
  • Gastrins
  • Hemoglobins
  • Vitamin B 12