title: A laboratory score in the diagnosis of autoimmune atrophic gastritis: a prospective study.
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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: *1st Department of Internal Medicine †Clinical Chemistry Laboratory ‡Service of Biometry and Statistics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Miceli
authors.forename: Donatella
authors.initials: D
authors.lastname: Padula
authors.forename: Marco V
authors.initials: MV
authors.lastname: Lenti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gallia
authors.forename: Riccardo
authors.initials: R
authors.lastname: Albertini
authors.forename: Michele
authors.initials: M
authors.lastname: Di Stefano
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Gino R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D053379:Chromogranin A / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D015415:Biomarkers; D053379:Chromogranin A; D005755:Gastrins; D006454:Hemoglobins; D014805:Vitamin B 12