Diagnostic Accuracy of Gastropanel® for Atrophic Gastritis in Brazilian Subjects and the Effect of Proton Pump Inhibitors

Abstract

BACKGROUND: It has been proposed that the combination of gastrin-17 (G-17), pepsinogens I and II (PGI and PGII), and anti-Helicobacter pylori (H. pylori) antibodies (GastroPanel®, BIOHIT HealthCare, Helsinki, Finland) could serve as biomarkers of atrophic gastritis. OBJECTIVE: This study aimed to ensure the diagnostic accuracy of GastroPanel® and evaluate the effect of proton pump inhibitors (PPIs) on these biomarkers. METHODS: Dyspeptic patients who underwent gastrointestinal endoscopy were enrolled in the present study. Histological findings, which were the gold standard to stratify groups, were as follows: no atrophy (controls); antrum atrophy; corpus atrophy; multifocal atrophy; and neoplasia. G-17, PGI, PGII, and anti-H. pylori immunoglobulin (Ig)G antibodies were assayed using commercially available kits. The ratio of PGI/PGII was calculated. RESULTS: Among 308 patients, 159 (51.6%) were PPI users. The overall prevalence of atrophy was 43.8% (n=135). Ninety-two (29.9%) patients were H. pylori positive according to anti-H. pylori IgG levels. G-17 levels were not low in those with antrum atrophy but were high in those with corpus and multifocal atrophies. PGI levels were significantly lower in those with corpus and multifocal atrophies. The sensitivity of PGI <30 µg/L to detect corpus atrophy was 50% (95% CI 27.8-72.1%), with a specificity of 93.2% (95% CI 84.3-97.5%), a positive likelihood ratio of 7.4 (95% CI 2.9-19.2), and a negative likelihood ratio of 0.5 (95% CI 0.3-0.8). A small number of subjects (n=6) exhibited moderate to intense atrophy (4%), among whom 66.7% exhibited decreased PGI levels. PPI significantly increased the levels of G-17 and PGI, except in those with corpus and multifocal atrophies, in whom PGI levels were not increased by PPIs. CONCLUSION: GastroPanel® (Gastrin-17, PGI, and PGI/PGII ratio) did not demonstrate high sensitivity for detecting gastric atrophy.

Serological Biomarker Panel in Diagnosis of Atrophic Gastritis andHelicobacter pyloriInfection in Gastroscopy Referral Patients: Clinical Validation of the New-Generation GastroPanel®Test

“…The GP literature accumulated until 2016/2017 was covered by two separate meta-analyses (31,41), disclosing pooled sensitivity of 72-75% and pooled specificity close to 95% for the AGC endpoint. Since the appearance of these two meta-analyses, the number of relevant studies and tested patients have almost doubled (42)(43)(44)(45)(46)(47), only few to cite), indicating an increased global interest in this test (23,(25)(26)(27)(28)(29). Before finalizing the GastroPanel ® quick (POC) test, a newgeneration (unified) GastroPanel ® test was introduced, harmonizing the ELISA processing conditions of the 4 biomarkers.…”

Gastrin-17 Levels in Pre-malignancy Gastritis Lesions

“…Gastrin then stimulates the proliferation of gastric mucosal endocrine cells such as parietal cells. 7,8 A total of 40 patients with gastritis were enrolled in this study. Twenty-two were male, with the highest gastritis rate in the age group 50-59 years, but there was no statistical significance.…”

Determining Gastric Cancer-Related Risk Factors in Mongolian Population Using ABC(D) Method: A Matched Case-Control Study

“…Therefore, there is an urgent need to introduce effective screening method to stratify high risk-population to decrease gastric cancer incidence and mortality in this country. In some wealthy countries, such as Japan, South Korea, China, Finland, and Brazil, H. pylori IgG, PGI, and PGI/II ratios have been started to be used as a non-invasive serological evaluation of gastric cancer (Tu et al, 2017;Mattar et al, 2020;Chapelle et al, 2020;Yoshida et al, 2014). Human pepsinogens, which are protein-digestive enzymes secreted as proenzymes by chief cells, are classified into PGI and PGII.…”