Accuracy of GastroPanel for the diagnosis of atrophic gastritis

Abstract

BackgroundIt has been suggested that GastroPanel might be a useful tool for the diagnosis of chronic atrophic gastritis (CAG) measuring four biomarkers in blood: basal gastrin-17 (G17), pepsinogen I and II (PGI and PGII), and Helicobacter pylori antibodies.AimTo determine the accuracy of GastroPanel for the diagnosis of CAG.MethodsThis was a prospective, blinded, multicenter study that included dyspeptic patients. G17, PGI, and PGII were determined by enzyme immunoassays. Three antrum and two corpus biopsies were obtained for standard histological analysis and rapid urease test. Biopsies were analyzed by a single blinded expert pathologist.ResultsNinety-one patients were included (77% women, mean age 44 years, 51% H. pylori positive, 17% with CAG). G17 was reduced in patients with antrum CAG (5.4 vs. 13.4 pmol/l; P<0.01) and increased in patients with corpus CAG (11 vs. 24 pmol/l; P<0.05), but its accuracy was only acceptable in the case of corpus localization [area under the receiver operating characteristic curve (AUC), 74%]; PGII difference was almost statistically significant only when testing for corpus atrophy (33 vs. 21 μg/l; P=0.05; AUC=72%). The PGI and PGI/PGII ratio showed no significant differences (AUCs were all unacceptably low). Helicobacter pylori antibody levels were higher in H. pylori-infected patients (251 vs. 109 EIU, P=0.01; AUC=70). The accuracy of GastroPanel for the diagnosis of CAG was as follows: sensitivity 50%; specificity 80%; positive 25% and negative 92% predictive values; and positive 2.4 and negative 0.6 likelihood ratios.ConclusionGastroPanel is not accurate enough for the diagnosis of CAG; thus, its systematic use in clinical practice cannot be recommended.

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

“…In their study, there were no statistically significant differences in the level of PGs in the groups with and without corpus atrophy. Only in the case of PG II was found a borderline significant difference [30]. Concerning the corpus atrophy, we noted changes in PG II: the mean levels of PG II significantly decreased in these patients in dynamics.…”

Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma

“…In our present study, serologic atrophy was identified in 18.5% of patients, and the rate was similar in both groups. Gastrin-17, another noninvasive serologic marker, has been shown to detect antral atrophy [28–30]. However, the performance of gastrin-17 test alone is not enough to detect atrophy and the test is mostly used with combination of a test-pannel including PGA and PGC [30,31].…”

“…Gastrin-17, another noninvasive serologic marker, has been shown to detect antral atrophy [28–30]. However, the performance of gastrin-17 test alone is not enough to detect atrophy and the test is mostly used with combination of a test-pannel including PGA and PGC [30,31]. Total ghrelin, a recently reported serologic marker, has been previously shown to be related to histological atrophy [32–35].…”

The stomach in health and disease

“…33 Measurement of fasting serum gastrin concentration in combination with the pepsinogen I/II ratio has been proposed as a non-invasive screening tool for detecting chronic atrophic gastritis and is used for this purpose in several regions, but a recent report has questioned the accuracy of this approach. 34 There is, however, strong evidence that gastrin plays a major stimulatory role in the development of both type I and II gastric neuroendocrine tumours (NETs). Type I gastric NETs arise in the setting of autoimmune atrophic gastritis and pernicious anaemia, whereas type II gastric NETs are associated with a gastrinoma, usually in the setting of multiple endocrine neoplasia-1.…”