Low Serum Levels of Pepsinogen and Gastrin 17 Are Predictive of Extensive Gastric Atrophy with High-Risk of Early Gastric Cancer

Abstract

Atrophic gastritis (AG) is a well-recognized high-risk condition for developing gastric cancer (GC). Gastrin 17 (G17), a hormone secreted from antral G cells, regulates gastric acid secretion, and its serum level is a possible indicator of antral atrophy. Serum pepsinogen is well established as the indicator of AG involving the corpus. Here we investigated whether serum PG and G17 levels would be useful for determining the topographic pattern of AG and estimating the risk of GC. Enrolled were 122 Japanese patients with early GC (114 well-to moderate-differentiated cancers and 8 poorly-differentiated cancers). In addition, 178 subjects without GC were recruited as control from those undergoing endoscopic examination (non-GC group). All subjects were histologically assigned to the following four groups: non-AG, antrum-predominant AG, corpus-predominant AG, and multifocal AG, affecting the antrum and corpus. Serum concentrations of pepsinogen and G17 were determined using ELISA. Multifocal AG was more frequent in the GC group than in the adjusted non-GC group, and had the highest risk of GC (OR 25.1). Serum G17 was significantly decreased with the exacerbation of antral atrophy in the coexistence of corpus atrophy. Serum biomarker profiles showed that the low levels of pepsinogen and G17 could discriminate between multifocal AG and other types of AG, but not with pepsinogen level alone. Serologically defined multifocal AG had the highest cancer risk among other serologically defined AG groups (OR 26.9). In conclusion, the low serum levels of pepsinogen and G17 are predictive of extensive gastric atrophy with high-risk of early GC.

Diagnostic Values of Serum Levels of Pepsinogens and Gastrin-17 for Screening Gastritis and Gastric Cancer in a High Risk Area in Northern Iran

“…So, it has been proposed to find alternative non-invasive methods for early diagnosis or screening of these conditions. Using serum biomarkers has been considered as potential screening method in this regards (Kikuchi et al, 2011). Pepsinogen enzyme (Pg), secreted from the gastric mucosa, has been suggested as a good non-invasive marker for diagnosis of corpus atrophic gastritis (Iijima et al, 2009;Kikuchi et al, 2011).…”

“…Different factors have been proposed in the pathogenesis of GC including helicobacter pylori (HP) infection (Zheng et al, 2014), smoking (Zhong et al, 2012), diet (Lin et al, 2014) and family history (Mansour-Ghanaei et al, 2012). GC may develop by progression from its precancerous condition, called gastric atrophy (GA) (Kikuchi et al, 2011). Subjects with chronic GA are more susceptible to GC (Kikuchi et al, 2011;Vannella et al, 2012).…”

“…GC may develop by progression from its precancerous condition, called gastric atrophy (GA) (Kikuchi et al, 2011). Subjects with chronic GA are more susceptible to GC (Kikuchi et al, 2011;Vannella et al, 2012). So, diagnosis and treatment of this condition has a pivotal role in GC prevention.…”

“…In addition, diagnosis and treatment of GC in early stages is very important in controlling this fatal disease, especially in high-risk areas. Endoscopic examination of the stomach is the method of choice for diagnosis GA and GC (Kikuchi et al, 2011;Rollan et al, 2006). But, it is an expensive and invasive method and…”

Serum Pepsinogens, Gastrin-17 and <i>Helicobacter pylori</i> Antibody in the Residents of Two Cities in China with Distinct Mortality Rates of Gastric Cancer

“…In some previous studies, an increased level of serum G-17 was applied to screen gastric cancer through improving the serological detection of atrophic corpus gastritis (Shiotani et al 2005;Rollan et al 2006;Cao et al 2007). Consequently, the measurement of serum PG in combination with serum G-17 can yield a topographic assessment of atrophic gastritis, potentially serving as a serological risk assessment of gastric cancer (Germaná et al 2005;Cao et al 2007;Kikuchi et al 2011). In order to explore underlying mechanisms of the great difference in mortality of gastric cancer between Changle and Fuan, in this study, we investigated whether or not the risk condition such as the prevalence of atrophic gastritis was different between Changle and Fuan through determination the serological profiles of serum PG I, PG II, G-17 and IgG antibody against H. pylori in the residents from the two cities.…”