Low serum pepsinogen I and pepsinogen I/II ratio and Helicobacter pylori infection are associated with increased risk of gastric cancer: 14‐year follow up result in a rural Chinese community

Zhang, Xianghong; Xue, Liang; Xing, Lingxiao; Wang, Junling; Cui, Jinfeng; Mi, Jianmin; Xing, Xin; Wang, Juan; Du, Zhanjun; Misumi, Jyuji; Tian, Qing‐Bao; Wang, Liqin

doi:10.1002/ijc.26172

Cited by 41 publications

(51 citation statements)

References 27 publications

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“…When we deleted data of patients treated with PPI/H2RA, mean PG I level and PG I/II ratio in H. pylori -negatives were 318.6 ± 241.6 and 9.5 ± 4.3 ng/mL, which were significantly higher than those in H. pylori -positives (212.8 ± 197.9 [ p = 0.004] and 10.5 ± 3.8 ng/mL [ p < 0.001], respectively; Table 1). These values were higher than those generally reported in subjects with normal renal function (estimated glomerular filtration rate >60 mL/min/1.73 m 2 ) [23,24,25,26]. …”

Section: Resultsmentioning

confidence: 48%

Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients

Sugimoto

Sahara²,

Ichikawa³

et al. 2017

Digestion

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Introduction:Helicobacter pylori (H. pylori) infection is one of the major risk factors for gastrointestinal morbidity in hemodialysis patients. Primary end point is to investigate H. pylori infection rate in hemodialysis patients. As secondary end point, we clarified whether pepsinogen (PG) level was related with H. pylori infection status in hemodialysis patients. Methods: Serum levels of PG I, II, and anti-H. pylori IgG antibody were assessed in 500 Japanese hemodialysis patients. Results:H. pylori infection rate was 15.0% (75/500; 95% CI 12.0-18.4). The duration of hemodialysis in H. pylori-positives was 4.6 ± 3.8 years, which was significantly shorter than in H. pylori-negatives (7.3 ± 6.9, p = 0.001). PG I levels positively correlated with the PG II level and PG I/II ratio (|R| = 0.661, p < 0.001, and |R| = 0.544, p <0.001, respectively). Using a cutoff value of 7.75, the sensitivity and specificity of PG I/II ratio for predicting H. pylori-negatives were 86.3 and 87.8%, respectively (area under the curve 0.930). Conclusions: In hemodialysis patients, infection rate with H. pylori was <20%, with lower rates in patients receiving hemodialysis for longer terms. A PG I/II ratio with a cutoff value of 7.75 may be useful for screening for H. pylori status.

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Section: Resultsmentioning

confidence: 48%

Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients

Sugimoto

Sahara²,

Ichikawa³

et al. 2017

Digestion

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“…Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) [3][4][5] and upper gastrointestinal endoscopy (UGI-ES) [6][7][8] are the typical measures belonging to the former group, whereas serum markers including anti-Helicobacter pylori (H. pylori) IgG, pepsinogens, gastrin-17, methylation status of several genes, etc. [9][10][11][12][13][14] are representative measures affiliated with the latter group.…”

Section: Introductionmentioning

confidence: 44%

Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis

et al. 2015

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Background Upper gastrointestinal endoscopy (UGI-ES) and double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) are two major image-based methods to diagnose atrophic gastritis, which is mostly induced by Helicobacter pylori infection. However, there have been few studies directly comparing them. Methods Atrophic gastritis was evaluated using the data of 962 healthy subjects who underwent UGI-ES and UGI-XR within 1 year. Results and conclusion Based on UGI-ES and UGI-XR, 602 subjects did not have atrophic gastritis and 254 subjects did have it. Considering UGI-ES-based atrophic gastritis as the standard, sensitivity and specificity of UGI-XR-based atrophic gastritis were 92.0 % (254/276) and 92.8 % (602/649), respectively. The seven-grade KimuraTakemoto classification of UGI-ES-based atrophic gastritis showed a strong and significant association with the fourgrade UGI-XR-based atrophic gastritis. Sensitivity and specificity of serum anti-Helicobacter pylori IgG to detect UGI-ES/UGI-XR-based atrophic gastritis were 89.4 % (227/254) and 99.8 % (601/602), indicating that atrophic gastritis can be overlooked according to serum anti-Helicobacter pylori IgG alone.Keywords Atrophic gastritis Á Helicobacter pylori Á Upper gastrointestinal endoscopy (UGI-ES) Á DoubleElectronic supplementary material The online version of this article

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“…However, several cohort studies with follow-up up to 14 years showed promising results [149,[155][156][157]. Although serum PG assessment shows good diagnostic properties for the detection of gastric mucosal atrophy (sensitivity 74.4%, 95% CI 62.0-84.3; specificity 95.6%, 95% CI in 92.6-97.4) in a recent meta-analysis, this strategy cannot yet be recommended for countries with low incidence of gastric cancer [158].…”

Section: Secondary Preventionsupporting

confidence: 41%

The Rationale and Efficacy of Primary and Secondary Prevention in Adenocarcinomas of the Upper Gastrointestinal Tract

Bornschein

Bird‐Lieberman

Malfertheiner

2019

Dig Dis

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While the primary risk factor for oesophageal adenocarcinoma (OAC) and its precursor lesion Barrett’s oesophagus (BO) is gastro-oesophageal reflux, the infection with Helicobacter pylori (H. pylori) is the dominant risk factor for gastric cancer. Reduction of reflux by dietary measures and proton pump inhibitors has some merits in OAC prevention, and the chemopreventive effect of Aspirin and statins is being widely investigated; however, improved outcome in OAC occurs primarily as the result of secondary prevention. Early detection of neoplastic lesions in Barrett’s metaplasia can be achieved by surveillance endoscopies. Novel endoscopic imaging modalities carry similar importance as the endoscopic treatment techniques as without detection of early lesions, therapy cannot be applied. Minimally invasive approaches are currently being investigated to identify patients with BO who are at particular risk of neoplastic progression. While dietary factors also play an important role in the prevention of gastric cancer and chemoprevention seems to be promising, the most beneficial effect has been shown for the eradication of H. pylori infection, which results in at least a one third reduction of gastric cancer risk. This effect can be further improved if the eradication takes place prior to the development of pre-neoplastic gastric conditions such as mucosal atrophy or intestinal metaplasia (IM). The definition of the “point of no return”, after which eradication is less effective, is of high importance, although H. pylori eradication can still be beneficial even at more advance stages of mucosal changes. For this reason, patients with advanced atrophy and IM should undergo endoscopic surveillance in the same way as patients with BO. There is also need for development of non-invasive tests to identify patients at high risk of progression to gastric cancer to improve outcome of these surveillance approaches.

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Low serum pepsinogen I and pepsinogen I/II ratio and Helicobacter pylori infection are associated with increased risk of gastric cancer: 14‐year follow up result in a rural Chinese community

Cited by 41 publications

References 27 publications

Natural Course of <b><i>Helicobacter pylori</i></b> Infection in Japanese Hemodialysis Patients

Natural Course of <b><i>Helicobacter pylori</i></b> Infection in Japanese Hemodialysis Patients

Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis

The Rationale and Efficacy of Primary and Secondary Prevention in Adenocarcinomas of the Upper Gastrointestinal Tract

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