Prevalence of atrophic gastritis in southwest China and predictive strength of serum gastrin-17: A cross-sectional study (SIGES)

Abstract

A hospital-based cross-sectional study in SIGES project was conducted during 2016.5-2017.5 in West China Hospital. It was aimed to observe the prevalence of atrophic gastritis (AG) in southwest China, and assess the diagnostic strength of serum gastrin-17 (G-17) in predicting AG in Chinese population. Asymptomatic healthy controls from health checkup , cancer-free patients with unspecific upper gastrointestinal symptoms, and histologically proven gastric cancer patients were eligible, if serum pepsinogen-I (PG-I), PG-II, and G-17 were detected. AG status was classified by the accredited cutoffs of PG-I (<70 ug/L) and PG-I/II ratio (<3). Totally, healthy controls (n = 9,425), symptomatic patients (n = 671) and gastric cancer patients (n = 305) were simultaneously observed, in which the prevalence of AG in southwest China were estimated as 15.9/1,000, 28.3/1,000, and 55.7/1,000 persons, respectively. The age-specific prevalence of AG in healthy controls showed a significantly uphill trend (p for trend <0.001). Higher level of serum G-17 was significantly associated with increased risk of AG in healthy population (15-30 pmol/L, aOR = 20.67, 95% CI 9.17-46.55; >30 pmol/L, aOR = 314.41, 95% CI 166.10-595.12). Throughout the progression of stomach diseases, the diagnostic strength of serum G-17 for AG showed a downhill trend across more advanced situations. In despite of that, serum G-17 displayed a good performance in predicting AG in the entire cross-sectional population (AUC = 0.92, 95% CI 0.89-0.94; SEN = 85.5%; SPE = 93.2%; LR+ = 12.55; LR− = 0.11). Population in southwest China had intermediate prevalence of AG, while the prevalence was increased over age or disease progression. High level of serum G-17 might be a reliable non-invasive measurement to predict AG in southwest Chinese population. Atrophic gastritis is a well-established precursor of intestinal-type gastric cancer. The population prevalence of atrophic gastritis generally ranged from 2.1% to 8.2% 1. The presence of atrophic gastritis was associated with the increased risk of gastric cancer during longitudinal observation in both the western and eastern populations 2-4. Therefore, the China Consensus on Early Gastric Cancer Screening, Endoscopic Diagnosis and Treatment (2014) recommended to define patients with atrophic gastritis as a kind of high-risk candidates for gastric cancer screening 5. The European Helicobacter Study Group agreed on the statement "Serologic screening is suitable for clinical use in countries with a relatively low incidence of gastric cancer, because it enables endoscopic follow-up of caseswith an abnormal serologic profile suggesting atrophic gastritis" 6. However, nationwide massive screening programs for gastric cancer were established only in Japan and Korea, but not in China and other nations yet 7,8. Regarding the great health burden from gastric cancer in China 9,10 , particularly the relatively low proportion of early gastric cancer 7,11 , it would be necessary to investigate the relevant screening strategy covering pr...

Association between serum pepsinogen and atherosclerotic cardiovascular disease

“…In the screening of gastrointestinal diseases, PGI 70 ng/mL and PGR 3 was a commonly accepted cutoff [10]. In fact, many studies have defined the thresholds of serum PGs based on the characteristics of the data [24,33,34]. It has been reported that the cutoff value of PGI was 123 ng/mL in the aspirin-induced gastroduodenal injury [24].…”

Protective Effect of Ultraviolet C Irradiation on the Gastric Mucosa of Rats with Chronic Gastritis Induced by Physicochemical Stimulations

“…According to the consensus on chronic gastritis in China published in 2017 [19], the levels of serum PGI, PGII, PGR, and G-17 could be used to accurately distinguish the secretion features, atrophy degrees, and tissue function of gastric mucosa in different areas. us, the measurement of these markers has been recognized as a reliable noninvasive method for diagnosing gastric mucosal diseases in early stages [6,33]. Several previous studies indicated that the levels of PGI and PGR were positively correlated with the severity of corpus gastritis [34][35][36][37], while the level of G-17 decreased with the aggravation of antral inflammation and 8 Evidence-Based Complementary and Alternative Medicine atrophy [38][39][40].…”

“…In addition, disease recurrence after drug withdrawal, antibiotic resistance after long-term medication, and several other side effects complicate the treatment of CG [3][4][5]. Long-term nonatrophic CG is very likely to progress into atrophic CG, which is a recognized precursor of gastric cancer [6].…”

Development and Validation of Nomograms to Predict Operative Link for Gastritis Assessment Any-Stage and Stages III–IV in the Chinese High-Risk Gastric Cancer Population

“…G-17 is a predominant form of antral hormone gastrins in plasma or tissue in antral mucosa, which can regulate gastric acid secretion and gastric mucosa growth. Wang et al reported that elevated serum G-17 level was significantly associated with an increased risk of AG in healthy people ( 29 ). However, the diagnostic ability of serum G-17 level for AG decreased at higher levels during the whole process of gastric disease ( 29 ).…”

“…Wang et al reported that elevated serum G-17 level was significantly associated with an increased risk of AG in healthy people ( 29 ). However, the diagnostic ability of serum G-17 level for AG decreased at higher levels during the whole process of gastric disease ( 29 ). In the present study, there were significant differences in PG I, PG II, PGR, and G-17 among the nonatrophic gastritis, OLGA stages I–II and III–IV subgroups.…”