Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal, healthy stomach

Abstract

AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa: i.e. those with Helicobacter pylori (H pylori) gastritis or atrophic gastritis, who have a high risk of gastric cancer or peptic ulcer diseases. METHODS:Among 162 Japanese outpatients, pepsinogen Ⅰ (Pg Ⅰ) and Ⅱ (Pg Ⅱ) were measured using a conventional Japanese technique, and the European GastroPanel examination (Pg Ⅰ and Pg Ⅱ, gastrin-17 and H pylori antibodies). Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa, H pylori nonatrophic gastritis or atrophic gastritis. RESULTS:Pg Ⅰ and Pg Ⅱ assays with the GastroPanel and the Japanese method showed a highly significant correlation. For methodological reasons, however, serum Pg Ⅰ, but not Pg Ⅱ, was twice as high with the GastroPanel test as with the Japanese test. The biomarker assays revealed that 5% of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies. GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings, the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy, 95% sensitivity and 93% specificity. CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.

Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies

“…Ideally, studies could be designed in such a way that they allow for assessment of international variation as well as temporal trends. Using non-invasive tests (such as serum PG concentrations) [32] for the diagnosis of CAG might greatly enhance possibilities to conduct such studies in population-based (asymptomatic) study samples. In order to further clarify the role of age, gender, socio-demographic factors, diet and lifestyle factors, such as smoking on the incidence of CAG future follow-up studies should address these, as well as the role of any other potential risk factors.…”

Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

“…Several authors from different parts of the world reported on the relationship between the serum levels of PGI and PGII as related to mucosal changes in the stomach, mostly in asymptomatic and/or unknown gastric mucosal lesions (Miki et al, 1989;Kitahara et al, 1999;Varis et al, 2000;Dinis-Ribeiro et al, 2004;Iijima et al, 2009), but another study in our country showed neither PGI nor PGI/PGII ratio were able to select those with precancerous conditions and corpus-predominant gastritis among the first-degree relatives of gastric cancer patients (Haj-Sheykholeslami et al, 2008). In the present study, the PGI, and PGI/II ratio tests were used in a set of patients with very high probability of a positive test in Iran.…”

“…Serum levels of pepsinogen (PG) have been used for decades to diagnose atrophic corpus gastritis non-invasively (Borch et al, 1989;Karnes et al, 1991;Iijima et al, 2009). In particular, in Japan, a country known to have a high prevalence of H pylori infection accompanied by gastric atrophy, the usefulness of the serum test to diagnose gastric atrophy has been extensively investigated, and there has been some success in screening subjects with a high risk of gastric cancer by determining the serum PG and PGI/II ratio (Borch et al, 1989).…”

Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

“…Serum concentrations of PG I were measured using a CLEIA kit (Lumipulse pepsionogen I, Fujirebio Inc, Tokyo, Japan) (Iijima et al 2009b).…”