Serum Pepsinogens as a Predicator of the Topography of Intestinal Metaplasia in Patients with Atrophic Gastritis

Urita, Yoshihisa; Hike, Kazuo; Torii, Naotaka; Kikuchi, Yoshinori; Kanda, Eiko; Sasajima, Masahiko

doi:10.1023/b:ddas.0000030091.92379.91

Cited by 34 publications

(39 citation statements)

References 33 publications

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“…Urita et al reported that the pepsinogen I/pepsinogen II ratio 3 identified gastric atrophy with a sensitively of 71.7% and a specificity of 66.7%. 25 We believe that the pepsinogen data could explain the level of atrophy, to some extent, if added to the model. Past history of DM and drug treatment for DM were considered positive if subjects were diagnosed with DM before and used a diabetic drug at the time of the baseline survey, respectively.…”

Section: Discussionmentioning

confidence: 95%

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

Hidaka¹,

Sasazuki

Goto

et al. 2014

Intl Journal of Cancer

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To date, the association between diabetes mellitus (DM) and gastric cancer has been controversial, including the underlying mechanism. We investigated the association between plasma diabetic biomarkers (insulin, C-peptide, and blood glucose) and gastric cancer risk. In addition, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of b-cell function (HOMA-b) were calculated. A total of 36,745 subjects aged 40-69 years in the Japan Public Health Center-based prospective study (JPHC) who returned the baseline questionnaire and provided blood samples were followed from 1990 to 2004. In the present analysis, 477 cases and 477 matched controls were used. The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) for developing gastric cancer were calculated using conditional logistic regression models. Plasma insulin was positively associated with increased risk of gastric cancer; compared to tertile 1, ORs were 1.69 (95% CI 5 1.11-2.59) and 2.01 (1.19-3.38) for tertiles 2 and 3, respectively (p for trend 5 0.009). In men, Cpeptide was also positively associated with a significant risk; corresponding ORs were 1.42 (0.85-2.38) and 1.91 (1.03-3.54), respectively (p for trend 5 0.04). These findings were confirmed for blood samples from the fasting group (8 hr after a meal). Higher HOMA-IR was also associated with increased risk, whereas no association was observed for blood glucose. Our findings suggest that Japanese population with higher insulin and C-peptide levels derived from insulin resistance have an elevated risk of gastric cancer.Gastric cancer is the second leading cause of death and the fourth most common cancer in the world. 1 Although Helicobacter pylori (H. pylori) infection is well known as a major risk factor for gastric cancer, only some of the people infected with H. pylori will develop gastric cancer. Therefore, other risk factors might affect the association between H. pylori and gastric cancer occurrence.Diabetes mellitus (DM) is associated with many types of cancer, including colorectal, liver, breast, and pancreatic cancer.2 However, the association between DM and gastric cancer remains to be clarified. Some prospective studies reported that DM determined by questionnaire or medical records is positively associated with gastric cancer, 3-6 but others found a null association.7-12 However, DM can be easily misclassified when based on self-report of disease in questionnaire survey or medical records. To overcome this problem, several studies were directly based on diabetic biomarkers, such as hemoglobin A1c (HbA1c) and blood glucose, but the associations were also inconsistent in these prospective studies. [13][14][15][16]

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Section: Discussionmentioning

confidence: 95%

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

Hidaka¹,

Sasazuki

Goto

et al. 2014

Intl Journal of Cancer

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“…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 [22][23][24][25][26] , and there has been some success in screening subjects with a high risk of gastric cancer by determining the serum Pg Ⅰ and Pg Ⅰ/Ⅱ ratio [8,27] . Recently, a European biomarker examination, GastroPanel (Biohit Plc, Helsinki, Finland), which not only assays Pg levels but also measures serum or plasma levels of gastrin-17 (G-17) and H pylori antibodies (HpAb) of both IgG and IgA class from the same sample using the ELISA technique has been validated [28][29][30] .…”

Section: Introductionmentioning

confidence: 99%

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

Iijima¹,

Abe²,

Kikuchi³

et al. 2009

WJG

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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.

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“…They found that low PG I levels and PG I/II ratios were common in subjects with intestinal metaplasia and that a PG I/ II ratio cutoff value of 3.0 yielded a sensitivity of 72% and specificity of 67% as a predictor of intestinal metaplasia. 17 Karita et al investigated the relationship between the H. pylori infection and the progression of gastric mucosal atrophy and showed that atrophy progressed and the incidence of gastric cancer increased as the rate of the annual decline in PG levels increased. 18 From the above, serum PG levels are used as a marker of gastritis, in particular H. pylori-associated gastritis.…”

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confidence: 99%

Correlation of serum pepsinogen with histological atrophy following successful Helicobacter pylori eradication

Kawai

Kawakami

Kataoka

et al. 2006

Aliment Pharmacol Ther

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Serum Pepsinogens as a Predicator of the Topography of Intestinal Metaplasia in Patients with Atrophic Gastritis

Cited by 34 publications

References 33 publications

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

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

Correlation of serum pepsinogen with histological atrophy following successful Helicobacter pylori eradication

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