Serum pepsinogens as a screening test of extensive chronic gastritis

Miki, Kazumasa; Ichinose, Masakazu; Shimizu, Akihiro; Huang, Shih-Che; Oka, Hiroshi; Furihata, Chie; Matsushima, Taijiro; Takahashi, Kenji

doi:10.1007/bf02774209

Cited by 271 publications

(266 citation statements)

References 17 publications

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“…However, the pepsinogen method is a well- established surrogate marker of gastric atrophy, particularly for Japanese populations. [41][42][43] We utilized the validated cutoff levels employed routinely in Japan, namely, a PG I level of < 70 ng/ml and a PG I:II ratio of < 3.0. [44][45][46] Thus, we feel confident that the designation of atrophy was accurate and reflected the important histologic entity of corpus atrophy.…”

Section: Discussionmentioning

confidence: 99%

Association between serum pepsinogens and polymorphismof PTPN11 encoding SHP‐2 among Helicobacter pylori seropositive Japanese

Goto

Ando

Yamamoto

et al. 2005

Intl Journal of Cancer

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Helicobacter pylori (H. pylori) plays a crucial role in the development of gastric atrophy and cancer, and cagA‐positive strains, which are universal in Japan, increase the risk of these outcomes substantially. The CagA protein is injected from attached H. pylori into gastric epithelial cells and undergoes Src‐dependent tyrosine phosphorylation and activation of the eukaryotic phosphatase SHP‐2. The CagA/SHP‐2 interactions elicit cellular changes that increase the risk of carcinogenesis. We investigated the association of a frequent single nucleotide polymorphism (SNP; JST057927; G‐to‐A) in the PTPN11 gene that encodes SHP‐2 with gastric atrophy and gastric cancer in Japan. Gastric atrophy was assessed by measuring serum pepsinogen I and II levels. The subjects comprised 454 healthy controls (126 males; mean age, 58.4) and 202 gastric cancer cases (134 males and 68 females; mean age, 66.7). All gastric cancer cases and 250 (55%) controls were H. pylori seropositive; 179 (89%) of the gastric cancer cases had gastric atrophy compared to 137 (55%) of the H. pylori seropositive controls (p < 0.001). Among HP seropositive controls compared to the common PTPN11 G/G genotype, the odds ratio of atrophy was nonsignificantly reduced with the G/A genotype (0.70; 95% CI = 0.39–1.25) and significantly reduced with the A/A genotype (0.09; 95% CI = 0.01–0.72). Lower risk for gastric atrophy had a gene‐dose association with the A allele (p = 0.01, trend test). There was a clear deficiency of the A/A genotype in those with atrophy compared to those without (1 subject in the gastric atrophy group vs. 8 in the group without). Cancer cases differed from controls in frequencies of PTPN11 G/A genotype only because of a higher prevalence of atrophy among the cancer cases. The G/A SNP in the PTPN11 gene appears to be a risk factor for gastric atrophy in subjects infected with cagA‐positive H. pylori. This may explain why only a proportion of CagA‐positive individuals develop gastric atrophy and gastric cancer, even though infection with cagA strains is universal in Asian countries such as Japan. The functional consequences of the G/A polymorphism remain to be elucidated. © 2005 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Association between serum pepsinogens and polymorphismof PTPN11 encoding SHP‐2 among Helicobacter pylori seropositive Japanese

Goto

Ando

Yamamoto

et al. 2005

Intl Journal of Cancer

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“…The degree of gastric mucosal atrophy was endoscopically evaluated using the classification of Kimura and Takemoto, by which gastric mucosal atrophy was divided into six groups (C1, C2, C3, O1, O2, O3) (25). It has been shown that gastric acid secretion in patients with gastric mucosal atrophy decreases successively from C1 to O3 (26). In this study, we defined C1-C2 as mild, C3-O1 as moderate and O2-O3 as severe gastric mucosal atrophy.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

et al. 2015

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Objective Obesity is related to an increased prevalence of reflux esophagitis and gastroesophageal reflux disease symptoms. This study was performed to clarify the influence of gender on time-course changes in the rate of a high BMI and incidence of reflux esophagitis in Japanese subjects. Results A multiple logistic regression analysis showed that a high BMI, milder degree of gastric mucosal atrophy and larger size of diaphragmatic hiatus were significant predictive factors for the presence of reflux esophagitis in both men and women. The number of male subjects with reflux esophagitis and a high BMI increased during the 10-year examination period. In contrast, the number of individuals with reflux esophagitis and a high BMI was not increased among women. For both men and women, the proportions of patients with a large diaphragmatic hiatus and mild gastric mucosal atrophy increased during the 10-year period. Conclusion The prevalence of reflux esophagitis in the female subjects remained constant over 10 years, different from that observed in the men. A lack of change in BMI may be an important factor accounting for the constant prevalence of reflux esophagitis in women.

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“…But, considering the pathophysiology of GA (Miki et al, 1993;Miki et al, 1987), the combination of PgI and PgI/II ratio may reflect a more accurate picture of the mucosal status in the stomach. Therefore, these points should be taken into consideration for conducting gastric cancer screening program in our area as well as other similar population.…”

Section: Discussionmentioning

confidence: 99%

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

Nejadi-Kelarijani

Roshandel²,

Semnani³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Gastric cancer (GC) is the second cause of cancer related death in the world. It may develop by progression from its precancerous condition, called gastric atrophy (GA) due to gastritis. The aim of this study was to evaluate the accuracy of serum levels of pepsinogens (Pg) and gastrin-17 (G17) as non-invasive methods to discriminate GA or GC (GA/GC) patients. Materials and Methods: Subjects referred to gastrointestinal clinics of Golestan province of Iran during 2010 and 2011 were invited to participate. Serum levels of PgI, PgII and G17 were measured using a GastroPanel kit. Based on the pathological examination of endoscopic biopsy samples, subjects were classified into four groups: normal, non-atrophic gastritis, GA, and GC. Receiver operating curve (ROC) analysis was used to determine cut-off values. Indices of validity were calculated for serum markers. Results: Study groups were normal individuals (n=74), non-atrophic gastritis (n=90), GA (n=31) and GC patients (n=30). The best cut-off points for PgI, PgI/II ratio, G17 and HP were 80 μg/L, 10, 6 pmol/L, and 20 EIU, respectively. PgI could differentiate GA/GC with high accuracy (AUC=0.83; 95%CI: 0.76-0.89). The accuracy of a combination of PgI and PgI/II ratio for detecting GA/GC was also relatively high (AUC=0.78; 95%CI: 0.70-0.86). Conclusions: Our findings suggested PgI alone as well as a combination of PgI and PgI/II ratio are valid markers to differentiate GA/GC. Therefore, Pgs may be considered in conducting GC screening programs in high-risk areas.

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Serum pepsinogens as a screening test of extensive chronic gastritis

Cited by 271 publications

References 17 publications

Association between serum pepsinogens and polymorphismof PTPN11 encoding SHP‐2 among Helicobacter pylori seropositive Japanese

Association between serum pepsinogens and polymorphismof PTPN11 encoding SHP‐2 among Helicobacter pylori seropositive Japanese

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

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

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