The Ratio of Pepsinogen A to Pepsinogen C: A Sensitive Test for Atrophic Gastritis

Borch, Kurt; Axelsson, C. K.; Halgreen, H; Nielsen, Meta Damkjær; Ledin, Torbjörn; Szesci, P B

doi:10.3109/00365528909089228

Cited by 95 publications

(68 citation statements)

References 23 publications

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“…[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. In summary, we have found that a polymorphism in the PTPN11 gene that encodes SHP-2 increases the risk of gastric atrophy in H. pylori-positive patients.…”

Section: Discussionmentioning

confidence: 88%

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: 88%

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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“…In the previous studies, no cut-off values were demonstrated to be related to serum PG I level and PG I / PG II ratios. In similar studies on this subject, different cut-off values were used, and the sensitivity and specificity were reported to range from 74.3-93% and 68.4-100%, respectively [8,[19][20][21][22]. The current study shows that cut-off values for the serum PG I level <25 ng/ml and the serum PG I / PG II ratio <3.0 would be convenient and meaningful for stomach cancer and atrophic gastritis screening.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Serum Pepsinogen Levels as a Screening Test For Atrophic Gastritis and Gastric Cancer

Agkoc

Dursun

Albayrak

et al. 2010

EAJM

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Objective: The purpose of our study was to research the applicability of measuring serum pepsinogen I (PG I) and PG I/pepsinogen II (PG II) ratios as screening tests for atrophic gastritis, which is the most important predisposition for stomach cancer. Materials and Methods:We measured serum pepsinogen levels in non-specifi c gastritis, atrophic gastritis and gastric cancer using a radioimmunoassay method. We included in this study 30 healthy control, 30 nonspecifi c gastritis, 30 atrophic gastritis and 50 gastric cancer cases. Results:The serum PG I level was statistically higher in the control group and in the patient group with chronic nonspecifi c gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p<0.05). The best cutoff values for diagnosing stomach cancer using serum PG I and PG I / PG II ratios were found to be <25 ng/ml for PG I and <3.0 for PG I / PG II. The same cut-off values were also most eff ective for the patients with atrophic gastritis. Conclusions:Serum pepsinogen screening was shown to be a practical predictor of stomach cancer and atrophic gastritis, the most important predisposing lesion for stomach cancer. Although the diagnosis of stomach cancers localized in the pylorus and cardia via this method is diffi cult, we believe that the detection of early-stage cancers that develop following chronic atrophic gastritis in particular will be possible, and therefore the morbidity and mortality of stomach cancer will be decreased.

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“…At these cut-off values, Kitahara et al (37) reported a sensitivity of 84.6% and specificity of 73.5% in gastric cancer screening. In a study by Borch et al (40), serum PGI level of ≤71.6 µg/l had a sensitivity of 100% and specificity of 86%, while the serum PGI:II ratio of ≤5.5 had a sensitivity of 99% and specificity of 94% in diagnosing fundal CAG. A previous study reported that an accuracy of 83%, sensitivity of 83% and specificity of 95% using different serum PGI and G-17 cut-off values to diagnose CAG depending on the HpAb level (21).…”

Section: Histological Finding ---------------------------------------mentioning

confidence: 99%

Serum pepsinogen and gastrin-17 as potential biomarkers for pre-malignant lesions in the gastric corpus

et al. 2017

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Abstract. There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study. The mean age of the participants was 56.2±16.2 years. Serum PGI:I, PGI:II, G-17 and Helicobacter pylori antibody levels were measured by enzyme-linked immunosorbent assay. Median levels of PGI:I, PGI:II, the PGI:II ratio and G-17 for were 129.9 µg/l, 10.3 µg/l, 14.7 and 4.4 pmol/l, respectively. Subjects with corpus CAG/IM exhibited a significantly lower PGI:II ratio (7.2) compared with the control group (15.7; P<0.001). Histological CAG and IM correlated well with the serum PGI:II ratio (r=-0.417; P<0.001). The cut-off value of the PGI:II ratio of ≤10.0 demonstrated high sensitivity (83.3%), specificity (77.9%) and area under the receiver operating characteristic curve of 0.902 in detecting the two conditions. However, the sensitivity was particularly low at a ratio of ≤3.0. The serum PGI:II ratio is a sensitive and specific marker to diagnose corpus CAG/IM, but at a high cut-off value. This ratio may potentially be used as an outpatient, non-invasive biomarker for detecting corpus CAG/IM.

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The Ratio of Pepsinogen A to Pepsinogen C: A Sensitive Test for Atrophic Gastritis

Cited by 95 publications

References 23 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

Usefulness of Serum Pepsinogen Levels as a Screening Test For Atrophic Gastritis and Gastric Cancer

Serum pepsinogen and gastrin-17 as potential biomarkers for pre-malignant lesions in the gastric corpus

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