The Serological Gastric Biopsy: a Non-Endoscopical Diagnostic Approach in Management of the Dyspeptic Patient Significance for Primary Care Based on a Survey of the Literature

Korstanje, A; Hartog, G. den; Biemond, I.; Lamers, C. B. H. W.

doi:10.1080/003655202320621418

Cited by 48 publications

(49 citation statements)

References 12 publications

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“…Serum PG is a well-known indicator and "serological biopsy" of corpus mucosa [21,22] . A cascade of mucosal lesions, from chronic g astritis, atrophy, intestinal metaplasia, to dysplasia has been consistently identified, at least for Lauren's intestinal subtype of GC [23] .…”

Section: Discussionmentioning

confidence: 99%

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Sun¹

2007

WJG

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AIM:To explore the essential characteristics of serum pepsinogen (PG) levels in Chinese people, by analyzing the population-based data on the serum levels of PG Ⅰ and Ⅱ and the PGⅠ/Ⅱ ratio, and their influencing factors in Chinese from North China. METHODS:A total of 6990 subjects, who underwent a gastric cancer screening in North China from 1997 to 2002, were collected in this study. Serum pepsinogen levels were measured by enzyme-linked immunosorbent assay (ELISA). H pylori status was determined by histological examination and H pylori -IgG ELISA. The cut-off point was calculated by using receiving operator characteristics (ROC) curves. Factors linked to serum PG Ⅰ/Ⅱ ratio were identified using a multivariate logistic regression. RESULTS:The serum PGⅠ and PGⅡ levels were significantly higher in males than in females (95.2 μg/L vs 79.7 μg/L, P < 0.01; 12.1 μg/L vs 9.4 μg/L, P < 0.01), PGⅠ/Ⅱ ratio was significantly lower in males than in females (7.9 vs 8.3, P < 0.01). The PG Ⅰ/Ⅱ ratio decreased significantly in the aged groups following the progression of gastric mucosa from normal to non-atrophic and atrophic lesions (10.4, 8.8, and 6.6, respectively). The serum PGⅠand Ⅱ levels were significantly higher in patients with H pylori infection than in those without H pylori infection (88.7 μg/L vs 81.4 μg/L, P < 0.01; 11.4 μg/L vs 8.4 μg/L, P < 0.01), while the PGⅠ/Ⅱ ratio was significantly lower in patients with H pylori infection than in those without H pylori infection (7.7 vs 9.6, P < 0.01). For patients with atrophic lesions, the area under the PGⅠ/Ⅱ ROC curve was 0.622. The best cut-off point for PGⅠ/Ⅱ was 6.9, with a sensitivity of 53.2%, and a specificity of 67.5%. Factors linked to PG Ⅰ/Ⅱ were sensitive to identified PG using a multinomial logistic regression relying on the following inputs: males (OR: 1.151, 95% CI: 1.042-1.272, P = 0.006), age ≥ 61 years (OR: 1.358, 95% CI: 1.188-1.553, P = 0.000), atrophic lesion (OR: 2.075, 95% CI: 1.870-2.302, P = 0.000), and H pylori infection (OR: 1.546, 95% CI: 1.368-1.748, P = 0.000). CONCLUSION:The essential characteristics of serum PG levels in Chinese are significantly skewed from the normal distribution, and influenced by age, sex, gastric mucosa lesions and H pylori infection. PGⅠ/Ⅱ ratio is more suitable for identifying subgroups with different influence factors compared with PGⅠor PGⅡ alone.

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Section: Discussionmentioning

confidence: 99%

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Sun¹

2007

WJG

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“…In the present study, we measured plasma ghrelin concentrations in patients with various upper gastrointestinal disorders, with special reference to H. pylori infection. In addition, we assessed the relationship between ghrelin concentrations and circulating levels of pepsinogen I, pepsinogen II, and gastrin, which were considered as biomarkers for precancerous lesions, especially chronic atrophic gastritis, and peptic ulcer (12,13).…”

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confidence: 99%

Circulating Ghrelin Levels in Patients with Various Upper Gastrointestinal Diseases

et al. 2005

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The stomach is the main source of circulating ghrelin. Plasma concentrations of this hormone in patients with various upper gastrointestinal diseases remain undetermined. Thus we measured plasma ghrelin levels by radioimmunoassay in 225 subjects, including 134 Helicobacter pylori-infected and 91 uninfected subjects. They included 67 patients with chronic gastritis (CG), 26 with benign gastric polyp (BGP), 24 with gastric ulcer (GU), 24 with reflux esophagitis (RE), 18 with duodenal ulcer (DU), 28 with acute gastritis (AG), 23 with gastric cancer (GC), and 39 who had normal mucosa on upper endoscopy (N). Plasma pepsinogen I and II levels were also measured. The extent of gastritis was assessed endoscopically. Ghrelin levels differed significantly among the different disease groups. Plasma ghrelin concentrations were lowest in the CG group, followed by the GU group, and highest in the AG patients. There was a significant difference in the levels between differentiated and undifferentiated GC. Ghrelin concentrations in BGP, RE, and DU patients were comparable to those in the N group. Ghrelin circulating levels were lower in H. pylori-positive than -negative individuals, but the significant differences among disease groups were still observed in H. pylori-infected and uninfected populations. Ghrelin concentrations correlated positively with plasma pepsinogen I levels and I/II ratios and inversely with the extent of H. pylori-related gastritis. Plasma ghrelin levels varied widely in diverse conditions of the upper digestive tract, reflecting the inflammatory and atrophic events of the background gastric mucosa. Further investigation is warranted to unravel the mechanisms of the high circulating ghrelin levels in certain upper gastrointestinal diseases.

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“…Two months after treatment, a 13 C-UBT was performed in 128 of 157 H. pylori-positive patients; the remaining 29 patients underwent upper gastrointestinal endoscopy with biopsies (two in antrum and two in corpus), as described above. 13 C-UBT-tested patients with ¢C13 values lower than 5% were considered successfully cured, while those with ¢C13 values higher than 10% were considered failures.…”

Section: Spgii Levels and Eradication Therapymentioning

confidence: 99%

“…Furthermore, sPGI and sPGII levels dramatically decrease after eradication therapy, even in hemodialyzed patients [9][10][11]. Indeed, sPGI and/or the sPGI:sPGII ratio are now considered to be serological markers of atrophic body gastritis [12][13][14]. sPGII levels alone demonstrate a less dramatic drop in association with atrophic gastritis since pepsinogen II is also produced in different areas of the stomach and by metaplastic pyloric glands.…”

Section: Introductionmentioning

confidence: 99%

“…These methods are very expensive and in most cases there is no evidence of relevant gastroduodenal diseases. As such, non-invasive methods such as serology (IgG), 13 C-urea breath test ( 13 C-UBT) and H. pylori stool antigen (HpSA) methods [18,19] are being studied and their limits defined. Serology only gives evidence of a previous contact with H. pylori but does not necessarily indicate a current infection, a finding recently confirmed in a study by Megraud et al [20].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Usefulness of Serum Pepsinogen II in the Management of <i>Helicobacter pylori</i> Infection

et al. 2004

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Background: Serum pepsinogen II (sPGII) levels are known to increase during Helicobacter pylori infection. Aim: To assess H. pylori infection and success of H. pylori therapy by means of sPGII levels. Methods: sPGII levels were determined in 156 H. pylori-positive and 157 H. pylori-negative consecutive patients with dyspeptic symptoms. Additionally, sPGII determination was performed in 70 H. pylori-positive patients 2 months after H. pylori eradication therapy. In 29 of these 70 patients, gastroscopy was performed to evaluate the effect of H. pylori therapy on gastric activity. Results:H. pylori-positive subjects demonstrated a significantly higher mean of sPGII levels than H. pylori-negative subjects (16.8 ± 7.4 vs. 8.6 ± 3.7 µg/l; p < 0.001). The best sPGII cut-off for predicting H. pylori infection was 9.93 µg/l (sensitivity 83%, specificity 73%). The best cut-off values to evaluate success of therapy were: sPGII of 9.47 µg/l, a sPGII variation level (difference between baseline and after therapy) of 4.54 µg/l, and a sPGII Δvalue (sPGII variation divided by sPGII before therapy) of 25% (sensitivity 93%, specificity 91%). Conclusions: sPGII levels may be used as a reliable marker of H. pylori infection in the initial diagnosis as well as to evaluate H. pylori eradication and subsequent changes in gastric inflammation.

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The Serological Gastric Biopsy: a Non-Endoscopical Diagnostic Approach in Management of the Dyspeptic Patient Significance for Primary Care Based on a Survey of the Literature

Cited by 48 publications

References 12 publications

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Circulating Ghrelin Levels in Patients with Various Upper Gastrointestinal Diseases

Clinical Usefulness of Serum Pepsinogen II in the Management of <i>Helicobacter pylori</i> Infection

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