Clinical Utility of Serum Pepsinogen Levels as a Screening Test of Atrophic Gastritis.
10.3343/kjlm.2008.28.3.201
- Author:
Hyojin CHAE
1
;
Je Hoon LEE
;
Jihyang LIM
;
Myungshin KIM
;
Yonggoo KIM
;
Kyungja HAN
;
Chang Suk KANG
;
Sang In SHIM
;
Jin Il KIM
;
Soo Heon PARK
Author Information
1. Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ljh117@catholic.ac.kr
- Publication Type:Original Article ; English Abstract ; Evaluation Studies
- Keywords:
Atrophic gastritis;
Pepsinogen;
Pepsinogen I/II ratio;
Gastric cancer
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Female;
Gastritis, Atrophic/*diagnosis;
Helicobacter Infections/diagnosis;
Helicobacter pylori;
Humans;
Male;
Middle Aged;
Nephelometry and Turbidimetry;
Pepsinogen A/*blood;
Pepsinogen C/*blood;
ROC Curve;
Reagent Kits, Diagnostic;
Sensitivity and Specificity
- From:The Korean Journal of Laboratory Medicine
2008;28(3):201-206
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Atrophic gastritis is a well known risk factor for gastric adenocarcinoma. Its confirmatory diagnosis requires histology via endoscopy, which is an invasive method; therefore, periodic follow up evaluation as a screening method is difficult to perform. We evaluated the clinical utility of serum pepsinogens (PG) as a biomarker for screening of atrophic gastritis. METHODS: The study population consisted of 130 selected dyspeptic patients (M:F=52:78; age, 16-105 yrs; mean age, 50.8 yrs) who had undergone a diagnostic endoscopy. The serum pepsinogen test was performed by a latex turbidimetric immunoassay method (HBI, Korea) using Toshiba-200FR automatic analyzer. The PGI, II level and PGI:PGII ratio of non-atrophic gastritis group were compared with those of atrophic gastritis group, and a correlation with Helicobacter pylori infection was examined. Cut-off points for screening of atrophic gastritis were determined. RESULTS: The mean serum concentration of PGI showed a decline from normal (60.7 ng/mL), nonatrophic gastritis (54.2 ng/mL), and atrophic gastritis (51.8 ng/mL) to gastric adenocarcinoma (32.6 ng/mL). The mean ratio of PGI:PGII was lower in atrophic gastritis (3.2) compared to non-atrophic gastritis (4.7) (P=0.021). In patients with H. pylori infection, the mean serum PGII level was higher and the PGI:PGII ratio was lower than those in patients without H. pylori infection, and the differences were statistically significant. For screening of atrophic gastritis, the best cut-off point of PGI:PGII ratio was 4, with a sensitivity of 82.6% and specificity of 91.7%. CONCLUSIONS: The serum pepsinogen test is a useful biomarker for screening of atrophic gastritis, a well-known precancerous lesion of gastric adenocarcinoma. Measuring both pepsinogen I and II concentrations simultaneously to obtain pepsinogen I/II ratio provides a clinically useful information for the detection of atrophic gastritis.
