No abstract available.
Humans ; Pepsinogen A*

No abstract available.
Duodenal Ulcer* ; Pepsinogen A*

In addition to barium swallow, the health screening center of our hospital has started meansuring serum pepsinogen (PG) levels in the stomach cancer screening tests since 1998 if patients wish to receive the PG test. During the past five years, 94 gastric cancer cases were detected by both methods. The average detection ratio worked out at 79.8% for the barium method and 71.3% for the PG method. Of the 94 cases, 51.1% tested positive by both methods. The positivity ratio was 28.7% for the barium method alone and 20.2% for the pepsinogen method alone. In other words, it follows that nearly half of the cancer cases have been picked out by either of the two techniques. Therefore, it could be said that the two methods serve as complementary one to the other. Thus, it was confirmed that using the PG method together with the barium method is worthwhile.The hitting ratio of positive reaction was high in patients at level 2 and upward when checked according to PG levels, and in patients whose initial test results were negative and later shifted to level 2 or level 4 with the lapse of time. These findings suggest that it is feasible to presupposed a group of people at higher risk for developing gastric cancer.
Phosphatidylglycerols ; Pepsinogen A ; Stomach Cancer ; Serum ; Barium

OBJECTIVETo investigate the changes in serum pepsinogen (PG) I/II ratio induced by Helicobacter pylori (Hp) infection and assess the value of PG I/II test in evaluating organ damages in hypertensive patients.

METHODSThe serum total cholesterol, triglycerides, high density lipoprotein (HDL) and PG I/II ratio were tested in 288 hypertensive patients with or without Hp infection. The PG I/II ratio between the patients with different grade of hypertension, patients with and without hypertensive nephropathy, patients with and without hypertensive retinopathy. The relationship of PG I/II ratio with serum total cholesterol, triglycerides and HDL was analyzed with Pearson's correlation analysis and the effectiveness of PG I/II ratio in the the diagnosis of nephropathy and retinopathy was evaluated by receiver-operating characteristic curve (ROC) analysis.

RESULTSCompared with patients without Hp infection, the Hp-infected patients showed significantly decreased PG I/II ratio and increased total cholesterol and triglycerides (P<0.05), but their HDL levels, systolic pressure and diastolic pressure were comparable (P>0.05). PG I/II ratio was significantly decreased in patients with nephropathy and retinopathy compared with the patients without nephropathy and retinopathy (P<0.05), and was similar between patients with different grades of hypertension (P>0.05). PG I/II ratio was negatively correlated with serum total cholesterol and triglycerides in the hypertensive patients (P<0.05), and its area under curve (AUC) of ROC was 0.79 and 0.82 in the diagnosis of nephropathy and retinopathy, respectively.

CONCLUSIONSHypertensive patients with nephropathy and retinopathy have obviously decreased PG I/II ratio, which can be used for screening organ damages in hypertensive patients.

Helicobacter Infections ; blood ; Helicobacter pylori ; Humans ; Hypertension ; blood ; microbiology ; Pepsinogen A ; blood ; Pepsinogen C ; blood

Endoscopic findings of the background gastric mucosa are important in the Helicobacter pylori-seroprevalent population. It is strongly correlated not only with the risk of gastric cancer, but also with the excretion ability of gastric mucosa cells. In noninfected subjects, common endoscopic findings are regular arrangement of collecting venules, chronic superficial gastritis, and erosive gastritis. In cases of active H. pylori infection, nodularity on the antrum, hemorrhagic spots on the fundus, and thickened gastric folds are common endoscopic findings. The secreting ability of the gastric mucosa cells is usually intact in both noninfected and actively infected stomachs, and the intragastric condition becomes hyperacidic upon inflammation. Increased serum pepsinogen II concentration correlates well with active H. pylori infection, and also indicates an increased risk of diffuse-type gastric cancer. In chronic inactive H. pylori infection, metaplastic gastritis and atrophic gastritis extending from the antrum (closed-type chronic atrophic gastritis) toward the corpus (open-type chronic atrophic gastritis) are common endoscopic findings. The intragastric environment is hypoacidic and the risk of intestinal-type gastric cancer is increased in such conditions. Furthermore, there is a decrease in serum pepsinogen I concentration when the secreting ability of the gastric mucosa cells is damaged. Serologic and endoscopic changes that occur upon H. pylori infection are important findings for estimating the secreting ability of the gastric mucosa cells, and could be applied for the secondary prevention of gastric cancer.
Atrophy ; Endoscopy ; Gastric Mucosa ; Gastritis* ; Gastritis, Atrophic ; Helicobacter pylori* ; Helicobacter* ; Inflammation ; Pepsinogen A* ; Pepsinogen C ; Pepsinogens ; Secondary Prevention ; Stomach ; Stomach Neoplasms ; Venules

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) seroconversion may develop in seronegative adults. Although a positive correlation has been reported between alcohol consumption and seroconversion in Korea, an inverse correlation has been reported in other countries. The aim of this study was to investigate the risk factors for seroconversion in Korea. METHODS: We included Korean adults who were H. pylori-negative negative in their annual serum immunoglobulin G and pepsinogen assays, and in upper gastrointestinal endoscopy. Subjects with a history of H. pylori eradication or gastrectomy were excluded. The criteria for heavy alcohol consumption were ≥ 15 drinks/week for males and ≥ 8 drinks/week for females. RESULTS: Of 267 H. pylori-seronegative subjects, 26 (9.7%) exhibited seroconversion at a mean follow-up time of 39.0 ± 19.1 months. Seroconversion was positively correlated with alcohol consumption (p = 0.001), nonsteroidal anti-inflammatory drug use (p = 0.015), a higher body mass index (p = 0.033), a longer follow-up period (p = 0.038), and a greater number of follow-up tests (p = 0.004). Heavy drinking (odds ratio 6.754, 95% confidence interval 1.892–24.102, p = 0.003) and social drinking (odds ratio 4.360, 95% confidence interval 1.130–16.826, p = 0.033) were independent risk factors for seroconversion. During follow-up, subjects with seroconversion had higher serum levels of pepsinogen II (12.0 ± 7.8 ng/mL) than others (9.1 ± 5.3 ng/mL) (p = 0.038). CONCLUSIONS: Alcohol consumption is related to seroconversion in Koreans. H. pylori transmission might be prevented by reducing alcohol consumption and controlling drinking habits.
Adult ; Alcohol Drinking* ; Body Mass Index ; Drinking ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrectomy ; Helicobacter pylori ; Helicobacter* ; Humans ; Immunoglobulin G ; Korea ; Male ; Pepsinogen A ; Pepsinogen C ; Risk Factors ; Seroconversion*

Gastric cancer, the most common cancer in Korea, has come to be more frequently detected in the early stage thanks to regular endoscopy regardless of gastrointestinal symptoms. Early gastric cancer can be treated by endoscopic submucosal dissection or laparoscopic surgery, and its prognosis is very excellent. Thus, it is of an utmost importance to develop efficient screening method and set appropriate interval for the accurate diagnosis of early gastric cancer. Endoscopic screening for every two year is recommended, but the interval could be shortened in case of precancerous condition such as atrophic gastritis and intestinal metaplasia or subjects in a family with a history of gastric cancer. During the investigation, the benefit of using serology of H. pylori infection and serum pepsinogen I/II ratio of less than or equal to 3, instead of direct endoscopy, should also be considered for the selection of a high risk group of gastric cancer in Korea. Recently, appropriate screening and accurate diagnosis of early gastric cancer has become one of the most important issues.
Endoscopy ; Gastritis, Atrophic ; Humans ; Korea ; Laparoscopy ; Mass Screening ; Metaplasia ; Pepsinogen A ; Precancerous Conditions ; Prognosis ; Stomach Neoplasms

PURPOSE: In order to clarify the carcinogenesis mechanism from chronic atrophic gastritis toward gastric cancer, we measured the pepsinogen I and II and compared their ratio with several clinical findings. MATERIALS AND METHODS: We measured the preoperative serum pepsinogen I and II by using a radio-immunoassay and compared their ratio with several clinical findings, such as tumor size, mucinous vs non-mucinous tumor, cell differentiation, tumor location, depth of invasion, lymph-node status, Lauren's classification, and peritumoral atrophy in 103 consecutive patients with gastric adenocarcinomas who had received resections at Bundang CHA Hospital during the period from July 2003 to February 2005. RESULTS: There were significant differences in the serum pepsinogen I/II ratio between patients with mucinous vs non-mucinous tumors (n=4 vs 9 and mean pep I/II=1.29 vs. 2.99, P=0.0288), with tumor size more than and less than 10 cm2 (n=55 vs. 48 and mean pep I/II=2.64 vs. 3.24, P=0.0491), and with or without peritumoral atrophy (n=94 vs. 9 and mean pep I/II=2.83 vs. 3.89, P=0.0466). In patients with peritomoral atrophy, the pepsinogen I/II ratio was also lower in larger tumors (n=48 vs. 46 and mean pep I/II=2.44 vs. 3.23, P=0.0083). Well-differentiated carcinomas showed significantly lower serum pep I/II ratios than signet-ring-cell types. There was no correlation between serum pep I/II ratio and tumor location, depth of invasion, lymph-node status, or Lauren's classification. CONCLUSION: We proved the existence of a correlation between serum pepsinogen level and musosal atrophy, but these results are not sufficient for clinical application of serum pepsinogen level as a screening tool for gastric cancer.
Adenocarcinoma ; Atrophy ; Carcinogenesis ; Cell Differentiation ; Classification ; Gastritis, Atrophic ; Humans ; Mass Screening ; Mucins ; Pepsinogen A* ; Stomach Neoplasms*

BACKGROUND/AIMS: Clinical isolates of Helicobacter pylori (H. pylori) can be divided into at least two major types. Type I bacteria express VacA (vacuolating cytotoxin) and CagA (cytotoxin-associated antigen), type II bacteria do not exp~ress VacA or CagA. The purpose of this study is to evaluate the changes of gastric histology and serum level of gastric peptides (gastrin and pepsinogen) according to the bacteriological types in H. pylori infection. METHODS: In patients with H. pylori-positive functional dyspepsia, we classified the type of infection serologically by detecting IgG antibodies to CagA and VacA. Each patient was also evaluated for the degree of gastric inflammation and serum concentrations of gastrin and pepsinogen (PG). IgG antibodies to these proteins and concentrations of gastrin and PG were detected by using a immuno-blot kit and a radioimmunoassay kit, respectively, from the sera of each patient. From endoscopically biopsied antral specimens, the degree of gastric inflammation was evaluated by scoring inflammatory changes.
Antibodies ; Bacteria ; Dyspepsia* ; Gastrins ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Inflammation ; Pepsinogen A ; Peptides* ; Radioimmunoassay

BACKGROUND/AIMS: The serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG) and serum pepsinogen (PG) assays are widely used to screen for gastric cancer. An equivocal serology test finding indicates IgG titer between the positive and negative test findings. This study aims to evaluate the long-term follow-up result after an equivocal test finding on the serum anti-H. pylori IgG assay. METHODS: Koreans aged 18 years or older with an equivocal serum anti-H. pylori IgG assay finding were included. Subjects were excluded if they did not undergo H. pylori serology test, serum PG assay, and upper gastrointestinal (UGI) endoscopy on the same day at our center. The annual test findings were followed-up using the same methods. RESULTS: Of the 7,178 subjects who underwent the serum assays and UGI endoscopy on the same day, 274 (3.8%) subjects showed an equivocal H. pylori serology test finding. Of the 98 subjects who were followed-up, 58 (59.2%) showed seropositive finding at the mean follow-up period of 30.6±12.4 months. Subjects with seroconversion showed a higher initial serum PG I (p=0.023) and PG II (p=0.036) levels than those without seroconversion. CONCLUSIONS: An equivocal H. pylori serology test finding was not rare (3.8%) in Korean adults, and 60% of equivocal subjects showed seroconversion within 3 years. Higher seroconversion rates in subjects with high PG I and PG II levels suggest that intact gastric secreting ability plays a role in the survival of H. pylori. Therefore, equivocal subjects with increased serum PG levels should be considered as potential seropositive subjects.
Adult ; Endoscopy ; Follow-Up Studies ; Helicobacter pylori ; Helicobacter* ; Humans ; Immunoglobulin G ; Pepsinogen A ; Seroconversion ; Stomach Neoplasms