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*

BACKGROUND/AIMS: Gastric atrophy can be diagnosed by serum pesinogen I/II ratio. The aim of this study was to investigate whether the changes of serum pepsinogen I/II ratio can be predicted by gastroscopy. MATERIALS AND METHODS: Sixty healthy subjects who underwent screening for serum pepsinogen I/II levels, serum Helicobacter pylori (H. pylori) antibody, and gastroscopy for two sequential years were included. Endoscopic findings were classified into four different categories according to the degree of chronic atrophic gastritis; none, mild, moderate, and severe. Changes of the serum pepsinogen I/II ratio, body mass index, H. pylori antibody, and endoscopic findings were analyzed after a year. RESULTS: The serum pepsinogen I/II ratio showed a tendency to decrease after a year in subjects with H. pylori infection (P=0.013) and those with moderate to severe atrophic gastritis (P=0.004), whereas it increased in subjects without H. pylori infection and those with none to mild atrophic gastritis. On multivariate analysis, the degree of atrophic gastritis was the only factor that was related to the changing trends of the serum pepsinogen I/II ratio (odds ratio=5.385, P=0.023). CONCLUSIONS: The degree of atrophic gastritis on endoscopic findings can predict the changes of the serum pepsinogen I/II ratio after a year. Regardless of the current status of H. pylori infection, the serum pepsinogen I/II ratio decreases after a year in subjects with moderate to severe atrophic gastritis.
Atrophy ; Body Mass Index ; Gastritis, Atrophic ; Gastroscopy ; Helicobacter pylori ; Mass Screening ; Multivariate Analysis ; Pepsinogen A

BACKGROUND/AIMS: The presence of Helicobacter pylori (H. pylori) infection represents a high-risk state of gastric cancer, but the risk is even higher in gastric atrophy. H. pylori stool antigen (HpSA) and serum pepsinogen (PG) tests are useful tools for screening present infection and gastric atrophy, respectively. To determine the prevalence of subjects at a high risk (HpSA+ or PG+) or very high risk (PG+) of gastric cancer in Japan, we applied the two tests to a general population. METHODS: The subjects included 311 volunteers. We used Meridian HpSA ELISA for the HpSA test and Pepsinogen RIA Beads for the PG test. PG I at < or =70 microgram/L and I/II ratio of < or =3.0 were used as cutoffs for PG-test positivity. RESULTS: Positivity rates in HpSA and PG tests significantly increased with age in those younger than 60 years and in all age groups, respectively. The proportions of HpSA-/PG- and HpSA+/PG+ subjects decreased and increased with age, respectively. A small proportion of HpSA-/PG+ subjects were older than 40 years. The prevalence of subjects who were either HpSA+ or PG+ increased with age (>50% of those older than 40 years). Half of the subjects older than 60 years were PG+. CONCLUSIONS: In Japan, more than 50% of general population aged > or =40 years is at a high risk of gastric cancer, and half of the population aged > or =60 years is at a very high risk.
Aged ; Atrophy ; Enzyme-Linked Immunosorbent Assay ; Helicobacter pylori ; Humans ; Japan ; Mass Screening ; Pepsinogen A ; Prevalence ; Stomach Neoplasms

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

BACKGROUND: Tumor markers are used for diagnosing cancers and monitoring responses to cancer therapy. In this study, we evaluated the performance of Lumipulse G1200 (Fujirebio, Japan), a fully automated serum analyzer, for immunoassays of tumor markers. METHODS: We determined the precision and linearity of assays performed using Lumipulse G1200 and the correlation between the results of this and other analyzers used for tumor markers according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). We used 9 tumor markers, namely, carcinoembryonic antigen, alpha-fetoprotein, cancer antigen 125, cancer antigen 15-3 (CA 15-3), cancer antigen 19-9, prostate specific antigen, protein induced by vitamin K absence or antagonist-II, and pepsinogens I and II. Further, we validated reference intervals using 20 serum samples of healthy individuals. RESULTS: Lumipulse G1200 yielded acceptable precision with total CV< or =5% and within-run CV< or =3% for all markers. Total CV for all markers was 2.4-3.7%, with the exception of CA 15-3 and pepsinogens I and II (CV, 4.0-5.0%). Linearity was observed for all markers over the entire analytical range. Results of Lumipulse G1200 were in good agreement with those of currently used analyzers with correlation coefficients>0.975 for all markers, except pepsinogen I (0.9569). The reference intervals provided by the manufacturer met the criteria mentioned in the CLSI guideline. CONCLUSIONS: Assays using Lumipulse G1200 had high precision, clinically acceptable linearity, and good correlation with the established assays. This indicates that Lumipulse G1200 can be potentially used in routine laboratories.
alpha-Fetoproteins ; Carcinoembryonic Antigen ; Immunoassay ; Pepsinogen A ; Pepsinogens ; Prostate-Specific Antigen ; Biomarkers, Tumor ; Vitamin K