Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis

• Published in: Digestive diseases and sciences Vol. 49; no. 5; pp. 795 - 801
• Main Authors: URITA, Yoshihisa, HIKE, Kazuo, TORII, Naotaka, KIKUCHI, Yoshinori, KANDA, Eiko, SASAJIMA, Masahiko, MIKI, Kazumasa
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.05.2004; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastric Mucosa - pathology; Gastritis, Atrophic - blood; Gastritis, Atrophic - diagnosis; Gastritis, Atrophic - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroscopy; Helicobacter pylori; Human bacterial diseases; Humans; Infectious diseases; Male; Mass Screening; Medical sciences; Metabolic diseases; Metaplasia - blood; Metaplasia - diagnosis; Middle Aged; Other diseases. Semiology; Pepsinogens - blood; Predictive Value of Tests; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Human; Premalignant lesion; Spirillales; Nutrition; Atrophic gastritis; Spirillaceae; Metabolic diseases; Pepsinogen; Helicobacter pylori; Intestinal metaplasia; Topography; serum pepsinogens; Gastroenterology; Digestive diseases; Bacteria; Serum; Gastric disease
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/B:DDAS.0000030091.92379.91

The importance of atrophic gastritis with intestinal metaplasia is related to the fact that it increases the risk of gastric cancer development. The aim of this study is to evaluate the diagnostic potential of serum pepsinogens in predicting the topography of intestinal metaplasia. Both dye endoscopy and 13C-urea breath test were carried out in 878 subjects. Serum pepsinogen I, pepsinogen II, and IgG antibody to Helicobacter pylori were measured. The overall prevalence of intestinal metaplasia was higher in subjects with lower PG I/II ratios and lower PG I values. Based on ROC curves, a cutoff value for pepsinogen I/II ratio of less than 3.0 would have identified intestinal metaplasia with a sensitivity of 71.7% and a specificity of 66.7% in Helicobacter pylori-positive subjects. It is possible that serum pepsinogens could be used as a screening test for high-risk subjects with intestinal metaplasia.