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Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: a population-based study.
- Source :
-
Journal of gastrointestinal and liver diseases : JGLD [J Gastrointestin Liver Dis] 2018 Mar; Vol. 27 (1), pp. 11-17. - Publication Year :
- 2018
-
Abstract
- Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings.<br />Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system).<br />Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05).<br />Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.
- Subjects :
- Adult
Aged
Atrophy blood
Elder Nutritional Physiological Phenomena
Endoscopy, Gastrointestinal
Female
Gastritis blood
Gastritis pathology
Helicobacter Infections blood
Helicobacter pylori
Humans
Male
Mass Screening
Middle Aged
Stomach Neoplasms blood
Stomach Neoplasms pathology
Gastritis diagnosis
Pepsinogen A blood
Pepsinogen C blood
Stomach pathology
Stomach Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1842-1121
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal and liver diseases : JGLD
- Publication Type :
- Academic Journal
- Accession number :
- 29557410
- Full Text :
- https://doi.org/10.15403/jgld.2014.1121.271.pep