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Objective:To investigate the application value of pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer. Methods:Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology, the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group. An additional 60 patients with benign gastric lesions (benign gastric lesion group) and 60 patients with precancerous lesions of the stomach (precancerous lesion group) were also included in this study. Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer. Results:Compared with the benign gastric lesion and precancerous lesion groups, the pepsinogen I/pepsinogen II ratio was significantly lower, and the pepsinogen II level and Helicobacter pylori infection rate [71.67% (43/60)] were significantly higher in the gastric cancer group ( F = 108.14, 71.75, 38.43, χ2 = 6.89, all P < 0.05). Compared with the benign gastric lesion and precancerous lesion groups, the Kimura-Takenmoto classification in the gastric cancer group was significantly higher ( H = 38.91, P < 0.05). In the gastric cancer group, pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage ( F = 65.79, 5.66, 53.32, all P < 0.01). There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer ( P < 0.05) in the gastric cancer group. There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer (all P > 0.05) in the gastric cancer group. The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I, pepsinogen II, and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865, 0.664, and 0.881, respectively. Conclusion:Serum pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification can increase the diagnostic rate of early gastric cancer. The Kimura Takemoto classification is helpful for risk stratification in the endoscopic screening of gastric cancer, and its results are consistent with pepsinogen levels. The combined application is of a high application value.
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Objective:To correlate the expression of microRNA (miRNA)-21 and miRNA-335-5p with pepsinogen and gastrin-17 in patients with gastric cancer.Methods:Sixty-one patients with gastric cancer who received treatment in Linhai Second People's Hospital between January 2019 and January 2021 were included in the patient group. An additional 60 healthy patients who concurrently received physical examination were included in the control group. Serum pepsinogen I, pepsinogen II and gastrin-17 levels were determined by latex-enhanced immunoturbidimetry. miRNA-21 and miRNA-335-5p expression were determined by quantitative reverse transcription-polymerase chain reaction. Serum pepsinogen I, pepsinogen II and gastrin-17 levels and miRNA-21 and miRNA-335-5p expression were compared between the two groups. The sensitivity and specificity of miRNA-21 and miRNA-335-5p in the diagnosis of gastric cancer were analyzed. The correlation between miRNA-21 and miRNA-335-5p expression and pepsinogen I, pepsinogen II and gastrin-17 levels was analyzed.Results:Serum pepsinogen I and gastrin-17 levels in the patient group were (54.36 ± 9.89) μg/L and (13.74 ± 1.89) pg/mL, respectively, which were significantly lower than those in the control group [(112.31 ± 23.24) μg/L, (18.75 ± 2.36) pg/mL, t = 17.89, 12.90, both P < 0.05]. Serum pepsinogen II level in the patient group was significantly higher than that in the control group [(24.35 ± 4.53) μg/L vs. (20.37 ± 3.28) μg/L, t = 5.52, P < 0.05]. The relative mRNA expression of miRNA-21 in the patient group was significantly higher than that in the control group [(3.42 ± 0.61) vs. (0.53 ± 0.12), t = 30.01, P < 0.05]. The relative mRNA expression of miRNA-335-5p in the patient group was significantly lower than that in the control group [(0.32 ± 0.17) vs. (1.65 ± 0.35), t = 26.65, P < 0.05]. The receiver operating characteristic curve analysis showed that the sensitivity and specificity of miRNA-21 in the diagnosis of gastric cancer were 74.36% and 68.18%, respectively, and they were 79.49% and 60.90% for miRNA-335-5p, respectively. There was a negative linear correlation between miRNA-21 and pepsinogen I and gastrin-17 levels ( r = -0.82, -0.74), but there was a positive linear correlation between miRNA-21 and pepsinogen II levels ( r = 0.76). There was a positive linear correlation between miRNA-335-5p and pepsinogen I and gastrin-17 ( r = 0.79, 0.72), but there was a negative linear correlation between miRNA-335-5p and pepsinogen II levels ( r = -0.70). Conclusion:miRNA-21 is highly expressed in patients with gastric cancer, while miRNA-335-5p is lowly expressed. miRNA-21 and miRNA-335-5p are highly correlated with pepsinogen and gastrin-17 levels. miRNA-21 and miRNA-335-5p can be used as effective indices for diagnosis of gastric cancer. Findings of this study are highly innovative and scientific.
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Objective To analyze the infection situation of Helicobacter pylori (Hp) and its correlation with pepsinogen (PG) in the 60~80 year old population in Jianye District, Nanjing City. Methods From December 2018 to December 2020, 758 elderly people aged 60 to 80 in the community in Jianye District Nanjing City. were selected. All subjects were tested for Hp by 13C-UBT method, and clinical signs of Hp positive people aged 60 to 80 years were analyzed. Including gender, age, alcohol consumption, family history of stomach cancer, chronic gastritis, and spicy eating habits; Hp positive group was given amoxicillin capsule 1.0g/ time, twice a day, esomeprazole magnesium enteric-coated tablet 20mg/ time, twice a day, clarithromycin tablet 0.5g/ time, twice a day for 8 weeks, and Hp was detected again after the end of treatment. All levels of PGI, PGII and PGI/PGII were determined by ELISA. The serum PG level of the experimental group and the control group and the serum PG level of the Hp positive population before and after Hp eradication were compared, and the correlation between Hp infection and PG level in the elderly population was analyzed by Pearson correlation. Results A total of 161 cases (21.24%) of 758 patients with chronic gastritis had Hp infection. The proportion of Hp infection in males was significantly higher than that in females (χ2=4.128，P2=6.771, P2 =8.305，P2=6.169，P2=5.576 , P2=7.936, P<0.05). The levels of PGI and PGI/PGII in the experimental group were significantly higher than those in the control group (P<0.05). The level of PGII in experimental group was significantly lower than that in control group (P<0.05). After treatment, 76 hP-positive patients turned negative, and PGI and PGI/PGII levels after Hp eradication were significantly lower than those before Hp eradication (P<0.05). PGII after Hp eradication was significantly higher than before (P<0.05). According to Pearson correlation analysis, Hp infection in elderly population was positively correlated with PGI and PGI/PGII levels, with correlation coefficients (r1=0.408,r2=0.412,P<0.05), and negatively correlated with PGII, with correlation coefficients (r=-0.469, P<0.05). Conclusions The Hp infection rate in patients with chronic gastritis is high, mainly in elderly men in Jianye District, Nanjing City.The levels of PGI and PGII in HP-positive patients are high, and the levels of PGI/PGII are low. The serum PG level can be used to evaluate the diagnosis and treatment effect of patients with Hp infection.
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Objective:To explore the effects and underlying mechanisms of azintamide on gastric emptying and gastrointestinal hormone secretion in proton pump inhibitor related low gastric acid environment.Methods:A total of 60 rats were selected and randomly divided into low gastric acid control group, low gastric acid model group, low gastric acid and azintamide intervention group, high gastric acid control group, high gastric acid model group and high gastric acid and azintamide intervention group by random number table, with 10 rats in each group. The rats of low gastric acid control group and high gastric acid control group were all treated with 0.9% sodium chloride solution. The rats of low gastric acid model group and high gastric acid model group were established by intraperitoneal injection of 20 mg/kg omeprazole once per day for seven days, and subcutaneous injection of 2 mg/kg penta gastrin once per day for three days, respectively. The rats of low gastric acid and azintamide intervention group and high gastric acid and azintamide intervention group were gavaged with azintamide 50 mg/kg once per day for three days on the basis of low gastric acid model group and high gastric acid model group, respectively. Only the rats in three low gastric acid groups were analyzed. At Day 0, 2nd, 4th, 6th and 8th after modeling, the body weight of rats were compared. After modeling, the weight of gastric contents and pH of gastric fluid was measured and compared, and the peripheral blood levels of pepsinogen A (PGA), gastrin and cholecystokinin (CCK) were detected by enzyme linked immunosorbent assay. One-way analysis of variance and Tukey′s honestly significant difference post-hoc test were used for statistical analysis.Results:The pH value of gastric fluid in low gastric acid model group and low gastric acid and azintamide intervention group were both higher than that in the low gastric acid control group (2.17±0.53, 2.03±0.69 vs. 1.32±0.17), and the differences were statistically significant ( P=0.026 and 0.041, respectively). While there was no significant difference in pH value between the low gastric acid model group and low gastric acid and azintamide intervention group ( P>0.05). On the Day 0, 2nd, 4th, 6th and 8th after modeling, the body weight of rats of low gastric acid control group, low gastric acid model group and low gastric acid and azintamide intervention group was (285.40±10.86), (283.40±6.38), (282.00±5.04) g; (287.10±10.73), (283.20±5.83), (284.00±5.72) g; (292.20±11.18), (281.90±6.23), (289.00±5.82) g; (296.40±11.12), (277.70±6.96), (292.00±6.82) g; (300.80±11.29), (274.30±8.84), (297.00±4.17) g, respectively. On the Day 6th and 8th after modeling, the body weight of rats of low gastric acid model group was lower than that of the low gastric acid control group; and the body weight of rats of low gastric acid and azintamide intervention group was higher than that of low gastric acid model group, and the differences were statistically significant (both P<0.01). On the Day 0, 2nd, 4th, 6th and 8th, there was no statistically significant difference in body weight of rats between low gastric acid and azintamide intervention group and low gastric acid control group ( P>0.05). On the Day 0, 2nd, 4th, there were no statistically significant differences in body weight of rats between low gastric acid and azintamide intervention group and low gastric acid model group, and between low gastric acid model group and low gastric acid control group (both P>0.05). The weight of gastric contents of low gastric acid model group was heavier than that of low gastric acid control group ((2.36±0.11) g vs. (1.85±0.20) g), the weight of gastric contents of low gastric acid and azintamide intervention group was lighter than that of low gastric acid model group ((1.87±0.42) g vs. (2.36±0.11) g), and the differences were statistically significant ( P=0.019 and 0.016, respectively), and there was no statistically significant difference in weight of gastric contents between the low gastric acid and azintamide intervention group and the low gastric acid control group ( P>0.05). The peripheral blood level of PGA of rats of low gastric acid model group was lower than that of low gastric acid control group ((551.80±190.00) ng/L vs. (857.00±164.80) ng/L), while the peripheral blood level of PGA of the low gastric acid and azintamide intervention group was higher than that of the low gastric acid model group ((799.90±97.80) ng/L vs. (551.80±190.00) ng/L), and the differences were statistically significant ( P=0.011 and 0.037, respectively). There was no significant difference in peripheral blood level of PGA between the low gastric acid control group and the low gastric acid and azintamide intervention group ( P>0.05). The peripheral blood level of gastrin of the low gastric acid model group was higher than that of the low gastric acid control group ((49.31±11.93) ng/L vs. (35.59±5.29) ng/L), and the CCK level of the low gastric acid model group was lower than that of low gastric acid control group ((10.26±5.32) ng/L vs. (25.55±11.62) ng/L), and the differences were statistically significant ( P=0.037 and 0.035, respectively). The peripheral blood level of gastrin of the low gastric acid and azintamide intervention group was lower than that of low gastric acid model group ((35.65±6.49) ng/L vs. (49.31±11.93) ng/L), the level of CCK of the low gastric acid and azintamide intervention group was higher than that of low gastric acid model group ((27.59±11.22) ng/L vs. (10.26±5.32) ng/L), and the differences were statistically significant ( P=0.048 and 0.021, respectively). There were no significant differences in CCK and gastrin between low gastric acid and azintamide intervention group and low gastric acid control group (both P>0.05). Conclusion:Azintamide regulates the levels of gastrointestinal hormones CCK and gastrin under the condition of low gastric acid and affects the expression of pepsinogen A, thereby promoting gastric emptying in a low gastric acid environment.
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Objective:To evaluate the clinical efficacy of Wanfu-Qutong Decoction combined with esomeprazole in the treatment of chronic atrophic gastritis (CAG). Methods:A total of 106 CAG patients who met the inclusion criteria from June 2017 to June 2019 were randomly divided into two groups with 53 in each group. The control group took esomeprazole magnesium enteric coated tablets, and the observation group took Wanfu-Qutong Decoction on the basis of the control group. Both groups were treated continuously for 3 months. TCM syndrome score was performed before and after treatment, and the new Sydney system intuitive simulation score method was used to score the histopathology of gastric mucosa. The levels of gastrin 17 (G-17), pepsinogen (PGⅠ , PGⅡ) and the PG Ⅰ/Ⅱ were measured by ELISA. Results:The total effective rate was 96.2% (51/53) in the observation group and 79.2% (42/53) in the control group. There was significant difference between the two groups ( χ2=7.414, P<0.01). After treatment, the scores of epigastric pain, fullness, liking temperature and pressing, vomiting clear water, eating less and staying foolish, and limb burnout in the observation group were significantly lower than those in the control group ( t values were 2.788, 3.632, 3.816, 1.590, 2.183, 2.103, respectively, all Ps<0.05), and the scores of chronic inflammatory reaction, inflammatory activity, atrophy degree, dysplasia and intestinal metaplasia in the mucosa were significantly lower than those in the control group ( t values were 2.983, 2.106, 2.106, 3.773, 1.922, 3.095, respectively, all Ps<0.05). After treatment, the serum G-17 [(14.47 ± 3.06) pmol/L vs. (10.67 ± 2.47) pmol/L, t=10.510] and PG Ⅰ [(130.31 ± 14.79) μg/L vs. (102.36 ± 12.63) μg/L, t=8.178] and PG Ⅰ/Ⅱ [(10.45 ± 0.48) vs. (9.17 ± 0.72), t=2.104] in the observation group were significantly higher than those in the control group ( P<0.01 or P<0.05). Conclusion:Wanfu-Qutong Decoction combined with esomeprazole tablets can effectively improve the clinical symptoms of CAG patients, regulate the levels of G-17, PG Ⅰ , PG Ⅱ and PGⅠ/Ⅱ, and promote the repair of gastric mucosa.
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ABSTRACT BACKGROUND: It has been proposed that the combination of gastrin-17 (G-17), pepsinogens I and II (PGI and PGII), and anti-Helicobacter pylori (H. pylori) antibodies (GastroPanel®, BIOHIT HealthCare, Helsinki, Finland) could serve as biomarkers of atrophic gastritis. OBJECTIVE: This study aimed to ensure the diagnostic accuracy of GastroPanel® and evaluate the effect of proton pump inhibitors (PPIs) on these biomarkers. METHODS: Dyspeptic patients who underwent gastrointestinal endoscopy were enrolled in the present study. Histological findings, which were the gold standard to stratify groups, were as follows: no atrophy (controls); antrum atrophy; corpus atrophy; multifocal atrophy; and neoplasia. G-17, PGI, PGII, and anti-H. pylori immunoglobulin (Ig)G antibodies were assayed using commercially available kits. The ratio of PGI/PGII was calculated. RESULTS: Among 308 patients, 159 (51.6%) were PPI users. The overall prevalence of atrophy was 43.8% (n=135). Ninety-two (29.9%) patients were H. pylori positive according to anti-H. pylori IgG levels. G-17 levels were not low in those with antrum atrophy but were high in those with corpus and multifocal atrophies. PGI levels were significantly lower in those with corpus and multifocal atrophies. The sensitivity of PGI <30 µg/L to detect corpus atrophy was 50% (95% CI 27.8-72.1%), with a specificity of 93.2% (95% CI 84.3-97.5%), a positive likelihood ratio of 7.4 (95% CI 2.9-19.2), and a negative likelihood ratio of 0.5 (95% CI 0.3-0.8). A small number of subjects (n=6) exhibited moderate to intense atrophy (4%), among whom 66.7% exhibited decreased PGI levels. PPI significantly increased the levels of G-17 and PGI, except in those with corpus and multifocal atrophies, in whom PGI levels were not increased by PPIs. CONCLUSION: GastroPanel® (Gastrin-17, PGI, and PGI/PGII ratio) did not demonstrate high sensitivity for detecting gastric atrophy.
RESUMO CONTEXTO: Foi proposto que a combinação de gastrina 17 (G-17), pepsinogênios I e II (PGI e PGII), e anticorpos anti-Helicobacter pylori (H. pylori) (GastroPanel®, BIOHIT HealthCare), poderiam indicar gastrite atrófica. OBJETIVO: Portanto, o objetivo foi averiguar a acurácia diagnóstica do painel gástrico e avaliar o efeito dos inibidores de bomba de prótons (IBP) nesses marcadores. MÉTODOS: Pacientes dispépticos que se submeteram à endoscopia gastrointestinal entraram no estudo. Os achados histológicos foram o padrão ouro para estratificar os grupos: sem atrofia (controles), atrofia de antro, atrofia de corpo, atrofia multifocal e neoplasia. G-17, PGI, PGII, e anticorpos IgG anti-H. pylori foram determinados por kits comerciais. A razão PGI/PGII foi calculada. RESULTADOS: Entre 308 pacientes que foram incluídos, 159 estavam usando IBP (51,6%). A prevalência de atrofia foi de 43,8% (135 pacientes). H. pylori foi positivo em 92 (29,9%) pacientes por IgG anti-H. pylori. G-17 não estava diminuída na atrofia do antro, mas estava elevada nas atrofias do corpo e multifocal. PGI estava significantemente menor nas atrofias de corpo e multifocal. A sensibilidade da PGI <30 µg/L de indicar atrofia do corpo foi 50% (95%IC 27,8-72,1%) com especificidade de 93,2% (95%IC 84,3-97,5%), razão de verossimilhança positiva de 7,4 (95%IC 2,9-19,2) e razão de verossimilhança negativa de 0,5 (95%IC 0,3-0,8). O número de indivíduos com atrofia moderada para intensa foi pequeno (n=6;4%), dos quais 66,7% tinham diminuição dos níveis de PGI. IBP significantemente aumentou os níveis de G-17 e PGI, exceto nas atrofias de corpo e multifocal que não apresentaram aumento de PGI. CONCLUSÃO: O painel gástrico não teve alta sensibilidade de indicar gastrite atrófica.
Subject(s)
Humans , Proton Pump Inhibitors , Gastritis, Atrophic/diagnosis , Brazil , Helicobacter pylori , Helicobacter Infections , Antibodies, BacterialABSTRACT
OBJECTIVE@#To evaluate the clinical efficacy and partial action mechanism of mild moxibustion combined with salt-separated moxibustion for gastrointestinal discomfort caused by chemotherapy for breast cancer.@*METHODS@#A total of 48 patients were randomly divided into an observation group and a control group, 24 cases in each group. The patients in the control group were treated with intravenous infusion of tropisetron hydrochloride (5 mg), once a day for three days; the patients in the observation group were additionally treated with mild moxibustion at Zusanli (ST 36), Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6) and salt-separated moxibustion at Shenque (CV 8), 15 min per treatment, once a day for 7 days. Before treatment and on the 7th day of chemotherapy, the levels of pepsinogenⅠ(PGⅠ), pepsinogenⅡ (PGⅡ), the ratio of PGⅠto PGⅡ (PGR) and gastrin 17 (G-17) in serum were measured. Before treatment and on the 3rd, 5th, 7th day of chemotherapy, the gastrointestinal reactions (nausea, vomiting, constipation, diarrhea) were compared between the two groups.@*RESULTS@#On the 7th day of chemotherapy, the serum levels of PGⅠ, PGⅡand G-17 in the observation group were lower than those in the control group (0.05). The total scores of nausea, vomiting and constipation during chemotherapy in the observation group were significantly lower than those in the control group (all <0.05).@*CONCLUSION@#The mild moxibustion combined with salt-separated moxibustion could effectively improve the symptoms of nausea, vomiting and constipation caused by chemotherapy in patients with breast cancer, and its mechanism may be related to the down-regulation of the levels of PGⅠ, PGⅡ and G-17 in serum.
Subject(s)
Humans , Acupuncture Points , Breast Neoplasms , Therapeutics , Moxibustion , Nausea , Treatment OutcomeABSTRACT
OBJECTIVE： To provide reference for clinical treatment of precancerous lesions of gastric cancer. METHODS： A total of 685 patients with precancerous lesions of gastric cancer were selected from our hospital during Jan.-Dec. 2018. Totally 455 patients in treatment group received individualized TCM therapy according to syndrome differentiation， 7 days as a course， 4 courses in total； another 230 patients in control group received Folic acid tablets， 5 mg， tid， for 2 months. The changes of pepsinogen ratio （PGⅠ/PGⅡ）， gastrin-17 （G-17） and Helicobacter pylori （Hp）before and after treatment， and the occurrence of ADR were compared between 2 groups. RESULTS： After treatment， total response rate of treatment group was 90.3％， which was significantly higher than 68.6％ of control group. PGⅠ/PGⅡ of treatment group were increased significantly， which was significantly higher than control group； G-17 levels of 2 groups were decreased significantly （P＜0.05）； there was no statistical significance in Hp level between 2 groups before and after treatment （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： Chinese medicine syndrome differentiation individual therapy can significantly delay the development of precancerous lesions of gastric cancer， and has good safety.
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Objective To analyze the serum gastric function and Helicobacter pylori ( HP ) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps.Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies ( UreA, UreB, VacA, CagA antibodies ) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen?I ( PG?I),pepsinogen?Ⅱ( PG?Ⅱ),gastrin were detected by enzyme?linked immunosorbent assay (ELISA).Gastrin?17( G?17) and calculate PGⅠ and PGⅡ ratio( PGR).Results The levels of serum PGⅡ(13.13(8.15,20.30) μg ／L) and G17 (8.44(3.72,27.17) pmol／L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56,15.14) μg／L and 1.83(0.87,5.95) pmol／L) ( P＜0.05),and the PGR level was lower than the control group ( P＜0.05);serum PGI ( 120.12 ( 86.72,174.70) μg／L), PGII ( 11.92 ( 7.27,22.26) μg／L),G17 ( 5.68 ( 1.79, 14.65) pmol／L) in the gastric fundic gland polyp group was higher than the control group (( 101.32 (79.17,131.33) μg ／L,9.16 ( 5.56,15.14) μg ／L,1.83 ( 0.87,5.95) pmol／L) ( P 均＜0.05)) ( P＜0.05); serum G17 (8.44(3.72,27.17) pmol／L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79,14.65) pmol／L) ( P＜0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42／68)was higher than that in the gastric fundic gland polyp group40.30%(27／67) (P＜0.05),and type I Hp was the main one (P＜0.05).The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative ( all P＜0.05).There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP?positive and negative?positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type ( all P＜0.05).There was no significant difference in the levels of serum PGⅠ,PGⅡ,G17,and PGR between the gastric fundic gland polyps group and the type Ⅱ.Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps.
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BACKGROUND/AIMS: In the ABC classification system, group A consists of seronegative subjects without gastric corpus atrophy. This study aimed to determine the prevalence and characteristics of pseudo group A subjects. METHODS: Group A subjects were identified among consecutive Korean adults who underwent a serum anti-Helicobacter pylori immunoglobulin G (IgG) test and pepsinogen (PG) assay on the day of endoscopy. Past infection was defined as the presence of either eradication history or endoscopic findings suggesting past infection (i.e., gastric xanthoma, metaplastic gastritis, or advanced atrophy >closed-type 1). RESULTS: Among 2,620 group A subjects, 448 (17.1%) had eradication history, and 133 (5.1%) showed endoscopic findings suggesting past infection. Older age (odds ratio [OR], 1.148; 95% confidence interval [CI], 1.067 to 1.236) and earlier year of birth (OR, 1.086; 95% CI, 1.009 to 1.168) were independent risk factors for classification into pseudo group A, with cutoff points at 50.5 years and birth year of 1959.5, respectively. Positive H. pylori test findings were found in 22 subjects (3.1%) among the 715 subjects who underwent the urea breath test or Giemsa staining on the same day. Current infection was positively correlated with PG I and PG II levels (p<0.001) but not with age, anti-H. pylori IgG titer, or classification into pseudo group A. CONCLUSIONS: Among the group A subjects, 22.2% had past infection. The risk was higher in subjects older than 50 years, especially those born before 1960. Furthermore, current infection was found in 3.1% of the subjects and was correlated with increased gastric secretory ability.
Subject(s)
Adult , Humans , Atrophy , Azure Stains , Breath Tests , Classification , Endoscopy , Gastritis , Helicobacter pylori , Immunoglobulin G , Parturition , Pepsinogen A , Prevalence , Risk Factors , Urea , XanthomatosisABSTRACT
BACKGROUND/AIMS: In countries with a higher risk of gastric atrophic gastritis, noninvasive tests are helpful for a more reliable diagnosis of Helicobacter pylori infection. The aim of this study was to evaluate the characteristics of seropositive subjects according to their stool H. pylori antigen test, serum pepsinogen (PG) assay, and endoscopic findings. METHODS: Consecutive subjects who visited Konkuk University Medical Center for upper gastrointestinal endoscopy for a regular check-up were included in a prospective setting if the serum anti-H. pylori immunoglobulin G assay was positive. A H. pylori antigen stool test was measured using a stool H. pylori antigen enzyme-linked immunosorbent assay kit on the same day as a serum PG assay and endoscopy. RESULTS: Of 318 seropositive subjects, 256 (80.5%) showed positive stool test findings. Subjects with a negative stool test result showed lower serum PG I (p < 0.001) and PG II (p < 0.001) levels and higher PG I/II ratio (p < 0.001) than those with a positive stool test. Chronic atrophic gastritis was more common in the positive stool test group than the negative stool test group on endoscopic finding (p = 0.009). A higher serum PG I level (p = 0.001) and a lower serum PG I/II ratio (p = 0.001) were independent risk factors for the presence of H. pylori antigen in stool. CONCLUSIONS: A high serum PG level denotes an ongoing current H. pylori infection with positive stool H. pylori antigen test findings. Seropositive subjects with increased gastric secreting ability tend to have H. pylori in their fecal material as reflected by a positive stool H. pylori antigen test finding.
Subject(s)
Academic Medical Centers , Diagnosis , Endoscopy , Endoscopy, Gastrointestinal , Enzyme-Linked Immunosorbent Assay , Gastritis, Atrophic , Helicobacter pylori , Helicobacter , Immunoglobulin G , Pepsinogen A , Prospective Studies , Risk FactorsABSTRACT
Objective To investigate the clinical value of long chain non-coding RNA ( lncRNA) combined with pepsinogen in the detection of gastric cancer. Methods Totally eighty-six gastric cancer patients hospitalized in Chongqing Three Gorges Central Hospital from June 2014 to June 2017 were selected as the gastric cancer group. Another 86 patients who had no obvious abnormalities in the stomach during the same period were selected as the control group. Univariate analysis was used to compare the differences in baseline data and Carcinoembryonic antigen (CEA),carcinoembryonic antigen 19-9 (CA19-9),pepsinogen I (PGⅠ), pepsinogen II (PGⅡ) and lncRNA BC200 between the two groups. Univariate analysis was applied to analyze the differences of the baseline date between the two groups and to select the statistically significant factors which are further detected by multivariate logistic regression analysis. Meanwhile,the correlation analysis was used to analyze the relationship between the above-mentioned factors and traditional variables. Furthermore, the sensitivity and specificity of these factors in the value of diagnosing gastric cancer was calculated by ROC curve. Results The level of CEA (2. 84(1. 63- 8. 45) μg/ L),CA19-9(9. 05(5. 89- 29. 47) U/ ml) and lncRNA BC200(1. 872(1. 125-2. 611) in the gastric cancer group were significantly higher than those in the control group (CEA (1. 26(0. 87-2. 66) μg/ L,CA19-9(6. 42(4. 32-9. 86) U/ ml,lncRNA BC200( 1. 006 (0. 594-1. 282))(U= 3684,4782,2764;P<0. 001,P<0. 001,P = 0. 007); while the levels of PGⅠ(68. 3 (51. 2-89. 4) μg/ L ) and PGⅡ(18. 85(10. 06-29. 37) μg/ L) in the gastric cancer group were lower than those in the control group ( PGⅠ(115. 1(81. 7 - 166. 0) μg/ L,PGⅡ(23. 38(13. 72 - 34. 09) μg/ L) ( P<0. 001). Multivariate logistic analysis showed that CA19-9 (OR = 1. 206,95%CI 1. 302-1. 375,P = 0. 039), PGⅠ (OR= 1. 300,95%CI 1. 224-1. 623,P= 0. 023),PGⅡ (OR = 1. 208,95%CI 1. 002-1. 501,P = 0. 044) and lncRNA BC200 (OR = 1. 276,95%CI 1. 008 ~ 1. 107,P = 0. 020) had significant effects on gastric cancer and PGⅠ had the highest degree of influence. Spearman rank correlation showed that there was a positive correlation between lncRNA BC200 and CA19-9,and the difference was statistically significant (rs = 0. 891,P<0. 05); while PGⅠ (rs= -0. 482,P = 0. 026) and PGⅡ (rs = -0. 531,P = 0. 014) were negative correlated with CA19-9. The ROC curve indicated that the area under the ROC curve of lncRNA BC200 combined with PGⅠ,lncRNA BC200 combined with PGⅡ and CA19-9 in the detection of gastric cancer were 0. 844,0. 783 and 0. 721 respectively. The AUC (Area Under Curve) of lncRNA BC200 combined with PGⅠ was the highest,with a sensitivity of 53. 5% and a specificity of 100% . Conclusion LncRNA BC200 combined with PGⅠ can detect the existence of gastric cancer to a certain extent, and has a certain clinical diagnostic value, thus providing a theoretical basis for further diagnosis of early gastric cancer.
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Objective In order to detect gastric fluid pH value,Gastrin-17 (G-17),pepsinogen Ⅰ (PGⅠ),pepsinogen Ⅱ (PGⅡ) and figure out gastric secretory function in patients of functional constipation (FC).Methods 51 healthy individuals were chosen as control group and 42 patients with FC were chosen as FC group,of which serum gastric fluid pH value,Hp ratio,G-17,PGⅠ and PGⅡ were detected and analyzed.Results Compared with control group,gastric fluid pH value were marked reduced (t=2.180,P=0.032),and G-17,PGⅠ level in blood were marked increased in FC group (G-17:t=2.703,P=0.008;PGⅠ:t=7.388,P＜0.001).Hp ratio and blood level of PGⅡ in two groups showed no significant difference (Hp ratio:x2=0.031,P=0.861;PGⅡ:t=1.666,P=0.100).Conclusion Increased gastric secretory function level were found in patients of functional constipation.It gave a hint that stimulated gastroenteritic axis existed in patients of functional constipation.
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Objective To study the changes and significance of serum neutrophil gelatinase associated li-pocalin (NGAL ) ,cyclooxygenase 2 (COX-2 ) and pepsinogen (PG ) in the patients with gastric cancer . Methods Sixty cases of gastric cancer in this hospital from April 2015 to April 2017 were selected as the ob-servation group ,and contemporaneous 60 healthy subjects were selected as the control group .The double-anti-body sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum NGAL , COX-2 ,PGⅠ ,PG Ⅱ and PG Ⅰ /PGⅡ (PGR) in the two group .The results were compared .The relationship between serum NGAL and COX-2 with the clinicopathological parameters of gastric cancer was analyzed . Results The levels of serum NGAL and COX-2 in the observation group were (23 .43 ± 8 .34)ng/mL and (41 .44 ± 9 .51)ng/mL respectively ,which were higher than (11 .73 ± 2 .81)ng/mL and (16 .89 ± 6 .26)ng/mL in the control group ,the difference was statistically significant (P<0 .05) .Serum PGⅠ and PGR levels in the observation group were(13 .07 ± 20 .19)ng/mL and (2 .69 ± 1 .41) ,which were lower than (60 .15 ± 18 .70) ng/mL and (5 .08 ± 1 .86) in the control group ,the difference was statistically significant (P<0 .05) .The ser-um NGAL level in the patients with TNM stage Ⅰ + Ⅱwas significantly lower than that in the patients with TNM stage Ⅲ + Ⅳ ,the difference was statistically significant (P<0 .05);the serum NGAL level in the pa-tients with distant metastasis was significantly higher than that in the patients without distant metastasis ,the difference was statistically significant (P<0 .05) .The serum COX-2 level in the patients with TNM stage Ⅰ +Ⅱwas significantly lower than that in the patients with TNM stage Ⅲ + Ⅳ ,the difference was statistically sig-nificant(P<0 .05) .Conclusion Serum NGAL ,COX-2 and PG can serve as the effective indicators for gastric cancer screening ,disease condition judgment and prognosis assessment in gastric cancer .
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As a recognized precancerous disease, the chronic atrophic gastritis (CAG) has a low diagnosis rate at an early stage due to its atypical symptoms. While massive studies have shown that changes in the serum gastric function parameters including pepsinogen (PG) and gastrin 17 (G17) levels which can be reflected by the functional and morphological status of the gastric mucosa, moreover, H. pylori plays a catalytic role in mucosal atrophy and intestinal metaplasia, indirectly affects the values of the above items. In this article, we discussd the progress in the diagnosis of atrophic gastritis and the risk assessment of gastric cancer based on serum gastric function tests.
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@#Gastric cancer is the second leading cause of death worldwide. About half of the incidence of stomach cancer has been reported in East Asian countries. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. The age-standardized mortality rate for gastric cancer was 29.3 per 100,000 in 2016, ranking second after liver cancer. Pepsinogen (PG) is a proenzyme of pepsin, by chief and mucous neck cells in the gastric mucosa. On the basis of the source of secretion, PGs are subdivided into 2 types: PG I and II. PG I is only secreted from the fundic glands in the corpus of the stomach, whereas PG II is secreted from the corpus, as well as the pyloric glands in the antrum and proximal duodenum. PG is excreted mainly into the stomach lumen, but approximately 1% diffuses into the blood stream. Atrophic gastritis and intestinal metaplasia are well-known risk factors for gastric neoplasms including dysplasia. To identify these premalignant gastric conditions, histological biopsy or image-enhanced endoscopy is performed. Gastric cancer is usually preceded by a decades-long precancerous process driven by Helicobacter pylori infection and environmental conditions with well-defined successive lesions. In the advanced stages, they are characterized by glandular atrophy and intestinal metaplasia. These changes involve loss of the original glands and result in decrease of the mass of chief cells of the gastric corpus, where PGI is produced. Loss of chief cells leads to lower PGI levels and PGI/PGII ratio in the peripheral blood. Serum PG levels are therefore a key tool to be used in screening programs. Serum PG measurements could provide a simple and noninvasive method for screening gastric neoplasms.
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Objective:To investigate the feasibility of detection of serum pepsinogen (PG),gastrin-17 (G-17) and Helicobacter pylori antibody (anti-HP)in the gastric cancer screening,and to elucidate its clinical value. Methods:A total of 208 patients with early gastric cancer were selected as observation group;at the same time, 208 healthy examinees were regarded as blank control group.The levels of PGⅠ,PGⅡ and G-17 of the subjects in two groups were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetry;the positive rates of anti-HP were detected by 13 C urea breath test;the serum levels of PG Ⅰ,PG Ⅱ and PG Ⅰ /PGⅡ ratio of the anti-HP positive subjects (anti-HP positive group)and anti-HP negative subjects (anti-HP negative group)were compared and analyzed.Results:Compared with blank control group,the serum PGⅠ / PGⅡ ratio and PGⅠ level of the subjects in observation group were significantly decreased (P <0.01),and the levels of PG Ⅱ,G-17 and the positive rate of anti-HP were increased (P <0.01).Compared with anti-HP negative group,the serum PGⅠ / PGⅡ ratio and PGⅠ level of the subjects in anti-HP positive group were significantly decreased (P <0.01).The levels of PGⅡ and G-17 were significantly increased (P < 0.01).Conclusion:The detection of positive rate of anti-HP combined with the ratio of PGⅠ /PGⅡ has important clinical significance in gastric cancer screening.The levels of G-17 and PG Ⅱ in the epithelial neoplasia lesion tissue can be used as indicators of gastric precancerous lesions.
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Objective To observe the clinical efficacy of moxibustion at He-Sea plus Front-Mu points in treating chronic atrophic gastritis (CAG) due to deficient cold in spleen-stomach, and its effect on serum pepsinogen (PG) and gastrin. Method Sixty-three eligible patients with CAG due to deficient cold in spleen-stomach were divided into a control group (31 cases) and a treatment group (32 cases) by using random number table. The control group was intervened by Wei Fu Chun tablets, while the treatment group received moxibustion at He-Sea plus Front-Mu points, 12 weeks as a treatment course. Clinical efficacy, symptoms score of traditional Chinese medicine (TCM), serum PGⅠ, PG Ⅱ and gastrin levels were evaluated. Result The total effective rate was 93.8% in the treatment group, significantly better than that in the control group (P<0.05); the TCM symptoms scores dropped significantly in both groups after the treatment and in the follow-up study (P<0.01), and the treatment group was markedly superior to the control group (P<0.01); the levels of PG Ⅰ, PG Ⅰ/Ⅱ ratio (PGR) and gastrin-17 (G-17) increased significantly in the treatment group after the intervention (P<0.01), and PG Ⅱ dropped significantly (P<0.05); after the treatment, thelevels of PG I, PGR and G-17 increased significantly in the control group (P<0.05); after the intervention, the treatment group was significantly better than the control group in comparing the levels of PG Ⅰ, PGR and G-17 (P<0.01), and there was a significant difference in comparing the level of PG Ⅱ between the two groups after the intervention (P<0.05). The follow-up showed that the HP positive rate was 3.1% in the treatment group, significantly lower than that in the control group (P<0.05). Conclusion Moxibustion at He-Sea plus Front-Mu points can significantly improve CAG symptoms, enhance HT clearance and lower the relapse; its action mechanism is possibly through up-regulating PGⅠ, PGR and G-17 and down-regulating PG Ⅱ.
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Objective To investigate the infection status of Helicobacterpylori (HP) in the physical examination population and the contents of pepsinogen Ⅰ (PGⅠ),pepsinogen Ⅱ (PGⅡ) and gastrin-17 (G-17) in serumand the association with HP infection.Methods In this study,781 cases of physical examination were included.Serum HP antibody typing,PGl,PGⅡ and G-17 were measured by Helicobacter pylori antibody kit and enzyme-linked immunosorbent assay.The levels of PGⅠ,PGⅡ,PGⅠ/PGⅡ and G-17 were analyzed by SPSS22.0 analysis system,and the difference of HP infection rate between HP infection group and non-infected patients and different types of infection was analyzed.Analysis of the infection rate and the difference of each age group.Results There was no significant difference between the two groups (x2 =0.284,P=0.594),and there was significant difference between different age groups (x2 =8.523,P=0.014).The levels of PGⅠ,PGⅡ,PGR and G-17 in serum were statistically significant (Z=8.616～ 14.125,P=0.000) compared with those of HP positive and negative.There were significant differences in serum PGⅡ and PGR levels between HP Ⅰ type and HP Ⅱ type infection (Z=3.444,3.385,P=0.001).The levels of PGⅠ and PGⅡ in serum were significantly higher than those in other groups (Z=5.012,4.478,P=0.000).PGⅠ and PGⅡ were higher in women than in females (Z=0.444～0.941,P＞0.05),with the increase of age,PGⅠ,PGⅡ and G-17 has an upward trend,while PGR showed a downward trend.Conclusion The level of serum PG was closely related to gender,age and HP infection,and was closely related to HP infection classification.The combination of HP antibody typing and serum PG and G-17 as a routine test of gastric function is of great significance in the screening and evaluation of early gastric diseases.
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Objective To investigate the clinical application value of serum gastric function detection in early gastric cancer screening.Methods Forty-two cases of gastric cancer,75 cases of benign gastric diseases and 44 individuals undergoing normal physical examination in our hospital from December 2015 to December 2015 were selected as the research subjects,performed the gastroscopic examiantion,simultaneously conducted the microscopic biopsy,and extracted blood for conducting the related indexes detection of gastric function,including pepsinogen Ⅰ (PG Ⅰ),pepsinogen Ⅱ (PG Ⅱ),PG Ⅰ/PG Ⅱ,gastrin 17 (G17) and helicobactor pylori(HP).Serum gastric function situation in the research subjects of 4 groups was studied.Results PG Ⅰ and PG Ⅰ/PG Ⅱ expressions from low to high were gastric cancer group,atrophic gastritis group,gastric ulcer group,superficial gastritis group and normal group respectively,the pairwise comparison had statistical difference (P<0.05);G17 in the normal group was lower that that in gastric ulcer group,atrophic gastritis group and gastric cancer group G17 in the gastric ulcer group was lower than that in the gastric cancer group,the differences were statistically significant (P<0.05).The HP positive rate in the normal group was lower than that in the superficial gastritis group,the superficial gastritis group was lower than the gastric ulcer group,the gastric ulcer group was lower than the atrophic gastritis group,and the atrophic gastritis group was lower the gastric cancer group,the differences had statistical significance (P<0.05).Conclusion Serum gastric function detection can better distinguish gastric benign lesions from malignant lesions,and can serve as an important indicator of early screening,which is easy to accept with low cost,for the patients with positive results,the gastroscopic examination should be conducted in order to improve the early diagnostic rate.