[Correlation of changes in serum pepsinogen 1, pepsinogen 2 with helicobacter pylori eradication]

H.pylori infection in the stomach was the first major cause of gastritis and peptic ulcer disease and gastric adenocarcinoma and lymphoma [MALT]. Evaluation of the infection eradication is important. H.pylori infection was associated with gastric glands dysfunction such as increased serum gastrin and increased secretion of Pepsinogen. In recent years the measurement of serum gastrin and pepsinogen were considered to evaluation of Helicobacter pylori eradication.In a case - control study, we evaluated the changes of serum pepsinogen type 1 and 2 in H.pylori-positive patients after eradication therapy, and we assessed the correlation of serum pepsinogen type 1 and 2 and with successful eradication therapy. Pepsinogen type 1 and 2 serum levels significantly decreased after successful eradication in comparison with unsuccessful eradication. The both 2 markers decreased after 8 weeks of therapy. Pepsinogen 1 by a 41.1% decrease in 8 weeks after eradication had 95% sensitivity and 100% specificity for successful eradication. 64.1% reduction in pepsinogen 2, 8 weeks after treatment had 97.5% sensitivity and specificity for successful eradication. According to the findings of this study and other previous studies, changes in the type 2 pepsinogen serum levels, can be a reliable indicator of successful eradication of H.pylori infection. Although our study showed that changes in pepsinogen1 levels have a sufficient sensitivity and specificity of treatment, but in our study some factors including atrophic gastritis and age that affected on type 1 pepsinogen serum levels, did not considered

Differences in the Levels of Gastric Cancer Risk Factors Between Nanjing and Minqing Counties, China / 예방의학회지

OBJECTIVES: In Fujian Province, China, gastric cancer is one of the leading causes of mortality among all malignant tumors. Nanjing county and Minqing county are located in inland Fujian and have similar general demographics. However, the adjusted mortality rate of gastric cancer in Minqing was found to be much higher than that in Nanjing. We sought to explore factors associated with this increased risk of gastric cancer between the two counties. METHODS: We recruited 231 and 224 residents from Nanjing and Minqing, respectively, and analyzed differences between their dietary habits, Helicobacter pylori infection rates, and concentrations of serum pepsinogen I, pepsinogen II, gastrin-17, and ratio of pepsinogen I:II. RESULTS: Subjects in Minqing had more first-degree relatives who had been diagnosed with upper gastrointestinal tumor, more unhealthy dietary habits, a higher Helicobacter pylori positive rate, and greater proportion of abnormal serum gastrin-17 than those in Nanjing did. CONCLUSIONS: The factors that differed between these two counties might indicate that residents in Minqing have a higher risk for developing gastric cancer than those in Nanjing do.

Differences in the Levels of Gastric Cancer Risk Factors Between Nanjing and Minqing Counties, China / 예방의학회지

OBJECTIVES: In Fujian Province, China, gastric cancer is one of the leading causes of mortality among all malignant tumors. Nanjing county and Minqing county are located in inland Fujian and have similar general demographics. However, the adjusted mortality rate of gastric cancer in Minqing was found to be much higher than that in Nanjing. We sought to explore factors associated with this increased risk of gastric cancer between the two counties. METHODS: We recruited 231 and 224 residents from Nanjing and Minqing, respectively, and analyzed differences between their dietary habits, Helicobacter pylori infection rates, and concentrations of serum pepsinogen I, pepsinogen II, gastrin-17, and ratio of pepsinogen I:II. RESULTS: Subjects in Minqing had more first-degree relatives who had been diagnosed with upper gastrointestinal tumor, more unhealthy dietary habits, a higher Helicobacter pylori positive rate, and greater proportion of abnormal serum gastrin-17 than those in Nanjing did. CONCLUSIONS: The factors that differed between these two counties might indicate that residents in Minqing have a higher risk for developing gastric cancer than those in Nanjing do.

Clinical Utility of Serum Pepsinogen Levels as a Screening Test of Atrophic Gastritis / 대한진단검사의학회지

BACKGROUND: Atrophic gastritis is a well known risk factor for gastric adenocarcinoma. Its confirmatory diagnosis requires histology via endoscopy, which is an invasive method; therefore, periodic follow up evaluation as a screening method is difficult to perform. We evaluated the clinical utility of serum pepsinogens (PG) as a biomarker for screening of atrophic gastritis. METHODS: The study population consisted of 130 selected dyspeptic patients (M:F=52:78; age, 16-105 yrs; mean age, 50.8 yrs) who had undergone a diagnostic endoscopy. The serum pepsinogen test was performed by a latex turbidimetric immunoassay method (HBI, Korea) using Toshiba-200FR automatic analyzer. The PGI, II level and PGI:PGII ratio of non-atrophic gastritis group were compared with those of atrophic gastritis group, and a correlation with Helicobacter pylori infection was examined. Cut-off points for screening of atrophic gastritis were determined. RESULTS: The mean serum concentration of PGI showed a decline from normal (60.7 ng/mL), nonatrophic gastritis (54.2 ng/mL), and atrophic gastritis (51.8 ng/mL) to gastric adenocarcinoma (32.6 ng/mL). The mean ratio of PGI:PGII was lower in atrophic gastritis (3.2) compared to non-atrophic gastritis (4.7) (P=0.021). In patients with H. pylori infection, the mean serum PGII level was higher and the PGI:PGII ratio was lower than those in patients without H. pylori infection, and the differences were statistically significant. For screening of atrophic gastritis, the best cut-off point of PGI:PGII ratio was 4, with a sensitivity of 82.6% and specificity of 91.7%. CONCLUSIONS: The serum pepsinogen test is a useful biomarker for screening of atrophic gastritis, a well-known precancerous lesion of gastric adenocarcinoma. Measuring both pepsinogen I and II concentrations simultaneously to obtain pepsinogen I/II ratio provides a clinically useful information for the detection of atrophic gastritis.

Serum pepsinogen I and II levels in various gastric disorders with special reference to their use as a screening test for carcinoma stomach.

INTRODUCTION: The role of serum pepsinogen in the diagnosis of gastric carcinoma is well established. Its role in other common upper alimentary disorders has not been widely studied. The aim of this study was to describe the effect of various gastric disorders on the levels of pepsinogen I, pepsinogen II and pepsinogen I/II ratio, with an emphasis on the diagnosis of carcinoma stomach in the South Indian population. METHODS: A total of 210 patients in seven groups, including one control group, were studied. The groups included patients with carcinoma stomach, Helicobacter pylori gastritis, peptic ulcer, portal hypertensive gastropathy, non-ulcer dyspepsia and erosive gastritis. Serum pepsinogen I, pepsinogen II and pepsinogen I/II ratio were estimated using an enzyme-linked immunosorbent assay technique. RESULTS: Patients with carcinoma of the stomach, when compared with controls, had a significantly lower pepsinogen I level (87.2 microg/L vs. 158.1 microg/L, p=0.0002) and pepsinogen I/II ratio (4.3 vs. 7.2, p = 0.0001). No significant change in pepsinogen levels occurred in the other groups. The cut-off levels of pepsinogen I (115.3 microg/L) and pepsinogen I/II ratio (6.2), determined by THE ROC curve, when applied in parallel provided a sensitivity of 97% and a negative predictive value of 91.4% for the diagnosis of carcinoma stomach. When the tests were applied in parallel, the likelihood ratio of a negative test was 0.06, indicating that individuals without carcinoma stomach were 16 times more likely to have a negative test than those with carcinoma. This fulfilled the essential prerequisites of an ideal screening test. CONCLUSION: Serum pepsinogen estimation is a useful diagnostic tool in the diagnosis of carcinoma stomach. The significance of serum pepsinogen level in portal hypertensive gastropathy, non-ulcer dyspepsia, peptic ulcer, Helicobacter pylori gastritis and erosive gastritis was not established.

Significance of serum pepsinogens in atrophic gastritis

Chronic atrophic gastritis is a precancerous lesion. A commonly used test for the diagnosis of chronic atrophic gastritis, gastric endoscopy with biopsy collection, and a good serological test would be best include low levels of pepsinogen I [PGI] or a low PGI/PGII ratio. To confirm the use of serum pepsinogens as a screening marker in atrophic gastritis. A study was conducted in the period between December 2005 and March 2006 on 25 patients with artophic gastritis attending Gastroenterology and Hepatology Teaching Hospital in Baghdad, and 25 healyh control subjects. Sera were tested for PGI and PGII by ELISA test the serum PGI were decreased significantly with artophic gastritis and the PGI/PGII ratio were decreased in [78%] of patient group and not affected in healthy people

Relationship between Pepsinogen I/II Ratio and Age or Upper Gastrointestinal Diseases in Helicobacter pylori-positive and -negative Subjects / 대한소화기학회지

BACKGROUND/AIMS: Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status. METHODS: A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay. RESULTS: H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p<0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p<0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p<0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p<0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis). CONCLUSION: Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.

Relationship between Pepsinogen I/II Ratio and Age or Upper Gastrointestinal Diseases in Helicobacter pylori-positive and -negative Subjects / 대한소화기학회지

BACKGROUND/AIMS: Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status. METHODS: A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay. RESULTS: H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p<0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p<0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p<0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p<0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis). CONCLUSION: Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.

Pepsinógenos séricos para detectar cáncer gástrico en Costa Rica / Serum pepsinogen in screening for gastric cancer in Costa Rica

Las concentraciones de pepsinógenos (PG) I y II en suero, reflejan el estado funcional y morfológico de la mucosa gástrica. En este estudio se determinaron los puntos de corte óptimos de los niveles séricos de PGI, PGII y de la razón PGI/PGII, para identificar a las personas con alto riesgo de cáncer gástrico en una población de alto riesgo en Costa Rica. La población en estudio estaba formada por 338 personas sin cáncer gástrico y por 20 pacientes con cáncer gástrico. Los niveles de PGI y el valor de PGI/PGII fueron significativamente más bajos en las personas con cáncer gástrico que en los controles. Los puntos de corte óptimos para la detección de cáncer gástrico fueron de PGI ¾ 2,5. Usando estos puntos de corte la sensibilidad y especificidad fueron de 90 y 64 por ciento. Las concentraciones bajas de PGI y valores bajos de PGI/PGII indican alto riesgo de presentar un cáncer gástrico. El tamizaje por medio de pepsinógenos es simple y relativamente barato, sin embargo el beneficio real de esta prueba debe determinarse en el impacto sobre las tasas de mortalidad por cáncer gástrico

Role of Gastroesophageal reflux in the pathogenesis of otitis media with effusion

This prospective comparative study was designed to define the presence of Helicobacter pylori [H. pylori] in middle ear effusion [MEE] and to compare pepsin levels both in serum and MEE as a trial to define a possible role for them in the pathogenesis of otitis media with effusion [OME]. The study included 40 children with chronic OME, 30 patients had bilateral OME, whereas 10 patients had unilateral OME. Blood samples were taken before induction of anesthesia and MEEs were collected at the time of myringotomy and was divided into two parts; the first was used for determination of the presence of H. pylori and the second part for determination of pepsin-like activity. H. pylori could be detected in 48 effusion samples [71.6%] obtained from 21 patients with bilateral OME [21/30; 70%] and 6 patients with unilateral OME [6/10; 60%]. Twenty-seven [56.3%] samples were obtained from right ear and 21 samples [43.7%] were obtained from the left ear. There was a negative significant correlation, [r=-0.662, P<0.05] between age and the presence of H. pylori. Pepsin-like activity was detected in 35 samples [52.2%], at pH 2.2 in 26 samples [74.3%] and at pH 8 in 9 samples [25.7%]. There was a significant increase [P<0.05] of total pepsin-like activity in effusion compared to levels detected in serum. Furthermore, mean pepsin-like activity detected at pH 2.2 showed a significant increase compared to activity level detected both in serum and to that detected in effusion at pH 8, moreover, mean pepsin-like activity detected at pH 8 showed a significant increase compared to activity level detected in serum. There was a positive significant correlation between the presence of H. pylori and the activity level of pepsin, [r=0.81, P<0.05]. We could conclude that gastric reflux with its acidity and contents of H. pylori and pepsin plays a role in pathogenesis of otitis media with effusion

Genetic markers and duodenal ulcer

Serum pepsinogen, alpha 1-antitrypsin [alpha 1-AT] and blood groups were studied as genetic markers in 32 patients with endoscopically proven duodenal ulcer and 44 control subjects with no family history of ulcer disease. Serum pepsinogen was determined by the modified method of Edward et al, alpha 1-AT by single radial immunodiffusion [RID] and phenotyping was carried out by isoelectric focusing [IEF]. Duodenal ulcer patients with hyper- pepsinogenemia [28%] and low serum alpha 1-AT [35%] had a dominant blood group O, lower mean age, an early onset of disease, a higher frequency of gastrointestinal [GI] bleeding and ulcer perforation. These parameters were found considerably different in patients with normal serum pepsinogen and alpha 1-AT. Phenotype analysis of alpha 1-AT revealed that four duodenal ulcer patients had partial deficiency of the protease inhibitor and none of the normal exhibited the deficiency pattern. The etiology of the disease appears to be genetic anomaly in 28% of patients while the rest [72%] had ulcers as a result of neuroendocrinological or environmental factors

Gastric chief cell mass in duodenal ulcer

A 25 pacientes ulcerosos duodenales y 40 controles sanos se les calculó la massa de células principales y el Pepsinogeno serico I. Se comparó también con la masa celular parietal y la secreción ácida estimulada. La masa celular principal fue expresada por el índice Zinogenico (IZ) obtenido multiplicando al número de células principales por mm2 por el espesor de la capa glandular. Se encontró una significativa disminución del IZ en pacientes com úlcera duodenal que en controles. El agrupamiento según la edad por encima y debajo de 50 anos, confirma que el IZ disminuye significativamente en ulcerosos duodenales en relación a controles. No hay cambios de IZ en ulcerosos duodenales con gastritis fundica superficial en comparación con aquellos con mucosa fundica normal. El pepsinógeno serico II está aumentado en pacientes ulcerosos con gastritis fundica superficial en relación a los que tienen mucosa normal. Se observa hipopesinogenemia en pacientes con hiperparietolismo y normopepsinogenemia en los pacientes con normoparietolismo. Finalmente no se observa correlación entre índice Zinogenico y Pepsinógeno serico I

Serum pepsinogen in duodenal ulcer

Total serum pepsinogen concentration was determined in 100 patients with endoscopically proven duodenal ulcer and an equal number of age and sex matched controls. Serum pepsinogen levels were within normal limits in 82% cases and raised in 17% cases. Comparison of demographic profile of hyper with normopepsinogenemics showed that patients with raised levels had an early onset of the disease, predominantly belonged to blood group "O" and had a higher frequency of duodenal ulcer perforation than those with normal pepsinogen levels

Niveles de pepsinógeno I sérico en descendientes de ulcerosos duodenales / Levels of blood pepsinogen I in the offspring of patients with duodenal ulcer

La hiperpepsinogenemia I es un fidedigno marcador subclínico de predisposición genética a sufrir úlcera duodenal, por ello determinamos los niveles basales de pepsinógeno I (PG I) sérico en 25 ulcerosos y el 75

Niveles de pepsinógeno I sérico en el ulceroso duodenal sangrante / Serum pepsinogen I levels in bleeding duodenal ulcerous

Se compararon los niveles de Pepsinógeno I (PG I) séricos de 25 ulcerosos duodenales con antecedentes de sangramiento (UDS), 25 ulcerosos duodenales no sangrantes (UDNS) y un grupo control, igualmente distribuídos por edad y sexo. El valor más elevado que en los UDNS, esta diferencia sin embargo, no fue estadísticamente significativa. No obstante, el 88%de los UDS presentaron valores de PG I elevados comparados con el 72%de los uDNS. Dichos grupos si tuvieron diferencia significativa (p<0.001) con el grupo control. Concluímos que la medición del PG I sérico, es un sensible método diagnóstico complementario en el ulceroso duodenal. Su capacidad discriminatoria como índice de severidad, por el antecedente de hemorragia, sin embargo, no pudo ser demostrado. La hemorragia sigue siendo unreto en la historia natural del ulceroso duodenal

Pepsinógeno I sérico y enfermedad ulcerosa duodenal / Serum pepsinogen I and duodenal ulcer disease

La úlcera duodenal es una enfermedad frcuente. Se ha dicho siempre que resulta de un inadecuado balance entre las fuerzas agresivas (HC1 y pepsina) y las fuerzas defensivas. Tradicionalmente mayor atención se ha prestado al ácido y relativo menor interés a la pepsina. Dos tipo de pepsinógenos han sido reconocidos como precursores de la actividad péptica intraluminal. El Pepsinógeno I ha sido mayormente implicado en ulcerogénesis. La intención de esta revisión es considerar los diferentes aspectos actuales fisiopatológicos y clínicos, como marcador predictivo y genético de esta enzima en la enfermedad ulcerosa duodenal, la cual es siempre un reto en la práctica diaria de los gastroenterólogos

Niveles de pepsinogeno I sérico en ulcerosos duodenales sangrantes y no sangrantes / Serum pepsinogeno I levels in patients with bleeding or not duodenal ulcer

Se midieron por radioinmunoanálisis los niveles de Pepsinógeno I Sérico basal en 25 sujetos controles y 50 individuos ulcerosos duodenales, subdivididos éstos en dos grupos de 25 pacientes de acuerdo al antecedente o no de hemorragia proveniente de la úlcera. Los valores de Pepsinógeno I Sérico del grupo total de ulcerosos duodenales estuvieron elevados en forma altamente significativa en relación con el grupo control. Los niveles de Pepsinógeno I Sérico en el grupo de los ulcerosos duodenales sangrantes estuvieron discretamente elevados en relación con los ulcerosos duodenales no sangrantes. dicha diferencia sin embargo no fue estadistícamente significativa, no pudiendo discriminarse por tanto, de acuerdo a dichos valores entre aquellos que sangraron y los que no lo han hecho

Pepsinogenio sérico em cäes submetidos a anastomose porto-cava / Serum pepsinogen in dogs subjected to a portocaval anastomosis

Tendo-se realizado APC em 20 cäes, averiguou-se a importância do desvio do sangue portal no tocante aos níveis séricos de pepsinogênio (NSP), da albumina e da colinesterase. As dosagens de oito semanas pós-operatórias foram realizadas em 10 animais. Aplicou-se o teste T. de Student para análise estatística dos resultados. O NSP näo se alterou, houve queda da labuminemia e os níveis de colinesterase näo se alteraram, sugerindo, por este estudo, que o desvio de sangue portal näo tem efeito no comportamento secretor de pepsinogênio no período estudado. Conclusäo: a curto prazo, a APC näo influi nos NSP apesar de determinar certa deteriorizaçäo da funçäo hepática

Pepsinogênio I e úlcera duodenal / Serum pepsinogen I and duodenal ulcer

Neste artigo de revisäo procurou-se enfocar o papel do pepsinogênio/pepsina desde sua descoberta até sua aplicaçäo prática que, à semelhança do teste de secreçäo gástrica de ácido clorídrico, apresenta padröes diferentes de secreçäo basal ou estimulada na úlcera péptica, gastrite etc. Säo avaliados os métodos de determinaçäo do pepsinogênio, verificando-se que apesar da utilizaçäo do radioimunoensaio, outros métodos menos sofisticados, porém com alta especificidade, têm sido usados com sucesso. Os níveis séricos de pepsinogênio (NSP) após estímulo com Histalog discriminam pacientes com úlcera duodenal de indivíduos normais e säo mais elevados em homens do que em mulheres. É feito um paralelismo entre os pepsinogênios I e II verificando-se níveis mais elevados do pepsinogênio I em fumantes. O pepsinogênio I está aumentado na úlcera duodenal e o II na úlcera gástrica, e os dois tendem a caracterizar uma predisposiçäo genética para úlcera péptica. Finalmente, a principal aplicabilidade clínica da determinaçäo dos NSP do grupo I é na detecçäo da gastrite atrófica, em funçäo de seu potencial para o cáncer gástrico