ABSTRACT
INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied.For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.
Subject(s)
Gastrins/blood , Gastritis, Atrophic/blood , Pepsinogen A/blood , Pepsinogen C/blood , Adult , Biomarkers , Biopsy , Case-Control Studies , Dyspepsia/etiology , Gastritis, Atrophic/diagnosis , Gastritis, Atrophic/epidemiology , Gastroscopy , Humans , Peru/epidemiology , ROC Curve , Sensitivity and Specificity , Stomach Neoplasms/prevention & controlABSTRACT
INTRODUCCIÓN: La detección de atrofia gástrica podría ser utilizada en el diagnóstico precoz de cáncer gástrico en Perú. Se evaluó la determinación de niveles séricos de pepsinógenos I y II (PGI, PGII), gastrina-17 (G17), y la relación PGI/PGII como posible prueba de diagnóstico no invasivo de atrofia en pacientes peruanos. MATERIAL Y MÉTODOS: Se estudiaron adultos con dispepsia sometidos a endoscopía con biopsia gástrica, considerando dos controles sin atrofia por cada caso con atrofia. Se evaluaron las diferencias y se confeccionaron curvas ROC, así como el perfil serológico combinando PGI y PGI/PGII. Se calculó su sensibilidad y especificidad. RESULTADOS: Se analizaron 22 casos y 44 controles. El área bajo la curva ROC fue 0.599, 0.546 y 0.534 para PGI, PGII, y PGI/PGII respectivamente. Ninguna prueba discriminó entre casos y controles. El perfil serológico no alcanzó sensibilidad y especificidad adecuadas. DISCUSIÓN: Este primer estudio de pepsinógeno, gastrina y atrofia en Perú, no mostró utilidad de estos métodos. El impacto potencial en la detección y prevención de una neoplasia prevalente justifica mayor investigación. Incluir más pacientes, excluir a los tratados previamente contra Helicobacter pylori, y procesar separadamente las biopsias de antro y cuerpo, podrían revelar asociaciones no vistas en este estudio.
INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied. For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.
Subject(s)
Humans , Male , Female , Gastrins , Gastritis, Atrophic/diagnosis , Biomarkers , Stomach Neoplasms/diagnosis , Pepsinogen A , Pepsinogen C , Case-Control Studies , PeruABSTRACT
The international course Emerging Viruses: Global Approaches and Specificities of the Amazon Region was held in Porto Velho, Rondonia, Brazil, November 17-December 7, 2007. Organized as part of the Amsud-Pasteur research collaboration program (sponsored by Institut Pasteur), the course was held there primarily because Rondonia State is located in the Amazon region, a particular environment in which new viruses could emerge as a consequence of ecologic changes brought about by exploration and other human activities.
Subject(s)
Communicable Diseases, Emerging/virology , Brazil , Humans , International Cooperation , South America , Virology/education , Virus Diseases/virologyABSTRACT
The southernmost limit of the distribution of endemic Andean cutaneous leishmaniasis (CL), commonly known as Uta, is localized in the western Andean valleys of Ayacucho, Peru. This area is completely isolated from other regions endemic for this disease. Identification of the insect vector for Andean CL was carried out by combining entomologic and parasitologic approaches. Two Lutzomyia species were captured: Lutzomyia ayacuchensis and Lu. noguchii. The former species was considered responsible for transmission of Leishmania because 1) there was a coincidence in space and time between the presence of this insect and the distribution of Andean CL, 2) it was shown to be highly anthropophilic, 3) Leishmania parasites of the subgenus Viannia were detected by a specific polymerase chain reaction assay, 4) promastigotes isolated from this insect were shown by multilocus enzyme electrophoresis and molecular karyotyping to belong to the same deme of Leishmania (Viannia) peruviana as the one circulating in humans living in the study area, and 5) the complete cycle of L. (V.) peruviana was observed in experimental infections of Lu. ayacuchensis. Parasite and vector homogeneity found in Ayacucho contrasted with the heterogeneity reported for other areas endemic for Andean CL. The potential influence of ecologic determinants on this geographically isolated area is discussed.
