Diagnóstico serológico de gastritis atrófica con una combinación de pepsinógeno I y II, gastrina-17 y anticuerpos anti-Helicobacter pylori / Serological diagnosis of atrophic gastritis with a combination of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori antibodies

Objetivo: El diagnóstico no invasivo de gastritis atrófica ayudaría a identificar individuos con un riesgo elevado de carcinoma gástrico. En este estudio se ha evaluado la utilidad de un panel serológico que combina pepsinógeno I y II, gastrina-17 y anticuerpos anti-Helicobacter pylori (Gastropanel) como método de cribado de la gastritis atrófica. Pacientes y métodos: El panel serológico se evaluó en 56 pacientes de dos grupos: a) 47 pacientes con dispepsia no investigada, y b) 9 pacientes consecutivos con carcinoma gástrico. En todos ellos se realizó una endoscopia con toma de biopsias del antro y el cuerpo gástricos. Los valores de pepsinógeno I y II, gastrina-17 y anticuerpos anti-H. pylori se determinaron mediante test EIA específicos (Biohit plc, Helsinki, Finlandia) en muestras de suero de los pacientes obtenidas en ayunas. Resultados: La gastritis atrófica fue significativamente más frecuente en los pacientes con carcinoma gástrico que en los pacientes dispépticos (el 56 frente al 6%; p = 0,0015). El grado de concordancia entre el panel serológico y la histología gástrica fue bueno (kappa = 0,68). La sensibilidad y la especificidad del panel serológico para diagnosticar la gastritis atrófica fueron del 87,5 y el 100%, respectivamente. Sin embargo, el panel serológico no habría detectado 4 de los 9 casos de carcinoma gástrico, ya que se originaron en un estómago con mucosa no atrófica. Conclusiones: El panel serológico es un método no invasivo útil para el diagnóstico de gastritis atrófica. Sin embargo, su utilidad como método de cribado está limitada por la existencia de casos de carcinoma gástrico que aparecen en estómagos sin atrofia mucosa

Objective: Noninvasive diagnosis of atrophic gastritis would help to identify individuals at increased risk of gastric carcinoma. In the present study, we evaluated the utility of a serological panel combining pepsinogen I and II, gastrin-17, and anti-Helicobacter pylori antibodies (Gastropanel) as a screening method for atrophic gastritis. Patients and methods: The serological panel was evaluated in 56 patients divided in two groups: group 1 consisted of 47 patients with uninvestigated dyspepsia and group 2 was composed of nine consecutive patients with gastric carcinoma. In all patients, we performed endoscopy with biopsies of the gastric antrum and body. Levels of pepsinogen I and II, gastrin-17, and anti-H. pylori antibodies were determined through a specific EIA test (Biohit plc, Helsinki, Finland) in fasting serum samples. Results: Atrophic gastritis was significantly more frequent in patients with gastric carcinoma than in those with dyspepsia (56 vs 6%; p = 0.0015). Agreement between the Gastropanel and gastric histology was good (kappa = 0.68). The sensitivity and specificity of the Gastropanel in the diagnosis of atrophic gastritis was 87.5% and 100%, respectively. However, the Gastropanel would not have detected four of the nine cases of gastric carcinoma, since these tumors arose in stomachs with nonatrophic mucosa. Conclusions: Gastropanel is a useful noninvasive method for the diagnosis of atrophic gastritis. However, its utility as a screening method is limited by cases of gastric carcinoma that arise in stomachs without atrophic mucosa

[Serological diagnosis of atrophic gastritis with a combination of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori antibodies]. / Diagnóstico serológico de gastritis atrófica con una combinación de pepsinógeno I y II, gastrina-17 y anticuerpos anti-Helicobacter pylori.

OBJECTIVE: Noninvasive diagnosis of atrophic gastritis would help to identify individuals at increased risk of gastric carcinoma. In the present study, we evaluated the utility of a serological panel combining pepsinogen I and II, gastrin-17, and anti-Helicobacter pylori antibodies (Gastropanel) as a screening method for atrophic gastritis. PATIENTS AND METHODS: The serological panel was evaluated in 56 patients divided in two groups: group 1 consisted of 47 patients with uninvestigated dyspepsia and group 2 was composed of nine consecutive patients with gastric carcinoma. In all patients, we performed endoscopy with biopsies of the gastric antrum and body. Levels of pepsinogen I and II, gastrin-17, and anti-H. pylori antibodies were determined through a specific EIA test (Biohit plc, Helsinki, Finland) in fasting serum samples. RESULTS: Atrophic gastritis was significantly more frequent in patients with gastric carcinoma than in those with dyspepsia (56 vs 6%; p = 0.0015). Agreement between the Gastropanel and gastric histology was good (kappa = 0.68). The sensitivity and specificity of the Gastropanel in the diagnosis of atrophic gastritis was 87.5% and 100%, respectively. However, the Gastropanel would not have detected four of the nine cases of gastric carcinoma, since these tumors arose in stomachs with nonatrophic mucosa. CONCLUSIONS: Gastropanel is a useful noninvasive method for the diagnosis of atrophic gastritis. However, its utility as a screening method is limited by cases of gastric carcinoma that arise in stomachs without atrophic mucosa.