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Ratio between serum IL‐8 and pepsinogen A/C: a marker for atrophic body gastritis
Author(s) -
Sanduleanu S.,
Bruïne A. D. E.,
Biemond I.,
Stridsberg M.,
Jonkers D.,
Lundqvist G.,
Hameeteman W.,
Stockbrügger R. W.
Publication year - 2003
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2003.01101.x
Subject(s) - gastrin , gastroenterology , medicine , atrophic gastritis , pepsin , gastritis , atrophy , helicobacter pylori , endocrinology , biology , secretion , biochemistry , enzyme
Background and aims Elevated serum gastrin and a low pepsinogen A/C ratio are well‐recognized markers for atrophic body gastritis (ABG). We have shown that the presence of body atrophy is also associated with elevated serum pro‐inflammatory cytokines. This study tested the hypothesis that serum cytokines provide additional information to gastrin and pepsinogens in screening for ABG. Methods Two hundred and twenty‐six consecutive patients were investigated on referral for upper gastrointestinal endoscopy: 150 were patients with gastro‐oesophageal reflux disease, receiving acid inhibitory medication either with proton pump inhibitors ( n = 113) or with histamine 2 ‐receptor antagonists ( n = 37), and 76 were nontreated controls, who had normal endoscopic findings. Gastric mucosal biopsies were sampled for histological examination (Sydney classification). Serum samples were analyzed for gastrin, chromogranin A (CgA), and pepsinogens A and C by RIA, and for the interleukins (IL)‐1β, IL‐6, and IL‐8 by ELISA. Results Subjects with ABG had significantly higher serum gastrin ( P < 0·01) and serum CgA ( P < 0·01) levels and significantly lower pepsinogen A/C ratios ( P < 0·001) than those without ABG. Additionally, serum IL‐1β, IL‐6 and, especially, IL‐8 levels were significantly higher in the subjects with than in those without ABG ( P < 0·0001, for all cytokines). To optimize the detection of body atrophy we defined the ABG index: the ratio between the simultaneously measured IL‐8 and pepsinogen A/C. The area under the ROC curve for the ABG index was significantly greater than that for serum gastrin and for serum pepsinogen A/C alone (0·91 ± 0·029 vs. 0·72 ± 0·042, and vs. 0·83 ± 0·031, P = 0·018 and P = 0·049). Using the ABG index at a cut‐off value of 1·8 pg mL −1 , 91% of the cases were classified correctly. Conclusions The ratio between serum IL‐8 and pepsinogen A/C accurately predicts the presence of ABG. We therefore propose the ABG index as a noninvasive screening test for ABG in population‐based studies.