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Diagnosis of H elicobacter pylori ‐induced gastritis by serum pepsinogen levels
Author(s) -
Kitamura Yoko,
Yoshihara Masaharu,
Ito Masanori,
Boda Tomoyuki,
Matsuo Taiji,
Kotachi Takahiro,
Tanaka Shinji,
Chayama Kazuaki
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12987
Subject(s) - medicine , gastritis , gastroenterology , helicobacter pylori , atrophic gastritis , pepsin , chronic gastritis , spirillaceae , enzyme , biology , biochemistry
Background and Aim Gastric cancer develops due to atrophic gastritis induced by H elicobacter pylori ( H . pylori ) infection. Serum levels of pepsinogen ( PG ) are known to be excellent markers for evaluating the degree of atrophic gastritis. We investigated whether chronic gastritis could be diagnosed by evaluating serum PG levels. Methods A total of 4483 patients (average age, 49.7 years; 2879 men) were included in this study. Fasting serum samples were collected and anti‐ H . pylori antibody and PG levels were evaluated. We evaluated the endoscopic atrophy grade or histological extent of gastritis, and calculated the diagnostic capability of this serum marker. Results A total of 4483 patients, were diagnosed as being positive (4160) or negative (323) for H . pylori ‐induced gastritis. In patients with H . pylori ‐induced gastritis, the PG II levels were higher and the PG I / II ratios were lower than among those without H . pylori gastritis. A cut‐off values of (i) PG I / II ≤ 5; (ii) PG II ≥ 10 or PG I / II ≤ 5; (iii) PG II ≥ 12 or PG I / II ≤ 4.5 showed high sensitivity and accuracy (over 90%) for diagnosing H . pylori ‐induced gastritis. Moreover, in a mass screening of healthy subjects, a cut‐off value of PG I / II ≤ 4.5 might be better for diagnosing the presence of gastritis because of a sensitivity and specificity > 80%. Conclusions The presence of H . pylori ‐induced gastritis can be evaluated using serum PG levels.