Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study
Journal of Gastrointestinal and Liver Diseases 2018
Olga Sjomina, J Pavlova, Ilva Daugule, Pavel Janovic, Ilze Kikuste, A Vanags, I Tolmanis, Dace Rudzīte, Inese Poļaka, Ilona Kojalo, Inta Liepniece-Karele, Sergejs Isajevs, Daiga Santare, Valdis Pīrāgs, J Pahomova, V Dzerve, Lilian Tzivian, A Erglis, Mārcis Leja

Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited. © 2018, Romanian Society of Gastroenterology. All rights reserved.

Atslēgas vārdi
Atrophy, Follow-up, Gastric cancer, H.Pylori, Pepsinogens, Screening

Sjomina, O., Pavlova, J., Daugule, I., Janovic, P., Kikuste, I., Vanags, A., Tolmanis, I., Rudzīte, D., Poļaka, I., Kojalo, I., Liepniece-Karele, I., Isajevs, S., Santare, D., Pīrāgs, V., Pahomova, J., Dzerve, V., Tzivian, L., Erglis, A., Leja, M. Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study. Journal of Gastrointestinal and Liver Diseases, 2018, Vol.27, No.1, 11.-17.lpp. ISSN 1841-8724. e-ISSN 1842-1121. Pieejams: doi:10.15403/jgld.2014.1121.271.pep

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