Clinical usefulness of serum pepsinogen II in the management of Helicobacter pylori infection.
BACKGROUND
Serum pepsinogen II (sPGII) levels are known to increase during Helicobacter pylori infection.


OBJECTIVE
To assess H. pylori infection and success of H. pylori therapy by means of sPGII levels.


METHODS
sPGII levels were determined in 156 H. pylori-positive and 157 H. pylori-negative consecutive patients with dyspeptic symptoms. Additionally, sPGII determination was performed in 70 H. pylori-positive patients 2 months after H. pylori eradication therapy. In 29 of these 70 patients, gastroscopy was performed to evaluate the effect of H. pylori therapy on gastric activity.


RESULTS
H. pylori-positive subjects demonstrated a significantly higher mean of sPGII levels than H. pylori-negative subjects (16.8 +/- 7.4 vs. 8.6 +/- 3.7 microg/l; p < 0.001). The best sPGII cut-off for predicting H. pylori infection was 9.93 microg/l (sensitivity 83%, specificity 73%). The best cut-off values to evaluate success of therapy were: sPGII of 9.47 microg/l, a sPGII variation level (difference between baseline and after therapy) of 4.54 microg/l, and a sPGII Deltavalue (sPGII variation divided by sPGII before therapy) of 25% (sensitivity 93%, specificity 91%).


CONCLUSIONS
sPGII levels may be used as a reliable marker of H. pylori infection in the initial diagnosis as well as to evaluate H. pylori eradication and subsequent changes in gastric inflammation.
Department of Clinical Sciences, Chair of Gastroenterology, University of Parma, Parma, Italy. francesco.dimario@unipr.it
Francesco
F
Di Mario
Ali Mahamat
AM
Moussa
Lucas Giovanni
LG
Cavallaro
Pietro
P
Caruana
Roberta
R
Merli
Simone
S
Bertolini
Veronica
V
Iori
Giulia Martina
GM
Cavestro
Nadia
N
Dal Bò
Alberto
A
Pilotto
Angelo
A
Franzé
Gioacchino
G
Leandro
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D020115:Pepsinogen C / Q000097:blood*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D015415:Biomarkers; D020115:Pepsinogen C