Anti-parietal cell antibody and serum pepsinogen assessment in screening for gastric carcinoma.
BACKGROUND
Anti-parietal cell antibody is found in patients with Helicobacter pylori-positive gastritis and is related to atrophic gastritis and gastric carcinoma.


OBJECTIVE
To identify the characteristics of patients at high-risk for gastric carcinoma in terms of anti-parietal cell antibody and serum pepsinogen.


METHODS
Subjects were 92 H. pylori-positive patients (54 men, 38 women; mean age, 57.9 years; range, 15-88 years). The serum concentrations of pepsinogen I and II were determined by radioimmunoassay, and the presence of anti-parietal cell antibody was assessed by enzyme-linked immunosorbent assay. Degrees of inflammation and atrophy in the corpus of the stomach were evaluated histologically.


RESULTS
Patients were classified into four groups according to anti-parietal cell antibody status and pepsinogen I/II ratio. Anti-parietal cell antibody-negative/pepsinogen I/II-low patients had the highest risk for gastric carcinoma (prevalence of gastric carcinoma: 7/13=53.8%, odds ratio=7.6, 95% confidence interval, 1.2-48.0). Anti-parietal cell antibody titre was high when inflammation in the corpus was severe (p=0.06) and significantly low when atrophy in the corpus was severe (p=0.01).


CONCLUSIONS
Our results showed that patients with a negative anti-parietal cell antibody titre and low pepsinogen I/II ratio are at high-risk for gastric carcinoma.
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Matsushima 577, Kurashiki 701-0192, Japan.
K
K
Sugiu
T
T
Kamada
M
M
Ito
S
S
Kaya
A
A
Tanaka
H
H
Kusunoki
J
J
Hata
K
K
Haruma
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology* / Q000473:pathology; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology
D001323:Autoantibodies; D015415:Biomarkers; D020115:Pepsinogen C; D020116:Pepsinogen A