[Serological diagnosis of atrophic gastritis with a combination of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori antibodies].
OBJECTIVE
Noninvasive diagnosis of atrophic gastritis would help to identify individuals at increased risk of gastric carcinoma. In the present study, we evaluated the utility of a serological panel combining pepsinogen I and II, gastrin-17, and anti-Helicobacter pylori antibodies (Gastropanel) as a screening method for atrophic gastritis.


METHODS
The serological panel was evaluated in 56 patients divided in two groups: group 1 consisted of 47 patients with uninvestigated dyspepsia and group 2 was composed of nine consecutive patients with gastric carcinoma. In all patients, we performed endoscopy with biopsies of the gastric antrum and body. Levels of pepsinogen I and II, gastrin-17, and anti-H. pylori antibodies were determined through a specific EIA test (Biohit plc, Helsinki, Finland) in fasting serum samples.


RESULTS
Atrophic gastritis was significantly more frequent in patients with gastric carcinoma than in those with dyspepsia (56 vs 6%; p = 0.0015). Agreement between the Gastropanel and gastric histology was good (kappa = 0.68). The sensitivity and specificity of the Gastropanel in the diagnosis of atrophic gastritis was 87.5% and 100%, respectively. However, the Gastropanel would not have detected four of the nine cases of gastric carcinoma, since these tumors arose in stomachs with nonatrophic mucosa.


CONCLUSIONS
Gastropanel is a useful noninvasive method for the diagnosis of atrophic gastritis. However, its utility as a screening method is limited by cases of gastric carcinoma that arise in stomachs without atrophic mucosa.
Valle Muñoz
Julio
J
Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España. juliov@sescam.jccm.es
Artaza Varasa
Tomás
T
López Pardo
Rafael
R
Rodríguez Merlo
Rufo
R
Pérez Grueso
María José
MJ
Martín Escobedo
Roberto
R
Alcántara Torres
Mariano
M
Cuena Boy
Rafael
R
Carrobles Jiménez
José María
JM
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D005260:Female; D005755:Gastrins / Q000097:blood*; D005757:Gastritis, Atrophic / Q000097:blood* / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008297:Male; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D012698:Serologic Tests
D000907:Antibodies, Bacterial; D005755:Gastrins; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A