Barrett's esophagus is characterized by the absence of Helicobacter pylori infection and high levels of serum pepsinogen I concentration in Japan.
OBJECTIVE
It has been reported that patients with Barrett's esophagus (BE) may have gastric acid hypersecretion. Serological markers such as serum pepsinogen or gastrin have been used to estimate the gastric secretory function. The aim of this study was to compare the serum pepsinogen and gastrin concentrations in view of Helicobacter pylori infection status between BE patients and the controls.


METHODS
Thirty-six patients with long-segment BE were enrolled in this study. Three age- and sex-matched controls were assigned to each patient. Serum pepsinogen and gastrin concentrations were measured by radioimmunoassay and H. pylori infection was determined by histology and serum IgG antibodies.


RESULTS
Helicobacter pylori infection was present in 4 of 36 patients (11%) with BE and in 80 of 108 controls (74%), being less prevalent in BE patients than in the controls (P < 0.0001). When examined in the H. pylori-negative subjects, both the serum pepsinogen I and pepsinogen II concentrations in BE patients were significantly higher than those in the controls (mean pepsinogen I:BE 51.0 +/- 14.0 ng/mL vs control 38.9 +/- 13.5 ng/mL, P = 0.0012; mean pepsinogen II:BE 10.8 +/- 4.0 ng/mL vs control 7.9 +/- 2.0 ng/mL, P = 0.0097). There was no significant difference in the serum gastrin levels between BE patients and the controls irrespective of the H. pylori infection status.


CONCLUSIONS
Most of the Japanese BE patients are characterized by the absence of H. pylori infection and high levels of serum pepsinogen. Determination of the serum pepsinogen level in combination with the H. pylori infection status could be a useful serological marker for BE screening.
Abe
Yasuhiko
Y
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. y_abe@mui.biglobe.ne.jp
Iijima
Katsunori
K
Koike
Tomoyuki
T
Asanuma
Kiyotaka
K
Imatani
Akira
A
Ohara
Shuichi
S
Shimosegawa
Tooru
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D044466:Asian People; D001471:Barrett Esophagus / Q000201:enzymology / Q000208:ethnology* / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000208:ethnology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood; D011237:Predictive Value of Tests; D015995:Prevalence; D015854:Up-Regulation
D000907:Antibodies, Bacterial; D015415:Biomarkers; D005755:Gastrins; D020115:Pepsinogen C; D020116:Pepsinogen A