title: Low serum levels of pepsinogen and gastrin 17 are predictive of extensive gastric atrophy with high-risk of early gastric cancer.
abstract: Atrophic gastritis (AG) is a well-recognized high-risk condition for developing gastric cancer (GC). Gastrin 17 (G17), a hormone secreted from antral G cells, regulates gastric acid secretion, and its serum level is a possible indicator of antral atrophy. Serum pepsinogen is well established as the indicator of AG involving the corpus. Here we investigated whether serum PG and G17 levels would be useful for determining the topographic pattern of AG and estimating the risk of GC. Enrolled were 122 Japanese patients with early GC (114 well- to moderate-differentiated cancers and 8 poorly-differentiated cancers). In addition, 178 subjects without GC were recruited as control from those undergoing endoscopic examination (non-GC group). All subjects were histologically assigned to the following four groups: non-AG, antrum-predominant AG, corpus-predominant AG, and multifocal AG, affecting the antrum and corpus. Serum concentrations of pepsinogen and G17 were determined using ELISA. Multifocal AG was more frequent in the GC group than in the adjusted non-GC group, and had the highest risk of GC (OR 25.1). Serum G17 was significantly decreased with the exacerbation of antral atrophy in the coexistence of corpus atrophy. Serum biomarker profiles showed that the low levels of pepsinogen and G17 could discriminate between multifocal AG and other types of AG, but not with pepsinogen level alone. Serologically defined multifocal AG had the highest cancer risk among other serologically defined AG groups (OR 26.9). In conclusion, the low serum levels of pepsinogen and G17 are predictive of extensive gastric atrophy with high-risk of early GC.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Kikuchi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Abe
authors.forename: Katsunori
authors.initials: K
authors.lastname: Iijima
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ara
authors.forename: Kaname
authors.initials: K
authors.lastname: Uno
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Asanuma
authors.forename: Naoki
authors.initials: N
authors.lastname: Asano
authors.forename: Akira
authors.initials: A
authors.lastname: Imatani
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001284:Atrophy; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D005755:Gastrins / Q000097:blood*; D016480:Helicobacter pylori / Q000502:physiology; D006403:Hematologic Tests; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D005755:Gastrins; C013550:gastrin 17; D020116:Pepsinogen A