title: The association between precancerous gastric lesions and serum pepsinogens, serum gastrin, vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between serum pepsinogens, serum gastrin, serum vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status in patients with various gastric precancerous lesions.
  
  
  METHODS
  One hundred and sixty two consecutive patients with various gastric lesions [38 (23.5%) H. pylori positive chronic non-atrophic gastritis, 45 (27.8%) autoimmune gastritis, 42 intestinal metaplasia and 37 dysplasia] were enrolled into the study. Serum pepsinogen I and II, gastrin 17, vascular endothelial growth factor, interleukin-1 Beta, toll-like receptor-4 levels, H. pylori Cag A status were evaluated.
  
  
  RESULTS
  H. pylori was positive in 98 (60.5%) patients and 38 of these patients were Cag A positive. Serum pepsinogen level was significantly lower in patients with autoimmune atrophic gastritis compared to the patients with non-atrophic chronic gastritis (p<0.001), intestinal metaplasia (P<0.001) and dysplasia (P=0.002). Mean serum gastrin was 1209.6±268.48 pg/mL in patients with autoimmune atrophic gastritis and 234.95±184.018 pg/mL in patients with chronic non-atrophic gastritis. Mean toll-like receptor-4 level was 0.56±0.098 ng/mL in patient with dysplasia, and this value was higher compared to patients with chronic non-atrophic gastritis (P=0.007), autoimmune atrophic gastritis (P=0.003) and intestinal metaplasia (P=0.006). Interleukin-1 Beta level was significantly lower in patients with dysplasia compared to patients with chronic non-atrophic gastritis (P=0.034).
  
  
  CONCLUSIONS
  Serum pepsinogens, serum gastrin and H. pylori Cag A status are important tests in detecting gastric precancerous lesions. However, toll-like receptor-4 may be a sensitive test to differentiate the patients with dysplasia from the other precancerous gastric lesions. Non-invasive tests are sensitive in the diagnosis of gastric precancerous lesions.
authors.affiliation: Ankara University Faculty of Medicine, Ibni Sina Hospital, Department of Gastroenterology, Sihhiye, 06100 Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yakut
authors.forename: Necati
authors.initials: N
authors.lastname: Örmeci
authors.forename: Harun
authors.initials: H
authors.lastname: Erdal
authors.forename: Onur
authors.initials: O
authors.lastname: Keskin
authors.forename: Zihni
authors.initials: Z
authors.lastname: Karayel
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Tutkak
authors.forename: Irfan
authors.initials: I
authors.lastname: Soykan
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000097:blood; D001426:Bacterial Proteins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000097:blood / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008679:Metaplasia / Q000097:blood / Q000473:pathology; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D011230:Precancerous Conditions / Q000097:blood* / Q000175:diagnosis; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology; D051197:Toll-Like Receptor 4 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D015415:Biomarkers; D005755:Gastrins; D053583:Interleukin-1beta; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D042461:Vascular Endothelial Growth Factor A; C080866:cagA protein, Helicobacter pylori; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A