[The clinical significance of GastroPanel in diagnostics of Helicobacter pylori eradication efficiency in patients with dyspepsia with correlation of family history of gastric cancer].
Gastric cancer remains a significant medical and social problem. Familial, hereditary, social, and demographic factors increase the susceptibility of subjects to cancer development, especially those infected with Helicobacter pylori (H. pylori). Apart from genetic studies, there are ongoing biochemical studies of possible practical value in assessment of the risk of gastric cancer development. The GastroPanelBiohit test, that include determination of the levels of gastrin (G-17), pepsinogen I (PGI), pepsinogen II (PGII) and antibodies IgG/IgA against H. pylori in serum, allowed us to determine whether there are any abnormal changes in the gastric mucosa. The aim of the study was to determine whether GastroPanel parameters, identified in patients with dyspeptic symptoms (with or without history of gastric cancer in first degree relatives) before and after successful eradication of H. pylori, have any clinical value, especially in gastric cancer development.


METHODS
The study comprised 61 patients aged 18-56 years with symptoms of dyspepsia. In all patients, the preliminary urea breath test (UBT) for the presence of H. pylori was performed and the positive result qualified for further study. For final analysis, 42 patients were approved, who were divided into two groups: group I (a control group) - 22 patients with negative family history of gastric cancer among the relatives of first degree, group II - 20 patients with positive history of gastric cancer among the relatives of first degree. All the patients had the gastroscopy with the biopsy of gastric mucosa for the histopathological evaluation. Additionally, the GastroPanel test was performed.


RESULTS
In the blood serum of the patients with H. pylori infection, the concentrations of gastrin (G-17), pepsinogen I (PGI) and pepsinogen II (PGII) did not depend on family history of gastric cancer (p > 0.05). Successful eradication of H. pylori decreases the levels of G-17, PGI and PGII (statistical significance p < 0.05), and this correlates with the histopathological changes of gastric mucosa. The patients with positive family history of gastric cancer had more intense H. pylori colonization of gastric mucosa (IV degree of insensitivity of infection in UBT; group I - 22% vs group II - 69%) as compared to the control group. After effective eradication of H. pylori, statistically significant decreases of IgG H. pylori antibodies and of the level of gastrin (p < 0.05) in blood serum were seen (in a 3 months follow up) only in the control group.


CONCLUSIONS
Independently of the history of familial gastric cancer, the GastroPanelBiohit test provides important clinical data useful for diagnosis, for assessment of effectiveness of H. pylori eradication therapy and in evaluation of the degree of the inflammatory changes in gastric mucosa.
Department of Gastroenterology, Medical University of Łódź, Poland. gastrologia@umed.lodz.pl
Marcin
M
Adamczyk
Łukasz
Ł
Peczek
Cezary
C
Rudnicki
Barbara
B
Nawrot
Krystyna
K
Stec-Michalska
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001944:Breath Tests; D004415:Dyspepsia / Q000150:complications*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology* / Q000473:pathology; D005755:Gastrins / Q000378:metabolism; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D020116:Pepsinogen A / Q000378:metabolism; D020115:Pepsinogen C / Q000378:metabolism; D013274:Stomach Neoplasms / Q000235:genetics*; D014508:Urea / Q000032:analysis; D055815:Young Adult
D005755:Gastrins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D020115:Pepsinogen C; D014508:Urea; D020116:Pepsinogen A