title: Temporal changes in serum biomarkers and risk for progression of gastric precancerous lesions: a longitudinal study.
abstract: Effectively managing precancerous lesions is crucial to reducing the gastric cancer (GC) burden. We evaluated associations of temporal changes in multiple serological markers (pepsinogen I [PGI], PGII, PGI/II ratio, gastrin-17 and anti-Helicobacter pylori IgG) with risk for progression of gastric precancerous lesions. From 1997 to 2011, repeated esophagogastroduodenoscopies with gastric mucosal biopsies and blood sample collections were conducted on 2,039 participants (5,070 person-visits) in the Zhuanghe Gastric Diseases Screening Program, Liaoning, China. Serum biomarkers were measured using ELISA, and gastric biopsies were evaluated using standardized histologic criteria. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using generalized estimating equations for correlated binary outcomes. The ORs for progression of gastric conditions comparing those whose serum PGI, PGII, and anti-H. pylori IgG levels increased ≥ 50% relative to those whose decreased ≥ 50% were, respectively 1.67 (CI, 1.22-2.28), 1.80 (CI, 1.40-2.33) and 1.93 (CI, 1.48-2.52). The OR for those whose PGI/II ratio decreased ≥ 50% relative to those whose increased ≥ 50% was 1.40 (CI, 1.08-1.81), and for those whose PGII and anti-H. pylori IgG levels both increased ≥ 50% relative to those whose levels both decreased ≥ 50% the OR was 3.18 (CI, 2.05-4.93). Changes in gastrin-17 were not statistically significantly associated with progression. These findings suggest that temporal changes in serum PGI, PGII, PGI/II ratio, and anti-H. pylori IgG levels (especially PGII and anti-H. pylori IgG combined) may be useful for assessing and managing risk for progression of gastric precancerous lesions.
authors.affiliation: Tumor Etiology and Screening Department of Cancer Institute and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention (China Medical University), Liaoning Provincial Education Department, Shenyang, Liaoning, 110001, China; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Molecules to Mankind Program, Laney Graduate School, Emory University, Atlanta, Georgia.
authors.forename: Huakang
authors.initials: H
authors.lastname: Tu
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.forename: Xiao
authors.initials: X
authors.lastname: Dong
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Gong
authors.forename: Qian
authors.initials: Q
authors.lastname: Xu
authors.forename: Jingjing
authors.initials: J
authors.lastname: Jing
authors.forename: Qi
authors.initials: Q
authors.lastname: Long
authors.forename: W Dana
authors.initials: WD
authors.lastname: Flanders
authors.forename: Roberd M
authors.initials: RM
authors.lastname: Bostick
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005755:Gastrins / Q000097:blood*; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D011230:Precancerous Conditions / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
chemical_list: D014408:Biomarkers, Tumor; D005755:Gastrins; D007074:Immunoglobulin G; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A
keywords: Helicobacter pylori; gastric precancerous lesions; pepsinogens; progression; serological biomarkers