title: Serum gastrin levels in different stages of distal gastric carcinogenesis: is there a role for serum gastrin in tumor growth?
abstract: OBJECTIVE
  Elevated levels of serum gastrin (SG) have been associated with tumorigenic effects in a number of gastrointestinal cancers. We decided to investigate the relationship between SG and gastric epithelial lesions.
  
  
  METHODS
  A total of 90 patients with gastric epithelial lesions (hyperplastic polyp, 12; adenoma, 41; early gastric cancer, 29; advanced gastric cancer, 8) were enrolled as the case group and 79 patients without epithelial lesions were enrolled as the control group.
  
  
  RESULTS
  Serum gastrin levels were significantly different between the case and control groups (p<0.001). A high SG level (>80 pg/mL), intestinal metaplasia, and a pepsinogen I/II ratio <3 were independently associated with an increased risk of epithelial lesions (odds ratio: 14.6, 9.4, and 4.1, respectively, p<0.05). SG levels in case subjects showed a unimodal distribution pattern as the disease progressed. The mean SG level was highest in those with hyperplastic polyps and then decreased significantly to the control level in the gastric cancer group. Higher SG levels in each disease category were not associated with increased tumor size, synchronicity, invasiveness, presence of lymph node metastasis, or a higher cellular proliferation index (p>0.05).
  
  
  CONCLUSIONS
  An increased SG level was an independent and potent risk factor for gastric epithelial lesions. However, it does not seem to relate with distal gastric tumor growth. Serial decreases in SG levels should be considered a warning sign in index hypergastrinemic patients with no prior Helicobacter pylori eradication.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Republic of Korea.
authors.forename: Byung Chun
authors.initials: BC
authors.lastname: Kim
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Jin Bae
authors.initials: JB
authors.lastname: Kim
authors.forename: A Rum
authors.initials: AR
authors.lastname: Han
authors.forename: Sung Ill
authors.initials: SI
authors.lastname: Jang
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Myung Seok
authors.initials: MS
authors.lastname: Lee
authors.forename: Jai Hoon
authors.initials: JH
authors.lastname: Yoon
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.forename: Hyung Joo
authors.initials: HJ
authors.lastname: Jang
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyung Su
authors.initials: HS
authors.lastname: Kim
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Shin
authors.forename: Jeong Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
mesh_terms: D016022:Case-Control Studies; D049109:Cell Proliferation; D005260:Female; D005755:Gastrins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D005755:Gastrins