title: The optimal serum pepsinogen cut-off value for predicting histologically confirmed atrophic gastritis.
abstract: BACKGROUND
  Although serum pepsinogen tests are useful for predicting the presence of atrophic gastritis, the optimal cut-off values have not been fully evaluated.
  
  
  OBJECTIVE
  To determine the optimal serum pepsinogen cut-off value for predicting atrophic gastritis.
  
  
  METHODS
  Patients scheduled for upper endoscopy at Severance Hospital, Korea, between August 2012 and October 2013, were recruited prospectively. Endoscopic biopsies for atrophic gastritis were obtained and histologically graded, based on the updated Sydney system.
  
  
  RESULTS
  Ninety-five patients were enrolled in the study. The mean age was 57.7±12.1 years, and 44.2% of the patients were male. Serum pepsinogen I/II ratios were lower in patients with atrophic gastritis than in those without it (antrum, 4.2±1.7 vs. 5.2±2.1, P=0.040; corpus, 3.3±1.9 vs. 5.4±1.9, P<0.001). Serum pepsinogen I/II ratios were significantly correlated with histologic atrophic gastritis (antrum, P=0.030; corpus, P<0.001). Using a cut-off value of 4.9, the sensitivity and specificity of the serum pepsinogen I/II ratio for predicting atrophic gastritis in the antrum were 68.2% and 60.3%, respectively.
  
  
  CONCLUSIONS
  The optimal serum pepsinogen I/II ratio cut-off values for atrophic gastritis of the antrum and for the corpus were 4.9 and 3.5, respectively. Serum pepsinogen I/II ratios, with these cut-off values, are useful for screening patients for the presence of atrophic gastritis.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Huapyong
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
authors.forename: Chan Hyuk
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Da Hyun
authors.initials: DH
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyunsoo
authors.initials: H
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: leeyc@yuhs.ac.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000097:blood* / Q000473:pathology*; D016481:Helicobacter Infections / Q000097:blood; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000097:blood / Q000473:pathology; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D011237:Predictive Value of Tests; D011706:Pyloric Antrum / Q000473:pathology*; D012372:ROC Curve; D012016:Reference Values
chemical_list: D015415:Biomarkers; D005755:Gastrins; D020115:Pepsinogen C; D020116:Pepsinogen A
keywords: Atrophic gastritis; Cut-off value; Helicobacter pylori; Pepsinogen