Document Detail

Serological assessment of gastric intestinal metaplasia and atrophy using pepsinogen-I, pepsinogen-II and gastrin-17 levels in a low incidence area of gastric cancer endemic for H. pylori infection.
MedLine Citation:
PMID:  22696910     Owner:  NLM     Status:  In-Process    
BACKGROUND: Intestinal metaplasia (IM), a precursor of gastric cancer (GC), may be amenable to non-invasive assessment.
AIMS: We evaluated the diagnostic utility of serum PG-I, PG-II, PG-I/PG-II ratio and gastrin-17 (G-17) to detect IM and atrophy.
METHODS: The study was conducted at a tertiary care center located in low-incidence area of GC, endemic for H. pylori. The evaluation was designed as a prospective case-control study. Patients with GC and dyspepsia were evaluated by endoscopy, histology for IM (H&E, PAS and Alcian blue stains) and H. pylori (H&E and Giemsa stains), rapid urease test and IgG antibody (positive results in any two assays). Serum levels of PG-I, PG-II and G-17 were estimated using ELISA.
RESULTS: Of the 98 patients with GC and 62 with dyspepsia, 35 (36%) and 9 (14%) had IM, respectively (p = 0.004). Patients with IM (n = 44) had lower PG-UPG-II ratio than those without IM (n = 116; median 4.4, 0.37-23.6 vs. 6.3, 0.19-38.6, respectively; p = 0.005). A cut-off value of PG-I/PG-II ratio of 6.0 had 64% sensitivity and 52% specificity for detecting IM (area under ROC curve 0.64). 26/44 (60%) patients with IM and 52/98 (53%) with GC had PG-I/PG-II ratio < 6. Serum G-17 was comparable among patients with and without IM.
CONCLUSIONS: Though the PG-I/PG-II ratio was lower in patients with IM, only 60% had a lower ratio suggesting that this test and G-17 may not be useful to detect IM in low-incidence areas of GC, endemic for H. pylori infection.
Uday C Ghoshal; Sushil Kumar; Narendra Krishnani; Neeraj Kumari; Dipti Chourasia; Shweta Tripathi
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Tropical gastroenterology : official journal of the Digestive Diseases Foundation     Volume:  32     ISSN:  0250-636X     ISO Abbreviation:  Trop Gastroenterol     Publication Date:    2011 Oct-Dec
Date Detail:
Created Date:  2012-06-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8107122     Medline TA:  Trop Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  292-8     Citation Subset:  IM    
Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014, India.
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