Correlations Among Endoscopic, Histologic and Serologic Diagnoses for the Assessment of Atrophic Gastritis

Abstract

a total of 2,558 subjects were enrolled. Endoscopic atrophic gastritis was graded by Kimura-Takemoto classification and histological atrophic gastritis was assessed by updated Sydney system. Serological assessment of atrophic gastritis was based on serum pepsinogen test. Results: The serum pepsinogen I/II ratio showed a significant decreasing nature when the extent of atrophy increased (R 2 =0.837, P＜0.001) and the cut-off value for distinguishing between presence and absence of endoscopic atrophic gastritis was 3.2. The serum pepsinogen I and pepsinogen I/II ratio were significantly lower when the histological atrophic gastritis progressed and the cut-off value was 3.0 for a diagnosis of histological atrophic gastritis. A significant correlation between endoscopic and histological atrophic gastritis was noted and the sensitivity and specificity of endoscopic diagnosis were 65.9% and 58.0% for antrum, 71.3% and 53.7% for corpus, respectively. Conclusions: The endoscopic, histological, and serological atrophic gastritis showed relatively good correlations. However, as these three methods have a limitation, a multifactorial assessment might be needed to ameliorate the diagnostic accuracy of atrophic gastritis. (J Cancer Prev 2014;19:47-55)

Serum pepsinogen and gastrin-17 as potential biomarkers for pre-malignant lesions in the gastric corpus

“…For example, the median PGI levels were >90 µg/l in Shandong, China (25), the mean PGI was >100 µg/l in Hunan, China (17) and Yazd, Iran (24), whereas values were usually <70 µg/l in European countries (4,26). However, a Japanese study by Inoue et al (19) involving 200 patients and a Korean study involving 2,558 patients by Lee et al (27) reported a mean serum PGI:I level of <70 µg/l (56.0 and 63.5 µg/l, respectively). Whether these variations in serum PG levels are due to different geographical locations (with ensuing different ethnicities), prevalence of the H. pylori infection, prevalence of CAG and gastric carcinoma or varying dietary patterns remains uncertain and requires further investigation.…”

Finding out Serologically Active Gastritis Subjects by Conventional Endoscopy and Picking out Subjects Who might be Benefit from Helicobacter pylori Eradication as a Primary Prevention for Gastric Cancer

“…Recently Lee et al [25] revealed PGI and PG I/II ratio decreased significantly as EAB progressed, and we also searched relationships between serology and EAB. Yanaoka et al [2] showed H.pylori eradication was effective for preventing GC only in serologically mild atrophic gastritis, we uncovered which EAB could be matched with upper limit of serologically mild atrophic gastritis, the cut-off value of EAB for group C being above type C-3, this identification was similar to that of several previous studies, however there were differences, first most of previous studies identified serologic values to discriminate open type atrophic gastritis from closed type, we took different approach from opposite side: defining optimal EAB for serologically significant value, second we subdivided EAB in more detail (12 categories) because in Korea endoscopy is more dominant GC screening tool than any other method including serologic study, consequently we need to get much more delicate description for endoscopic findings than just simple delineation of open or closed type.…”

Association between receptor interacting serine/threonine kinase 2 polymorphisms and gastric cancer susceptibility

“…Sydney system scores express the severity of gastritis at a biopsy point, whereas PG I/II ratio express the spread of mucosal atrophy (16,26). It has been reported that the significant association between serum and histological atrophy is more strongly observed in the corpus compared with in the antrum (27). The present study assessed the histological gastritis only in the antrum, as the antrum is affected by H. pylori infection for the longest period (4).…”