Using serum pepsinogens wisely in a clinical practice

Miki, Kazumasa; Urita, Yoshihisa

doi:10.1111/j.1443-9573.2007.00278.x

Cited by 85 publications

(84 citation statements)

References 56 publications

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“…When it came to the atrophic lesion from the non-atrophic lesion, both PGⅠand PG Ⅱ levels had a trend to go down, suggesting that the PG Ⅰ/Ⅱ ratio reflects the development of atrophic lesion on gastric membranes better than either PGⅠor PGⅡ alone. The PGⅠ/Ⅱ values for atrophic gastritis were significantly lower than those for NOR and non-atrophic lesions, while there was no difference among these atrophic lesions, suggesting that the PGⅠ/Ⅱ ratio is an effective parameter for screening individuals at high risk of GC [9,[24][25][26][27] . We obtained the best cut-off points of the PG Ⅰ/Ⅱ ratio for detecting GC and its precursors by ROC curve with a sensitivity of 53.2% and a specialty of 67.5%, which can be used for further investigation as a screening tool in the first period.…”

Section: Discussionmentioning

confidence: 99%

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Sun¹

2007

WJG

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AIM:To explore the essential characteristics of serum pepsinogen (PG) levels in Chinese people, by analyzing the population-based data on the serum levels of PG Ⅰ and Ⅱ and the PGⅠ/Ⅱ ratio, and their influencing factors in Chinese from North China. METHODS:A total of 6990 subjects, who underwent a gastric cancer screening in North China from 1997 to 2002, were collected in this study. Serum pepsinogen levels were measured by enzyme-linked immunosorbent assay (ELISA). H pylori status was determined by histological examination and H pylori -IgG ELISA. The cut-off point was calculated by using receiving operator characteristics (ROC) curves. Factors linked to serum PG Ⅰ/Ⅱ ratio were identified using a multivariate logistic regression. RESULTS:The serum PGⅠ and PGⅡ levels were significantly higher in males than in females (95.2 μg/L vs 79.7 μg/L, P < 0.01; 12.1 μg/L vs 9.4 μg/L, P < 0.01), PGⅠ/Ⅱ ratio was significantly lower in males than in females (7.9 vs 8.3, P < 0.01). The PG Ⅰ/Ⅱ ratio decreased significantly in the aged groups following the progression of gastric mucosa from normal to non-atrophic and atrophic lesions (10.4, 8.8, and 6.6, respectively). The serum PGⅠand Ⅱ levels were significantly higher in patients with H pylori infection than in those without H pylori infection (88.7 μg/L vs 81.4 μg/L, P < 0.01; 11.4 μg/L vs 8.4 μg/L, P < 0.01), while the PGⅠ/Ⅱ ratio was significantly lower in patients with H pylori infection than in those without H pylori infection (7.7 vs 9.6, P < 0.01). For patients with atrophic lesions, the area under the PGⅠ/Ⅱ ROC curve was 0.622. The best cut-off point for PGⅠ/Ⅱ was 6.9, with a sensitivity of 53.2%, and a specificity of 67.5%. Factors linked to PG Ⅰ/Ⅱ were sensitive to identified PG using a multinomial logistic regression relying on the following inputs: males (OR: 1.151, 95% CI: 1.042-1.272, P = 0.006), age ≥ 61 years (OR: 1.358, 95% CI: 1.188-1.553, P = 0.000), atrophic lesion (OR: 2.075, 95% CI: 1.870-2.302, P = 0.000), and H pylori infection (OR: 1.546, 95% CI: 1.368-1.748, P = 0.000). CONCLUSION:The essential characteristics of serum PG levels in Chinese are significantly skewed from the normal distribution, and influenced by age, sex, gastric mucosa lesions and H pylori infection. PGⅠ/Ⅱ ratio is more suitable for identifying subgroups with different influence factors compared with PGⅠor PGⅡ alone.

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Section: Discussionmentioning

confidence: 99%

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Sun¹

2007

WJG

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“…In cases of gastroduodenal diseases, especially gastric cancer, the pathogenesis involves three major factors: H. pylori virulence factors, host factors, and environmental factors (1,10,14,16,21,34,57). Two H. pylori virulence factors that have been focused on in many studies all around the world are VacA and CagA.…”

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confidence: 99%

Diverse Characteristics of the cagA Gene of Helicobacter pylori Strains Collected from Patients from Southern Vietnam with Gastric Cancer and Peptic Ulcer

et al. 2009

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The pathogenesis of gastroduodenal diseases is related to the diversity of Helicobacter pylori strains. CagApositive strains are more likely to cause gastric cancer than CagA-negative strains. Based on EPIYA (GluPro-Ile-Tyr-Ala) motifs at the carboxyl terminus corresponding to phosphorylation sites, H. pylori CagA is divided into East Asian CagA and Western CagA. The former type prevails in East Asia and is more closely associated with gastric cancer. The present study used full sequences of the cagA gene and CagA protein of 22 H. pylori strains in gastric cancer and peptic ulcer patients from Southern Vietnam to make a comparison of genetic homology among Vietnamese strains and between them and other strains in East Asia. A phylogenetic tree was constructed based on full amino acid sequences of 22 Vietnamese strains in accordance with 54 references from around the world. The cagA gene was found in all Vietnamese H. pylori strains. Twenty-one of 22 (95.5%) strains belonged to the East Asian type and had similar characteristics of amino acid sequence at the carboxyl terminus to other strains from the East Asian region. From evidence of East Asian CagA and epidemiologic cancerous lesions in Vietnam, H. pylori-infected Vietnamese can be classified into a high-risk group for gastric cancer, but further studies on the interaction among environmental and virulence factors should be done. Finally, phylogenetic data support that there is a Japanese subtype in the Western CagA type.

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“…These mechanisms were investigated by measuring the levels of PGI, a practical biomarker in the determination of the status of the gastric mucosa. 19 An earlier report showed that low PGI values indicate progression of mucosal atrophy. 20 In this study, the level of PGI was significantly higher in the AA genotype than in the AG+GG genotype, suggesting that genotypes causing higher GST-M3 activity are involved in protection from mucosal atrophy progression.…”

Section: Discussionmentioning

confidence: 99%

Association between polymorphisms in glutathione S-transferase Mu3 and IgG titer levels in serum against Helicobacter pylori

Tatemichi

Iwasaki²,

Sasazuki³

et al. 2009

J Hum Genet

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This study investigated the association between glutathione S-transferases (GST) polymorphisms and immunoglobin G (IgG) titer levels in serum against Helicobacter pylori (H. pylori). Out of a total 300 healthy subjects seropositive for H. pylori, we analyzed the relationship between 15 single-nucleotide polymorphisms (SNPs), namely two in GST-mu2 (GST-M2), five in GST-mu3 (GST-M3), four in GST-pi1 (GST-P1) and four in GST-theta2 (GST-T2), and IgG antibody titer levels in serum against cytotoxin-associated gene A (CagA) and the surface antigen of H. pylori (Hp), as well as the levels of pepsinogen I (PGI). Titer levels were classified by tertile. The age-sex adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in the middle and low titer groups were calculated using a polytomous logistic regression model, with the high titer group considered as control. Results for GST-M3 showed a significant association between SNPs, CagA and Hp titers. In addition, the AA genotype (high enzyme activity) from SNP rs7483 (Val224Ile) in GST-M3 showed a significantly low risk for being in the low titer group (OR: 0.48, 95% CI: 0.27-0.86 and OR: 0.46, 95% CI: 0.26-0.83 for CagA and Hp, respectively). Furthermore, the AA genotype from the rs7483 SNP showed significantly (Po0.05) higher PGI levels than did the genotypes harboring a G allele (mean (s.d.)¼66.9 (32.0) and 59.1 (30.7) lg ml À1 for AA and AG+GG, respectively). Our results suggest that GST-M3 polymorphisms are associated with levels of IgG titer in serum against H. pylori. GST-M3 activity is possibly involved in protection against mucosal atrophy caused by H. pylori as the levels of IgG titer and PGI are linked to mucosal status.

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Using serum pepsinogens wisely in a clinical practice

Cited by 85 publications

References 56 publications

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Serum pepsinogen levels and their infl uencing factors: A population-based study in 6990 Chinese from North China

Diverse Characteristics of the cagA Gene of Helicobacter pylori Strains Collected from Patients from Southern Vietnam with Gastric Cancer and Peptic Ulcer

Association between polymorphisms in glutathione S-transferase Mu3 and IgG titer levels in serum against Helicobacter pylori

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