Value of Serological Biomarker Panel in Diagnosis of Atrophic Gastritis and Helicobacter pylori Infection

Abstract

Background: Gastric cancer is one of the most common types of cancer worldwide. Helicobacter pylori infection is clearly correlated with gastric carcinogenesis. Therefore, the use of a new non-invasive test, known as the GastroPanel test, can be very helpful to identify patients at a high risk, including those with atrophic gastritis, intestinal metaplasia, and dysplasia. This study aimed to compare the results of GastroPanel test with the pathological findings of patients with gastric atrophy to find a safe and simple alternative for endoscopy and biopsy as invasive methods.Methods: This cross-sectional study was performed on patients with indigestion, who were referred to Motahari Clinic and Shahid Faghihi Hospital of Shiraz, Iran, since April 2017 until August 2017 for endoscopy of the upper gastrointestinal tract. The serum levels of gastrin-17 (G17), pepsinogen I (PGI), and pepsinogen II (PGII), as well as H. pylori antibody IgG, were determined by ELISA assays. Two biopsy specimens from the antrum and gastric body were taken for standard histological analyses and rapid urease test. A pathologist examined the biopsy specimens of patients blindly. Results: A total of 153 patients with indigestion (62.7% female; mean age, 63.7 years; 37.3% male; mean age, 64.9 years) were included in this study. The G17 levels significantly increased in patients with chronic atrophic gastritis (CAG) of the body (9.7 vs. 32.8 pmol/L; P = 0.04) and reduced in patients with antral CAG (1.8 vs. 29.1 pmol/L; P = 0.01). The results were acceptable for all three types of CAG, including the antral, body, and multifocal CAG (AUCs of 97%, 91%, and 88% for body, antral, and multifocal CAG, respectively). The difference in PGII level was not significant. Also, the PGI and PGI/PGII ratio did not show a significant difference (unacceptably low AUCs for all). The H. pylori antibody levels were higher in patients infected with H. pylori (251 EIU vs. 109 EIU, AUC = 70, P = 0.01). There was a significant relationship between antibody tests and histopathology.Conclusion: Contrary to Biohit’s claims, the GastroPanel kit is not accurate enough to detect CAG; therefore, it cannot be used for establishing a clinical diagnosis.

Comparison between the GastroPanel test and the serum pepsinogen assay interpreted with the ABC method—A prospective study

“…The GastroPanel test is widely used for risk stratification 18 ; nonetheless, there are concerns regarding I/II ratios. Recent studies reported that I/II ratios did not correlate with the severity or location of atrophy when using the GastroPanel test 19,20 . Another study concluded that the GastroPanel test is insufficient for cancer screening because only 32.4% of gastric cancer patients showed low I/II ratios of <3 21 .…”

“…Recent studies reported that I/II ratios did not correlate with the severity or location of atrophy when using the GastroPanel test. 19,20 Another study concluded that the GastroPanel test is insufficient for cancer screening because only 32.4% of gastric cancer patients showed low I/II ratios of <3. 21 In our study, low I/II ratios and high G-17 levels correlated well with atrophy and IM scores according to the Kyoto classification.…”