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Accuracy and cut-off values of pepsinogens I, II and gastrin 17 for diagnosis of gastric fundic atrophy: Influence of gastritis

Nasrollahzadeh, D. and Aghcheli, K. and Sotoudeh, M. and Shakeri, R. and Persson, E.C. and Islami, F. and Kamangar, F. and Abnet, C.C. and Boffetta, P. and Engstrand, L. and Dawsey, S.M. and Malekzadeh, R. and Ye, W. (2011) Accuracy and cut-off values of pepsinogens I, II and gastrin 17 for diagnosis of gastric fundic atrophy: Influence of gastritis. PLoS ONE, 6 (10).

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Abstract

Background: To establish optimal cutoff values for serologic diagnosis of fundic atrophy in a high-risk area for oesophageal squamous cell carcinoma and gastric cancer with high prevalence of Helicobacter pylori (H. pylori) in Northern Iran, we performed an endoscopy-room-based validation study. Methods: We measured serum pepsinogens I (PGI) and II (PGII), gastrin 17 (G-17), and antibodies against whole H. pylori, or cytotoxin-associated gene A (CagA) antigen among 309 consecutive patients in two major endoscopy clinics in northeastern Iran. Updated Sydney System was used as histology gold standard. Areas under curves (AUCs), optimal cutoff and predictive values were calculated for serum biomarkers against the histology. Results: 309 persons were recruited (mean age: 63.5 years old, 59.5 female). 84.5 were H. pylori positive and 77.5 were CagA positive. 21 fundic atrophy and 101 nonatrophic pangastritis were diagnosed. The best cutoff values in fundic atrophy assessment were calculated at PGI<56 μg/l (sensitivity: 61.9, specificity: 94.8) and PGI/PGII ratio<5 (sensitivity: 75.0, specificity: 91.0). A serum G-17<2.6 pmol/l or G-17>40 pmol/l was 81 sensitive and 73.3 specific for diagnosing fundic atrophy. At cutoff concentration of 11.8 μg/l, PGII showed 84.2 sensitivity and 45.4 specificity to distinguish nonatrophic pangastritis. Exclusion of nonatrophic pangastritis enhanced diagnostic ability of PGI/PGII ratio (from AUC = 0.66 to 0.90) but did not affect AUC of PGI. After restricting study samples to those with PGII<11.8, the sensitivity of using PGI<56 to define fundic atrophy increased to 83.3 (95CI 51.6-97.9) and its specificity decreased to 88.8 (95CI 80.8-94.3). Conclusions: Among endoscopy clinic patients, PGII is a sensitive marker for extension of nonatrophic gastritis toward the corpus. PGI is a stable biomarker in assessment of fundic atrophy and has similar accuracy to PGI/PGII ratio among populations with prevalent nonatrophic pangastritis. © 2011 Nasrollahzadeh et al.

Item Type: Article
Additional Information: cited By 21
Uncontrolled Keywords: bacterium antibody; cytotoxin associated gene A antibody; gastrin 17; pepsinogen I; pepsinogen II; unclassified drug; bacterial antigen; bacterial protein; cagA protein, Helicobacter pylori; gastrin; gastrin 17; pepsinogen; pepsinogen II, adult; aged; article; atrophy; controlled study; diagnostic accuracy; endoscopy; female; gastric fundus atrophy; gastrin 17 blood level; gastritis; Helicobacter pylori; human; Iran; major clinical study; male; nonatrophic pangastritis; pepsinogen I blood level; pepsinogen II blood level; predictive value; protein blood level; receiver operating characteristic; reference value; sensitivity and specificity; stomach fundus; validity; area under the curve; atrophic gastritis; blood; gastritis; mass screening; microbiology; middle aged; pathology, Helicobacter pylori, Antigens, Bacterial; Area Under Curve; Bacterial Proteins; Female; Gastric Fundus; Gastrins; Gastritis; Gastritis, Atrophic; Helicobacter pylori; Humans; Male; Mass Screening; Middle Aged; Pepsinogen A; Pepsinogen C; Reference Values
Subjects: کهورت
مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 21 Apr 2015 07:32
Last Modified: 19 May 2015 04:00
URI: http://eprints.goums.ac.ir/id/eprint/2596

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