Serological assessment of gastric mucosal atrophy in gastric cancer
Open Access
- 31 January 2012
- journal article
- Published by Springer Science and Business Media LLC in BMC Gastroenterology
- Vol. 12 (1), 10
- https://doi.org/10.1186/1471-230X-12-10
Abstract
Non-invasive tools for gastric cancer screening and diagnosis are lacking. Serological testing with the detection of pepsinogen 1 (PG1), pepsinogen 2 (PG2) and gastrin 17 (G17) offers the possibility to detect preneoplastic gastric mucosal conditions. Aim of this study was to assess the performance of these serological tests in the presence of gastric neoplasia. Histological and serological samples of 118 patients with gastric cancer have been assessed for tumor specific characteristics (Laurén type, localisation), degree of mucosal abnormalities (intestinal metaplasia, atrophy) and serological parameters (PG1, PG2, PG1/2-ratio, G17, H. pylori IgG, CagA status). Association of the general factors to the different serological values have been statistically analyzed. Patients with intestinal type gastric cancer had lower PG1 levels and a lower PG1/2-ratio compared to those with diffuse type cancer (p = 0.003). The serum levels of PG2 itself and G17 were not significantly altered. H. pylori infection in general had no influence on the levels of PG1, PG2 and G17 in the serum of gastric cancer patients. There was a trend towards lower PG1 levels in case of positive CagA-status (p = 0.058). The degree of both intestinal metaplasia and atrophy correlated inversely with serum levels for PG1 and the PG1/2-ratio (p < 0.01). Laurén-specific analysis revealed that this is only true for intestinal type tumors. Univariate ANOVA revealed atrophy and CagA-status as the only independent factors for low PG1 and a low PG1/2-ratio. Glandular atrophy and a positive CagA status are determinant factors for decreased pepsinogen 1 levels in the serum of patients with gastric cancer. The serological assessment of gastric atrophy by analysis of serum pepsinogen is only adequate for patients with intestinal type cancer.Keywords
This publication has 50 references indexed in Scilit:
- Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)Endoscopy, 2011
- Higher number of Helicobacter pylori CagA EPIYA C phosphorylation sites increases the risk of gastric cancer, but not duodenal ulcerBMC Microbiology, 2011
- Plasma pepsinogens, antibodies against Helicobacter pylori, and risk of gastric cancer in the Shanghai Women's Health Study CohortBritish Journal of Cancer, 2011
- The Validity of a Biomarker Method for Indirect Detection of Gastric Mucosal Atrophy Versus Standard HistopathologyDigestive Diseases and Sciences, 2009
- Serum pepsinogens and risk of gastric and oesophageal cancers in the General Population Nutrition Intervention Trial cohortGut, 2009
- The Role of Serum Pepsinogen and Gastrin Test for the Detection of Gastric Cancer in KoreaHelicobacter, 2008
- Serum Pepsinogen I, Pepsinogen II, and Gastrin 17 in Relatives of Gastric Cancer Patients: Comparative Study With Type and Severity of GastritisClinical Gastroenterology and Hepatology, 2008
- Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori statusGut, 2007
- Gastritis staging in clinical practice: the OLGA staging systemGut, 2007
- Gastric cancer screening using the serum pepsinogen test methodGastric Cancer, 2006