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 22 February 2018

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News

Serum gastrin as a reliable marker for atrophy in asymptomatic Helicobacter pylori infected patients

In October's issue of the American Journal of Gastroenterology, researchers from Italy investigated whether serum gastrin and pepsinogens were reliable markers of atrophy in asymptomatic patients infected with Helicobacter Pylori.

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Atrophic gastritis is a precancerous condition that is commonly caused by chronic Helicobacter pylori (H. pylori) infection.

Dr Ricci and colleagues from Italy carried out a blind, controlled study to determine if serum gastrin and pepsinogens were reliable markers of atrophy in asymptomatic patients.

In total, 147 asymptomatic patients underwent endoscopy and the researchers obtained multiple gastric biopsies obtained for histology, culture, and rapid urease test.

Using standard immunoassays, the group recorded fasting serum gastrin (total and G-17) and serum pepsinogens (I-II).

The group followed internationally accepted criteria in order to assess the histological features of gastric atrophy.

Three main patterns of gastritis were distinguished: (a) nonatrophic gastritis, (b) atrophic antrum-restricted and antrum-predominant gastritis, and (c) corpus-restricted gastritis.

Serum Gastrin and pepsinogens do not discriminate nonatrophic versus antrum-restricted/predominant atrophic gastritis
American Journal of Gastroenterology

Using receiving operating characteristic (ROC) analysis, the research group were able to determine the best cut-off for each serum test in nonatrophic gastritis versus antrum-restricted/antrum-predominant atrophic gastritis.

The group found no significant differences in serum gastrin and pepsinogens I-II were detected in nonatrophic gastritis versus patients with antrum-restricted/antrum-predominant atrophic gastritis.

The positive likelihood ratios for an abnormal serum test to detect antrum-restricted/antrum-predominant atrophy in the gastric body were total serum gastrin 2.13, gastrin-17: 1.55, pepsinogen I: 2.74, pepsinogen II: 1.74, and the ratio of pepsinogen I and II: 1.8.

Negative likelihood ratios ranged from 0.20 to 0.65.

Dr Ricci concluded, "In an asymptomatic population, serum gastrin (total and G-17) and pepsinogens I-II do not discriminate nonatrophic versus antrum-restricted/predominant atrophic gastritis."

American Journal of Gastroenterology 2004; 99 (10):1910
30 September 2004

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