Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study

Olga Sjomina; Jelizaveta Pavlova; Ilva Daugule; Pavel Janovic; Ilze Kikuste; Aigars Vanags; Ivars Tolmanis; Dace Rudzite; Inese Polaka; Ilona Kojalo; Inta Liepniece-Karele; Sergejs Isajevs; Daiga Santare; Valdis Pirags; Jelena Pahomova; Vilnis Dzerve; Lilian Tzivian; Andrejs Erglis; Marcis Leja

doi:10.15403/jgld.2014.1121.271.pep

Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study

Olga Sjomina (Corresponding Author), Jelizaveta Pavlova, Ilva Daugule, Pavel Janovic, Ilze Kikuste, Aigars Vanags, Ivars Tolmanis, Dace Rudzite, Inese Polaka, Ilona Kojalo, Inta Liepniece-Karele, Sergejs Isajevs, Daiga Santare, Valdis Pirags, Jelena Pahomova, Vilnis Dzerve, Lilian Tzivian, Andrejs Erglis, Marcis Leja

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

Original language	English
Article number	4
Pages (from-to)	11-17
Number of pages	7
Journal	Journal of Gastrointestinal and Liver Diseases
Volume	27
Issue number	1
DOIs	https://doi.org/10.15403/jgld.2014.1121.271.pep
Publication status	Published - Mar 2018
Externally published	Yes

Keywords*

Atrophy
Follow-up
Gastric cancer
H.Pylori
Pepsinogens
Screening

Field of Science*

3.1 Basic medicine
3.2 Clinical medicine

Publication Type*

1.1. Scientific article indexed in Web of Science and/or Scopus database

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.15403/jgld.2014.1121.271.pep

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Sjomina, O., Pavlova, J., Daugule, I., Janovic, P., Kikuste, I., Vanags, A., Tolmanis, I., Rudzite, D., Polaka, I., Kojalo, I., Liepniece-Karele, I., Isajevs, S., Santare, D., Pirags, V., Pahomova, J., Dzerve, V., Tzivian, L., Erglis, A., & Leja, M. (2018). Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study. Journal of Gastrointestinal and Liver Diseases, 27(1), 11-17. Article 4. https://doi.org/10.15403/jgld.2014.1121.271.pep

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title = "Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study",

abstract = "Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.",

keywords = "Atrophy, Follow-up, Gastric cancer, H.Pylori, Pepsinogens, Screening",

author = "Olga Sjomina and Jelizaveta Pavlova and Ilva Daugule and Pavel Janovic and Ilze Kikuste and Aigars Vanags and Ivars Tolmanis and Dace Rudzite and Inese Polaka and Ilona Kojalo and Inta Liepniece-Karele and Sergejs Isajevs and Daiga Santare and Valdis Pirags and Jelena Pahomova and Vilnis Dzerve and Lilian Tzivian and Andrejs Erglis and Marcis Leja",

year = "2018",

month = mar,

doi = "10.15403/jgld.2014.1121.271.pep",

language = "English",

volume = "27",

pages = "11--17",

journal = "Journal of Gastrointestinal and Liver Diseases",

issn = "1841-8724",

publisher = "Romanian Society of Gastroenterology",

number = "1",

}

Sjomina, O, Pavlova, J, Daugule, I, Janovic, P, Kikuste, I, Vanags, A, Tolmanis, I, Rudzite, D, Polaka, I, Kojalo, I, Liepniece-Karele, I , Isajevs, S, Santare, D, Pirags, V, Pahomova, J, Dzerve, V, Tzivian, L, Erglis, A & Leja, M 2018, 'Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study', Journal of Gastrointestinal and Liver Diseases, vol. 27, no. 1, 4, pp. 11-17. https://doi.org/10.15403/jgld.2014.1121.271.pep

TY - JOUR

T1 - Pepsinogen test for the evaluation of precancerous changes in gastric mucosa

T2 - A population-based study

AU - Sjomina, Olga

AU - Pavlova, Jelizaveta

AU - Daugule, Ilva

AU - Janovic, Pavel

AU - Kikuste, Ilze

AU - Vanags, Aigars

AU - Tolmanis, Ivars

AU - Rudzite, Dace

AU - Polaka, Inese

AU - Kojalo, Ilona

AU - Liepniece-Karele, Inta

AU - Isajevs, Sergejs

AU - Santare, Daiga

AU - Pirags, Valdis

AU - Pahomova, Jelena

AU - Dzerve, Vilnis

AU - Tzivian, Lilian

AU - Erglis, Andrejs

AU - Leja, Marcis

PY - 2018/3

Y1 - 2018/3

N2 - Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

AB - Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

KW - Atrophy

KW - Follow-up

KW - Gastric cancer

KW - H.Pylori

KW - Pepsinogens

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=85044475981&partnerID=8YFLogxK

U2 - 10.15403/jgld.2014.1121.271.pep

DO - 10.15403/jgld.2014.1121.271.pep

M3 - Article

C2 - 29557410

AN - SCOPUS:85044475981

SN - 1841-8724

VL - 27

SP - 11

EP - 17

JO - Journal of Gastrointestinal and Liver Diseases

JF - Journal of Gastrointestinal and Liver Diseases

IS - 1

M1 - 4

ER -

Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study

Abstract

Keywords*

Field of Science*

Publication Type*

UN SDGs

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