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Non-invasive diagnostic tools for assessment of function and structure of the stomach mucosa

February 23, 2009

Risks for gastric cancer or peptic ulcer diseases are low in subjects with healthy stomach mucosa but are remarkably high in those with "diseased" stomach mucosa: i.e., in those with H pylori gastritis or atrophic gastritis. Therefore, the differentiation between patients with healthy (no H pylori, gastritis, or atrophic gastritis) and diseased gastric mucosa is clinically relevant. Serum levels of pepsinogen have been used for decades to diagnose atrophic corpus gastritis non-invasively. Recently, a European biomarker examination, GastroPanel (Biohit Plc, Helsinki, Finland), has been validated in which, in addition to Pg assays, the serum or plasma levels of gastrin-17 and H pylori antibodies of both IgG and IgA class are measured from the same sample using an ELISA technique.

A research article to be published on February 21, 2009 in the World Journal of Gastroenterology addresses this question. Dr. Iijima et al examine, in a Japanese population, how well the European GastroPanel examination delineatespatients with atrophic gastritis, and, in particular, how well these examinations differentiate between patients with healthy and diseased gastric mucosa.

Among 162 Japanese outpatients, pepsinogen I and pepsinogen II were measured using a conventional Japanese technique, and with the European GastroPanel examination. Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa, H pylori non-atrophic gastritis or atrophic gastritis.

Pepsinogen I and pepsinogen II assays using the GastroPanel and the Japanese methods showed a highly significant correlation. For methodological reasons, however, serum Pg I, but not Pg II, was twice as high with the GastroPanel test as with the Japanese test. The biomarker assays revealed that 5% of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies. The GastroPanel examination revealed an additional 7 patients who had either advanced atrophic gastritis limited to the antrum or antrum predominant H pylori gastritis. When compared with the endoscopic biopsy findings, the GastroPanel examination classified patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy, 95% sensitivity and 93% specificity.

World Journal of Gastroenterology