Helicobacter pylori gastritis and serum pepsinogen levels in a healthy population: Development of a biomarker strategy for gastric atrophy in high-risk groups
| Autor: | T Knight, Penelope M. Webb, M Corlett, James B. Elder, K Hengels, J Wyatt, David Forman, A Wilson, Diane G. Newell, S Greaves |
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| Předmět: |
Adult
Gastritis Atrophic Male Cancer Research medicine.medical_specialty Pepsinogen A Adolescent Atrophic gastritis Chronic gastritis Gastroenterology Serology Helicobacter Infections Risk Factors Stomach Neoplasms Internal medicine Gastrins medicine Prevalence Humans Risk factor biology Helicobacter pylori Pepsinogens business.industry Stomach Middle Aged medicine.disease biology.organism_classification digestive system diseases Occupational Diseases medicine.anatomical_structure Oncology Gastritis medicine.symptom business Biomarkers Research Article |
| Zdroj: | Scopus-Elsevier British Journal of Cancer |
| Popis: | This study aimed to estimate the prevalence and type of chronic gastritis in an asymptomatic working population and to determine whether a combination of serum pepsinogen levels and Helicobacter pylori serology could be used to identify a subgroup with atrophic gastritis at elevated risk of gastric carcinoma. A 10% subsample of 544 male volunteer factory workers aged 18-63 years and participating in a larger study underwent endoscopy and biopsy. Of these men, 29 were seropositive for Helicobacter pylori; all but three (89.7%) had chronic gastritis. Serum pepsinogen A levels increased with progression from a corpus predominant pattern of gastritis through pangastritis to an antral predominant pattern. Nine subjects had corpus atrophy, which was in most cases accompanied by fasting hypochlorhydria and hypergastrinaemia. A combination of pepsinogen A below 80 ng ml-1 and Helicobaceter pylori seropositivity detected corpus atrophy with sensitivity 88.9% and specificity 92.3%. A second screening stage, using a pepsinogen A/C ratio of below 2.5 as a cut-off, resulted in a reduction in numbers requiring further investigation but with some loss of sensitivity (77.8%). Application of this two-stage screening programme to the original sample of 544 workers would have resulted in 11 (2.2%) men being selected for follow-up, excluding 25 (5.1%) false negatives. Our results suggest that a combination of serum pepsinogen levels and Helicobacter pylori serology could be useful as a biomarker strategy for detection of individuals at increased risk of gastric carcinoma and for non-invasive investigation of the natural history of Helicobacter pylori gastritis. |
| Databáze: | OpenAIRE |
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