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Cutoff serum pepsinogen values for predicting gastric acid secretion status
Katsunori Iijima1, Tomoyuki Koike, Yasuhiko Abe
1Division of Gastroenterology, Tohoku University Graduate School of medicine.
The Tohoku Journal of Experimental Medicine
|April 11, 2014
Summary
Serum pepsinogen levels can predict gastric acid secretion status, offering a less invasive method than traditional tests. This finding aids in assessing upper gastrointestinal disease risks.
Area of Science:
- Gastroenterology and Clinical Chemistry
Background:
- Gastric acid secretion measurement is crucial for upper gastrointestinal disease risk assessment but is invasive.
- Serum pepsinogen levels (pepsinogen I and II) reflect gastric function and may offer a less distressing alternative.
Purpose of the Study:
- To establish optimal serum pepsinogen cutoff points for predicting gastric acid secretion status (hypochlorhydria, hyperchlorhydria).
Main Methods:
- Correlated gastric acid secretion (endoscopic gastrin test) with serum pepsinogen I, pepsinogen II, pepsinogen I/II ratio, and Helicobacter pylori-IgG antibody in 627 Japanese subjects.
- Utilized receiver operating characteristic (ROC) analyses to determine the most accurate cutoff points.
Main Results:
- The pepsinogen I/II ratio correlated best with gastric acid secretion in H. pylori-positive subjects.
- Pepsinogen I showed the strongest correlation in H. pylori-negative subjects.
- Serum pepsinogen levels demonstrated acceptable to outstanding diagnostic accuracy (AUC: 0.79-0.93) for predicting gastric acid secretion status, with improved accuracy when stratified by H. pylori infection.
Conclusions:
- Serum pepsinogen I/II ratio (or pepsinogen I for H. pylori-negative individuals) is a valuable, non-invasive biomarker for assessing gastric acid secretion.
- This method has significant clinical implications for estimating upper gastrointestinal disease risks.
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