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Serum pepsinogen levels indicate the requirement of upper gastrointestinal endoscopy among Group A subjects of ABC

Daisuke Chinda1, Tadashi Shimoyama2, Tatsuya Mikami3

  • 1Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.

Journal of Gastroenterology
|January 22, 2018
PubMed

Insights

This study found that approximately 20% of individuals in Group A have current or past Helicobacter pylori infection. Serum pepsinogen levels can help identify past infections, which urea breath tests and stool antigen tests cannot.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Oncology

Background:

  • ABC classification is used for gastric cancer risk assessment.
  • Group A in ABC classification includes individuals with current and past H. pylori infections.
  • Distinguishing past H. pylori infection is crucial for accurate risk stratification.

Purpose of the Study:

  • To determine the proportion of current and past H. pylori infections within Group A.
  • To develop criteria for identifying subjects with past H. pylori infection among Group A individuals negative for current infection via UBT/stool antigen tests.

Main Methods:

  • 201 Group A subjects underwent urea breath test (UBT) and/or stool antigen testing, followed by upper gastrointestinal endoscopy.
  • H. pylori infection status was determined by endoscopic findings.
  • Pepsinogen (PG) I, PG II levels, and PG I/II ratio were analyzed, with ROC curves used to establish cutoff values.

Main Results:

  • 22 subjects tested positive for H. pylori via UBT/stool antigen tests.
  • 15 subjects were identified as having past H. pylori infection based on endoscopic findings.
  • Optimal cutoff values for past infection were PG I ≤ 31.2 ng/mL and PG I/II ratio ≤ 4.6.

Conclusions:

  • Around 20% of Group A subjects harbor current or past H. pylori infections.
  • UBT and stool antigen tests effectively identify current H. pylori infection but not past infection.
  • Serum pepsinogen levels are valuable for identifying individuals with a history of H. pylori infection.
Abstract

Keywords:
Group A of ABC classificationHelicobacter pylori infectionPepsinogen levelsUpper gastrointestinal endoscopy

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