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Serum pepsinogen cut-off values in Helicobacter pylori-infected children
Shin-Ichi Fujiwara1, Mutsuko Konno1, Satoshi Watanabe1
1Department of Pediatrics, Sapporo Kosei General Hospital, Sapporo, Japan.
Insights
Serum pepsinogen II (sPG II) levels ≥9.0 ng/mL are a strong indicator for detecting Helicobacter pylori infection in children. This finding aids in diagnosing H. pylori-related gastritis in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Biomarker Discovery
Background:
- Helicobacter pylori (H. pylori) infection is a common cause of gastritis in children.
- Accurate diagnostic methods are crucial for timely H. pylori-related gastritis management.
- Serum pepsinogen (sPG) levels may serve as a non-invasive biomarker.
Purpose of the Study:
- To establish standard gender- and age-stratified serum pepsinogen (sPG) values in H. pylori non-infected children.
- To determine optimal sPG cut-off values for predicting H. pylori-infected gastritis in pediatric populations.
Main Methods:
- Prospective study involving children with epigastric pain undergoing esophagogastroduodenoscopy.
- Exclusion of subjects with inflammatory bowel diseases, eosinophilic gastrointestinal disorders, or immunoglobulin A vasculitis.
- H. pylori infection diagnosis confirmed by positive tissue culture or concordant histology and rapid urease test results.
Main Results:
- In H. pylori non-infected children, males showed higher sPG I and sPG II levels than females.
- H. pylori-infected children had significantly higher sPG I and sPG II levels and a lower sPG I/II ratio compared to non-infected children.
- An sPG II cut-off value of ≥9.0 ng/mL demonstrated high diagnostic accuracy (92.4% sensitivity, 93.9% specificity) for H. pylori infection.
Conclusions:
- The sPG II level of ≥9.0 ng/mL is a reliable predictor for H. pylori-infected gastritis in children.
- sPG II shows excellent potential as a non-invasive biomarker for diagnosing H. pylori infection in pediatric patients.
- These findings support the use of sPG II in screening and diagnosing H. pylori-related gastritis in children.
Background:
The aim of this study was to evaluate the standard values for gender- and age-stratified serum pepsinogen (sPG) in Helicobacter pylori (H. pylori) non-infected children and to determine the optimal cut-off values of sPG for predicting H. pylori-infected gastritis in children.
Methods:
A prospective study for determination of sPG levels was performed in children with epigastric pain who underwent esophagogastroduodenoscopy over the past 16 years. After excluding subjects diagnosed with inflammatory bowel diseases, eosinophilic gastrointestinal disorders, or immunoglobulin A vasculitis, the diagnosis of H. pylori infection was defined by positive tissue culture or concordant-positive results for histology and the rapid urease test.
Results:
A total of 405 subjects were diagnosed as being H. pylori-infected (79) or non-infected (326). In the H. pylori non-infected group, there were no significant differences in sPG levels among age groups; males had higher sPG I and sPG II levels than females. In the H. pylori-infected group, sPG I and sPG II levels were significantly higher and the sPG I/II ratio was lower than those in the non-infected group. In receiver operating characteristics analyses in diagnosing H. pylori infection, the areas under the curves for sPG I, sPG II and sPG I/II ratio were 0.896, 0.980, and 0.946, respectively. The optimal cut-off value of sPG II of ≥9.0 ng/mL was considered positive for H. pylori infection (sensitivity: 92.4%, specificity: 93.9%).
Conclusions:
The optimal cut-off value of sPG II of ≥9.0 ng/mL may be a good predictor of H. pylori-infected gastritis in children.
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