Clinical usefulness of serum pepsinogens I and II, gastrin-17 and anti-Helicobacter pylori antibodies in the management of dyspeptic patients in primary care

B. Germaná, F. Di Mario, L. G. Cavallaro, A. M. Moussa, P. Lecis, S. Liatoupolou, G. Comparato, C. Carloni, G. Bertiato, M. Battiestel, N. Papa, G. Aragona, G. M. Cavestro, V. Iori, R. Merli, S. Bertolini, P. Caruana, A. Franzé

Research output: Contribution to journalArticlepeer-review

Abstract

Background.: Several tests have been proposed for evaluating dyspeptic symptoms and their relationship to the underlying gastric disease. Serum pepsinogens and gastrin-17 are known to be useful biomarkers for the detection of gastric pathologies. Aim.: To evaluate the capability of screening dyspeptic patients in the primary care by analyses of serum pepsinogens I (sPGI) and II (sPGII), gastrin-17 (sG-17) and the IgG anti-Helicobacter pylori antibodies (IgG-Hp). Patients and methods.: Three hundred and sixty-two consecutive patients with dyspeptic symptoms (208 females, mean age 50.6 ± 16 years, range 18-88 years) referred by general practitioners for upper gastrointestinal endoscopy were enrolled. A blood sample was taken from each subject for IgG-Hp, sPGI, sPGII and sG-17 analyses. Results.: Two hundred and eighty-seven patients had a complete screening; of these, 132 resulted positive for Hp infection. Patients with atrophic chronic gastritis showed significantly lower serum pepsinogen I levels and sPGI/sPGII ratio than patients with non-atrophic chronic gastritis. Moreover, by calculating the values of sPGI by sG-17 and sG-17 by sPGII/sPGI, subjects with atrophic chronic gastritis could be distinguished from those with non-atrophic chronic gastritis and from those with normal mucosa, respectively. sG-17 levels were found to be a useful biomarker for the detection of antral atrophic gastritis, while the combination of sPGI, the sPGI/sPGII ratio and sG-17 was found effective in identifying corpus atrophy. Conclusion.: A panel composed of PGI, PGII, G-17 and IgG-Hp could be used as a first approach in the 'test and scope' and/or 'test and treat' strategy in the primary care management of dyspeptic patients.

Original languageEnglish
Pages (from-to)501-508
Number of pages8
JournalDigestive and Liver Disease
Volume37
Issue number7
DOIs
Publication statusPublished - Jul 2005

Keywords

  • Chronic gastritis
  • Dyspeptic patients
  • Gastrin-17
  • IgG anti-H. pylori
  • Serum pepsinogens

ASJC Scopus subject areas

  • Gastroenterology

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