Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

Authors

  • Olga Sjomina Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Jelizaveta Pavlova Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Ilva Daugule Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Pavel Janovic Faculty of Medicine, University of Latvia
  • Ilze Kikuste Institute of Clinical and Preventive Medicine, University of Latvia; Department of Research, Riga East University Hospital
  • Aigars Vanags Department of Research, Riga East University Hospital
  • Ivars Tolmanis Department of Research, Riga East University Hospital
  • Dace Rudzite Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Inese Polaka Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University
  • Ilona Kojalo Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Inta Liepniece-Karele Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia; Academic Histology Laboratory
  • Sergejs Isajevs Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia; Academic Histology Laboratory
  • Daiga Santare Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia
  • Valdis Pirags Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University
  • Jelena Pahomova Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital
  • Vilnis Dzerve Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital
  • Lilian Tzivian Institute of Clinical and Preventive Medicine, University of Latvia
  • Andrejs Erglis Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital
  • Marcis Leja Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia; Department of Research, Riga East University Hospital; Digestive Diseases Centre Gastro

DOI:

https://doi.org/10.15403/jgld.2014.1121.271.pep

Keywords:

pepsinogens, screening, atrophy, gastric cancer, follow-up, H. pylori

Abstract

Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings.
Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system).
Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV – 10.5% and 0.0%, OLGIM stages III-IV – 3.5% and 0%, and low-grade dysplasia – 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05).
Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed.
However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

March 2018, volume 27, issue 3

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Published

2018-03-31

How to Cite

1.
Sjomina O, Pavlova J, Daugule I, Janovic P, Kikuste I, Vanags A, Tolmanis I, Rudzite D, Polaka I, Kojalo I, Liepniece-Karele I, Isajevs S, Santare D, Pirags V, Pahomova J, Dzerve V, Tzivian L, Erglis A, Leja M. Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study. JGLD [Internet]. 2018 Mar. 31 [cited 2026 Jun. 15];27(1):11-7. Available from: https://jgld.ro/jgld/index.php/jgld/article/view/119

Issue

Vol. 27 No. 1: March 2018

Section

Original Article