Serological markers as predictors of the severity of gastric mucosal atrophy in autoimmune and H. pylori-associated gastritis

Abstract

Background: The data on the role of serum pepsinogens in detecting atrophic gastritis are conflicting.
Оbjective: To evaluate the accuracy of pepsinogen (PG) I and pepsinogen II for the detection and staging of atrophy.
Materials and methods: 237 patients (56 men and 181 women) were examined. All respondents underwent a ¹³C-UBT, a blood pepsinogens and antibodies to gastric parietal cells. ¹³C-UBT positivity was defined as a DOB value ≥ 4‰. Serological markers of atrophy were PGI≤30μg/l and PGI/PGII≤3. EGD with a biopsy of the gastric mucosa from 5 standard points according to the Sydney system and a morphological study according to the OLGA system.
Results: H. pylori-associated gastritis was present in 135 patients, of whom 13 had severe atrophy (OLGA stages III–IV). Autoimmune gastritis (AIG) was diagnosed in 47 patients, of whom 34 had severe atrophy. AIG & H. pylori gastritis was present in 55 patients, of whom 13 had severe atrophy. Sensitivity and specificity of pepsinogens by gastritis etiology are shown in Table 1.
Conclusion: Serum pepsinogens showed the higher diagnostic accuracy in autoimmune gastritis (due to corpus involvement) and the lower in H. pylori-associated gastritis (likely due to isolated antral lesions).