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Gut and Liver 2010; 4(4): 475-480 https://doi.org/10.5009/gnl.2010.4.4.475 Low Levels of Pepsinogen I and Pepsinogen I/II Ratio are Valuable Serologic Markers for Predicting Extensive Gastric Corpus Atrophy in Patients Undergoing Endoscopic Mucosectomy
Author Information
Ho June Song*, Se Jin Jang†, Sung-Cheol Yun‡, Young Soo Park†, Mi-Jung Kim†, Sun-Mi Lee*, Kee Don Choi*, Gin Hyug Lee*, Hwoon-Yong Jung*, and Jin-Ho Kim*
*Asan Digestive Disease Research Institute, Division of Gastroenterology, Department of Internal Medicine, Departments of †Pathology and ‡Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Jin-Ho Kim
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: The levels of pepsinogen (PG) I and the PGI/II ratio are useful serologic markers for chronic atrophic gastritis. This study evaluated the performance and clinical implications of these markers in patients undergoing endoscopic mucosectomy. Methods: We enrolled 142 consecutive patients with early gastric tumors and Helicobacter pylori infection who were eligible for mucosectomy. Chronic gastritis and atrophy were assessed using four defined biopsy procedures. Serum PGs were measured by an enzyme immunoassay. Optimal diagnostic cut-offs and performance were determined using receiver operating characteristic curves. Results: The PGI level and the PGI/II ratio decreased with corpus-dominant gastritis and as atrophy advanced toward the corpus greater curvature (GC). For the presence of corpus GC atrophy, the areas under the PGI and PGI/II-ratio curves were 0.82 and 0.77, respectively. The optimal cut-off levels were 59.3Ռg/L for PGI (sensitivity, 83.3%; specificity, 78.4%) and 3.6Ռg/L for PGI/II ratio (sensitivity, 70.0%; specificity, 78.4%). Using these serologic cut-off levels, we found that the frequency of corpus tumor location differed significantly (32.9% vs 11.1% for PGI ＜59.3 and ≥59.3Ռg/L, respectively; and 31.1% vs 14.8% for PGI/II ratio ＜3.5 and ≥3.5, respectively; p＜0.05). Conclusions: A low PGI level and PGI/II ratio are valuable serologic markers for predicting corpus GC atrophy, and have clinical implications with respect to the corpus location of tumors in mucosectomy patients. (Gut Liver 2010;4:475-480)
Keywords: Pepsinogens; Atrophic gastritis; Stomach neoplasia; Helicobacter pylori; Endoscopy
Abstract
Background/Aims: The levels of pepsinogen (PG) I and the PGI/II ratio are useful serologic markers for chronic atrophic gastritis. This study evaluated the performance and clinical implications of these markers in patients undergoing endoscopic mucosectomy. Methods: We enrolled 142 consecutive patients with early gastric tumors and Helicobacter pylori infection who were eligible for mucosectomy. Chronic gastritis and atrophy were assessed using four defined biopsy procedures. Serum PGs were measured by an enzyme immunoassay. Optimal diagnostic cut-offs and performance were determined using receiver operating characteristic curves. Results: The PGI level and the PGI/II ratio decreased with corpus-dominant gastritis and as atrophy advanced toward the corpus greater curvature (GC). For the presence of corpus GC atrophy, the areas under the PGI and PGI/II-ratio curves were 0.82 and 0.77, respectively. The optimal cut-off levels were 59.3Ռg/L for PGI (sensitivity, 83.3%; specificity, 78.4%) and 3.6Ռg/L for PGI/II ratio (sensitivity, 70.0%; specificity, 78.4%). Using these serologic cut-off levels, we found that the frequency of corpus tumor location differed significantly (32.9% vs 11.1% for PGI ＜59.3 and ≥59.3Ռg/L, respectively; and 31.1% vs 14.8% for PGI/II ratio ＜3.5 and ≥3.5, respectively; p＜0.05). Conclusions: A low PGI level and PGI/II ratio are valuable serologic markers for predicting corpus GC atrophy, and have clinical implications with respect to the corpus location of tumors in mucosectomy patients. (Gut Liver 2010;4:475-480)
Keywords: Pepsinogens; Atrophic gastritis; Stomach neoplasia; Helicobacter pylori; Endoscopy
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