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Osumi H, Fujisaki J, Suganuma T, Horiuchi Y, Omae M, Yoshio T, Ishiyama A, Tsuchida T, Miki K. A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication. PLoS One 2017; 12:e0183980. [PMID: 28854276 PMCID: PMC5576670 DOI: 10.1371/journal.pone.0183980] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/15/2017] [Indexed: 12/12/2022] Open
Abstract
Background Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori. Materials and methods In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively. Results Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05). Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively. Conclusion In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.
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Affiliation(s)
- Hiroki Osumi
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junko Fujisaki
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
- * E-mail:
| | - Takanori Suganuma
- Department of Gastroenterology, Iida Municipal Hospital, Nagano, Japan
| | - Yusuke Horiuchi
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masami Omae
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akiyoshi Ishiyama
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiro Tsuchida
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazumasa Miki
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Leja M, Lapina S, Polaka I, Rudzite D, Vilkoite I, Daugule I, Belkovets A, Pimanov S, Makarenko J, Tolmanis I, Lejnieks A, Boka V, Rumba-Rozenfelde I, Vikmanis U. Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy. MEDICINA-LITHUANIA 2014; 50:8-13. [PMID: 25060199 DOI: 10.1016/j.medici.2014.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 01/11/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication. MATERIAL AND METHODS Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23-74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test. RESULTS Eradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P=0.029) and unsuccessful (P=0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P=0.025) but not the unsuccessful (P=0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P=0.0018) but not in the group in which treatment failed (P=0.12). There were no differences in gastrin-17 or H. pylori antibody values. CONCLUSIONS A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.
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Affiliation(s)
- Marcis Leja
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia.
| | - Sanita Lapina
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia
| | - Inese Polaka
- Department of Modelling and Simulation, Riga Technical University, Riga, Latvia
| | - Dace Rudzite
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia
| | - Ilona Vilkoite
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia
| | - Ilva Daugule
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Anna Belkovets
- Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia
| | - Sergey Pimanov
- Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus
| | - Jelena Makarenko
- Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus
| | | | - Aivars Lejnieks
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia
| | - Viesturs Boka
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia
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Uedo N, Yao K, Ishihara R. Screening and treating intermediate lesions to prevent gastric cancer. Gastroenterol Clin North Am 2013; 42:317-35. [PMID: 23639643 DOI: 10.1016/j.gtc.2013.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Early gastric cancer is defined as adenocarcinoma confined to the mucosa or submucosa irrespective of lymph node involvement. In Japan, mucosal high-grade neoplasia is diagnosed as intramucosal early gastric cancer. Some early gastric cancers progress to advanced gastric cancer after several years of follow-up. Image-enhanced endoscopy (chromoendoscopy), narrow-band imaging, and magnifying endoscopy increase the diagnostic yield in characterizing early gastric cancer. Endoscopic resection of intramucosal early gastric cancer with endoscopic mucosal resection or endoscopic submucosal dissection is currently performed in East Asian countries to prevent the development of advanced gastric cancer and preserve patients' quality of life after treatment.
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Affiliation(s)
- Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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Leung WK, Wu MS, Kakugawa Y, Kim JJ, Yeoh KG, Goh KL, Wu KC, Wu DC, Sollano J, Kachintorn U, Gotoda T, Lin JT, You WC, Ng EKW, Sung JJY. Screening for gastric cancer in Asia: current evidence and practice. Lancet Oncol 2008; 9:279-87. [DOI: 10.1016/s1470-2045(08)70072-x] [Citation(s) in RCA: 642] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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