Non-Invasive Diagnostic Tools For Assessment Of Function And Structure Of The Stomach Mucosa

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Cancer / Oncology;  Infectious Diseases / Bacteria / Viruses;  Medical Devices / Diagnostics
Article Date: 24 Feb 2009 - 3:00 PDT

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Risks for gastric cancer or peptic ulcer diseases are low in subjects with healthy stomach mucosa but are remarkably high in those with "diseased" stomach mucosa: i.e., in those with H pylori gastritis or atrophic gastritis. Therefore, the differentiation between patients with healthy (no H pylori, gastritis, or atrophic gastritis) and diseased gastric mucosa is clinically relevant. Serum levels of pepsinogen have been used for decades to diagnose atrophic corpus gastritis non-invasively. Recently, a European biomarker examination, GastroPanel (Biohit Plc, Helsinki, Finland), has been validated in which, in addition to Pg assays, the serum or plasma levels of gastrin-17 and H pylori antibodies of both IgG and IgA class are measured from the same sample using an ELISA technique.

A research article published on February 21, 2009 in the World Journal of Gastroenterology addresses this problem. Dr. Iijima et al examine, in a Japanese population, how well the European GastroPanel examination delineatespatients with atrophic gastritis, and, in particular, how well these examinations differentiate between patients with healthy and diseased gastric mucosa.

Among 162 Japanese outpatients, pepsinogen I and pepsinogen II were measured using a conventional Japanese technique, and with the European GastroPanel examination. Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa, H pylori non-atrophic gastritis or atrophic gastritis.

Pepsinogen I and pepsinogen II assays using the GastroPanel and the Japanese methods showed a highly significant correlation. For methodological reasons, however, serum Pg I, but not Pg II, was twice as high with the GastroPanel test as with the Japanese test. The biomarker assays revealed that 5% of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies. The GastroPanel examination revealed an additional 7 patients who had either advanced atrophic gastritis limited to the antrum or antrum predominant H pylori gastritis. When compared with the endoscopic biopsy findings, the GastroPanel examination classified patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy, 95% sensitivity and 93% specificity.

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Reference: Iijima K, Abe Y, Kikuchi R, Koike T, Ohara S, Sipponen P, Shimosegawa T. Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal, healthy stomach. World J Gastroenterol 2009; 15(7): 853-859 http://www.wjgnet.com/1007-9327/15/853.asp

Correspondence to:Katsunori Iijima, MD, Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aobaku, Sendai 980-8574, Japan.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Lin Tian
World Journal of Gastroenterology

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