Serum pepsinogen I and serum gastrin in the screening of severe atrophic corpus gastritis

Scand J Gastroenterol Suppl. 1991:186:109-16. doi: 10.3109/00365529109103997.

Abstract

The possibilities to screen atrophic corpus gastritis with serum pepsinogen I (S-PGI) and serum gastrin (S-gastrin) concentrations have been studied in 774 subjects: 71 index subjects selected from a general population at random, 353 of their first-degree relatives, 276 first-degree relatives of patients with gastric cancer, 53 patients with pernicious anaemia, and 21 of their relatives. Discrimination function analysis was calculated from members of random and gastric carcinoma families. S-PGI less than 30 ng/ml had a high sensitivity for severe diffuse atrophic corpus gastritis (SDAG) alone (89.5%) and SDAG + severe patchy atrophic corpus gastritis (SPAG) (89.1%). Respective figures for specificity were 91.5% and 94.8%. The discriminatory power of S-PGI less than 30 ng/ml and S-PGI less than 25 ng/ml was of the same order. The sensitivity of low S-PGI decreased sharply in detection of slighter forms of atrophic corpus gastritis. The sensitivity of S-gastrin greater than 100 pmol/l to discriminate SDAG was 57.9% and SDAG+SPAG 58.7%. Respective figures for specificity were 90.2% and 92.2%. Diffuse and patchy atrophic changes behaved similarly regarding S-PGI and S-gastrin mean concentrations. Accordingly, the biopsy specimen with the severest atrophic changes indicates the degree of atrophy, which associates closely with the changes in S-PGI and S-gastrin. In conclusion, severe atrophic (diffuse or patchy) corpus gastritis may be screened from a general population with high sensitivity and specificity by low S-PGI less than 30 ng/ml, whereas an increased level of S-gastrin is too insensitive for this.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anemia, Pernicious / complications
  • Female
  • Gastric Mucosa / pathology
  • Gastrins / blood*
  • Gastritis, Atrophic / blood
  • Gastritis, Atrophic / complications
  • Gastritis, Atrophic / pathology*
  • Humans
  • Male
  • Middle Aged
  • Pepsinogens / blood*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Stomach Neoplasms / blood
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / pathology

Substances

  • Gastrins
  • Pepsinogens