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Sjomina O, Pavlova J, Daugule I, Janovic P, Kikuste I, Vanags A, Tolmanis I, Rudzite D, Polaka I, Kojalo I, Liepniece-Karele I, Isajevs S, Santare D, Pirags V, Pahomova J, Dzerve V, Tzivian L, Erglis A, Leja M. Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: a population-based study. J Gastrointestin Liver Dis 2019; 27:11-17. [PMID: 29557410 DOI: 10.15403/jgld.2014.1121.271.pep] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AIMS The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. METHODS Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). RESULTS Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). CONCLUSIONS All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.
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Affiliation(s)
- Olga Sjomina
- Institute of Clinical and Preventive Medicine, University of Latvia;Faculty of Medicine, University of Latvia, Riga, Latvia. or sjomina.
| | - Jelizaveta Pavlova
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Pavel Janovic
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia; Department of Research, Riga East University Hospital, Riga, Latvia
| | - Aigars Vanags
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Ivars Tolmanis
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Ilona Kojalo
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia;Academic Histology Laboratory, Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia;Academic Histology Laboratory, Riga, Latvia
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Valdis Pirags
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Jelena Pahomova
- Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Vilnis Dzerve
- Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Lilian Tzivian
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Andrejs Erglis
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia; Digestive Diseases Centre Gastro, Riga, Latvia
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