Non-invasive diagnosis of gastric mucosal atrophy in an asymptomatic population with high prevalence of gastric cancer

Table 1 Correlation between the serum levels of pepsinogen and gastrin with the type and topography of histological gastritis (median)

	Chronic non-atrophicgastritis (n = 10)	Antrum-predominant atrophicgastritis (n = 10)	Corpus-predominantatrophic gastritis1 (n = 9)
PG-1 (µg/L)a	115.6	103.3	40.9
PG-1/PG-2a	4.39	5.62	2.22
17-gastrinb (pmol/L)	6.2	3.7	36.8

¹Including 1 patient with multifocal atrophic gastritis;

^aP < 0.05 or

^bP < 0.01 between the three groups (Kruskal-Wallis Test).

Table 2 Diagnostic performance of serology (pepsinogen and 17-gastrin) to diagnose gastric atrophy

	Cut-off level	Sensitivity% (95% CI)	Specificity% (95% CI)	LR5+	LR-	Youden’s J index
PG-1 (µg/L)3	< 251	44 (12-77)	95 (87-100)	8.8	0.59	0.40 ± 0.17
	≤ 61.52	78 (40-97)	91 (71-99)	8.6	0.24	0.69 ± 0.15
PG-1/PG-23	< 2.51	56 (21-86)	100 (84-100)	∞	0.44	0.56 ± 0.17
	≤ 2.22
17-gastrin (pmol/L)	< 214	30 (16-58)	86 (70-100)	2.1	0.81	0.16 ± 0.16
	≤ 7.524	90 (56-98)	52 (30-74)	1.89	0.19	0.42 ± 0.14
	> 13.323	67 (30-92)	96 (77-99)	14.7	0.35	0.62 ± 0.16

¹Suggested by the manufacturer;

²Determined by ROC curves;

³To detect corpus-predominant atrophic gastritis;

⁴To detect antrum-predominant atrophic gastritis;

⁵ LR = likelihood ratio.

Table 3 Characteristics of the asymptomatic population samples according to the estimated gastric cancer risk

Characteristics	Estimated gastric cancer risk			Total(n = 536)
	Low (A)(n = 115)	Medium (B)(n = 354)	High (C)(n = 67)
Corpus atrophy1	Absent	Absent	Present
H pylori infection2	Absent	Present	Present or absent
Men, n (%)	46 (40.0)	168 (47.5)	35 (52.2)	249 (46.5)
Age (yr)a, (mean ± SD)	49.6 ± 22.2	48.6 ± 18.0	61.9 ± 13.3	50.5 ± 19.0
Educational level (yr)a, (mean ± SD)	8.8 ± 5.2	8.2 ± 4.3	5.8 ± 4.2	8.0 ± 4.6
Rurality, n (%)	27 (23.5)	99 (28.0)	22 (32.8)	148 (27.6)
Living in high-risk counties, n (%)	39 (33.9)	146 (41.2)	24 (35.8)	209 (39.0)
17-Gastrina (pmol/L), (mean ± SD)	4.1 ± 6.8	5.6 ± 7.1	14 ± 14.3	6.3 ± 8.8

¹As determined by serum level of PG-1 ≤ 61.5 µg/L and PG-1/PG-2 ratio ≤ 2.2.

²Serology (+) for H pylori (ELISA).

^aSignificant variables in the multivariate analysis (P < 0.05): B vs A: 17-gastrin (OR 1.05); C vs A: sex (OR 2.08); age (OR 1.02); education years (OR 0.9); 17-gastrin (OR 1.13).