Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9431-9439
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9431
Association of serum pepsinogen with degree of gastric mucosal atrophy in an asymptomatic population
Hao-Lei Cai, Yu-Ling Tong
Hao-Lei Cai, Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Yu-Ling Tong, International Healthcare Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Cai HL performed the research and wrote the paper; Tong YL designed the research, contributed to the analysis, and supervised the report.
Supported by National Natural Science Foundation of China, No. 71804161 and No. 72074188.
Institutional review board statement: This study was reviewed and approved by the Human Research Ethics Committee of the Second Hospital Affiliated to Zhejiang University School of Medicine (No. 2015-079).
Informed consent statement: All subjects provided written informed consent prior to enrollment in this study.
Conflict-of-interest statement: The authors declare that they have no related financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-ling Tong, MD, Doctor, International Healthcare Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. tongyl0313@zju.edu.cn
Received: March 26, 2021
Peer-review started: March 26, 2021
First decision: April 28, 2021
Revised: May 6, 2021
Accepted: September 27, 2021
Article in press: September 27, 2021
Published online: November 6, 2021
Processing time: 216 Days and 22.1 Hours
Abstract
BACKGROUND

Atrophic gastritis is a precancerous lesion of the stomach. It has been reported that pepsinogen (PG) can reflect the morphology and function of the gastric mucosa, and it is therefore used as a marker for the early diagnosis of atrophic gastritis.

AIM

To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.

METHODS

Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018. For each study subject, serum PG levels and presence of Helicobacter pylori (H. pylori) infection were investigated. Pathology was evaluated using the Operative Link for Gastritis Assessment (OLGA) classification and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) systems. All statistical analyses were carried out using SPSS statistical software.

RESULTS

A total of 2256 subjects were enrolled and 1922 cases were finally included in the study. Based on the OLGA grading system, the levels of PGI were slightly decreased, while those of PGII were slightly increased. The PGI/PGII ratio (PGR) was reduced with increasing atrophy. The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system. Compared with the OLGA-0 group, a statistically significant difference was observed in the mean age of OLGA-I, III, and IV groups (P < 0.05). In the H. pylori-positive subjects, the PGR levels were notably lower in the OLGA-I, II, and III groups compared with the OLGA-0 group (P < 0.05). H. pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H. pylori-negative patients in different OLGA groups (P < 0.05).

CONCLUSION

Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.

Keywords: Pepsinogen; Helicobacter pylori; Operative Link for Gastritis Assessment; Atrophic gastritis; Gastric mucosal atrophy; Biomarker

Core Tip: The current study evaluated the diagnostic value of serum pepsinogen (PG) as a screening marker for atrophic gastritis in asymptomatic healthy check-up populations in different regions of China. Serum PG levels were closely associated with Operative Link for Gastritis Assessment grading and could be used as an effective non-invasive screening tool for atrophic gastritis in asymptomatic subjects. In addition, better results could be obtained in Helicobacter pylori-positive individuals. Screening is more necessary in the elderly, and the application of the aforementioned screening tool may be beneficial for this population.