Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10948-10955
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10948
Serum gastrin-17 concentration for prediction of upper gastrointestinal tract bleeding risk among peptic ulcer patients
Jun-Xian Wang, Yu-Ping Cao, Peng Su, Wei He, Xiao-Ping Li, Ya-Meng Zhu
Jun-Xian Wang, Yu-Ping Cao, Peng Su, Wei He, Xiao-Ping Li, Ya-Meng Zhu, Department of Gastroenterology, The Second People’s Hospital of Anhui Province, Hefei 230011, Anhui Province, China
Author contributions: Wang JX and Su P contributed study concept, design, analysis and interpretation of data; Cao YP, Su P, He W, Li XP and Zhu YM contributed acquisition of data; Wang JX, Cao YP and Su P wrote the manuscript; all authors wrote, read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Second People's Hospital of Anhui Province, Institutional Review Board (Approval No. 2015-036).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no potential competing interests to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Jun-Xian Wang, PhD, Chief Doctor, Department of Gastroenterology, The Second People’s Hospital of Anhui Province, No. 1868 Dangshan Road, Hefei 230011, Anhui Province, China. ahwjx168@sina.com
Received: April 25, 2021
Peer-review started: April 25, 2021
First decision: June 3, 2021
Revised: June 18, 2021
Accepted: August 30, 2021
Article in press: August 30, 2021
Published online: December 16, 2021
Processing time: 229 Days and 0.9 Hours
ARTICLE HIGHLIGHTS
Research background

Peptic ulcer is a relatively common chronic gastrointestinal disorder most frequently caused by Helicobacter pylori infection or long-term non-steroid anti-inflammatory drug administration. Severe cases are often complicated by bleeding, which can exacerbate symptoms, cause anemia, and lead to life-threatening hemorrhage. Hypersecretion of gastric acid increases the risk and severity of peptic ulcer. Gastric acid secretion is controlled by the hormones gastrin-17 (G-17), pepsinogen I (PGI), and pepsinogen II (PGII), suggesting that these factors may be predictive of bleeding among peptic ulcer patients.

Research motivation

If left untreated, peptic ulcer can result in gastrointestinal bleeding and gastric tumors. Therefore, accessible biomarkers such as serum factors predictive of bleeding risk are important tools for early diagnosis and treatment guidance, and may reduce the incidence of severe complications.

Research objectives

To examine if serum G-17, PGI, PGII, and (or) PGI/PGII ratio (PGR) can predict bleeding risk among peptic ulcer patients.

Research methods

We compared serum G-17, PGI, PGII, and PGR between 199 peptic ulcer patients with bleeding (n = 92) or without bleeding (n = 107), and then assessed the efficacy of each factor for bleeding prediction by receiver operating characteristic curve analysis.

Research results

Serum G-17 was significantly higher among peptic ulcer patients with upper gastrointestinal bleeding, whereas serum PGI, PGII, and PGR did not differ significantly between bleeding and non-bleeding patients. A serum G-17 greater than 9.86 pmol/L distinguished bleeding from non-bleeding patients with 90.2% sensitivity and 68.2% specificity.

Research conclusions

Elevated serum G-17 is predictive of bleeding risk among peptic ulcer patients. Lowering serum G-17 should be a major goal of clinical intervention.

Research perspectives

Prospective studies are warranted to assess if elevated serum G-17 can predict bleeding complication prior to disease onset. The development of drugs able to regulate G-17 secretion is also desired to help reduce bleeding risk.