1. bookVolume 72 (2018): Issue 3 (June 2018)
Journal Details
License
Format
Journal
eISSN
2255-890X
First Published
14 Sep 2008
Publication timeframe
6 times per year
Languages
English
access type Open Access

Non-Invasive Diagnosis of Gastroesophageal Reflux Disease Using Gastrin- and Pepsinogen-Based Tests

Published Online: 21 Jun 2018
Volume & Issue: Volume 72 (2018) - Issue 3 (June 2018)
Page range: 172 - 176
Received: 17 Sep 2017
Accepted: 07 Jan 2018
Journal Details
License
Format
Journal
eISSN
2255-890X
First Published
14 Sep 2008
Publication timeframe
6 times per year
Languages
English
Abstract

Gastrin-17 (G-17), pepsinogen-1 (Pg1) and pepsinogen-2 (Pg2) reflect the functional state of gastric mucosa and are used for non-invasive diagnosis and screening of atrophic gastritis. The aim of the study was to clarify if erosive reflux disease (ERD) or non-ERD (NERD) can be distinguished from other dyspeptic conditions in patients, in a non-invasive manner using specific biomarkers. Levels of G-17, Pg1, and Pg2 were measured in 141 ERD patients (median age 48 years, males — 68), 122 NERD patients (median age 45 years, males — 32) and 410 control patients (median age 50 years, males — 97). Levels of biomarkers in ERD and NERD groups were compared to controls. Median levels of G-17 (1.94 vs 2.92 pmol/L, p = 0.036) and Pg2 (6.70 vs 7.79 µg/l, p = 0.046) were lower in the ERD group compared to control patients; no difference with respect to the control was found for the NERD group. After exclusion of the patients having at least one potential condition that might modify the levels of the biomarkers (gastric mucosa atrophy, Helicobacter pylori colonisation), no difference in levels of biomarkers was observed with respect to the control for both the ERD and NERD groups. G-17, Pg1, and Pg2 based tests cannot be used to distinguish ERD or NERD from other dyspeptic conditions in patients.

Keywords

Abe, Y., Iijima, K., Koike, T., Asanuma, K., Imatani, A., Ohara, S., Shimosegawa, T. (2009). Barrett’s esophagus is characterized by the absence of Helicobacter pylori infection and high levels of serum pepsinogen I concentration in Japan. J. Gastroenterol. Hepatol., 24 (1), 129–134.10.1111/j.1440-1746.2008.05691.x19196398Search in Google Scholar

Collen, M. J., Johnson, D. A. (1992). Correlation between basal acid output and daily ranitidine dose required for therapy in Barrett’s esophagus. Digestive Dis. Sci., 37 (4), 570–576.10.1007/BF013075811551347Search in Google Scholar

Dixon, M. F., Genta, R. M., Yardley, J. H., Correa, P. (1996). Classification and grading of gastritis. The updated Sydney System. International workshop on the histopathology of gastritis, Houston 1994. Amer. J. Surg. Pathol., 20 (10), 1161–1181.10.1097/00000478-199610000-000018827022Search in Google Scholar

Dockray, G. J. (2004). Clinical endocrinology and metabolism. Gastrin. Best Practice Res. Clin. Endocrin. Metab., 18 (4), 555–568.10.1016/j.beem.2004.07.00315533775Search in Google Scholar

Fujiwara, Y., Higuchi, K., Shiba, M., Yamamori, K., Watanabe, Y., Sasaki, E., Tominaga, K., Watanabe, T., Oshitani, N., Arakawa, T. (2005). Differences in clinical characteristics between patients with endoscopy-negative reflux disease and erosive esophagitis in Japan. Amer. J. Gastroenterol., 100 (4), 754–758.10.1111/j.1572-0241.2005.40966.x15784015Search in Google Scholar

Gritti, I., Banfi, G., Roi, G. S. (2000). Pepsinogens: Physiology, pharmacology pathophysiology and exercise. Pharmacol. Res., 41 (3), 265–281.10.1006/phrs.1999.058610675278Search in Google Scholar

Iijima, K., Abe, Y., Kikuchi, R., Koike, T., Ohara, S., Sipponen, P. (2009). Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal, healthy stomach. World J. Gastroenterol., 15 (7), 853–859.10.3748/wjg.15.853265338619230047Search in Google Scholar

Katz, P., Gerson, L. B., Vela, M. F. (2013). Guidelines for the diagnosis and management of gastroesophageal reflux disease. Amer. J. Gastroenterol., 108 (3), 308–328.10.1038/ajg.2012.44423419381Search in Google Scholar

Kuipers, E. J. (2003). In through the out door: Serology for atrophic gastritis. Eur. J. Gastroenterol. Hepatol., 15 (8), 877–879.10.1097/00042737-200308000-0000712867797Search in Google Scholar

Lundell, L. R., Dent, J., Bennett, J. R., Blum, A. L., Armstrong, D., Galmiche, J. P., Johnson, F., Hongo, M., Richter, J. E., Spechler, S. J., Tytgat, G. N., Wallin, L. (1999). Endoscopic assessment of eosophagitis: clinical and functional correlates and futher validation of the Los Angeles classification. Gut, 45 (2), 172–180.10.1136/gut.45.2.172172760410403727Search in Google Scholar

Minatsuki, C., Yamamichi, N., Shimamoto, T., Kakimoto, H., Takahashi, Y., Fujishiro, M., Sakaguchi, Y., Nakayama, C., Konno-Shimizu, M., Matsuda, R., Mochizuki, S., Asada-Hirayama, I., Tsuji, Y., Kodashima, S., Ono, S., Niimi, K., Mitsushima, T., Koike, K. (2013). Background factors of reflux esophagitis and non-erosive reflux disease: A cross-sectional study of 10,837 subjects on Japan. PLOS ONE, 8 (7). DOI: 10.1371/journal.pone.0069891.10.1371/journal.pone.0069891372473823922844Search in Google Scholar

Monkemuller, K., Neumann, H., Nocon, M., Vieth, M., Labenz, J., Willich, S. N., Stolte, M., Hocker, M., Jaspersen, D., Lind, T., Malftheiner, P. (2008). Serum gastrin and pepsiongens do not correlate with the different grades of severity of gastro-oesophageal reflux disease: A matched case-control study. Alimentary Pharmacol. Ther., 28 (4), 491–496.10.1111/j.1365-2036.2008.03769.x18557987Search in Google Scholar

Mulholland, N. M., Reid, B. J., Levine, D. S., Rubin, C. E. (1989). Elevated gastric acid secretion in patients with Barrett’s metaplastic epithelium. Digest. Dis. Sci., 34 (9), 1329–1334.10.1007/BF015380642766898Search in Google Scholar

Narsollahzadeh, D., Aghcheli, K., Sotoudeh, M., Shakeri, R., Persson, E. C., Islami, F., Kamangar, F., Abnet, C. C., Boffetta, P., Engstrand, L., Dawsey, S. M., Malekzadeh, R., Ye, W. (2011). Accuracy and cut-off values of pepsinogens I, II and gastrin 17 for diagnosis of gastric fundic atrophy: Influence of gastritis. PLOS ONE, 6 (10). DOI: 10.1371/journal.pone.0026957.10.1371/journal.pone.0026957320499722066020Open DOISearch in Google Scholar

Pasechnikov, V. D., Chukov, S. Z., Kotelevets, S. M., Mostovov, A. N., Mernova, V. P., Polyakova, M. B. (2005). Invasive and non-invasive diagnosis of Helicobacter pylori-associated atrophic gastritis: A comparative study. Scand. J. Gastroenterol., 40 (3), 297–301.10.1080/0036552041001060715932170Search in Google Scholar

Peitz, U., Wex, T., Vieth, M., Stolte, M., Willich, S., Labenz, J., Jaspersen, D., Lind, T., Malfertheiner, P. (2011). Correlation of serum pepsinogens and gastrin-17 with atrophic gastritis in gastroesophageal reflux patients: A matched-pairs study. J. Gastroenterol. Hepatol., 26 (1), 82–89.10.1111/j.1440-1746.2010.06413.x21175799Search in Google Scholar

Sipponen, P., Vauhkonen, M., Helske, T., Kaariainen, I., Harkonen, M. (2005). Low circulating levels of gastrin-17 in patients with Barrett’s esophagus. World J. Gastroenterol., 11 (38), 5988–5992.10.3748/wjg.v11.i38.5988443639716273611Search in Google Scholar

Tack, J., Talley, N. J., Camilleri, M., Holtmann, G., Hu, P., Malagelada, J.-R., Stanghellini, V. (2006). Functional gastroduodenal disorders. Gastroenterology, 130 (5), 1466–1479.10.1053/j.gastro.2005.11.05916678560Search in Google Scholar

Vaananen, H., Vauhkonen, M., Helske, T., Kaariainen, I., Rasmussen, M., Tunturi-Hihnala, H., Koskenpato, J., Sotka, M., Turunen, M., Sandstrom, R., Ristikankare, M., Jussila, A., Sipponen, P. (2003). Non-endoscopic diagnosis of atrophic gastritis with a blood test. Correlation between gastric histology and serum levels of gastrin-17 and pepsinogen I: A multicentre study. Eur. J. Gastroenterol. Hepatol., 15 (8), 885–891.Search in Google Scholar

Yoshikawa, I., Murata, I., Kume, K., Kanagawa, K., Hirohata, Y., Nakamura, H., Otsuki, M. (2002). Serum pepsinogen can predict response to H2-receptor antagonist in patients with functional dyspepsia. Alimentary Pharmacol. Ther., 16 (10), 1805–1809.10.1046/j.1365-2036.2002.01352.x12269975Search in Google Scholar

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