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Long-term follow-up of pepsinogen I/II ratio after eradication of Helicobacter pylori in patients who underwent endoscopic mucosal resection for gastric cancer

Published:December 22, 2016DOI:https://doi.org/10.1016/j.dld.2016.12.016

      Abstract

      Background

      Although the pepsinogen I/II (PGI/II) ratio after Helicobacter pylori eradication is recovered at short-term follow-up, long-term follow-up studies of PGI/II are rare.

      Methods

      A total of 773 patients with gastric cancer who underwent endoscopic resection and pepsinogen and H. pylori tests were enrolled. H. pylori was eradicated in these patients. Endoscopic and pepsinogen tests were performed every year. A low PGI/II ratio was defined as ≤3.

      Results

      The PGI/II ratio was higher in non-infected patients (n = 275, 4.99) than infected patients (n = 498, 3.53). After H. pylori eradication, the PGI/II ratio increased to 5.81 and 5.63 after 1 and 2 years (each p < 0.05). The PGI/II ratio in the non-eradication group decreased to 3.94 and 2.75 after 1 and 2 years. The PGI/II ratio in the H. pylori eradication group became similar to that of the H. pylori-negative group at 3 (4.48 vs. 4.34), 4 (4.88 vs. 4.34), and 5 years (4.89 vs. 4.23). The adjusted odds ratios for a lower PG I/II ratio in the non-eradication group compared to the eradication group were 4.78 (95% CI 2.15–10.67) after 1 year and 8.13 (95% CI 2.56–25.83) after 2 years.

      Conclusions

      After H. pylori eradication, the PGI/II ratio increased and was similar to that of H. pylori-negative controls for up to 5 years of follow-up.

      Keywords

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      References

        • Ferlay J.
        • Soerjomataram I.
        • Dikshit R.
        • et al.
        Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.
        International Journal of Cancer. 2015; 136: E359-86
        • Correa P.
        • Piazuelo M.B.
        Natural history of Helicobacter pylori infection.
        Digestive and Liver Disease. 2008; 40: 490-496
        • Pasechnikov V.
        • Chukov S.
        • Fedorov E.
        • et al.
        Gastric cancer: prevention, screening and early diagnosis.
        World Journal of Gastroenterology. 2014; 20: 13842-13862
        • Choi I.J.
        Endoscopic gastric cancer screening and surveillance in high-risk groups.
        Clinical Endoscopy. 2014; 47: 497-503
        • Samloff I.M.
        • Liebman W.M.
        Cellular localization of the group II pepsinogens in human stomach and duodenum by immunofluorescence.
        Gastroenterology. 1973; 65: 36-42
        • Samloff I.M.
        Cellular localization of group I pepsinogens in human gastric mucosa by immunofluorescence.
        Gastroenterology. 1971; 61: 185-188
        • Samloff I.M.
        • Varis K.
        • Ihamaki T.
        • et al.
        Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia.
        Gastroenterology. 1982; 83: 204-209
        • Kitahara F.
        • Kobayashi K.
        • Sato T.
        • et al.
        Accuracy of screening for gastric cancer using serum pepsinogen concentrations.
        Gut. 1999; 44: 693-697
        • Graham D.Y.
        • Nurgalieva Z.Z.
        • El-Zimaity H.M.
        • et al.
        Noninvasive versus histologic detection of gastric atrophy in a Hispanic population in North America.
        Clinical Gastroenterology and Hepatology. 2006; 4: 306-314
        • Mukoubayashi C.
        • Yanaoka K.
        • Ohata H.
        • et al.
        Serum pepsinogen and gastric cancer screening.
        Internal Medicine. 2007; 46: 261-266
        • Iijima K.
        • Koike T.
        • Abe Y.
        • et al.
        Alteration of correlation between serum pepsinogen concentrations and gastric acid secretion after H. pylori eradication.
        Journal of Gastroenterology. 2009; 44: 819-825
        • Kawai T.
        • Miki K.
        • Ichinose M.
        • et al.
        Changes in evaluation of the pepsinogen test result following Helicobacter pylori eradication therapy in Japan.
        Inflammopharmacology. 2007; 15: 31-35
        • Ohkusa T.
        • Miwa H.
        • Nomura T.
        • et al.
        Improvement in serum pepsinogens and gastrin in long-term monitoring after eradication of Helicobacter pylori: comparison with H. pylori-negative patients.
        Alimentary Pharmacology Therapeutics. 2004; 20: 25-32
        • Pimanov S.I.
        • Makarenko E.V.
        • Voropaeva A.V.
        • et al.
        Helicobacter pylori eradication improves gastric histology and decreases serum gastrin, pepsinogen I and pepsinogen II levels in patients with duodenal ulcer.
        Journal of Gastroenterology and Hepatology. 2008; 23: 1666-1671
        • Yoon S.B.
        • Park J.M.
        • Lim C.H.
        • et al.
        Effect of Helicobacter pylori eradication on metachronous gastric cancer after endoscopic resection of gastric tumors: a meta-analysis.
        Helicobacter. 2014; 19: 243-248
        • Urita Y.
        • Hike K.
        • Torii N.
        • et al.
        Comparison of serum IgA and IgG antibodies for detecting Helicobacter pylori infection.
        Internal Medicine. 2004; 43: 548-552
        • Iijima K.
        • Abe Y.
        • Kikuchi R.
        • et al.
        Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal, healthy stomach.
        World Journal of Gastroenterology. 2009; 15: 853-859
        • Dinis-Ribeiro M.
        • da Costa-Pereira A.
        • Lopes C.
        • et al.
        Validity of serum pepsinogen I/II ratio for the diagnosis of gastric epithelial dysplasia and intestinal metaplasia during the follow-up of patients at risk for intestinal-type gastric adenocarcinoma.
        Neoplasia. 2004; 6: 449-456
        • He C.Y.
        • Sun L.P.
        • Gong Y.H.
        • et al.
        Serum pepsinogen II: a neglected but useful biomarker to differentiate between diseased and normal stomachs.
        Journal of Gastroenterology and Hepatology. 2011; 26: 1039-1046
        • Lomba-Viana R.
        • Dinis-Ribeiro M.
        • Fonseca F.
        • et al.
        Serum pepsinogen test for early detection of gastric cancer in a European country.
        European Journal of Gastroenterology and Hepatology. 2012; 24: 37-41
        • Kang J.M.
        • Kim N.
        • Yoo J.Y.
        • et al.
        The role of serum pepsinogen and gastrin test for the detection of gastric cancer in Korea.
        Helicobacter. 2008; 13: 146-156
        • Shikata K.
        • Ninomiya T.
        • Yonemoto K.
        • et al.
        Optimal cutoff value of the serum pepsinogen level for prediction of gastric cancer incidence: the Hisayama Study.
        Scandinavian Journal of Gastroenterology. 2012; 47: 669-675
        • Furuta T.
        • Kaneko E.
        • Baba S.
        • et al.
        Percentage changes in serum pepsinogens are useful as indices of eradication of Helicobacter pylori.
        American Journal of Gastroenterology. 1997; 92: 84-88
        • Sanduleanu S.
        • Jonkers D.
        • De Bruine A.
        • et al.
        Double gastric infection with Helicobacter pylori and non-Helicobacter pylori bacteria during acid-suppressive therapy: increase of pro-inflammatory cytokines and development of atrophic gastritis.
        Alimentary Pharmacology Therapeutics. 2001; 15: 1163-1175
        • Sanduleanu S.
        • Jonkers D.
        • De Bruine A.
        • et al.
        Non-Helicobacter pylori bacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa.
        Alimentary Pharmacology Therapeutics. 2001; 15: 379-388
        • Nomura A.
        • Stemmermann G.N.
        • Chyou P.H.
        • et al.
        Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii.
        New England Journal of Medicine. 1991; 325: 1132-1136
        • Parsonnet J.
        • Friedman G.D.
        • Vandersteen D.P.
        • et al.
        Helicobacter pylori infection and the risk of gastric carcinoma.
        New England Journal of Medicine. 1991; 325: 1127-1131
        • Lim S.H.
        • Kwon J.W.
        • Kim N.
        • et al.
        Prevalence and risk factors of Helicobacter pylori infection in Korea: nationwide multicenter study over 13 years.
        BMC Gastroenterology. 2013; 13: 104
        • Nam S.Y.
        • Choi I.J.
        • Ryu K.H.
        • et al.
        Effect of Helicobacter pylori infection and its eradication on reflux esophagitis and reflux symptoms.
        American Journal of Gastroenterology. 2010; 105: 2153-2162
        • Kim N.
        Epidemiology and transmission route of Helicobacter pylori infection.
        Korean Journal of Gastroenterology. 2005; 46: 153-158
        • Do M.Y.
        • Lee Y.C.
        • Choi C.H.
        • et al.
        The changes in prevalence and the related factors of Helicobacter pylori infection in Korean health check-up subjects during 8 years.
        Korean Journal of Gastroenterology. 2009; 53: 76-83
        • Lee J.Y.
        • Kim N.
        • Lee H.S.
        • et al.
        Correlations among endoscopic, histologic and serologic diagnoses for the assessment of atrophic gastritis.
        Journal of Cancer Prevention. 2014; 19: 47-55
        • Nardone G.
        • Rocco A.
        • Staibano S.
        • et al.
        Diagnostic accuracy of the serum profile of gastric mucosa in relation to histological and morphometric diagnosis of atrophy.
        Alimentary Pharmacology Therapeutics. 2005; 22: 1139-1146