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Scand J Gastroenterol. 2012 Feb;47(2):136-47. doi: 10.3109/00365521.2011.645501.

Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers.

Author information

1
Karolinska Institute, Center for Family and Community Medicine, Stockholm, Sweden.

Erratum in

  • Scand J Gastroenterol. 2012 Dec;47(12):1525.

Abstract

BACKGROUND AND AIMS:

Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers.

METHODS:

The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice.

RESULTS:

In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria.

CONCLUSIONS:

Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach.

PMID:
22242613
PMCID:
PMC3279132
DOI:
10.3109/00365521.2011.645501
[Indexed for MEDLINE]
Free PMC Article

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