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.
Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers / Lars Agréus;Ernst J Kuipers;Limas Kupcinskas;Peter Malfertheiner;Francesco Di Mario;Marcis Leja;Varocha Mahachai;Niv Yaron;Martijn van Oijen;Guillermo Perez Perez;Massimo Rugge;Jukka Ronkainen;Mikko Salaspuro;Pentti Sipponen;Kentaro Sugano;Joseph Sung. - In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. - ISSN 0036-5521. - 47(2012), pp. 136-147. [10.3109/00365521.2011.645501]
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