Diagnostic accuracy of serum pepsinogens for atrophic gastritis in Myanmar

Abstract

Background

Chronic atrophic gastritis (CAG) is a precancerous lesion of gastric cancer. This study investigated the diagnostic accuracy of serum pepsinogens in Myanmar to diagnose CAG as non-invasive makers.

Methods

A cross-sectional study of 70 dyspeptic patients without red flag signs was recruited and performed endoscopy with mucosal biopsies. Histologic severity was assessed by Operative Link for Gastritis Assessment (OLGA) staging. Serum pepsinogens (PG I and PG II) were measured by ELISA Gastro Panel, Biohit Healthcare (Finland). Serum pepsinogens I/II ratio (PGR) was calculated.

Results

The mean (±SD) age of the study population was 52.57 (±16.33) years. The CAG was diagnosed in 61.4% of dyspeptic patients. The median values of PG I, PG II and PGR in dyspeptic patients were 114.5 ng/mL, 12.7 ng/mL and 9.5, respectively. The median values of PG I and PG II were significantly lower in patients with CAG (P = 0.006 and 0.029) but that of PGR was not significantly changed. Both PG I and PGR were reversely correlated with OLGA stages (P = 0.013 and 0.048). For the best discrimination of CAG, the cut-off values of PG I in Myanmar was ≤114 ng/mL (Sensitivity 55.8%, specificity 63%, accuracy 58.6% and AUC 0.59) and that of PGR was ≤9.5 (Sensitivity 55.8%, specificity 55.6%, accuracy 55.7% and AUC 0.56).

Conclusion

Either PG I or PGR is useful as a non-invasive biomarker for screening of CAG with moderate diagnostic accuracy.