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
A cohort of individuals (n = 136) with lesions as severe as atrophic chronic gastritis (ACG) was cross-sectionally evaluated for the validity assessment of pepsinogen I (PGI) and pepsinogen II (PGII) serum levels for the diagnosis of intestinal metaplasia (IM) and gastric dysplasia. PGI/PGII ratio [...
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| Format: | Article |
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Elsevier
2004-09-01
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| Series: | Neoplasia: An International Journal for Oncology Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1476558604800228 |
| _version_ | 1819200154447642624 |
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| author | Mário Dinis-Ribeiro Altamiro da Costa-Pereira Carlos Lopes Joana Barbosa Mateus Guilherme Luís Moreira-Dias Helena Lomba-Viana Rui Silva Nuno Abreu Rafael Lomba-Viana |
| author_facet | Mário Dinis-Ribeiro Altamiro da Costa-Pereira Carlos Lopes Joana Barbosa Mateus Guilherme Luís Moreira-Dias Helena Lomba-Viana Rui Silva Nuno Abreu Rafael Lomba-Viana |
| author_sort | Mário Dinis-Ribeiro |
| collection | DOAJ |
| description | A cohort of individuals (n = 136) with lesions as severe as atrophic chronic gastritis (ACG) was cross-sectionally evaluated for the validity assessment of pepsinogen I (PGI) and pepsinogen II (PGII) serum levels for the diagnosis of intestinal metaplasia (IM) and gastric dysplasia. PGI/PGII ratio [median (range)] was 4 (0.57.5) in patients with ACG (n = 35); 4.6 (1.9-6.8) in type I IM (n = 18); 4.2 (1.4-5.9) in type II or type III IM limited to the antrum and incisura (n = 20); 2.4 (0.4-5.6) in extensive incomplete IM (n = 38); and 1.3 (0.4-6.4) in low-grade dysplasia (n = 23) (P = .002). Using histopathologic data as a reference test, the area under the receiver operating characteristic curves (CI 95%) was 0.73 (0.64-0.82) for extensive IM, 0.72 (0.58-0.85) for the diagnosis of dysplasia, and 0.81 (0.66-0.95) for the diagnosis of high-grade dysplasia. Using a PGI/PGII ratio of ≤3 as the cutoff for dysplasia diagnosis, the sensitivity was 70% (62-78%), the specificity was 65% (57-73%), and the negative predictive value estimates were over 90%. No differences in PG levels according to age or gender were observed. Helicobacter pylori did not significantly influence validity measurement estimates. PGI/PGII serum level ratio can be used even in the management of patients with a high a priori probability for a positive test. It may be useful for the exclusion of more advanced lesions (extensive IM and neoplastic lesions). |
| first_indexed | 2024-12-23T03:27:43Z |
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| id | doaj.art-3374398ce6924dad8a65327efc5480fb |
| institution | Directory Open Access Journal |
| issn | 1476-5586 1522-8002 |
| language | English |
| last_indexed | 2024-12-23T03:27:43Z |
| publishDate | 2004-09-01 |
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| series | Neoplasia: An International Journal for Oncology Research |
| spelling | doaj.art-3374398ce6924dad8a65327efc5480fb2022-12-21T18:01:47ZengElsevierNeoplasia: An International Journal for Oncology Research1476-55861522-80022004-09-016544945610.1593/neo.03505Validity 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 AdenocarcinomaMário Dinis-Ribeiro0Altamiro da Costa-Pereira1Carlos Lopes2Joana Barbosa3Mateus Guilherme4Luís Moreira-Dias5Helena Lomba-Viana6Rui Silva7Nuno Abreu8Rafael Lomba-Viana9Department of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalPorto Faculty of Medicine, Department of Biostatistics and Medical Informatics, Oporto, PortugalDepartment of Pathology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Pathology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Pathology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalDepartment of Gastroenterology, Oncology Portuguese Institute, Oporto, PortugalA cohort of individuals (n = 136) with lesions as severe as atrophic chronic gastritis (ACG) was cross-sectionally evaluated for the validity assessment of pepsinogen I (PGI) and pepsinogen II (PGII) serum levels for the diagnosis of intestinal metaplasia (IM) and gastric dysplasia. PGI/PGII ratio [median (range)] was 4 (0.57.5) in patients with ACG (n = 35); 4.6 (1.9-6.8) in type I IM (n = 18); 4.2 (1.4-5.9) in type II or type III IM limited to the antrum and incisura (n = 20); 2.4 (0.4-5.6) in extensive incomplete IM (n = 38); and 1.3 (0.4-6.4) in low-grade dysplasia (n = 23) (P = .002). Using histopathologic data as a reference test, the area under the receiver operating characteristic curves (CI 95%) was 0.73 (0.64-0.82) for extensive IM, 0.72 (0.58-0.85) for the diagnosis of dysplasia, and 0.81 (0.66-0.95) for the diagnosis of high-grade dysplasia. Using a PGI/PGII ratio of ≤3 as the cutoff for dysplasia diagnosis, the sensitivity was 70% (62-78%), the specificity was 65% (57-73%), and the negative predictive value estimates were over 90%. No differences in PG levels according to age or gender were observed. Helicobacter pylori did not significantly influence validity measurement estimates. PGI/PGII serum level ratio can be used even in the management of patients with a high a priori probability for a positive test. It may be useful for the exclusion of more advanced lesions (extensive IM and neoplastic lesions).http://www.sciencedirect.com/science/article/pii/S1476558604800228Pepsinogensstomach neoplasmsreceiver operating characteristic curvedisease managementprecancerous conditions |
| spellingShingle | Mário Dinis-Ribeiro Altamiro da Costa-Pereira Carlos Lopes Joana Barbosa Mateus Guilherme Luís Moreira-Dias Helena Lomba-Viana Rui Silva Nuno Abreu Rafael Lomba-Viana 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: An International Journal for Oncology Research Pepsinogens stomach neoplasms receiver operating characteristic curve disease management precancerous conditions |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Pepsinogens stomach neoplasms receiver operating characteristic curve disease management precancerous conditions |
| url | http://www.sciencedirect.com/science/article/pii/S1476558604800228 |
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