Long‐term follow up of serum pepsinogens in patients with gastric cancer or dysplasia after Helicobacter pylori eradication

Abstract

Few studies have evaluated the change in serum pepsinogen (sPG) levels after the eradication of Helicobacter pylori. The aim of this study was to evaluate the effect of H.pylori eradication on sPG levels in patients with gastric cancer/dysplasia in comparison to a control group. We prospectively enrolled 368 patients with gastric cancer/dysplasia and 610 control subjects. H.pylori status and sPG levels were measured before and after eradication. The follow-up time points were classified as <12, 12-23, 24-35, and ≥36months. In 179 H.pylori-eradicated patients with gastric cancer/dysplasia and 168 control group subjects, sPG I significantly decreased, and the sPG I/II ratio significantly increased after eradication compared to baseline, and this improvement in sPG values was maintained during all follow-up time points. Significant differences in sPG I and the sPG I/II ratio were observed between the gastric cancer/dysplasia group and the control group <24months after eradication. However, these differences in sPG values disappeared after ≥24months of follow up. Moreover, significant differences in the intestinal metaplasia grade were observed between these two groups before eradication until <24months after eradication. However, these differences in the intestinal metaplasia grade disappeared after ≥24months of follow up in the corpus. The sPG values and intestinal metaplasia grade (corpus) in the gastric cancer/dysplasia group became similar to those in the control group at long-term follow up after H.pylori eradication. It might be related with the reduction of metachronous gastric neoplasm.