Niveles séricos de pepsinógeno y su capacidad diagnóstica de atrofia gástrica en diferentes poblaciones colombianas

Abstract

ObjectiveTo characterize levels of pepsinogen and evaluate the discrimination ability of pepsinogen I (PGI) and the PGI/ pepsinogen II (PGII) ratio for the serological diagnosis of gastric atrophy in different Colombian populations. MethodsA total 600 subjects without gastric symptoms participated and 544 samples from patients with gastric symptomatology were analyzed from different populations with opposing risks to gastric cancer. A blood sample was taken from all participants; a gastric antrum and body biopsy for the initial diagnosis of gastroduodenal lesions was obtained from the patients. The levels of pepsinogen and Helicobacter pylori serology were estimated with ELISA. Statistical analyses included Kruskal -Wallis and Mann -Whitney test, ROC curve and diagnostic values. ResultsThe levels of PGI and PGI / PGII differ by risk area of origin. Levels of PGI, PGII and PGI / PGII decreased with increasing severity of histological diagnosis (P<.005), as with the severity of atrophy and multifocal localization (P ≤.001). The PGI ≤ 86.68 and PGI / PGII ≤ 3.19 with an area under the curve of 0.76 identified patients with severe multifocal atrophy, positive serology for H. pylori, and from the high risk area, with a sensitivity of 77.5% and specificity of 71.74%. ConclusionThe results suggest that PGI levels together with PGI / PGII ratios and positive serology for H. pylori could be considered for the detection of severe atrophy in high-risk areas. Further studies are needed in high-risk populations