Serum Pepsinogen Values as Possible Markers for Evaluating the Possibility of Peptic Ulcer Recurrence under H2-Blocker Half-Dose Maintenance Therapy

Abstract

The introduction of H2-blockers and proton pump inhibitors has made peptic ulcer a curative disease without surgery. However, prevention of the ulcer recurrence is still a difficult problem. Various maintenance therapies have been set up and tried. But there has been almost no indicator to select a proper therapy for each case. Thus, a marker for predicting ulcer recurrence has been long desired. Serum pepsinogen (PG) values, PG I originating from fundic gland (1) and PG II from throughout stomach mucosa and Brunner gland (2), have been reported to reflect morphology and function of the gastroduodenal mucosa (3,4). Some of the previous studies suggested their possible roles as markers for peptic ulcer diseases and recurrence. For the ulcer incidence, a high PG II value and a low PG I/II ratio in gastric ulcer patients and high PG I value in duodenal ulcer patients were reported to be observed against normal control subjects (5). For the ulcer recurrence, high PG I values in recurrent peptic ulcer patients were reported to be observed against no recurrent ones (6). For evaluating the clinical usefulness as a marker of ulcer recurrence, Table 1 Serum Pepsinogen Values in Peptic Ulcer Patients with or without RecurrenceFull size table there must be done a follow-up study of peptic ulcer patients under a fixed, widely used maintenance therapy according to a rigid follow-up protocol. In the past, there were a few follow-up studies with serum pepsinogens under H2-blocker half-dose therapy, a representative maintenance therapy, only of duodenal ulcer patients, which suggested the possibility of PG I or total pepsinogen being a recurrence marker (7,8). Here, we report that PG I, II and I+II are useful recurrence markers not only in duodenal ulcer, but also in gastric ulcer patients under H2-blocker half-dose maintenance therapy.KeywordsPeptic UlcerDuodenal UlcerMaintenance TherapyUlcer PatientUlcer RecurrenceThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.