The diagnostic value of indicators of acid-forming and pepsinoguena functions of the stomach in the detection of precancerous changes of the gastric mucosa in patients with chronic gastritis

Abstract

It was found that in patients with chronic atrophic gastritis, low gastric secretory functions are present in the localization of atrophy in the mucous membrane of the body of the stomach with a tendency to decrease in indices as the degree of atrophy increases and are not associated with the presence of disregenerative changes in the gastric mucosa (intestinal metaplasia and dysplasia). Reduced levels of pepsin in gastric juice and reduced levels of pepsinogen in the mucous membrane of the body of the stomach reliably reflect the presence of severe atrophy of the mucous membrane of the body of the stomach. However, neither the concentration of pepsinogen in the tissues of the mucous membrane of the body of the stomach nor the level of pepsin in the gastric juice make it possible to differentiate the degree of atrophy of the gastric mucosa. The most profound disregenerative changes in gastric mucosa such as colonic metaplasia or dysplasia were detected, accordingly in 18,4 and 10,5% of patients. The presence of intestinal metaplasia or dysplasia causes a low activity of pepsinogen-pepsin. It worth noting that in case of the presence of intestinal metaplasia and dysplasia there is a significant difference between indicators of the concentration of pepsinogen-pepsin and those at patients with chronic gastritis, but without disregenerative changes of the mucous membrane. Also was found an association between the severity of disregenerative changes in the gastric mucosa and the degree of the reduction of pepsin-forming function.