Volume 22 Issue 5
May  2024
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ZHOU Taomei, LIU Siyu, DAI Mugen. Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection[J]. Chinese Journal of General Practice, 2024, 22(5): 772-775. doi: 10.16766/j.cnki.issn.1674-4152.003500
Citation: ZHOU Taomei, LIU Siyu, DAI Mugen. Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection[J]. Chinese Journal of General Practice, 2024, 22(5): 772-775. doi: 10.16766/j.cnki.issn.1674-4152.003500
shu

Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection

doi: 10.16766/j.cnki.issn.1674-4152.003500
  • 1.

    Department of Gastroenterology, the Fifth Hospital Affiliated to Wenzhou Medical University, Lishui, Zhejiang 323000, China

Funds:

 2022ZB406

  • Received Date: 2023-09-26
    Available Online: 2024-07-20
    Abstract
  •   Objective  This study aimed to explore serum pepsinogen (PG) detection results in asymptomatic patients with persistent Helicobacter pylori (H. pylori) infection, with the potential application of serum PG detection for screening high-risk gastric cancer patients.  Methods  A total of 583 patients who underwent gastroscopy at the Fifth Affiliated Hospital of Wenzhou Medical University between January 2021 and December 2022 were included in this study. Among them, asymptomatic individuals who underwent 13C urea breath test (13C-UBT) and serum PG detection for cancer screening on the same day of gastroscopy were enrolled.  Results  Out of the 583 subjects, 206 patients (35.33%) tested positive for the 13C-UBT, exhibiting higher levels of serum PG Ⅰ and PG Ⅱ compared to the uninfected population. Additionally, their PG Ⅰ/Ⅱ ratios were lower than those observed in the uninfected population (P<0.05). Univariate logistic regression analysis showed that H. pylori infection was associated with PG Ⅰ, PG Ⅱ, and PG Ⅰ/Ⅱ ratio (P<0.05), as well as age and diabetes (P<0.001). In the multivariate analysis, only serum PG Ⅱ (OR=1.293, 95% CI: 0.932-2.085, P<0.001) and PG Ⅰ/Ⅱ ratio (OR=0.594, 95% CI: 0.343-0.978, P<0.001) remained as independent risk factors for persistent H. pylori infection. A serum PG Ⅱ level > 13.59 μg/L (AUC=0.934, sensitivity 87.5%, specificity 91.7%) and a PG Ⅰ/Ⅱ ratio<4.85 (AUC=0.890, sensitivity 86.8%, specificity 81.6%) are associated with H. pylori infection. Further, the PG Ⅰ/Ⅱ ratio showed an inverse correlation with age (r=-0.167, P=0.041). Notably, the cut-off value of PG Ⅰ/Ⅱ ratio in elderly subjects aged 50 (<4.27; AUC=0.865, sensitivity 80.7%, specificity 88.2%) was lower than that in young subjects under 50 (<4.85; AUC=0.903, sensitivity 87.4%, specificity 82.9%).  Conclusion  Serum PG Ⅱ level > 13.59 ng/mL, PG Ⅰ/Ⅱ ratio<4.85 indicates persistent infection in asymptomatic subjects, and consideration should be given to conducting Helicobacter pylori 13C-UBT confirmation testing. Compared to young subjects, elderly subjects aged ≥ 50 years require stricter standards (PG Ⅰ/Ⅱ ratio<4.27) to detect persistent infections.

     

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