The decreased ratio of serum
pepsinogen (PG) I and II has good correlation with the presence of
atrophic gastritis. A total of 1,540 residents aged 30-89 years were enrolled into this study to investigate which serum PG level of residents with Helicobacter pylori
infection would represent an adjunct to the diagnosis and progression of
atrophic gastritis. All participants received esophagogastroduodenoscopy. Serum antibody to H. pylori (anti-H. pylori) was measured by an
enzyme-linked
immunosorbent assay (ELISA). Serological
atrophic gastritis was defined as serum PG I
isozyme level ≤70 ng/ml and a PG I/II ratio of ≤3.0. Of the 1,540 participants, 923 (59.9%) were positive for anti-H. pylori. Serological
atrophic gastritis was found significantly more often in anti-H. pylori-positive participants (40.8%) than in anti-H. pylori-negative participants (7.9%) (p ≤ 0.0001). The endoscopic findings of anti-H. pylori-positive participants with serological
atrophic gastritis were significantly more frequent by 4.06 times for
atrophic gastritis (p ≤ 0.0001) than anti-H. pylori-negative participants without serological
atrophic gastritis. Eight anti-H. pylori-positive participants were diagnosed with
gastric cancer, but no
cancer was found in anti-H. pylori-negative participants without serological
atrophic gastritis. Serum PG testing is clinically useful for the prediction of gastric lesions in H. pylori-infected persons.