The association between precancerous gastric lesions and serum pepsinogens, serum gastrin, vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status.

Abstract

BACKGROUND AND OBJECTIVE:

The aim of this study was to investigate the association between serum pepsinogens, serum gastrin, serum vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status in patients with various gastric precancerous lesions.

METHODS:

One hundred and sixty two consecutive patients with various gastric lesions [38 (23.5%) H. pylori positive chronic non-atrophic gastritis, 45 (27.8%) autoimmune gastritis, 42 intestinal metaplasia and 37 dysplasia] were enrolled into the study. Serum pepsinogen I and II, gastrin 17, vascular endothelial growth factor, interleukin-1 Beta, toll-like receptor-4 levels, H. pylori Cag A status were evaluated.

RESULTS:

H. pylori was positive in 98 (60.5%) patients and 38 of these patients were Cag A positive. Serum pepsinogen level was significantly lower in patients with autoimmune atrophic gastritis compared to the patients with non-atrophic chronic gastritis (p<0.001), intestinal metaplasia (P<0.001) and dysplasia (P=0.002). Mean serum gastrin was 1209.6±268.48 pg/mL in patients with autoimmune atrophic gastritis and 234.95±184.018 pg/mL in patients with chronic non-atrophic gastritis. Mean toll-like receptor-4 level was 0.56±0.098 ng/mL in patient with dysplasia, and this value was higher compared to patients with chronic non-atrophic gastritis (P=0.007), autoimmune atrophic gastritis (P=0.003) and intestinal metaplasia (P=0.006). Interleukin-1 Beta level was significantly lower in patients with dysplasia compared to patients with chronic non-atrophic gastritis (P=0.034).

CONCLUSIONS:

Serum pepsinogens, serum gastrin and H. pylori Cag A status are important tests in detecting gastric precancerous lesions. However, toll-like receptor-4 may be a sensitive test to differentiate the patients with dysplasia from the other precancerous gastric lesions. Non-invasive tests are sensitive in the diagnosis of gastric precancerous lesions.

• Authors: Mustafa Yakut, Necati Örmeci, Harun Erdal, Onur Keskin, Zihni Karayel, Hüseyin Tutkak, Irfan Soykan
• Journal: Clinics and research in hepatology and gastroenterology (Clin Res Hepatol Gastroenterol) Vol. 37 Issue 3 Pg. 302-11 (Jun 2013) ISSN: 2210-741X [Electronic] France
• PMID: 23137754 (Publication Type: Journal Article)
• Copyright: Copyright © 2012. Published by Elsevier Masson SAS.

Chemical References

• Antigens, Bacterial
• Bacterial Proteins
• Biomarkers
• Gastrins
• Interleukin-1beta
• TLR4 protein, human
• Toll-Like Receptor 4
• Vascular Endothelial Growth Factor A
• cagA protein, Helicobacter pylori
• gastrin 17
• Pepsinogen C
• Pepsinogen A

Topics

• Adult
• Aged
• Antigens, Bacterial (blood)
• Bacterial Proteins (blood)
• Biomarkers (blood)
• Female
• Gastrins (blood)
• Gastritis (blood, pathology)
• Helicobacter pylori (isolation & purification)
• Humans
• Interleukin-1beta (blood)
• Male
• Metaplasia (blood, pathology)
• Middle Aged
• Pepsinogen A (blood)
• Pepsinogen C (blood)
• Precancerous Conditions (blood, diagnosis)
• Sensitivity and Specificity
• Stomach (pathology)
• Stomach Neoplasms (blood, pathology)
• Toll-Like Receptor 4 (blood)
• Vascular Endothelial Growth Factor A (blood)