Serum Pepsinogen I Level as a Marker for Predication of Atrophic Gastritis in Relation to Presence of H.pylori

Background: Atrophic gastritis is a long-term inflammatory process of the gastric mucosa with loss of the gastric cells and replacement by intestinal epithelium cells, pyloric-type glands, and fibrosis. Pepsinogen I (PGA) serum levels decrease with increased grade of atrophy (loss of parietal glands), and this substance is exclusively released by chief and mucous cells in the stomach glands. Aim: The objective of this work was to investigate the utility of serum pepsinogen I (PG I) as a screening tool for atrophic gastritis, the main indicator of stomach malignancy risk. Methods: This cross-sectional analytical investigation was conducted on 84 patients who presented with dyspepsia and had upper gastrointestinal tract endoscopies at Suez Canal University Hospitals. Serum pepsinogen levels were measured using ELISA KITS in dyspeptic patients with and without an H. pylori infection. In this study, we included 28 healthy controls, 28 patients with atrophic gastritis who also had an H. pylori infection, and another 28 patients who did not have an H. pylori infection. Results: The control group showed a significantly higher blood PG I level than the patient groups with chronic atrophic gastritis (p≤0.05), particularly in cases of H. pylori infection. The serum PG I cut off values that are most effective for diagnosing atrophic gastritis are 1.521 ng/ml or lower. Conclusions: Screening for serum pepsinogen allows for the highly accurate prediction of atrophic gastritis, one of the primary risk factors for stomach cancer. Reducing the mortality and morbidity caused by stomach cancer is our expectation.