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Masci E. 1, Pellicano R. 2, Mangiavillano B. 1, Luigiano C. 3, Stelitano L. 4, Morace C. 4, Viale E. 5, Freschi M. 6, Locatelli M. 7, Ieri R. 7, Cavallaro A. 7, Testoni S. 5, Testoni P. A. 5
1 Unit of Gastrointestinal Endoscopy “San Paolo” University Hospital, Milan, Italy;
2 Department of Gastro-Hepatology Molinette Hospital, Turin, Italy;
3 Unit of Gastroenterology and Digestive Endoscopy ARNAS Garibaldi, Catania, Italy;
4 Department of Medicine and Pharmacology University of Messina, Messina, Italy;
5 Unit of Gastroenterology and Gastrointestinal Endoscopy IRCCS San Raffaele Institute Vita Salute University, Milan, Italy;
6 Unit of Surgical Pathology IRCCS San Raffaele Institute Vita Salute University, Milan, Italy;
7 Unit of Laboratory Medicine IRCCS San Raffaele Institute Vita Salute University, Milan, Italy
Aim: Atrophic gastritis (AG), first step in the cascade leading to gastric adenocarcinoma, is related to Helicobacter pylori (H. pylori) infection. Currently, the gold standard for the diagnosis of AG is esophagogastroduodenoscopy (EGD) with histological examination of the biopsy specimens. However, since the latter are taken in random order and the distribution of AG is often patchy, histology is only representative of mucosal status. Considering this limitation, a test named GastroPanel®, that measures the blood concentrations of pepsinogen I and II, gastrin-17 and H. pylori antibodies, has been developed as a potential non-invasive biopsy. Aim of this study has been to assess the accuracy of GastroPanel® in patients with AG.
Methods: Forty-seven dyspeptic patients (24 males, mean age 52.2±9.3 years), in follow-up for antral or diffuse AG, were enrolled. All underwent at least two EGDs with random biopsies and blood collection for GastroPanel® parameters examination.
Results: Of the 47 patients, 16 (34.1%) had histological diagnosis of antral and 31 (65.9%) multifocal AG; 17 (36.2%) patients had mild and 30 (63.8%) had moderate-severe AG. H. pylori was detected in 39 (82.9%) and intestinal metaplasia was found in all patients. GastroPanel® showed 82.9% sensitivity for the diagnosis of AG and 53.8% for the diagnosis of H. pylori infection. The prediction of advanced atrophy was not sufficiently accurate, neither in patients with antral nor in those with multifocal AG.
Conclusion: GastroPanel® can be useful for detecting patients with AG. However, it does not reflect the severity of atrophy.