TY - JOUR
T1 - Serum pepsinogen level as a biomarker for atrophy, reflux esophagitis, and gastric cancer screening in Indonesia
AU - Miftahussurur, Muhammad
AU - Waskito, Langgeng Agung
AU - Syam, Ari Fahrial
AU - Nusi, Iswan Abbas
AU - Dewa Nyoman Wibawa, I.
AU - Rezkitha, Yudith Annisa Ayu
AU - Fauzia, Kartika Afrida
AU - Siregar, Gontar Alamsyah
AU - Akil, Fardah
AU - Waleleng, Bradley Jimmy
AU - Saudale, Alexander Michael Joseph
AU - Abubakar, Azzaki
AU - Maulahela, Hasan
AU - Richardo, Marselino
AU - Rahman, Abdul
AU - Namara, Yoma Sari
AU - Sudarmo, Eko
AU - Adi, Pangestu
AU - Maimunah, Ummi
AU - Setiawan, Poernomo Boedi
AU - Doohan, Dalla
AU - Uchida, Tomohisa
AU - Dewayani, Astri
AU - Rejeki, Purwo Sri
AU - Sugihartono, Titong
AU - Yamaoka, Yoshio
N1 - Funding Information:
This work was supported in part by grants from the National Institutes of Health (DK62813) and Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan (16H05191, 16H06279, 18KK0266 and 19H03473) (YY). It was also supported by the Japan Society for the Promotion of Science (JSPS) Institutional Program for Core-to-Core Program; B. Africa-Asia Science Platform (YY). Support was also provided by the JSPS Institutional Program for Young Researcher Overseas Visits (YY), the Strategic Funds for the Promotion of Science and Technology from the Japan Science and Technology Agency (YY). LAW, DD, and KAF are PhD students supported by the Japanese government (MEXT) scholarship program for 2015, 2016, and 2017, respectively. Program Penelitian Kolaborasi Indonesia (PPKI) 2021 (MM, AFS, GAS). The funders had no role in the study design, data collection, and data analysis, interpretation of data and writing of the manuscript.
Publisher Copyright:
© 2022 Journal of Research in Medical Sciences.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: Chronic dyspepsia’s symptoms are frequently seen in primary to tertiary healthcare in Indonesia. This study aimed to describe the potential usability of pepsinogen (PG) values in determining gastric mucosal conditions, including superficial gastritis and atrophic gastritis. Materials and Methods: We recruited 646 adult dyspeptic patients and then analyzed PG values (including PGI, PGII, and PGI/II ratio) with endoscopic findings, gastric mucosal damages, and Helicobacter pylori infection. The gastric mucosal damage and H. pylori infection were evaluated using histological examination based on the updated Sydney system. Results: Among 646 enrolled patients, 308 (47.2%), 212 (32.8%), 91 (14.1%), 34 (5.2%), and 1 (0.2%) patient were diagnosed with normal mucosa, gastritis, reflux esophagitis, peptic ulcer disease, and gastric cancer, respectively. Significant differences in PGI, PGII, and PGI/II ratio values were observed among ethnic groups (all P < 0.01). The PGI and PGII levels were significantly higher and PGI/II was significantly lower in H. pylori-infected patients than in uninfected ones (all P < 0.001). The optimal cutoff value for PGII and PGI/II was 12.45 ng/mL with an area under the curve (AUC) value of 0.755 (0.702–0.811), sensitivity 59.3%, and specificity 77.1%; and 4.75 with AUC value of 0.821 (0.763–0.855), sensitivity 81.5%, and specificity 78.7%, respectively, to determine moderate–severe atrophy. Conclusion: Serum PG levels, a useful biomarker, represent the endoscopic findings, especially for reflux esophagitis. In addition, the benefits of PG values detecting atrophic gastritis were limited to moderate–severe atrophic gastritis. This usefulness requires careful attention for several ethnic groups in Indonesia.
AB - Background: Chronic dyspepsia’s symptoms are frequently seen in primary to tertiary healthcare in Indonesia. This study aimed to describe the potential usability of pepsinogen (PG) values in determining gastric mucosal conditions, including superficial gastritis and atrophic gastritis. Materials and Methods: We recruited 646 adult dyspeptic patients and then analyzed PG values (including PGI, PGII, and PGI/II ratio) with endoscopic findings, gastric mucosal damages, and Helicobacter pylori infection. The gastric mucosal damage and H. pylori infection were evaluated using histological examination based on the updated Sydney system. Results: Among 646 enrolled patients, 308 (47.2%), 212 (32.8%), 91 (14.1%), 34 (5.2%), and 1 (0.2%) patient were diagnosed with normal mucosa, gastritis, reflux esophagitis, peptic ulcer disease, and gastric cancer, respectively. Significant differences in PGI, PGII, and PGI/II ratio values were observed among ethnic groups (all P < 0.01). The PGI and PGII levels were significantly higher and PGI/II was significantly lower in H. pylori-infected patients than in uninfected ones (all P < 0.001). The optimal cutoff value for PGII and PGI/II was 12.45 ng/mL with an area under the curve (AUC) value of 0.755 (0.702–0.811), sensitivity 59.3%, and specificity 77.1%; and 4.75 with AUC value of 0.821 (0.763–0.855), sensitivity 81.5%, and specificity 78.7%, respectively, to determine moderate–severe atrophy. Conclusion: Serum PG levels, a useful biomarker, represent the endoscopic findings, especially for reflux esophagitis. In addition, the benefits of PG values detecting atrophic gastritis were limited to moderate–severe atrophic gastritis. This usefulness requires careful attention for several ethnic groups in Indonesia.
KW - Atrophic gastritis
KW - Helicobacter pylori
KW - human and disease
KW - Indonesia
KW - neoplasms
KW - pepsinogens
KW - reflux esophagitis
UR - http://www.scopus.com/inward/record.url?scp=85146610510&partnerID=8YFLogxK
U2 - 10.4103/jrms.jrms_983_21
DO - 10.4103/jrms.jrms_983_21
M3 - Article
AN - SCOPUS:85146610510
SN - 1735-1995
VL - 27
JO - Journal of Research in Medical Sciences
JF - Journal of Research in Medical Sciences
IS - 1
M1 - 90
ER -
