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Journal of Gastroenterology

, Volume 53, Issue 8, pp 924–931 | Cite as

Serum pepsinogen levels indicate the requirement of upper gastrointestinal endoscopy among Group A subjects of ABC classification: a multicenter study

  • Daisuke Chinda
  • Tadashi Shimoyama
  • Tatsuya Mikami
  • Tetsu Arai
  • Daisuke Chiba
  • Yoshio Sasaki
  • Kazuo Komai
  • Yoshihiko Sawada
  • Yoshiharu Saito
  • Hironobu Chiba
  • Shinsaku Fukuda
  • RINGO Study Group
Original Article—Alimentary Tract

Abstract

Background

ABC classification has been used to assess the risk for gastric cancer. The current problem of ABC classification is that Group A contains individuals with current and past H. pylori infection. The aims of this study were to assesse the proportion of current and past infection in Group A and to establish a criteria for the identification of subjects with past infection from Group A subjects with negative results of urea breath test (UBT) and/or stool antigen test.

Methods

201 subjects classified into Group A received UBT and/or stool antigen test, and also subsequent upper gastrointestinal endoscopy. The subjects were classified by the status of H. pylori infection defined by endoscopic findings. Levels of pepsinogen (PG) I, PG II and PG I/II ratio were compared between the groups, and receiver operating characteristic curves were constructed to extract the corresponding cutoff values.

Results

22 subjects were tested positive by UBT and/or stool antigen test. Endoscopic images of 157 out of 179 subjects were studied. 15 of the subjects were regarded to have past H. pylori infection. The optimal cut-off value of PG I and PG I/II ratio for the determination of past H. pylori infection were ≤ 31.2 ng/mL and ≤ 4.6, respectively.

Conclusions

Approximately 20% of Group A subjects have current or past H. pylori infection. Addition of UBT and/or stool antigen test can identify current but not past infection. Serum PG levels would be useful to identify subjects with past H. pylori infection.

Keywords

Helicobacter pylori infection Group A of ABC classification Pepsinogen levels Upper gastrointestinal endoscopy 

Notes

Acknowledgements

We gratefully acknowledge the members of The RINGO Study Group. The names of the RINGO study group are as follows: Chinda D, M.D, Ph.D. (author); Shimoyama T, M.D, Ph.D. (author); Sasaki Y, M.D., Ph.D. (author); Komai K, M.D., Ph.D. (author); Sawada Y, M.D., Ph.D. (author); Saito Y, M.D., Ph.D. (author); Chiba H, M.D., Ph.D. (author); Fukuda S, M.D., Ph.D. (author); Akiyama M, M.D., Ph.D.; Ebina T, M.D., Ph.D.; Fukushi G, M.D., Ph.D.; Fukushi M, M.D., Ph.D.; Ichinohe H, M.D., Ph.D.; Ishizawa M, M.D., Ph.D.; Ito J, M.D., Ph.D.; Iwamura H, M.D., Ph.D.; Iwane S, M.D., Ph.D.; Kawaguchi H, M.D., Ph.D.; Kawaguchi S, M.D., Ph.D.; Konuma Y, M.D., Ph.D.; Moriyama Y, M.D., Ph.D.; Nakajima M, M.D., Ph.D.; Nakasato F, M.D., Ph.D.; Nishiya D, M.D., Ph.D.; Okamoto K, M.D., Ph.D.; Soma Y, M.D., Ph.D.; Suzuki H, M.D., Ph.D.; Tomita T, M.D., Ph.D.; Tsushima K, M.D., Ph.D.; Wada T, M.D., Ph.D.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interests regarding the publication of this paper.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Daisuke Chinda
    • 1
  • Tadashi Shimoyama
    • 1
  • Tatsuya Mikami
    • 2
  • Tetsu Arai
    • 1
  • Daisuke Chiba
    • 1
  • Yoshio Sasaki
    • 3
  • Kazuo Komai
    • 4
  • Yoshihiko Sawada
    • 5
  • Yoshiharu Saito
    • 6
  • Hironobu Chiba
    • 7
  • Shinsaku Fukuda
    • 1
  • RINGO Study Group
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
    • 7
    • 8
  1. 1.Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineHirosakiJapan
  2. 2.Division of EndoscopyHirosaki University HospitalHirosakiJapan
  3. 3.Sasaki Clinic of Gastroenterology and Internal MedicineAomoriJapan
  4. 4.Komai Clinic of Gastroenterology and Internal MedicineAomoriJapan
  5. 5.Sawada Clinic of Internal MedicineHirosakiJapan
  6. 6.Shinjo Clinic of Gastroenterology and Internal MedicineAomoriJapan
  7. 7.Chiba Clinic of Gastroenterology and Internal MedicineHirosakiJapan
  8. 8.Risk Investigation of Gastric Cancer and Observation After Eradication Study GroupHirosakiJapan

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