Optimal Criteria and Diagnostic Ability of Serum Pepsinogen Values for <i>Helicobacter pylori</i> Infection
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- Kikuchi Shogo
- Department of Public Health, Aichi Medical University, School of Medicine
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- Kato Mototsugu
- Division of Endoscopy, Hokkaido University Hospital National Hospital Organization Hakodate Hospital
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- Mabe Katsuhiro
- Department of Cancer Preventive Medicine, Graduate School of Medicine, Hokkaido University Department of Gastroenterology, National Hospital Organization Hakodate Hospital
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- Kawai Takashi
- Department of Gastroenterological Endoscopy, Tokyo Medical University
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- Furuta Takahisa
- Center for Clinical Research, Hamamatsu University School of Medicine
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- Inoue Kazuhiko
- Department of General Medicine, Kawasaki Medical School Center for Gastroenterological Endoscopy, Asahigaoka Hospital
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- Ito Masanori
- Department of Gastroenterology and Metabolism, Hiroshima University
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- Yoshihara Masaharu
- Health Service Center, Hiroshima University
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- Kodama Masaaki
- Department of Gastroenterology, Faculty of Medicine, Oita University
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- Murakami Kazunari
- Department of Gastroenterology, Faculty of Medicine, Oita University
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抄録
<p>Background: Practical criteria for the use of serum pepsinogen (PG) values in diagnosing Helicobacter pylori infection have not yet been determined.</p><p>Methods: The results of gastric endoscopies, H. pylori infection tests, and PG values were retrospectively reviewed. Subjects were assigned to groups, including never-infected (with neither infection nor gastric mucosal atrophy), infected (with atrophy or findings indicating infection in endoscopy and positive infection tests except for antibody tests), and ex-infected (with gastric mucosal atrophy and negative infection tests, except for antibody tests). The optimal criteria with combined use of the PG II concentrations and the PG I/PG II ratio were investigated separately for PG measurements obtained with the chemiluminescent magnetic particle immunoassay (CLIA) and latex agglutination (LA) methods, such that the specificity was greater than 70% and the sensitivity was no less than 95% among the never-infected and infected subjects. Similar analyses were performed by combining the data from ex-infected and infected subjects.</p><p>Results: For the CLIA (LA) method, the optimal criterion among 349 (397) never-infected and 748 (863) infected subjects was a PG II value of at least 10 (12) ng/mL or a PG I/PG II ratio no more than 5.0 (4.0), which produced 96.3% (95.1%) sensitivity and 82.8% (72.8%) specificity. When 172 (236) ex-infected subjects were included, the optimal criterion was the same, and the sensitivity was 89.1% (86.9%).</p><p>Conclusions: The above criteria may be practical for clinical use, and PG tests using these criteria might prevent unnecessary endoscopic examinations for never-infected subjects.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ 29 (4), 147-154, 2019-04-05
日本疫学会
