Serum gastrin and pepsinogen in shift workers

Summary Gastrointestinal complaints, including peptic ulcer, are believed to be associated and enhanced by shift work (SW). However, there are no clear reports in the literature about this acquired pathology. Serum gastrin (G) and group I pepsinogen (PG1) are thought to play a role in the pathogenesis of peptic ulcer and may be considered a useful test of the gastric function. Five adult male foundry shift workers, without any demonstrated gastrointestinal pathology, were studied over a month's span during the following weekly rotating shift schedule: 07.45–16.45, 06.00–14.00, 14.00–22.00, 22.00–06.00. Six adult, day-working males acted as controls. Blood samples drawn at the beginning and at the end of each weekly shift were assayed for G and PG1 utilizing RIA kits. Our data showed that SW causes a prominent change in the gastrin/acidopepsin secretion system.     

Immunohistochemical localization of pepsinogen A and C containing cells in Barrett's oesophagus

Summary No data are available on the localization of Pepsinogen A (PGA=PG I) and Pepsinogen C (PGC=PG II) positive cells in Barrett's epithelium. Endoscopic biopsy specimens were taken from the columnar epithelium from 23 patients (n=93), and in addition from the cardia from eight healthy control subjects (n=38). The tissue was stained by the immunoperoxidase technique with specific anti-pepsinogen antisera, and double immunostained for PGA and PGC. In the Barrett's epithelium PGA was found in 28 out of 93 biopsy specimens (30.1%) and PGC in 55 out of 93 (59.1%). Chief cells always stained both for PGA and PGC, while clear mucous cells were often PGA– and PGC+. PGA+ and PGC+ cells were found each in 100% of the biopsy specimens with fundic type epithelium, in 21.7% and 70.7% of biopsy specimens with junctional type, in 0% and 26.1% of biopsy specimens with specialized epithelium and in 12.5% and 43.5% of biopsy specimens with mixed junctional/specialized features respectively. Dysplastic epithelium stained always negatively with both anti-pepsinogen antisera. In most control cardia biopsy specimens PGA as well as PGC were demonstrable; occasionally clear mucous glands were PGA– and PGC+.It is concluded that pepsinogen-containing cells can be accurately identified in the Barrett's epithelium; their presence seems related to the histological cell type. Identification of pepsinogen positive cells may contribute to a more accurate morphological classification of the Barrett's epithelium.Presented in part at the Annual Meeting of the American Gastroenterological Association, San Francisco, May 1986     

Helicobacter pylori clearance and serum gastrin and pepsinogen I concentrations in omeprazole treatment of duodenal ulcer patients

Objective: To determine which demographic factors may influence serum gastrin and pepsinogen I (PGI) levels in duodenal ulcer patients undergoing omeprazole treatment. Methods: We conducted an outpatient-based prospective study in the Veterans General Hospital, Taipei, to investigate the pharmacological effects on patients with duodenal ulcers receiving omeprazole treatment for 4 weeks. Sixty-eight patients (61 males/7 females, aged 25–73 years) with endoscopically confirmed duodenal ulcer were included. Gastrin and pepsinogen I levels were measured before and after treatment. Demographic factors including age, sex, smoking, ulcer healing and antral Helicobacter pylori colonization/clearance were analyzed, in order to measure their probable influences on serum gastrin and pepsinogen I levels. Results: Ulcer healing was seen in 92.6% of patients while 48 (70.6%) antral clearances were seen in 66 H. pylori colonized patients at the end of trial. Omeprazole monotherapy led to a marked elevation of serum gastrin (85.8 pg · ml⁻¹, SD 32.0 pg · ml⁻¹ vs 133.9 pg · ml⁻¹, SD 71.6 pg · ml⁻¹, P < 0.01), and pepsinogen I (111.0 ng · ml⁻¹, SD 36.7 ng · ml⁻¹ vs 253.6 ng · ml⁻¹, SD 64.8 ng · ml⁻¹, P < 0.01) levels when measured on day 29. Only patients showing antral H. pylori clearance exhibited an influence on the magnitude of pepsinogen I elevation following omeprazole monotherapy (143.9%, SD 67.3% vs 78.6%, SD 51.2%, P < 0.01). Moreover, the sensitivity and specificity of serum pepsinogen I variations were plotted on a receiving operating characteristic (ROC) curve. The 140% increased pepsinogen I level yielded a maximum accuracy of 80% specificity or 50% sensitivity to predict antral H. pylori clearance. Conclusion: Antral H. pylori clearance is at least partially responsible for the omeprzaole-induced hyperpepsinogenemia I. The magnitude of hyperpepsinogenemia I probably provides a non-invasive alternative for predicting H. pylori clearance. Received: 22 August 1996 / Accepted in revised form: 1 October 1998     

养胃颗粒联合四联疗法治疗Hp阳性慢性胃炎的疗效

目的探讨养胃颗粒联合四联抗菌法治疗Hp阳性慢性胃炎的疗效及其安全性。方法选取2018年12月至2019年12月Hp相关性慢性胃炎患者120例,按照随机数字法分为对照组和观察组,各60例。对照组给予四联疗法,观察组给予养胃颗粒联合四联疗法,比较两组患者治疗有效率、Hp根除率、血液指标变化及不良反应情况。结果观察组临床治疗总有效率、Hp根除率、血清GAS水平、血清PGⅠ水平和PGⅠ/PGⅡ比值均高于对照组,差异有统计学意义(P<0.05)。结论养胃颗粒联合四联抗菌法治疗Hp阳性慢性胃炎的临床效果更优越,能显著提高Hp根除率,并可以减少消化道不良反应和肝损病例。     

胃蛋白酶原，胃泌素测定在胃癌诊断中的应用研究

[目的]探讨胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）、胃泌素（GS）水平变化对胃癌的诊断价值。[方法]应用免疫放射分析法测定了100例正常人，66例胃癌、107例胃溃疡，101例慢性胃炎患者血清PGⅠ、PGⅡ、GS含量及PGⅠ／PGⅡ比值的变化。[结果]胃癌组血清PGⅠ、PGI／PGⅡ水平较对照组显著降低（〈0．001），PGⅡ水平较对照组无显著变化（P〉0．05），GS水平较对照、慢性胃炎组和溃疡病组组明显增高（P〈0．001）。[结论]血清PGⅠ和PGⅠ／PGⅡ比值下降，GS增高是与胃癌发生密切相关的高危因素，可作为诊断胃癌的一项血清学指标，对胃癌的诊断有一定的临床意义。     

Differences in the Levels of Gastric Cancer Risk Factors Between Nanjing and Minqing Counties,China

Objectives:

In Fujian Province, China, gastric cancer is one of the leading causes of mortality among all malignant tumors. Nanjing county and Minqing county are located in inland Fujian and have similar general demographics. However, the adjusted mortality rate of gastric cancer in Minqing was found to be much higher than that in Nanjing. We sought to explore factors associated with this increased risk of gastric cancer between the two counties.

Methods:

We recruited 231 and 224 residents from Nanjing and Minqing, respectively, and analyzed differences between their dietary habits, Helicobacter pylori infection rates, and concentrations of serum pepsinogen I, pepsinogen II, gastrin-17, and ratio of pepsinogen I:II.

Results:

Subjects in Minqing had more first-degree relatives who had been diagnosed with upper gastrointestinal tumor, more unhealthy dietary habits, a higher Helicobacter pylori positive rate, and greater proportion of abnormal serum gastrin-17 than those in Nanjing did.

Conclusions:

The factors that differed between these two counties might indicate that residents in Minqing have a higher risk for developing gastric cancer than those in Nanjing do.     

降逆胃舒汤治疗萎缩性胃炎疗效及对患者病理评分的影响

目的:研究降逆胃舒汤对幽门螺杆菌感染致萎缩性胃炎病理评分的功效。方法:选取238例幽门螺杆菌感染致萎缩性胃炎患者作为本次研究观察对象,入选患者遵循随机数字表法平均分配入对照组与治疗组,对照组以常规西药四联疗法治疗,治疗组在对照组疗法的基础上给予降逆胃舒汤治疗; 治疗3个月后,观察两组患者HP清除率并随访6个月统计复发率,观察两组患者中医证候积分、胃黏膜胃镜征象积分、胃黏膜病理评分及血清胃泌素-17(G-17)、血清胃蛋白酶原Ⅰ、Ⅱ(PGⅠ、PGⅡ)、PGⅠ/PGⅡ比值(PGR)治疗前、后的变化情况。结果:治疗前两组患者各项中医证候、胃黏膜胃镜积分、病理评分及血清指标表达水平比较,差异无统计学意义(P>0.05); 治疗后两组患者各项中医证候、胃黏膜胃镜积分、病理评分及血清指标表达水平比较,差异有统计学意义(P<0.05),治疗组均优于对照组(P<0.05); 治疗后3个月时治疗组HP清除率为88.24%、对照组为73.11%,随访6个月治疗组复发率为3.81%,对照组为18.39%,两组HP根除率、复发率比较,差异有统计学意义(P<0.05)。结论:降逆胃舒汤能够提高幽门螺杆菌清除率并降低复发,更有效缓解幽门螺杆菌感染致萎缩性胃炎的各项中医证候,进一步改善患者胃黏膜病理评分与胃镜征象,更良好的调节患者血清指标。     

血清胃蛋白酶原检测在胃癌及其癌前病变筛查中的价值

目的:探讨血清胃蛋白酶原(PG)检测在胃癌及其癌前病变筛查中的价值.方法:在胃癌高发区对35岁以上无症状、有胃病史及胃癌家族史者进行内镜筛查.同时采用免疫比浊法测定受检者血清PG水平,结合内镜活检和病理检查结果,对比分析接受受检者血清PGⅠ、PGⅡ水平和PGⅠ/Ⅱ值与胃癌及其癌前病变的关系.结果:内镜筛查共计918例,其中PG阴性718例(78.21%);阳性200例(21.79%),阳性人群中以40-60岁最多139例(69.50%);总体胃癌检出率7/918(0.76%),早期胃癌检出率为5/7(71.43%),进展期为2/7(28.57%);PG阳性癌检出率3/200(1.50%),高级别上皮内瘤变检出率2/200(1.00%),低级别上皮内瘤变检出率23/200(11.50%);PG阴性癌检出率4/718(0.56%),高级别上皮内瘤变检出率0/718(00.00%),低级别上皮内瘤变检出率54/718(7.52%);PG阳性与PG阴性之间胃癌及其癌前病变检出率有显著性差异(P<0.01).PG阳性中早期胃癌检出率为2/3(66.67%),胃癌诊断的敏感性42.86%,特异性78.38%.结论:以血清...     

Inverse correlation between gastroesophageal reflux disease and atrophic gastritis assessed by endoscopy and serology

BACKGROUND Helicobacter pylori(H.pylori)infection is known to prevent the occurrence of gastroesophageal reflux disease(GERD)by inducing gastric mucosal atrophy.However,little is known about the relationship between atrophic gastritis(AG)and GERD.AIM To confirm the inverse correlation between AG and the occurrence and severity of GERD.METHODS Individuals receiving health checkups who underwent upper gastrointestinal endoscopy at Seoul National University Healthcare System Gangnam Center were included.The grade of reflux esophagitis was evaluated according to the Los Angeles classification.Endoscopic AG(EAG)was categorized into six grades.Serologic AG(SAG)was defined as pepsinogen I≤70 ng/m L and pepsinogen I/II ratio≤3.0.The association between the extent of EAG and SAG and the occurrence and severity of GERD was evaluated using multivariate logistic regression analysis.RESULTS In total,4684 individuals with GERD were compared with 21901 healthy controls.In multivariate logistic regression analysis,advanced age,male sex,body mass index>23 kg/m2,presence of metabolic syndrome,current smoking,and alcohol consumption were associated with an increased risk of GERD.Seropositivity for H.pylori immunoglobulin G antibodies was associated with a decreased risk of GERD.There was an inverse correlation between the extent of EAG and occurrence of GERD:Odds ratio(OR),1.01[95%confidence interval(CI):0.90-1.14]in C1,0.87(0.78-0.97)in C2,0.71(0.62-0.80)in C3,0.52(0.44-0.61)in O1,0.37(0.29-0.48)in O2,and 0.28(0.18-0.43)in O3.Additionally,the extent of EAG showed an inverse correlation with the severity of GERD.The presence of SAG was correlated with a reduced risk of GERD(OR=0.49,95%CI:0.28-0.87,P=0.014).CONCLUSION The extent of EAG and SAG exhibited strong inverse relationships with the occurrence and severity of GERD.AG followed by H.pylori infection may be independently protect against GERD.     

血清胃蛋白酶原水平变化对肝硬化患者胃黏膜功能的评估价值

目的研究血清胃蛋白酶原水平变化对肝硬化患者胃黏膜功能的评估价值。方法选取2014年12月至2015年12月我院收治的肝硬化患者85例作为研究组,同期健康体检正常者85例作为对照组,比较两组患者血清胃蛋白酶原水平变化以及按照Child-Pugh肝功能改良分级法不同等级间患者血清胃蛋白酶原水平变化情况。结果研究组患者PGI及PGⅡ水平均高于对照组,且组间比较差异有统计学意义(P<0.05);研究组患者PGR低于对照组,但是组间比较差异无统计学意义(P>0.05);按照Child-Pugh肝功能分级,B级和C级患者血清PGI、PGⅡ水平及PGR均高于A级患者,且组间比较均有统计学意义(P<0.05)。结论肝硬化患者可出现血清PG水平异常情况,且与肝功能分级有关,血清PG水平在一定程度上可以反映肝硬化患者胃黏膜功能状态。