Serum biomarkers provide an accurate method for diagnosis of atrophic gastritis in a general population: The Kalixanda study

Objective. Serological biomarkers can be used for non-invasive diagnosis of gastritis and atrophic gastritis. The aim of this study was to compare the validity of serum levels of pepsinogen I (PGI) and II (PGII), gastrin-17 (G-17) and Helicobacter pylori antibodies (Hpab) with that of the gold standard histology for diagnosis of atrophic gastritis in a population sample from Northern Sweden. Material and methods. In all, 1000 subjects underwent endoscopies with biopsies. Serum biomarkers were available in 976 subjects for independent diagnosis of gastric mucosal status using a predetermined diagnostic algorithm. Results. Overall agreement between histology and serological biomarkers in diagnosing corpus atrophy was 96% (CI 95%: 95–97%). Sensitivity and specificity of markers for atrophic gastritis were 71% (CI 68–74%) and 98% (CI 97–99%) respectively, corresponding to 69% (CI 95%: 66–72%) and 98% (95% CI 97–99%) positive and negative predictive values. The positive likelihood ratio was 35.5 (95% CI: 35.0–36.0%). In subgroups with normal stomachs, H. pylori non-atrophic gastritis and H. pylori-negative gastritis by histology, the prevalence of corpus atrophy diagnosed with the biomarkers was 0.8% and 4.9%, respectively. In total, 6.6% of subjects in the study population had corpus atrophy according to the serological biomarkers. Conclusions. Serological biomarkers show a high degree of accuracy as a non-invasive method to diagnose corpus atrophy, which is common in the general population.