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Accuracy of GastroPanel for the diagnosis of atrophic gastritis

McNicholl, Adrian G.a,b; Forné, Montserratc; Barrio, Jesuse; De la Coba, Cristobalf; González, Begoñad; Rivera, Robing; Esteve, Mariab,c; Fernandez-Bañares, Fernandoc; Madrigal, Beatrize; Gras-Miralles, Beatrizd; Perez-Aisa, Angelesg; Viver-Pi-Sunyer, Jose M.c; Bory, Feliped; Rosinach, Mercec; Loras, Carmenb,c; Esteban, Carlosa; Santolaria, Santosh; Gomollon, Fernandob,i; Valle, Julioj; Gisbert, Javier P.a,b

European Journal of Gastroenterology & Hepatology: September 2014 - Volume 26 - Issue 9 - p 941–948
doi: 10.1097/MEG.0000000000000132
Original Articles: Gastro-oesophageal Disease

Background It has been suggested that GastroPanel might be a useful tool for the diagnosis of chronic atrophic gastritis (CAG) measuring four biomarkers in blood: basal gastrin-17 (G17), pepsinogen I and II (PGI and PGII), and Helicobacter pylori antibodies.

Aim To determine the accuracy of GastroPanel for the diagnosis of CAG.

Methods This was a prospective, blinded, multicenter study that included dyspeptic patients. G17, PGI, and PGII were determined by enzyme immunoassays. Three antrum and two corpus biopsies were obtained for standard histological analysis and rapid urease test. Biopsies were analyzed by a single blinded expert pathologist.

Results Ninety-one patients were included (77% women, mean age 44 years, 51% H. pylori positive, 17% with CAG). G17 was reduced in patients with antrum CAG (5.4 vs. 13.4 pmol/l; P<0.01) and increased in patients with corpus CAG (11 vs. 24 pmol/l; P<0.05), but its accuracy was only acceptable in the case of corpus localization [area under the receiver operating characteristic curve (AUC), 74%]; PGII difference was almost statistically significant only when testing for corpus atrophy (33 vs. 21 μg/l; P=0.05; AUC=72%). The PGI and PGI/PGII ratio showed no significant differences (AUCs were all unacceptably low). Helicobacter pylori antibody levels were higher in H. pylori-infected patients (251 vs. 109 EIU, P=0.01; AUC=70). The accuracy of GastroPanel for the diagnosis of CAG was as follows: sensitivity 50%; specificity 80%; positive 25% and negative 92% predictive values; and positive 2.4 and negative 0.6 likelihood ratios.

Conclusion GastroPanel is not accurate enough for the diagnosis of CAG; thus, its systematic use in clinical practice cannot be recommended.

aHospital of La Princesa, and Instituto de Investigación Sanitaria Princesa

bCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain

Gastroenterology Units of cHospital Mutua de Terrassa, Terrassa

dHospital del Mar, Barcelona

eHospital Rio Hortega, Valladolid

fHospital de Cabueñes, Gijon

gHospital Costa del Sol, Malaga

hHospital San Jorge, Huesca

iHospital Clínico de Zaragoza, Zaragoza

jHospital Virgen de la Salud, Toledo

Correspondence to Adrian G. McNicholl, PhD, Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, C/Diego de León 62, Madrid 28006, Spain Tel: +34 91 309 39 11; fax: +34 91 402 22 99; e-mail: adrian.mcn@gmail.com

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Received February 25, 2014

Accepted May 1, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins