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110 - Non invasive diagnosis of gastrointestinal disorders: GastroPanel and Fibrotest

Autore/i: D. Basso

Rivista: RIMeL - IJLaM, Vol. 5, N. 3-S1, 2009 (MAF Servizi srl ed.)

Pagina/e: 110

Clinical biochemistry of gastritis. Gold standard for the diagnosis of type and etiology of gastritis is the histological examination of gastric mucosal biopsies obtained from the antrum, the corpus and the angulus. A non invasive screening procedure able to identify subjects at high or low risk for gastritis should allow to limit un-necessary endoscopies and histological examinations especially among dyspeptics. A serological panel combining pepsinogen I and II (PGA and PGC), gastrin-17 (G17), and anti-Helicobacter pylori antibodies (anti-Hp)(GastroPanel) is actually the most reliable non invasive test to screen patients for gastritis: it has a very high negative predictive value (about 95%) and a positive predictive value of about 65%. A classification algorithm including the four biochemical parameters measured in fasting sera, allows to classify patients as having or not non atrophic or atrophic gastritis and to ascertain whether gastritis is associated or not with H. pylori infection. GastroPanel was demonstrated to be of utility in screening subjects at high risk for gastric cancer. This test, in fact, is highly sensitive (80-90%) and specific (90-100%) in identifying the precancerous chronic atrophic gastritis. Gastric corpus mucosal atrophy associates with reduced PGA levels (<25 ug/L), reduced PGA/ PGC ratio (<3) and increased G17 (>10 pmol/L)...

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