Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia
Samloff, I.M.; Varis, K.; Ihamaki, T.; Siurala, M.; Rotter, J.I.
Gastroenterology 83(1 Pt 2): 204-209
1982
ISSN/ISBN: 0016-5085 PMID: 7084603 Document Number: 194880
To examine the possible effect of gastritis on the endocrine component of pepsinogen secretion, the relationships among gastric mucosal histologic characteristics and serum levels of pepsinogen I and pepsinogen II in 170 1st-degree relatives of patients with pernicious anemia, were determined. Sixty-four had normal fundic gland mucosa, 66 had superficial gastritis, 17 had mild or moderate atrophic gastritis and 23 had severe atrophic gastritis. In superficial gastritis, serum pepsinogen I and pepsinogen II were both significantly higher than normal, but the percentage rise in pepsinogen II was significantly greater than the rise in pepsinogen I. In mild/moderate atrophic gastritis, pepsinogen I did not differ from normal, but pepsinogen II was significantly elevated, while in severe atrophic gastritis, pepsinogen II did not differ from normal, but pepsinogen I was significantly decreased. The nonparallel changes in serum pepsinogen I and pepsinogen II levels resulted in a decrease in the pepsinogen I to pepsinogen II ratio from 6.2 .+-. 0.2 in subjects with normal fundic gland mucosa to 4.3 .+-. 0.2, 2.9 .+-. 0.4 and 0.7 .+-. 0.2, respectively, in those with superficial gastritis, mild to moderate atrophic gastritis and severe atrophic gastritis. The pepsinogen I to pepsinogen II ratio in combination with the absolute level of serum pepsinogen I correctly predicted the histologic status of the gastric mucosa in 119 of the 170 subjects, 70.0%. The increasing severity of gastritis is associated with nonparallel alterations in serum levels of pepsinogen I and pepsinogen II. These changes apparently lead to a progressive decrease in the pepsinogen I to pepsinogen II ratio. The pepsinogen I to pepsinogen II ratio, in combination with pepsinogen I, is predictive of the histologic status of the gastric mucosa.