Correlation of serum pepsinogen with histological atrophy following successful Helicobacter pylori eradication

Summary

Background

Levels of pepsinogen have been reported to correlate with the degree of gastric atrophy in Helicobacter pylori-infected gastric mucosa.

Aim

To investigate the relationship between PG levels and histological atrophy before and after H. pylori eradication.

Methods

Eradication therapy was conducted on 180 H. pylori-positive patients with upper gastrointestinal conditions. Endoscopy was performed prior to and at 2, 12 and 24 months after successful eradication therapy. Histological findings were scored using the updated Sydney System in the antrum and the corpus of the stomach. Pepsinogen was measured.

Results

Pepsinogen I levels dropped significantly at 2 months after the eradication. By 12 months and 24 months post-eradication they had risen again. Histological improvement was seen in atrophy at all sites at 24 months after the eradication. A significant correlation between atrophy and pepsinogen I was seen from prior to eradication. The correlation coefficient was greater at 2 months post-eradication, decreased again at 12 months and was no longer significant at 24 months.

Conclusions

Our results suggest that pepsinogen levels correlate with the degree of gastric mucosal atrophy prior to and soon after successful eradication therapy, but that the degree of correlation subsequently declines over time.