Clinical usefulness of serum pepsinogens I and II, gastrin-17 and anti-Helicobacterpylori antibodies in the management of dyspeptic patients in primary care

Dig Liver Dis. 2005 Jul;37(7):501-8. doi: 10.1016/j.dld.2005.01.016. Epub 2005 Apr 18.


Background: Several tests have been proposed for evaluating dyspeptic symptoms and their relationship to the underlying gastric disease. Serum pepsinogens and gastrin-17 are known to be useful biomarkers for the detection of gastric pathologies.

Aim: To evaluate the capability of screening dyspeptic patients in the primary care by analyses of serum pepsinogens I (sPGI) and II (sPGII), gastrin-17 (sG-17) and the IgG anti-Helicobacter pylori antibodies (IgG-Hp).

Patients and methods: Three hundred and sixty-two consecutive patients with dyspeptic symptoms (208 females, mean age 50.6 +/- 16 years, range 18-88 years) referred by general practitioners for upper gastrointestinal endoscopy were enrolled. A blood sample was taken from each subject for IgG-Hp, sPGI, sPGII and sG-17 analyses.

Results: Two hundred and eighty-seven patients had a complete screening; of these, 132 resulted positive for Hp infection. Patients with atrophic chronic gastritis showed significantly lower serum pepsinogen I levels and sPGI/sPGII ratio than patients with non-atrophic chronic gastritis. Moreover, by calculating the values of sPGI by sG-17 and sG-17 by sPGII/sPGI, subjects with atrophic chronic gastritis could be distinguished from those with non-atrophic chronic gastritis and from those with normal mucosa, respectively. sG-17 levels were found to be a useful biomarker for the detection of antral atrophic gastritis, while the combination of sPGI, the sPGI/sPGII ratio and sG-17 was found effective in identifying corpus atrophy.

Conclusion: A panel composed of PGI, PGII, G-17 and IgG-Hp could be used as a first approach in the 'test and scope' and/or 'test and treat' strategy in the primary care management of dyspeptic patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / analysis*
  • Chronic Disease
  • Dyspepsia / blood*
  • Dyspepsia / etiology
  • Female
  • Gastrins / blood*
  • Gastritis / complications
  • Gastritis / diagnosis*
  • Gastritis / microbiology
  • Gastroscopy
  • Helicobacter pylori / immunology*
  • Humans
  • Immunoglobulin G / immunology
  • Male
  • Mass Screening
  • Middle Aged
  • Pepsinogen A / blood*
  • Pepsinogen C / blood*
  • Primary Health Care


  • Antibodies, Bacterial
  • Gastrins
  • Immunoglobulin G
  • gastrin 17
  • Pepsinogen C
  • Pepsinogen A