Serum biomarkers provide an accurate method for diagnosis of atrophic gastritis in a general population: The Kalixanda study

Scand J Gastroenterol. 2008;43(12):1448-55. doi: 10.1080/00365520802273025.


Objective: Serological biomarkers can be used for non-invasive diagnosis of gastritis and atrophic gastritis. The aim of this study was to compare the validity of serum levels of pepsinogen I (PGI) and II (PGII), gastrin-17 (G-17) and Helicobacter pylori antibodies (Hpab) with that of the gold standard histology for diagnosis of atrophic gastritis in a population sample from Northern Sweden.

Material and methods: In all, 1000 subjects underwent endoscopies with biopsies. Serum biomarkers were available in 976 subjects for independent diagnosis of gastric mucosal status using a predetermined diagnostic algorithm.

Results: Overall agreement between histology and serological biomarkers in diagnosing corpus atrophy was 96% (CI 95%: 95-97%). Sensitivity and specificity of markers for atrophic gastritis were 71% (CI 68-74%) and 98% (CI 97-99%) respectively, corresponding to 69% (CI 95%: 66-72%) and 98% (95% CI 97-99%) positive and negative predictive values. The positive likelihood ratio was 35.5 (95% CI: 35.0-36.0%). In subgroups with normal stomachs, H. pylori non-atrophic gastritis and H. pylori-negative gastritis by histology, the prevalence of corpus atrophy diagnosed with the biomarkers was 0.8% and 4.9%, respectively. In total, 6.6% of subjects in the study population had corpus atrophy according to the serological biomarkers. CONCLUSIONS. Serological biomarkers show a high degree of accuracy as a non-invasive method to diagnose corpus atrophy, which is common in the general population.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antibodies, Bacterial / blood*
  • Biomarkers / blood
  • Female
  • Gastrins / blood
  • Gastritis, Atrophic / blood*
  • Gastritis, Atrophic / diagnosis*
  • Gastritis, Atrophic / pathology
  • Helicobacter pylori / immunology
  • Humans
  • Male
  • Middle Aged
  • Pepsinogen A / blood*
  • Pepsinogen C / blood*
  • Reproducibility of Results
  • Sensitivity and Specificity


  • Antibodies, Bacterial
  • Biomarkers
  • Gastrins
  • gastrin 17
  • Pepsinogen C
  • Pepsinogen A