Percentage changes in serum pepsinogens are useful as indices of eradication of Helicobacter pylori.

Abstract

Eradication of Helicobacter pylori has been gaining significance for the treatment of gastroduodenal diseases. Establishment of a precise diagnostic method for H. pylori is of great value. The aim of this study was to establish a new method for precisely judging the eradication of this bacteria. We measured serum pepsinogen I (PG I) and pepsinogen II (PG II) levels in 105 cases of peptic ulcer with H. pylori infection before and after anti-H. pylori treatment, determined percentage changes in serum PG I:PG II ratios before and 1 month after the treatment, and established cut-off values for them to distinguish success from failure of H. pylori eradication. Cut-off values for percentage changes in serum PG I:PG II ratios were tentatively set as +40%, +25%, and +10% when the serum PG I:PG II ratios before treatment were less than 3.0, not less than 3.0 but less than 5.0, and not less than 5.0, respectively. With these cut-off values, the sensitivity, specificity, and validity for determination of eradication of H. pylori-on the basis of culture, histology, the rapid urease test, and a polymerase chain reaction method-were 100.0%, 93.1%, and 96.2%, respectively. These cut-off values could be applied to both gastric ulcer and duodenal ulcer. Our findings suggest that percentage changes in serum PG I:PG II ratios are useful as indices for distinguishing success from failure in eradication therapy for H. pylori.