Integrating serological markers of Helicobacter pylori and pepsinogen to improve detection of gastric precancerous conditions.

BACKGROUND

Gastric cancer (GC) remains a significant global health burden due to its high incidence and mortality, especially in China. This study aimed to evaluate the performance of combined serological assessment of pepsinogen (PG) and Helicobacter pylori (H. pylori) antibodies for identifying gastric precancerous conditions.

METHODS

From November 2016 to September 2019, an observational cohort study was performed to evaluate serum levels of PG and H. pylori antibodies. Among 19,879 participants, four groups were defined based on serological status: Group A (PG-/ H. pylori-), Group B (PG-/ H. pylori+), Group C (PG+/ H. pylori+), and Group D (PG+/ H. pylori-). Participants from Groups C and D were included in the analysis, while individuals from Groups A and B were randomly selected at a 3:1 ratio relative to Groups D and C, respectively. In total, 1,152 subjects underwent endoscopic and histopathological assessment.

RESULTS

Group C demonstrated significantly elevated odds of atrophic gastritis (AG) (OR = 1.98; 95% CI: 1.17-3.26) and intestinal metaplasia (IM) (OR = 1.40; 95% CI: 0.73-2.67) compared to Group A. In the gastric corpus, the odds of AG and IM were 5.0 and 6.8 times higher, respectively, in Group C versus Group A.

CONCLUSION

Combined serological assessment of PG and anti- H. pylori IgG improves the identification of gastric precancerous conditions, with particularly enhanced performance in the gastric corpus.