Serum pepsinogen levels in the Japanese population: prospective study of 9 years of follow-up.

BACKGROUND/AIMS: Natural alterations of serum pepsinogen (PG) levels are still unclear. We investigated the natural course of pepsinogen levels by prospective study over a period of 9 years. METHODOLOGY: Out of 18,676 participants of a cancer screening program, 262 individuals (79 males, mean age 58.6 years) were enrolled. Sera were obtained from all participants in 1989 and again in 1998 to screen for gastric cancer. PG concentrations were determined by radioimmunoassay. Subjects with a PGI concentration of > 50 or a PGI/II ratio of > 3 were considered PG-negative. RESULTS: Initially, 207 and 55 subjects were considered to be PG-negative and positive, respectively. Of the 207 PG-negative subjects, 25 (12.1%) had seroconverted to a PG-positive status. All of the 41 subjects with a PGI/II ratio > 6.5, in whom H. pylori should be negative, remained PG-negative. Seroconversion to a PG-positive status was more frequently found in subjects with PGII > 15ng/mL, in whom active gastritis is more likely to be present. Of the 55 with PG-positive subjects, as assessed in 1989, 18 (32.7%) had seroconversion to a PG-negative status. CONCLUSIONS: PG-seroconversion occurred in 16% of people over a 9-year period. Seroconversion to a PG-positive status may be induced by active gastritis.

The effect of Helicobacter pylori eradication therapy on gastric ulcer healing after endoscopic mucosal resection.

BACKGROUND AND AIM: It remains unclear whether Helicobacter pylori eradication therapy accelerates the healing of acute gastric ulcer after endoscopic mucosal resection (EMR) of gastric tumor. We examined the effect of H. pylori eradication therapy on ulcer healing after EMR. METHODS: Twenty-six patients who underwent successful H. pylori eradication therapy before EMR were followed prospectively. Patients underwent endoscopic examination 1 or 2 months after EMR, during which the ulcer status and reduction rate were assessed. The effect of H. pylori eradication on the quality of ulcer healing was also evaluated. Six patients in whom eradication therapy failed and 26 patients who underwent EMR without eradication therapy served as control subjects. RESULTS: Endoscopically, 18 (75%) of 24 ulcers in the eradication group were at the healing stage 1 month after EMR. The ulcer reduction rates were 85.0 +/- 2.6% and 96. 9 +/- 1.1% at 1 and 2 months after EMR, respectively. Ulcer stage and reduction rate did not differ significantly between the eradication group and control group. However, we frequently observed a better quality of ulcer healing in the eradication group than in the control groups (P < 0.01). CONCLUSION: H. pylori eradication therapy does not accelerate ulcer healing after EMR but may improve the quality of ulcer healing of gastric ulcer after EMR.