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Serum pepsinogen I and pepsinogen II, and the ratio of pepsinogen I/pepsinogen II in peptic ulcer diseases: with special emphasis on the influence of the location of the ulcer crater



Serum pepsinogen I and pepsinogen II, and the ratio of pepsinogen I/pepsinogen II in peptic ulcer diseases: with special emphasis on the influence of the location of the ulcer crater



Journal of Gastroenterology and Hepatology 10(4): 401-404



To investigate the effect of the location of the ulcer crater on the serum levels of pepsinogen I (PGI), pepsinogen II (PGII) and the ratio of PGI/PGII, these parameters were determined in 161 healthy controls, 29 patients with gastric ulcer in the gastric body (GU-I), 65 with coexistent gastroduodenal ulcer (GU-II), 104 with gastric ulcer in the prepyloric region (GU-III), and 116 with duodenal ulcer (DU). Serum PGI levels were significantly higher (P lt 0.01) in patients with GU-III (110.6 +- 65.1 ng/mL), GU-II (100.0 +- 46.6 ng/mL), and DU (92.2 +- 35.2 ng/mL) than in the controls (77.4 +- 31.4 ng/mL), while there were no significant differences between GU-I (82.5 +- 36.3 ng/mL) and the controls. Patients with gastric ulcer in any region had significantly higher (P lt 0.01) serum PGII levels (GU-I, 20.0 +- 15.7 ng/mL; GU-II, 15.5 +- 10.9 ng/mL; GU-III, 14.3 +- 10.0 ng/mL) than the controls (10.6 +- 6.0 ng/mL) and the patients with DU (10.0 +- 5.5 ng/mL), whereas no significant differences existed between the latter two. The ratio of PGI/PGII in GU-I (5.86+-3.90) was significantly lower (P lt 0.01) than any other group (controls, 8.83 +- 4.70; GU-II, 8.33 +- 4.99; GU-III; 9.64 +- 6.13; DU, 10.45 +- 4.49), while patients with DU it was significantly higher (P lt 0.01) than any other groups. These findings indicate that peptic ulcer is comprised of a heterogeneous group of diseases. A normal level of serum PGI, an increased level of PGII, and a decreased ratio of PGI/PGII in GU-I patients reflected extensive atrophic gastritis, while an elevated level of PGI, a normal level of PGII, and an increased ratio of PGI/PGII in DU patients implicated hypersecretory status coexistent with superficial fundic gastritis. These findings suggest functional heterogeneity of the gastric mucosa according to the different locations of the ulcer crater.

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Accession: 009406272

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PMID: 8527705



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