SERUM PEPSINOGEN-C - A USEFUL MARKER OF HELICOBACTER-PYLORI ERADICATION

Medical treatment for Helicobacter pylori (Hp) infection is now recomm ended in several types of gastroduodenal disease, and its success is u sually monitored by hystology. The end-points of our work were to iden tify the most suitable serum index of Hp eradication among pepsinogen A (PGA), pepsinogen C (PGC), PGA/PGC ratio, gastrin, and IgG anti-Hp ( IGG). We studied a total of 289 Hp positive (Giemsa staining) patients , who were treated with 40 mg/day omeprazole (140 cases) or with 480 m g/day bismuth subsalicylate (149 cases) for 4 weeks. All the patients also received 1 g/day metronidazole + 2 g/day amoxycillin for the firs t 2 weeks of treatment. Two months after the end of therapy, the patie nts underwent a second endoscopy and Hp histological assessment: the i nfection was eradicated in 192 and still present in the remaining 97 s ubjects. Gastrin, PGA, PGC, and IGG were measured before and after the rapy. All indices significantly decreased after therapy in eradicated patients, while PGA and gastrin significantly decreased after therapy in both eradicated and noneradicated patients, although in the latter group the variations were less pronounced. We calculated the per cent decrease of the studied indices. PGC, with a decrease of more than 25% , was found to be the most accurate biochemical index. Variation in PG C levels before and after treatment were correlated with corresponding variations in Hp bacterial load. In conclusion, between the different biochemical parameters evaluated, PGC showed the highest clinical eff iciency. (C) 1996 Wiley-Liss, Inc.