Comprehensive testing for pre-cancerous gastric conditions
Helicobacter pylori is a gram-negative bacterium that commonly infects the stomach. For most people, infection doesn’t trigger any problems, however, it can cause gastric and duodenal ulcers or, more alarmingly, lead to mucosal damage resulting in gastric atrophy (GA) or gastric intestinal metaplasia (GIM), which are both pre-neoplastic conditions. H. pylori is therefore recognised as a group 1 (carcinogenic) pathogen, and must be carefully considered in the care of patients presenting with gastrointestinal problems.
Dyspepsia is a common complaint associated with H. pylori infection, and is mostly well managed by GPs. However, in refractory cases or where patients present with more urgent symptoms, GPs may refer to a specialist for endoscopy or test for H. pylori infection.
Current testing guidelines
Public Health England currently recommends the stool antigen test in primary care, which accurately detects H. pylori fragments if the patient is shedding them in their stools. However, this test has many limitations in the patient’s overall care; if they have had previous antibiotic therapy, a bleeding gastric ulcer or GA, they can return false negative results. More critically, patients usually acquire infection earlier in life, and can therefore harbour H. pylori for 30 years or more before symptoms present. An H. pylori test alone does not show the extent of mucosal damage caused over this time.
A more thorough diagnostic approach
GastroPanel® is indicated for the first-line diagnosis of H. pylori infection and GA in patients with dyspepsia. It is a non-invasive blood test panel that comprises four analytes: an H. pylori antibody test, and three more tests for stomach-specific biomarkers, including:
- pepsinogen I, which is exclusively produced by the glands in the upper part of the stomach;
- pepsinogen II, which is produced across the whole stomach and, to a lesser extent, in the proximal duodenum;
- gastrin-17, which is exclusively produced by the antral G-cells in the lower part of the stomach.
By measuring these four biomarkers together, it is possible to determine whether there is any damage to the gastric glands that represents atrophy, which from a clinical point of view is one of the most important diseases of the stomach and a significant risk factor for gastric cancer. GastroPanel can help identify those patients at risk, and contribute to the early intervention of gastrointestinal disorders.
Reasons to use GastroPanel to improve patient care
- It is a risk-free, user-friendly laboratory blood test that supports the diagnosis of:
- healthy stomach mucosa;
- functional and organic dyspepsia. When GastroPanel results indicate a healthy stomach mucosa, the cause of stomach problems is often functional dyspepsia or a disease outside the stomach;
- GA and the severity of the condition (normal, gastritis or GA), specifically in the corpus and antrum areas of the stomach;
- H. pylori infection;
- achlorhydria of the stomach (anacidic stomach).
- The four-panel assay provides decisive clinical information on a patient, which leads to informed decisions on whether further examination (gastroscopy) or treatment (eg. PPI) is needed.
- It can reduce the cost burden on the healthcare system by:
- identifying patients who need a gastroscopy;
- prioritising and examining patients in the early phase of disease;
- detecting patients with a high risk of developing gastric cancer.
GastroPanel is a comprehensive test for patients presenting with gastrointestinal problems where H. pylori is suspected. It is proven to deliver excellent clinical performance, with a recent meta-analysis on the diagnostic accuracy of GastroPanel for GA reporting 74.7 % sensitivity, 95.6 % specificity and a negative predictive value of 91 %.1 These results strongly support GastroPanel in its use in screening selective patients for pre-cancerous gastric conditions.
To find out more about BIOHIT’s GastroPanel, visit: www.biohithealthcare.co.uk/gastropanel.
References:
1. Zagari RM, Rabitti S, Greenwood DC, Eusebi LH, Vestito A, Bazzoli F. Systematic review with meta-analysis: diagnostic performance of the combination of pepsinogen, gastrin-17 and anti-Helicobacter pylori antibodies serum assays for the diagnosis of atrophic gastritis. Aliment Pharmacol Ther. 2017 Oct;46(7):657-667. doi: 10.1111/apt.14248. Epub 2017 Aug 7. PMID: 28782119.
