ment of Nephrology and Hypertension, Diabetes and Endocrinology of the Otto-von-Guericke. University ... Alvaro J. Pazos, Luis E. Bravo, Mercedes . Figueroa.
support a role for metformin, at least as assessed by surrogate markers, for chemoprevention in patients with BE. Clinical trial registration number NCT01447927.
AGA Abstracts
Sa1860 Serum Pepsinogens for Detection of Fundic Gastric Atrophy in Subjects With Autoimmune Thyroid Disease Marino Venerito, Marcus Radünz, Kirsten Reschke, Peter R. Mertens, Francesco Di Mario, Peter Malfertheiner
Sa1858
Background: Autoimmune gastritis (AIG) leads to fundic gastric atrophy (FGA), a condition that increases the risk for gastric cancer. The prevalence of AIG is high among subjects with autoimmune thyroid disease (ATD). Aim: In this case-controlled study we evaluate the usefulness of serum pepsinogens for screening of FGA among subjects with ATD. Methods: Patients with known or newly diagnosed ATD (cases) and goitre (controls) presenting to the Department of Gastroenterology, Hepatology and Infectious Diseases and to the Department of Nephrology and Hypertension, Diabetes and Endocrinology of the Otto-von-Guericke University Hospital from October 2012 to October 2013 were enrolled in the study. Pepsinogen (PG)-I levels ≤ 25 μg/mL and PGI/II ratio ≤ 3 were indicative for FGA. Serum antiHelicobacter pylori (H. pylori) IgG antibody titers were also determined. Upper endoscopy was offered to subjects with serological FGA and histological FGA stage was assessed by OLGA. Results: 23 patients with ATD (17 with Hashimoto thyroiditis and 6 with Graves` disease), and 21 controls with goitre were enrolled. The majority of subjects were female, and subjects with ATD were younger than controls (mean age 56.6 ± 13.4 and 67.9 ± 12.8 years in cases and controls, respectively, p 5 cm, that were randomized and received study intervention (38-metformin, 36-placebo), baseline characteristics and agent adherence rates were similar between the 2 randomization arms. Treatment related AEs were similar for metformin vs. placebo (50% vs. 36%, p=0.25) and all but one AE were Grade 1 or 2. In the 69 participants that were evaluable for the primary endpoint, the percent change from baseline in tissue concentration of pS6K1 was similar for metformin vs. placebo (median = 1.4% vs. -14.7%, 1-sided p=0.80). Similar non-significant results were obtained when assessing absolute change (1-sided p=0.72). There were also no differences in cell proliferation or apoptosis in Barrett's epithelium as assayed by Ki-67 and caspase-3 immunohistochemistry when comparing metformin to placebo. Conclusions: In BE patients, short-term intervention with metformin appears to be safe but without a demonstrable effect on pS6K1 as compared to placebo. Metformin therapy also does not significantly alter proliferation or apoptosis in Barrett's epithelium. The findings of this short-term study do not
AGA Abstracts
Are All Patients With Histological Diagnosis of Atrophic Gastritis Really At Risk of Developing Gastric Cancer? Assessment of Gastric Acid Production by Correlation Between Maximal Acid Output and Pepsinogen I Francesco Di Mario, Hunor Pal Farkas, Francesco Ferrara, Nadia Dal Bo, Tiziana Slongo, Roberto Marcello, Stefania Liatopoulou, Alessandro Gnocchi, Vincenzo Corrente, Anna Bertele', Massimo Rugge, Carmelo Scarpignato Background: Gastric atrophy, which is believed to be a precursor for intestinal type gastric cancer, results in loss of parietal cell mass which manifests itself in reduced or absent gastric acid secretion. Increase in gastric pH may permits colonization of the stomach by bacteria which are capable of converting dietary nitrates to potent mutagenic N-nitroso compounds, consequently atrophic gastritis (AG) is associated with an increased risk of both cardia and non-cardia gastric adenocarcinomas. The gold standard for measuring gastric acid secretion remains the invasive method that involves aspiration of gastric content after pharmacological stimulation. In contrast serum pepsinogens are regarded as alternative, non-invasive, but reliable gastric secretory parameters, potential screening tools to detect patients at risk of developing gastric cancer. Aim: The aim of our study is to assess the usefulness of serum biomarkers in evaluating gastric cancer risk in patients with AG by correlation with the stomach's secretory function. Material and methods: A total of 42 subjects (18 male) were included in the study, aged between 41 and 71 years (mean: 53.7 years) and diagnosed with histologically confirmed AG (22 autoimmune). Fasting levels of pepsinogen I (sPGI), pepsinogen II and gastrin17 were measured as well as maximal acid output (MAO). Resulting data was statistically evaluated. Results: Patients were subdivided in groups with achlorhydria (64.3%) and normal gastric function according to MAO values. Statistically significant differences were found between these groups regarding both pepsinogen and gastrin 17 levels. Significant correlation was found between sPGI and MAO (Spearman r=0.782). A ROC curve identified the best sPGI cut-off point of 30 μg/L for the diagnosis of achlorhydria with a sensitivity of 100% (95% CI: 87.11-100), specificity of 93.33% (CI: 67.98-98.89) and negative predictive value of 100% (CI: 76.66-100). Conclusions: There is a correlation
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