Abstract
The purpose of the present study was to determine the relationship between IA values as described by brilliant blue chromo-endoscopy and serum pepsinogens, and thereby determine chromo-endoscopically the atrophic extent of gastric mucosa. During the period from September 1991 to July 1992, 728 consecutive subjects (342 males and 386 females with an average age of 56.7 years), including 101 patients with gastric carcinoma (n=40 advanced and 61 early), were examined by brilliant blue chromo-endoscopy. Serum pepsinogen I and pepsinogen II were concomitantly assayed by RIA (Dynabot) . IA refers to the sum of I and A (ranging from 0 to 6) ;Iis defined as the grading ofintestinal metaplasia (ranging from 0 to 3) ;Ais defined as the grading of rnucosal atrophy (ranging from 0 to 3) . The subjects were divided into 2 subgroups, IA=0 (n=221) and IA≥1 (n=507), and into 5 age groups of under 40, 40-49, 50-59, 60-69 and over 69 years old. The fallowing conclusions were obtained: (1) IA values correlated with the extent of the atrophic border (0.8926) classified by Kimura and Takemoto, and with the serum PGI/PGII ratios (-0.6794) ; (2) The number of subjects in the subgroup IA=0decreased while those subjects with higher IA values (in the subgroup IA≥1) increased in increasing order of age groups; (3) The serum PGI/PGII ratios were comparable in each age group in the subgroup IA=0, and decreased in increas-ing order of the age groups in the subgroup IA≥1. The serum PGI/PGII ratios in the subgroup IA=0 were significantly lower (P<0.0001) than in the subgroup IA≥1 in each age group. In conclusion, clinical application of IA values described by brilliant blue chromo-endoscopy can contribute to obtain an accurate noninvasive diagnosis of gastric mucosalatrophy.
