The gastropanel is a set of tests that allows for the assessment of the condition of the gastric mucosa without endoscopy. However, the results are most often interpreted simplistically: whether H. pylori is present or not.
In practice, it is important to look at the combination of indicators, as their ratio reflects the function of the stomach, the level of acidity, and the condition of the mucosa.
What indicators are included in the gastropanel
For correct interpretation, it is important to understand what each marker reflects:
- pepsinogen I — an indicator of the condition of the gastric body cells and the level of acidity;
- pepsinogen II — reflects the overall condition of the mucosa and inflammation;
- the ratio of pepsinogen I / pepsinogen II — a key marker of atrophy;
- gastrin-17 — reflects the regulation of acidity and the condition of the antrum;
- IgG to Helicobacter pylori — indicates contact with the bacterium.
How to read the indicators
Normal. If all markers are within reference values, it means:
- the structure of the gastric mucosa is preserved;
- there is no significant atrophy;
- acidity is adequately regulated;
- there is no active H. pylori infection.
H. pylori without mucosal damage. If antibodies to H. pylori are positive, but pepsinogens and gastrin remain normal, this indicates superficial inflammation without significant structural changes. In this condition:
- the mucosa is still preserved;
- acidity often remains normal or increased;
- risks are related not to current indicators, but to the duration of the process.
Atrophy of the gastric body. A decrease in pepsinogen I and the ratio of pepsinogen I / II with increased gastrin-17 is a sign of atrophy of the gastric body. This means:
- a decrease in hydrochloric acid production;
- worsening of protein digestion;
- decreased absorption of vitamin B12, iron, and zinc;
- compensatory increase in gastrin due to low acidity.
The presence or absence of H. pylori in this case does not change the fact of already formed atrophy.
Atrophy of the antrum. If gastrin-17 is decreased with normal pepsinogens and positive H. pylori, this indicates damage to the antrum. In this condition:
- the regulation of acidity is disrupted;
- increased acidity is more often observed;
- the load on the mucosa increases;
- symptoms of gastric irritation may occur.
Pangastritis. A decrease in all key indicators — pepsinogen I, the ratio of I/II, and gastrin-17 — indicates widespread damage to the entire gastric mucosa. This is the most pronounced condition, in which:
- acidity is significantly reduced;
- digestion of food is impaired;
- the risk of deficiencies increases;
- the barrier function of the stomach decreases.
How to properly approach the analysis
The gastropanel is not a test for one disease, but a tool for assessing the condition of the stomach. It is important to look at:
- the structure of the mucosa;
- the level of acidity;
- the presence of inflammation;
- the compensatory reactions of the body.
Only a comprehensive analysis allows us to understand where exactly the problem lies: in infection, regulation of acidity, or already in structural changes of the mucosa.
Main mistakes in interpretation:
- evaluation only of the presence of H. pylori without analyzing stomach function;
- ignoring the ratio of pepsinogens;
- not considering gastrin as a marker of acidity;
- considering indicators separately, rather than as a system.
Sources
- A Panel of Serum Biomarkers (GastroPanel) in Non-Invasive Diagnosis of Atrophic Gastritis: Systematic Review and Meta-Analysis
- 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
- Serological Biomarker Panel in Diagnosis of Atrophic Gastritis and Helicobacter pylori Infection in Gastroscopy Referral Patients: Clinical Validation of the New-Generation GastroPanel Test
- Prediction of Chronic Atrophic Gastritis and Gastric Neoplasms by Serum Pepsinogen Assay: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy
- ACG Clinical Guideline: Treatment of Helicobacter pylori Infection
