Gastropanel: a Kit of Biomarkers to Distinguish Dyspeptic Patients at High Risk of Developing Gastric Adenocarcinoma, a Prospective Study
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Papadia C.
Marelli L.
Wood E.
Feakins R.
Novelli M.
Shidrawi, R. G.
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2025
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Introduction: Gastric adenocarcinoma (GAC) is the the sixth most common cancer worldwide. It is estimated that 54% of cases are preventable; yet, its prognosis remains poor, with 1-year and 5-year survival rates being just 48% and 22%, respectively. GastroPanel (Biohit Oyj; Helsinki, Finland) is an ELISA kit that measures pepsinogen I (PGI); pepsinogen II (PGII); gastrin- 17 (G-17); and Helicobacter pylori IgG antibodies (Hp IgG). PGI and the PGI/PGII ratio correlate inversely with the severity of chronic atrophic gastritis (AG). Proximal open patterns (O1-O3) of Kimura and Takemoto classification of atrophic gastritis are associated with higher risk of developing gastric neoplasm. The aim of this study was to assess GastroPanel performance in the identification of moderate to severe AG in dyspepsia. Aims and Methods: In this UK, single-centre, prospective diagnostic accuracy study, 324 patients [56.8% (n=184) female; median age 57 years (range 39-92 years)] were recruited for gastroscopy with biopsy and histology according to the updated Sydney System (USS). Blood (plasma) samples were collected for GastroPanel analysis. Paired samples were obtained from 268 patients [56.3% (n=151) female; median age=57 (range 39-92 years)]. Patients with type 2 diabetes were enrolled in a separate group. GastroPanel results were interpreted using the GastroSoft app (Biohit) for all patients. Result(s): Overall agreement between GastroPanel and the USS classification was 90% (95% CI=86.7 to 93.8%), with a weighted kappa (kappaw) of 0.828 (95% CI=0.781 to 0.865). In receiver operating characteristics (ROC) curve analysis, using moderate/severe atrophic gastritis of the corpus (AGC2+) as the endpoint, AUC=0.840 (95% CI 0.630 to 1.000) and 0.960 (95% CI 0.907 to 1.000) for PGI and the PGI/PGII ratio, respectively. Conclusion(s): GastroPanel is a reliable dyspepsia triage test distinguishing patients who can be safely treated conservatively from those with moderate to severe proximal (corpus) atrophic gastritis at high risk of developing GAC. A new proposed clinical pathway for dyspepsia might include the GastroPanel.
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United.Eur.Gastroenterol.J.