A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication
Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usef...
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| creator | Osumi, Hiroki Fujisaki, Junko Suganuma, Takanori Horiuchi, Yusuke Omae, Masami Yoshio, Toshiyuki Ishiyama, Akiyoshi Tsuchida, Tomohiro Miki, Kazumasa |
| description | Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori.
In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.
Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p |
| doi_str_mv | 10.1371/journal.pone.0183980 |
| format | Article |
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In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.
Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05). Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively.
In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0183980</identifier><identifier>PMID: 28854276</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Allergies ; Antibiotics ; Antigens ; Bioindicators ; Biology and Life Sciences ; Biomarkers ; Biomarkers - blood ; Cancer ; Female ; Gastroenterology ; Health aspects ; Helicobacter infections ; Helicobacter Infections - blood ; Helicobacter Infections - diagnosis ; Helicobacter Infections - epidemiology ; Helicobacter Infections - therapy ; Helicobacter pylori ; Helicobacter pylori - isolation & purification ; Humans ; Hypersensitivity ; Immunology ; Immunotherapy ; Infection control ; Infections ; Japan - epidemiology ; Male ; Medical research ; Medicine and Health Sciences ; Middle Aged ; Patients ; Penicillin ; Pepsinogen ; Pepsinogen A - blood ; Pepsinogen C - blood ; Prevention ; Review boards ; Serum levels ; Therapy ; Urea</subject><ispartof>PloS one, 2017-08, Vol.12 (8), p.e0183980-e0183980</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Osumi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Osumi et al 2017 Osumi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c651t-ee0b4811e1446470932e5cdbf000a875cf1ecde677a2e83750c60c3c84544d2a3</citedby><cites>FETCH-LOGICAL-c651t-ee0b4811e1446470932e5cdbf000a875cf1ecde677a2e83750c60c3c84544d2a3</cites><orcidid>0000-0002-4742-0446</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576670/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576670/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28854276$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Osumi, Hiroki</creatorcontrib><creatorcontrib>Fujisaki, Junko</creatorcontrib><creatorcontrib>Suganuma, Takanori</creatorcontrib><creatorcontrib>Horiuchi, Yusuke</creatorcontrib><creatorcontrib>Omae, Masami</creatorcontrib><creatorcontrib>Yoshio, Toshiyuki</creatorcontrib><creatorcontrib>Ishiyama, Akiyoshi</creatorcontrib><creatorcontrib>Tsuchida, Tomohiro</creatorcontrib><creatorcontrib>Miki, Kazumasa</creatorcontrib><title>A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori.
In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.
Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05). Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively.
In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Allergies</subject><subject>Antibiotics</subject><subject>Antigens</subject><subject>Bioindicators</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Cancer</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Helicobacter infections</subject><subject>Helicobacter Infections - blood</subject><subject>Helicobacter Infections - diagnosis</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter Infections - therapy</subject><subject>Helicobacter pylori</subject><subject>Helicobacter pylori - isolation & purification</subject><subject>Humans</subject><subject>Hypersensitivity</subject><subject>Immunology</subject><subject>Immunotherapy</subject><subject>Infection control</subject><subject>Infections</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Penicillin</subject><subject>Pepsinogen</subject><subject>Pepsinogen A - blood</subject><subject>Pepsinogen C - blood</subject><subject>Prevention</subject><subject>Review boards</subject><subject>Serum levels</subject><subject>Therapy</subject><subject>Urea</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptkt-LEzEQxxdRvLP6H4gGBPGlvfze9OWgHOoVDnzR55DNzrapabImu8L515te945WfMqQ-eQ7851MVb0leEFYTa52cUzB-EUfAywwUWyp8LPqkiwZnUuK2fOT-KJ6lfMOY8GUlC-rC6qU4LSWl9WfFcpuE1znrAkDcsEmMBlKgIYtoB767ELcQEDrq_UaJTO4iFxGBiXwzjQeUOPi3qSfkFAXE8qjtZBzN3p0WwgbG2OHkuvvfUwOQTJtKVVUwuvqRWd8hjfTOat-fPn8_eZ2fvft6_pmdTe3UpBhDoAbrggBwrnkNS6eQNi26TDGRtXCdgRsC7KuDQXFaoGtxJZZxQXnLTVsVr0_6vY-Zj2NLesyHLYUtVjSQqyPRBvNTvfJFT_3OhqnHy5i2miTBmc96GbJzdJI3AKhnGJhQKim7igwSo2oVdG6nqqNzR5aC2FIxp-JnmeC2-pN_K2FqKWscRH4NAmk-GuEPOi9yxa8NwHi-NA3pwpLxQr64R_0_-4mamOKARe6WOrag6heCUw5V7LQs-rjCbUF44dtjn48_FQ-B_kRtCnmnKB78kawPmzmYxP6sJl62szy7N3pXJ4ePa4i-ws5X-DM</recordid><startdate>20170830</startdate><enddate>20170830</enddate><creator>Osumi, Hiroki</creator><creator>Fujisaki, Junko</creator><creator>Suganuma, Takanori</creator><creator>Horiuchi, Yusuke</creator><creator>Omae, Masami</creator><creator>Yoshio, Toshiyuki</creator><creator>Ishiyama, Akiyoshi</creator><creator>Tsuchida, Tomohiro</creator><creator>Miki, Kazumasa</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4742-0446</orcidid></search><sort><creationdate>20170830</creationdate><title>A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication</title><author>Osumi, Hiroki ; Fujisaki, Junko ; Suganuma, Takanori ; Horiuchi, Yusuke ; Omae, Masami ; Yoshio, Toshiyuki ; Ishiyama, Akiyoshi ; Tsuchida, Tomohiro ; Miki, Kazumasa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c651t-ee0b4811e1446470932e5cdbf000a875cf1ecde677a2e83750c60c3c84544d2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Allergies</topic><topic>Antibiotics</topic><topic>Antigens</topic><topic>Bioindicators</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Cancer</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Helicobacter infections</topic><topic>Helicobacter Infections - blood</topic><topic>Helicobacter Infections - diagnosis</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter Infections - therapy</topic><topic>Helicobacter pylori</topic><topic>Helicobacter pylori - isolation & purification</topic><topic>Humans</topic><topic>Hypersensitivity</topic><topic>Immunology</topic><topic>Immunotherapy</topic><topic>Infection control</topic><topic>Infections</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Penicillin</topic><topic>Pepsinogen</topic><topic>Pepsinogen A - blood</topic><topic>Pepsinogen C - blood</topic><topic>Prevention</topic><topic>Review boards</topic><topic>Serum levels</topic><topic>Therapy</topic><topic>Urea</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Osumi, Hiroki</creatorcontrib><creatorcontrib>Fujisaki, Junko</creatorcontrib><creatorcontrib>Suganuma, Takanori</creatorcontrib><creatorcontrib>Horiuchi, Yusuke</creatorcontrib><creatorcontrib>Omae, Masami</creatorcontrib><creatorcontrib>Yoshio, Toshiyuki</creatorcontrib><creatorcontrib>Ishiyama, Akiyoshi</creatorcontrib><creatorcontrib>Tsuchida, Tomohiro</creatorcontrib><creatorcontrib>Miki, Kazumasa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Osumi, Hiroki</au><au>Fujisaki, Junko</au><au>Suganuma, Takanori</au><au>Horiuchi, Yusuke</au><au>Omae, Masami</au><au>Yoshio, Toshiyuki</au><au>Ishiyama, Akiyoshi</au><au>Tsuchida, Tomohiro</au><au>Miki, Kazumasa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-08-30</date><risdate>2017</risdate><volume>12</volume><issue>8</issue><spage>e0183980</spage><epage>e0183980</epage><pages>e0183980-e0183980</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori.
In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan). The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.
Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%). The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429), 88.3% (99/112), 75% (12/16) and 100% (5/5), respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05). Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively.
In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28854276</pmid><doi>10.1371/journal.pone.0183980</doi><orcidid>https://orcid.org/0000-0002-4742-0446</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-08, Vol.12 (8), p.e0183980-e0183980 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1933957592 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Aged Aged, 80 and over Allergies Antibiotics Antigens Bioindicators Biology and Life Sciences Biomarkers Biomarkers - blood Cancer Female Gastroenterology Health aspects Helicobacter infections Helicobacter Infections - blood Helicobacter Infections - diagnosis Helicobacter Infections - epidemiology Helicobacter Infections - therapy Helicobacter pylori Helicobacter pylori - isolation & purification Humans Hypersensitivity Immunology Immunotherapy Infection control Infections Japan - epidemiology Male Medical research Medicine and Health Sciences Middle Aged Patients Penicillin Pepsinogen Pepsinogen A - blood Pepsinogen C - blood Prevention Review boards Serum levels Therapy Urea |
| title | A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication |
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