The relationship between salivary pepsin level and esophagitis on endoscopy and histopathology in patients with gastroesophageal reflux symptoms
Main Article Content
Abstract
The study was conducted on 30 patients who had gastroesophageal reflux symptoms; quantitative and qualitative pepsin diagnostic tests were conducted from saliva samples (Peptest), upper gastrointestinal endoscopy, and histopathology collected from esophageal mucosal biopsies. The prevalence of patients having positive Peptest results from at least one saliva sample and two samples were 100% and 83.3%, respectively. The prevalence of patients having esophagitis on endoscopy and histopathology were 70% and 36.7%, respectively. There was no significant difference in the prevalence of Peptest-positive result between sub-groups with and without esophagitis on both endoscopy and histopathology (p > 0.05). Pepsin levels in saliva collected after dinner and the morning after were 124.1 and 104.5 ng/ml, and no significant difference was found between sub-groups with and without esophagitis on both endoscopy and histopathology (p > 0.05).
Article Details
Keywords
Peptest, endoscopy, histopathology, gastroesophageal reflux disease
References
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2. Min YW, Lim SW, Lee JH, et al. Prevalence of Extraesophageal Symptoms in Patients With Gastroesophageal Reflux Disease: A Multicenter Questionnaire-based Study in Korea. J Neurogastroenterol Motil. 2014;20(1):87-93.
3. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67(7):1351-1362.
4. N E Schindlbeck, A G Klauser, G Berghammer, W Londong, S A Muller-Lissner. Three year follow up of patients with gastrooesophageal reflux disease. Gut. 1992;33:1016-1019.
5. Dent J. Microscopic esophageal mucosal injury in nonerosive reflux disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2007;5(1):4-16.
6. Zentilin P, Savarino V, Mastracci L, et al. Reassessment of the diagnostic value of histology in patients with GERD, using multiple biopsy sites and an appropriate control group. The American journal of gastroenterology. 2005;100(10):2299-2306.
7. Race C, Chowdry J, Russell JM, Corfe BM, Riley SA. Studies of salivary pepsin in patients with gastro-oesophageal reflux disease. Alimentary pharmacology & therapeutics. 2019;49(9):1173-1180.
8. Wang YJ, Lang XQ, Wu D, et al. Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-types of Gastroesophageal Reflux Disease and Gastroesophageal Reflux Disease-related Disorders. J Neurogastroenterol Motil. 2020;26(1):74-84.
9. Wang YF, Yang CQ, Chen YX, et al. Validation in China of a non-invasive salivary pepsin biomarker containing two unique human pepsin monoclonal antibodies to diagnose gastroesophageal reflux disease. Journal of digestive diseases. 2019;20(6):278-287.
10. Zhang M, Pandolfino JE, Zhou X, et al. Assessing different diagnostic tests for gastroesophageal reflux disease: a systematic review and network meta-analysis. Therapeutic advances in gastroenterology. 2019;12:1756284819890537.
11. Ocak E, Kubat G, Yorulmaz I. Immunoserologic pepsin detection in the saliva as a non-invasive rapid diagnostic test for laryngopharyngeal reflux. Balkan Med J. 2015;32(1):46-50.
12. Sami SS, Ragunath K. The Los Angeles Classification of Gastroesophageal Reflux Disease. Video Journal and Encyclopedia of GI Endoscopy. 2013;1(1):103-104.
13. Fiocca R, Mastracci L, Riddell R, et al. Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project. Hum Pathol. 2010;41(2):223-231.
14. NICE. Peptest for diagnosing gastro-esophageal reflux. 2015.
15. Strachan T, Melter J, Barabasová A, et al. Pepsin in secretion from the upper respiratory tract as a marker of extraesophageal reflux in children. Cesko-Slovenska Pediatrie. 2017;72:176-181.
16. Du X, Wang F, Hu Z, et al. The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China. BMC gastroenterology. 2017;17(1):107.
17. Hayat JO, Gabieta-Somnez S, Yazaki E, et al. Pepsin in saliva for the diagnosis of gastro-oesophageal reflux disease. Gut. 2015;64(3):373-380.
18. Mohamed H, Khodeer S, Shaheen W. Study of pepsin level in saliva as a noninvasive marker for diagnosis of gastroesophageal reflux disease. 2020;33(1):94-100.
19. Iluyomade A, Olowoyeye A, Fadahunsi O, et al. Interference with daily activities and major adverse events during esophageal pH monitoring with bravo wireless capsule versus conventional intranasal catheter: a systematic review of randomized controlled trials. Dis Esophagus. 2017;30(3):1-9.
20. Rasijeff AMP, Jackson W, Burke JM, Dettmar P. PWE-172 Does salivary pepsin measurement change diagnostic outcome in patients investigated by 24h ph monitoring? Gut. 2015;64:A287.283-A288.
21. Li YW, Sifrim D, Xie C, Chen M, Xiao YL. Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2017;23(4):517-525.
22. Ismail-Beigi F, Horton PF, Pope CE, 2nd. Histological consequences of gastroesophageal reflux in man. Gastroenterology. 1970;58(2):163-174.
23. Zhou LY, Wang Y, Lu JJ, et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. Journal of digestive diseases. 2014;15(5):230-238.
24. Hershcovici T, Fass R. Nonerosive Reflux Disease (NERD) - An Update. J Neurogastroenterol Motil. 2010;16(1):8-21.
25. El-Serag HB. Epidemiology of non-erosive reflux disease. Digestion. 2008;78 Suppl 1:6-10.