Perspectives

Using GastroPanel® as a first-line diagnostic tool for dyspeptic patients

 

Prof. Francesco Di Mario

 

From an epidemiological point of view, Italy is considered an area with a low incidence of gastric cancer. However, a study carried out in Parma has shown over the years the persistence of cases of gastric cancer, 90% of which were diagnosed at an advanced stage (1).

The Parma model proposes the use of GastroPanel® as a first-line diagnostic tool for dyspeptic patients to optimize the use of endoscopies and improve resource allocation in healthcare settings. Recent studies have demonstrated that GastroPanel® biomarkers, combined with clinical parameters such as age and symptoms, can accurately identify patients with organic dyspepsia who would benefit from further endoscopic evaluation (2,3). By stratifying patients based on their GastroPanel® results, clinicians can prioritize endoscopies for those at higher risk of underlying gastrointestinal pathology, while avoiding unnecessary procedures for patients with functional dyspepsia (4). This approach not only reduces healthcare costs but also minimizes patient discomfort and enhances the efficiency of diagnostic pathways for dyspeptic patients.

With the use of the GastroPanel® it is possible not only to diagnose HP infection but also to estabilish the damage caused by the bacteria on the gastric mucosa, particularly if Non Atrophic Gastritis (NAG) or precancerous gastric cancer, i.e. CAG, is present. This is because when the urea breath test or the facal antigen test is used, there is only the positivity or negativity of the infection in the stomach, while I would evaluate two parameters of the GastroPanel® together, namely the PGII and the Abs against Hp yes easily diagnoses NAG linked to the infection and using the PGI and G17 confirms the diagnosis of CAG (5).

PPIs (6) are often used as therapy for these patients without having information on the function of the stomach, i.e. on the actual production of acid. A recent study has made it possible to establish that the use of GastroPanel® correlates with the identification of patients who will benefit from the use of PPIs, achieving significant savings and improving therapeutic appropriateness.

 

References:

  1. Cavatorta O, Scida S, Miraglia C, Barchi A, Nouvenne A, Leandro G, Meschi T, De’ Angelis GL, Di Mario F. Epidemiology of gastric cancer and risk factors. Acta Biomed. 2018 Dec 17;89(8-S):82-87. doi: 10.23750/abm.v89i8-S.7966. PMID: 30561423; PMCID: PMC6502220.
  2. Storskrubb T, Aro P, Ronkainen J, et al. Serum biomarkers provide an accurate method for diagnosis of atrophic gastritis in a general population: The Kalixanda study. Scand J Gastroenterol. 2008;43(12):1448-1455. doi:10.1080/00365520802308083.
  3. Crafa P, Franceschi M, Rodriguez Castro KI, Barchi A, Russo M, Franzoni L, Antico A, Baldassarre G, Panozzo MP, Di Mario F. Functional Dyspesia. Acta Biomed. 2020 Jul 9;91(3):e2020069. doi: 10.23750/abm.v91i3.10150. PMID: 32921764; PMCID: PMC7716988.
  4. Rodriguez K, Franceschi M, Ferronato A, Brozzi L, Antico A, Panozzo MP, Massella A, Pertoldi B, Morini A, Barchi A, Russo M, Crafa P, Franzoni L, Cuoco L, Baldassarre G, Di Mario F. A non-invasive combined strategy to improve the appropriateness of upper gastrointestinal endoscopy. Acta Biomed. 2022 Aug 31;93(4):e2022210. doi: 10.23750/abm.v93i4.12772. PMID: 36043968; PMCID: PMC9534244.
  5. Di Mario F, Crafa P, Barchi A, Franzoni L, Franceschi M, Russo M, Bricca L, Brozzi L, Rodriguez Castro K, Rugge M. Pepsinogen II in gastritis and Helicobacter pylori infection. Helicobacter. 2022 Apr;27(2):e12872. doi: 10.1111/hel.12872. Epub 2022 Jan 8. PMID: 34997989.
  6. Russo M, Rodriguez-Castro KI, Franceschi M, Ferronato A, Panozzo MP, Brozzi L, Di Mario F, Crafa P, Brandimarte G, Tursi A. Appropriateness of Proton Pump Inhibitor Prescription Evaluated by Using Serological Markers. Int J Mol Sci. 2023 Jan 25;24(3):2378. doi: 10.3390/ijms24032378. PMID: 36768710; PMCID: PMC9917011.