The term "gastropanel" refers to the laboratory method of complex blood testing, the results of which not only provide very important information for an accurate diagnosis, but also relieve the patient from going through a number of rather unpleasant and painful procedures, such as stomach sensing or fibroadastroduodenoscopy( FGDS).
About
Method Gastroenterologists consider this method of differential primary diagnostics of dyspeptic functional disorders and sufficiently serious organic lesions as a valuable addition to the histological and instrumental methods of examination, which is not associated with a violation of the integrity of the skin.
Indications and contraindications
A good reason for doing the study are patients:
- complaining of discomfort and persistent pain in the stomach area;
- having a number of contraindications to the performance of endoscopic procedures;
- suffering from diseases of the nervous system( dementia, depression, polyneuropathy);
- whose body lacks vitamin B12;
- with diagnosed diseases of the cardiovascular system( heart attacks, strokes, atherosclerosis);
- in the blood of which a high level of homocysteine (a non-proteinogenic amino acid synthesized in the human body) is detected;
- related to the age category over forty-five years old and characterized by a predilection for smoking( gastropanel in this case is prescribed as a preventive medical procedure).
The study is also shown to close relatives of patients with stomach cancer.
What information does the survey provide?
With the help of the results of the "gastropanel" study, the gastroenterologist can:
- diagnose atrophic gastritis and helicobacter-associated gastritis, assessing the appropriateness of the treatment;
- suggests the presence of different conditions of the mucous membranes of the stomach( normal, gastritis, atrophic gastritis);
- make a decision on the feasibility of the implementation of fibrogastroscopy and a complex of histological studies;
- to assess the likelihood of occurrence: gastric ulcer, gastric cancer, GERD( gastroesophageal reflux disease) and Barrett syndrome, which is a serious complication of this pathology.
Indicators that are included in the analysis?
Being a fairly simple blood test based on only three indicators, the gastropanel gives data radically different from the results of other studies and allows one to judge the anatomical and functional state of the gastric mucosa.
- The analysis revealing the presence of antibodies to the Helicobacter pylori bacteria is performed for the diagnosis of Helicobacter-associated gastritis.
The spiral-like bacteria that are the causative agents of this disease are found in the mucous layer surrounding the epithelial tissues of the stomach. Infection with bacteria of this species, occurring, as a rule, in childhood, is the most frequent cause of the development of a chronic form of gastritis. In some patients, it is observed throughout life.
Specificity of infection with bacteria Helicobacter pylori is that, not penetrating deep into tissues, they contribute to the occurrence of periodic local inflammation of the mucous membranes of the stomach and duodenum, creating a threat of ulcers on the walls of these organs.
In a number of patients, a prolonged inflammatory process becomes the cause of atrophic gastritis with a decreased acidity of the stomach, characterized by a malfunction( up to complete atrophy) of the mucous membranes of this organ.
Despite the fact that modern gastroenterology has achieved great success in the treatment of Helicobacter pylori infection, cases of complete recovery of the gastric mucous membranes, brought to the state of complete tissue atrophy, are extremely rare.
Atrophic gastritis can provoke the appearance of ulcers and malignant tumors, as well as a violation of the process of assimilation of vital substances( vitamin B12, macro and microelements), fraught with the development of anemia, neurological abnormalities, depressive states and osteoporosis.
- The second indicator included in the analysis of the gastropanel is the level of pepsinogenes - proteins produced by the main( zymogenic) cells localized in the fundal glands of the stomach.
Once in the lumen of the stomach, pepsinogenes under the influence of hydrochloric acid, which is part of the gastric juice, are converted into pepsin, an enzyme that takes an active part in the processing of food proteins. In small concentrations, pepsinogen is also contained in the blood.
There are two types of pepsinogen:
- Pepsinogen I , synthesized only by the cervical mucosa and the main cells of the mucous membranes of the bottom and body of the stomach.
- Pepsinogen II , secreted by zymogenous( major) cells, localized in all( base, antral and cardiac) parts of the stomach, as well as structures of the Brunner glands of the duodenum.
The study aimed at detecting the level of pepsinogen in the blood, as well as determining their ratio, helps to assess the state of the gastric mucosa:
- The level of pepsinogen I is judged on the state of the mucosa of the body of the stomach , as a chronic Helicobacter pylori infection( as well asand disease of autoimmune etiology) can cause its atrophic damage( up to the onset of atrophic gastritis of the body of the stomach).With the atrophy of the mucous membranes of the body of the stomach, the number of cells producing pepsinogen I is significantly reduced, and therefore the concentration of this enzyme in the blood is less than 30 mg / l. If the inflammation of the body of the stomach does not lead to atrophic damage to its mucous membranes( such a pattern is characteristic of gastritis of the body of the stomach), the level of pepsinogen I in the blood, as a rule, increases.
If the level of pepsinogen II exceeds 10 mg / l, this indicates the presence of inflammation of the mucous membranes. At an atrophic lesion of the mucous body of the stomach, the level of pepsinogen II remains at the same level or slightly increases.
- The third indicator of analysis on the gastropanel is the level of gastrin - a polypeptide hormone that regulates the production of hydrochloric acid, maturation and motility of cells that make up the mucous membranes of the stomach.
The dominant form of this hormone present in the blood in several forms at once is gastrin-17, synthesized predominantly by G cells of the antral part of the stomach under the condition of stimulating action.
An abnormally high level of gastrin-17 in an analysis taken on an empty stomach can indicate a low acidity of the digestive juice, usually accompanying the atrophic gastritis of the body of the stomach.
High acidity of the digestive juice, on the contrary, due to the principle of reverse regulation, provokes a decrease in the concentration of gastrin-17 to undetectable( less than 1 pmol / l) level. Increased production of hydrochloric acid is fraught with the development of gastroesophageal reflux.
As a result of chronic acid damage to the esophageal tube, there is a high likelihood of ulcerative esophagitis and Barrett's syndrome-pathological conditions, which in the absence of timely treatment can provoke esophageal cancer.
Thus, a low( less than one picomole per liter) fasting gastrin-17 concentration is a factor indicative of increased acid secretion in the stomach and a high risk of developing Barrett's syndrome and gastroesophageal reflux.
High( more than 5 mmol / L) concentration of gastrin-17 in blood taken on an empty stomach indicates either a significant reduction or a complete lack of probability of developing Barrett's syndrome.
Preparation of
Patients who are to deliver blood to the gastropanel should prepare in advance for this study.
Preliminary consultation with an experienced therapist, they must:
- To stop taking medications seven days before the appointed date( for example, such as Pepsidin, Somak, Zantak, RanikSal, Nizatidin, Losek), which affect the production of gastric secretions.
- The day before the analysis, refuse the use of drugs( Gaviscon, Alsukrul, Prepulsed), intended to neutralize the hydrochloric acid produced by the stomach.
- Completely eliminate the significant physical and emotional stress and use of any alcoholic beverages and alkaline mineral water twenty-four hours before the scheduled study.
- After supper no later than 19-00, no more eating any food. The length of the fasting period before taking the test, therefore, should be at least twelve hours.
- To refrain from smoking during the morning hours preceding the procedure.
- Come to the laboratory on an empty stomach, no later than one hour after awakening.
How passes blood delivery to the gastro palan?
During the procedure, the patient takes blood from the vein twice: the first time - immediately after his arrival in the laboratory.
After this, the patient is offered slowly, through the tube, to drink 100 ml of a special beverage, which contains soy protein concentrate. The drink is prepared in the presence of the patient by diluting the dry finished mixture with water, and before opening the package, make sure that the mixture is not overdue.
How many days are the results produced?
The time required to obtain the results of the study on the gastro-palan is from five to sixteen days. In some medical institutions, data processing takes no more than 48 hours.
Description of the standard
The reference values of the four biomarkers obtained when taking blood for the gastropanel are as follows:
- The level of gastrin-17: 1 to 10 pmol / l.
- The amount of pepsinogen I: 30 to 164 μg / l.
- The amount of pepsinogen II: 3 to 15 μg / l.
- Antibodies( denoted by the abbreviation IgG) to Helicobacter pylori: 0 to 29.9 units.
It should be borne in mind that the reference values are applied to such laboratory studies that, for the analysis of the results obtained, require certain information about a specific patient.
The results considered "normal" should fit within the range of reference values established for a particular category of patients, selected according to their age, gender or a number of other indicators.
Reviews of doctors
Alexander, physician-therapist:
The research "Gastropanel" can be performed both with a stimulation test, and without it. Patients suffering from stomach diseases are more suited to the first version of the analysis. Taking the first portion of blood, given on an empty stomach, four biomarkers are immediately determined: antibodies to Helicobacter pylori, gastrin-17, pepsinogen I and pepsinogen II.A sample of blood taken after taking a protein cocktail is necessary to determine the level of only one biomarker - gastrin-17.Comparative analysis of the results of both samples allows the doctor to get an idea of the level of secretion of hydrochloric acid and the state of the mucous membranes of the antrum of the stomach. In some cases, it is recommended that patients only take a blood sample of blood.
Vladimir, physician-gastroenterologist:
Patients with stomach problems often ask a question about which study( gastropanel or gastroscopy) is most informative. Meanwhile, these diagnostic techniques perfectly complement each other.
On the one hand, gastropanel makes it possible to avoid performing unreasonable endoscopic procedures. Thanks to this analysis, an experienced physician receives valuable information about the level of tissue hormones synthesized by the cells of the gastric mucosa, allowing to assess their functional consistency. In addition, the level of hormone production indicates the number of functioning cells of the mucosa.
Gastroscopy is not able to give such information. An endoscopist examining the condition of the mucous membranes on the eye, and also performs a targeted biopsy, taking samples of tissues from the surface of areas with the most pronounced changes. The procedure, carried out according to all the rules, involves the sampling of five such samples( bioptates), although in practice this condition is observed quite rarely.
Since the performance of gastroscopy is associated with the need to perform insufflation( air injection), this can cause hyperemia of the gastric mucosa and the basis for an erroneous medical conclusion about the presence of superficial gastritis, while the patient's stomach can be perfectly healthy.
Price
- The cost of blood testing for a gastropanel, depending on the class of medical institution that provides this service, in clinics in Moscow can fluctuate in the range of 3200-20500 rubles.
- The average cost of this procedure in the clinics of the Russian Federation is 4,500 rubles.
Where can I make a test?
You can donate blood to the gastroplan in a multidisciplinary clinic, a medical center or a clinical laboratory.
Video on how to take a blood test for gastropanel: