Increased Serum Pepsinogen I and Recurrence of Duodenal Ulcer

Abstract

To determine whether the serum pepsinogen I (PG I) level would be a suitable marker for selecting patients at risk for duodenal ulcer recurrence and, thus, would benefit from maintenance therapy, we treated duodenal ulcer patients with H₂-receptor antagonists. After healing 140 ulcer patients we assessed the recurrence rate at 1 year with and without maintenance therapy. The annual recurrence rates in duodenal ulcer patients with hyper-PG I (95 ng/ml or more), with 66 ng/ml ± PG 1< 95 ng/ml, and with PG I < 66 ng/ml were 87.0%, 27.3%, and 17.9%, respectively, when they did not receive maintenace therapy. In patients with hyper-PG I the recurrence rate was significantly lower in patients receiving maintenance therapy than in patients not receiving maintenance therapy, whereas in patients with PG I< 66 ng/ml the recurrence rate was as low as 20% regardless of maintenance therapy. These results indicate that maintenance therapy with half the dose of H₂-receptor antagonist is not required by patients with PG I < 66 ng/ml, whereas those with hyper-PG I may be good candidates for long-term maintenance therapy.