Fasting blood samples were collected, and serum samples were stored at –20 °C until further use for both groups. Serum gastrin concentrations were measured using the Gastrin RIA Kit II (Dynabot, Tokyo, Japan). Serum PG I and PG II concentrations were determined by radioimmunoassay (Abbott, Tokyo, Japan) for the years 1990 to 1999, chemiluminescent immunoassay (Abbott) from 1999 to 2001, enzyme immunoassay (E-plate test; Eiken, Tokyo, Japan) from 2001 to 2003, and latex agglutination test (L-Z test; Eiken) from 2003 to 2014. PG positivity was defined as serum PG I concentrations of ≤ 70 ng/mL and a PG I/II ratio of ≤ 3.0 [31 –33 (link)]. Serum anti-Hp Abs in the pathology group was determined with the Pyloristat kit (Whittaker Bioproducts, Walkerville, MD, USA) using enzyme-linked immunosorbent assay (ELISA). Serum anti-Hp Abs titers of the endoscopically-evaluated group were evaluated using ELISA (E-plate; Eiken Chemical). The cut-off value for anti-Hp Abs in the endoscopically-evaluated group was 3 U/mL [34 (link), 35 (link)].
Lz test
Manufactured by Eiken Chemical
Sourced in Japan
The LZ test is a laboratory equipment product designed for analytical testing purposes. It serves as a tool to conduct various analyses and measurements in a laboratory setting. The core function of the LZ test is to provide accurate and reliable data for research and testing applications.
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7 protocols using lz test
1
Gastrin, Pepsinogens, and Helicobacter Pylori Evaluation
2
Evaluating Serum Gastrin and Pepsinogen
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We evaluated the levels of serum gastrin (Gastrin RIA Kit II; Dainabot Co., Ltd., Osaka, Japan) and serum pepsinogen (LZ test; Eiken Chemical Co., Ltd., Tokyo, Japan) instead of performing histological evaluation of the gastric mucosa. We could evaluate fasting serum gastrin and pepsinogen levels in 281 of the 357 patients.
3
Evaluating Gastrin and Pepsinogen Changes
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To fully evaluate the degree of changes in gastrin and pepsinogen caused by acid inhibitors, the values of these serum markers before and after administration were compared. Additionally, to examine the changes in G7 levels before and after administration, 10 cases from each group, the PPI group and PCAB group, were randomly selected for analysis. Fasting sera were collected on the day of the ESD and 4 weeks later and stored at -20°C until analysis. The levels of serum gastrin (Gastrin RIA Kit II; Dainabot, Tokyo, Japan), G17 (Gastrin-17 Advanced ELISA, Biohit, Finland), and PG (LZ test; Eiken, Tokyo, Japan) and the anti-H. pylori antibody titers (E-plate; Eiken, Tokyo, Japan) were evaluated [15 (link)].
4
H. pylori Eradication and Pepsinogen Levels
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The presence of H. pylori infection was examined with the urea breath test (Otsuka, Tokushima, Japan), serum anti-H. pylori antibody (Eiken, Tokyo, Japan) and either the culture method or rapid urease test (Otsuka, Tokushima, Japan). To eradicate H. pylori, patients were treated with lansoprazole (30 mg), amoxicillin (750 mg) and clarithromycin (200 mg), each taken twice daily for 1 week. Successful eradication was established by negative results of the urea breath test 2 months or more after the eradication. When the eradication was unsuccessful, the patients received second-line eradication therapy. Implementation of third-line and further eradication therapy was left to the doctors in charge. Fasting blood samples were collected on the day of endoscopy at the enrolment and serum levels of pepsinogen I and II were measured by the LZ test (Eiken, Tokyo, Japan).
5
Gastric Mucosa Assessment via Biomarkers
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Fasting blood samples were collected from participants, and the serum samples were stored at − 20 °C until use. Serum PG I and PG II levels were measured by radioimmunoassay (Abbott, Tokyo, Japan) from 1990 to 1999, chemiluminescent immunoassay (Abbott) from 1999 to 2001, enzyme immunoassay (E-plate test; Eiken, Tokyo, Japan) from 2001 to 2003, and latex agglutination test (L-Z test; Eiken) from 2003 to 2014. Patients with PG I levels > 70 ng/mL or PG I/PG II levels > 3 ng/mL were considered to have high PG levels [13 (link)]. Serum Hp-Ab titers were evaluated using an enzyme-linked immunosorbent assay (E-plate; Eiken). The cut-off value was set to 3 U/mL [24 (link)]. Using the definition of the ABC method, we classified patients with high PG levels and negative Hp-Ab, high PG levels and positive Hp-Ab, low PG levels and positive Hp-Ab and low PG levels and negative Hp-Ab, into groups A, B, C and D, respectively [13 (link)].
6
Diagnostic Approach for Atrophic Gastritis
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We used the ABC classification system as described previously [8, 9] . Fasting sera were obtained from all patients, and serum PG I and II levels (CLIA Abbott, E-plate Eiken; LZ test Eiken, Tokyo) and anti-H. pylori antibody titers (Eplate) were evaluated. In the PG test, a set of cutoff values (PG I B 70 ng/ml and PG I/II B 3.0 ng/ml) was used for the diagnosis of atrophic gastritis. If PG levels were less than the cutoff values, they were considered as positive for the test. In the anti-H. pylori antibody titer test, the cutoff value for the diagnosis of H. pylori infection was more than 10.0 U/ml. Because the lower sensitivity limit is 3.0 U/ml in this kit, antibody titers between 3 and 9.9 U/ml are considered within the measurable range of a negative test result (''negative-high test'').
7
Clinicopathological Characteristics of Gastric Cancer
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To clarify the clinicopathological characteristics of gastric cancer in group A, we enrolled gastric cancer patients who were classified into group B, C, or D between June 2003 and October 2014 in Hiroshima University Hospital (n = 167), Shiga Hospital (n = 6), or Kawasaki Medical hospital (n = 10). Regarding the patients in Hiroshima University Hospital, we chose the patients from the database used in the previous study by Boda et al. [12] . These 183 gastric cancer patients (136 men; mean age, 66.4 years) with H. pylori-positive results or with CAG were used as controls. We excluded those patients with gastric adenoma, those who were post gastrectomy, and those who had severe renal dysfunction. The use of PPI was checked during a medical interview. Fasting sera were similarly collected for the measurement of anti-H. pylori antibody titers (Eiken E-plate test) and serum PG I and II levels (CLIA Abbott; E-plate Eiken, LZ test Eiken).
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