Abstract
BackgroundSerum pepsinogen (PG) I/II ratio has been widely used as “serological biopsy” for the screening of gastric cancer (GC) and atrophic gastritis (GA). However, study concerning in situ expression of PGs is currently insufficient, particularly for their relationship with serum PGs levels. This study was designed to investigate in situ expression of PGI and PGII in subjects with normal mucosa (NOR), superficial gastritis (GS), GA and GC, and to evaluate the correlations between PGs expressions in situ and in serum.Methods185 subjects were enrolled for the study, including 30 NOR, 70 GS, 54 GA and 31 GC. PGI and PGII expressions in situ and in serum were detected by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) respectively. H. pylori immunoglobulin (Ig) G was also determined by ELISA.ResultsIn situ expressions of PGI, PGII and PGI/II ratio consistently decreased in sequence of NOR/GS- > GA- > GC. The expressions of PGI, PGII and PGI/II ratio in situ were statistically higher in youngers than in olders (P < 0.05). In the NOR subjects, PGI staining was statistically higher in males than that in females (p = 0.02). For the correlations between in situ and serum expressions of PGI, PGII and PGI/II ratio, a borderline correlation in the total study sample (r = 0.131, P = 0.076) and a statistical correlation in GA cases (r = 0.307, P = 0.027) were observed for the PGI/II ratio. The PGI expression correlated well with that of PGII in situ and in serum.ConclusionsThe in situ levels of PGI, PGII and PGI/II ratio sharply decreased in the GA and GC cases. The youngers exhibited higher levels of PGI, PGII and PGI/II ratios than the olders. The in situ PGI/II ratio rather than PGI and PGII alone showed certain correlation with that in serum, and the PGI expression correlated well with PGII expression. Further studies with large-scale samples are still required to validate our findings.
Highlights
Serum pepsinogen (PG) I/II ratio has been widely used as “serological biopsy” for the screening of gastric cancer (GC) and atrophic gastritis (GA)
For Pepsinogen II (PGII) staining, we evaluated the staining status of all the gastric corpus and antrum glands for normal mucosa (NOR) and GS subjects, the remaining gastric corpus and antral glands for GA subjects, and cells of the cancerous lesion for GC subjects
We found that in situ Pepsinoen I (PGI)/II ratios showed a decreased tendency in the sequence of NOR/GS- > GA- > GC, showed corresponding average level of 1.0/1.0, 0.8 and 0 (All the Immunoreactive score (IRS) of PGI and PGII staining in GC tissue were zero)
Summary
Serum pepsinogen (PG) I/II ratio has been widely used as “serological biopsy” for the screening of gastric cancer (GC) and atrophic gastritis (GA). There are overwhelming epidemiological evidences supporting that serum level of PGI and/or PGI/II ratio correlates well with morphologic and functional changes of gastric mucosa [3,4,5,6,7] They have been widely used as ‘serological biopsy’ for the screening of gastric cancer (GC) and its precancerous lesions [3,4,5,6,7]. In spite of the wide use of serum PGs in clinical practice, study concerning in situ expressions of PGs, in the stepwise progression from normal mucosa (NOR), superficial gastritis (GS), atrophic gastritis (GA) to carcinoma, is currently insufficient. These may, to some extent, puzzle the clinical work on how to appropriately interpret the variations of serum PGs expression in different status of gastric diseases
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