Abstract
BackgroundThe aim of this study is to investigate the difference of serum pepsinogen (PG) baseline levels in different regions of China and its influencing factors.MethodsFrom October 2016 to October 2018, asymptomatic health checkup people who underwent nasal endoscopy in nine health management centers in different regions of China were collected. Lifestyle questionnaires were conducted, and serum PG and gastroscopy were performed. The differences in PG levels in baseline population (OLGA-0 grade) were studied according to geographical subregions of China. SPSS software was used for statistical analysis.Results1922 patients were included in the final analysis. Compared with the non-atrophy (OLGA-0) group, PGR levels in atrophy group (OLGA-I to IV) were significantly decreased with the atrophy degree (p < 0.05). A total of 1590 baseline people (OLGA-0) were included in the study, including 254 from South China, 574 from East China, 210 from Southwest China, 332 from Northeast China, and 220 from Central/Northern China. There were significant differences in baseline PGI levels among the five regions (p < 0.05). The PGII levels were also different among the five regions, except for Central/Northern versus Southern China. PGR (PGI/PGII ratio) levels in Southern China were higher than other four regions. Further studies were conducted on the related factors that might affect the baseline PG level, which was affected by nationality, dietary habits, smoking, Helicobacter pylori infection and other related factors.ConclusionInfluenced by many factors, the baseline PG levels are different in different regions of China. In the follow-up studies of PG cut-off value, different PG cut-off value based on region may be more effective in the screening of gastric cancer and precancerous lesions in China.
Highlights
The aim of this study is to investigate the difference of serum pepsinogen (PG) baseline levels in different regions of China and its influencing factors
Pepsinogen II (PGII) is significantly correlated with gastric fundus mucosa lesions, and its elevation is correlated with gastric fundus duct atrophy, intestinal metaplasia or pseudopylori metaplasia, and dysplasia
The Operative Link on Gastritis Assessment (OLGA) classification is an effective way of classifying gastritis and grading cancer risk based on histopathological findings of biopsy specimens [20, 21]
Summary
The aim of this study is to investigate the difference of serum pepsinogen (PG) baseline levels in different regions of China and its influencing factors. Multiple studies have found that the cutoff value of PG in the diagnosis of gastric atrophy is different in different countries. A number of European studies suggested that the cut-off value for evaluating fundus atrophy was PGI ≤ 56 ng/ml (sensitivity: 61.9%, specificity: 94.8%), and PGR ≤ 5 (sensitivity: 75.0%, specificity: 91.0%) [8]. China is a vast country, it is necessary to explore whether there are significant differences of the baseline PG levels among different regions. In view of this situation, we combined with several domestic health management centers to carry out this research.
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