Abstract
BackgroundSerum pepsinogen (PG) levels are valuable in the diagnosis of gastric diseases. However, PG levels are affected by many factors such as the area and race. This study aimed to investigate serum PG levels in patients with different gastric diseases who were Chinese Han people in Hunan Province, midsouth China.MethodsA total of 248 gastric disease patients and 34 healthy controls were enrolled. The patients included those with non-atrophic and chronic atrophic gastritis, gastric and duodenal ulcer, early and advanced gastric cancer. Serum PG I and II levels were detected by Biohit ELISA kit (Finland), and PG I/II ratio was calculated. Differences in patients with gastric disease and healthy controls were analyzed using paired t-test.ResultsCompared with controls, patients with early and advanced gastric cancer had a significantly lower PG I level and PG I/II ratio (p <0.005). In contrast, patients with gastric and duodenal ulcer had a significantly higher PG I level (p <0.005). Compared with atrophic gastritis patients, patients with early and advanced carcinoma of the stomach had a significantly lower PG I/II ratio (p < 0.001). Combination of the cut-off levels of PG I (70 μg/L) and PG I/II ratio (6) provided 62.1% sensitivity of and 94.2% specificity for the diagnosis of gastric cancer.ConclusionsDecreased PG I level and PG I/II ratio are risk factors for gastric cancer. Combined use of serum PG I level and PG I/II ratio may help the early diagnosis of gastric cancer.
Highlights
Serum pepsinogen (PG) levels are valuable in the diagnosis of gastric diseases
Serum pepsinogen I (PGI) level and PGI/II ratio were significantly lower in patients with early or advanced gastric cancer than in the controls and non-atrophic gastritis (NAG) group (p < 0.001), but there were no significant differences in PG I and PG II levels and PG I/II ratio between early gastric cancer (EGC) and AGC group
Compared with chronic atrophic gastritis (CAG) patients, serum PGI level was lower in patients with AGC and PG I/II ratio was lower in patients with AGC or EGC (p < 0.05)
Summary
Serum pepsinogen (PG) levels are valuable in the diagnosis of gastric diseases. This study aimed to investigate serum PG levels in patients with different gastric diseases who were Chinese Han people in Hunan Province, midsouth China. PG I is secreted only from the gastric fundic mucosa, while PGII is secreted from the cardiac, fundic, and antral mucosa of the stomach, and from the duodenal mucosa [1,2]. The pepsinogen I/II ratio can Gastric cancer is the second leading cause of cancerrelated death in the world. The risk of gastric cancer varies among the countries and populations in the world. When diagnosed at an early stage, 5-year survival rate for gastric cancer exceeds 90%, but the 5-year survival rates are below 50% when diagnosed at an advanced stage [10]. It is necessary to diagnose gastric cancer at an early stage to reduce the morbidity and mortality from gastric cancer
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