Abstract
The purpose of our study was to research the applicability of measuring serum pepsinogen I (PG I) and PG I/pepsinogen II (PG II) ratios as screening tests for atrophic gastritis, which is the most important predisposition for stomach cancer. We measured serum pepsinogen levels in non-specific gastritis, atrophic gastritis and gastric cancer using a radioimmunoassay method. We included in this study 30 healthy control, 30 nonspecific gastritis, 30 atrophic gastritis and 50 gastric cancer cases. The serum PG I level was statistically higher in the control group and in the patient group with chronic nonspecific gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p<0.05). The best cutoff values for diagnosing stomach cancer using serum PG I and PG I / PG II ratios were found to be <25 ng/ml for PG I and <3.0 for PG I / PG II. The same cut-off values were also most effective for the patients with atrophic gastritis. Serum pepsinogen screening was shown to be a practical predictor of stomach cancer and atrophic gastritis, the most important predisposing lesion for stomach cancer. Although the diagnosis of stomach cancers localized in the pylorus and cardia via this method is difficult, we believe that the detection of early-stage cancers that develop following chronic atrophic gastritis in particular will be possible, and therefore the morbidity and mortality of stomach cancer will be decreased.
Highlights
Stomach cancer is the fourth most frequently observed malignant disease in the world and is the second most frequent cause of cancer death [1, 2]
The ages of the 30 patients diagnosed with chronic nonspecific gastritis ranged from 23-68 years, with an average age of 32.86±12.14 years
The serum pepsinogen I (PG I) level was statistically higher in the control group and in the patient group with chronic nonspecific gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p< 0.05)
Summary
Stomach cancer is the fourth most frequently observed malignant disease in the world and is the second most frequent cause of cancer death [1, 2]. When the distribution of cancer cases in men and women (respective incidences, 3.96 and 2.12 per 100,000) is examined according to respective organs, stomach cancer ranks second [3, 4]. Stomach cancer has a multifactor etiology, being influenced by a number of genetic, environmental and predisposing factors. Chronic atrophic gastritis is the most important, and its incidence increases with age [5, 6]. The most common type of gastric cancer, the intestinal type, is usually preceded by chronic atrophic gastritis [6, 7]. Gastritis serology is of crucial importance in population-based screening and prevention studies [6, 7]
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