Accuracy of screening for gastric cancer using serum pepsinogen concentrations

BACKGROUND/AIMSThe characteristics of pepsinogen screening for gastric cancer were investigated to establish a suitable cut off point for identifying gastric cancer, using endoscopic diagnosis as the yardstick.SUBJECTS/METHODSSerum pepsinogen concentrations were measured in 5113 subjects who were also screened for gastric cancer by endoscopy. The cut off point for pepsinogen was determined using receiver operator characteristics curves.RESULTSThe most suitable cut off point was a pepsinogen I concentration of less than 70 ng/ml and a ratio of pepsinogen I to pepsinogen II of less than 3.0. Using this cut off point, the sensitivity and specificity of pepsinogen screening for gastric cancer were 84.6% and 73.5% respectively. All cases of gastric cancer in patients with severe atrophic gastritis were detected. However, two of four cases of gastric cancer in patients with mild atrophic gastritis were overlooked. In subjects with mild atrophic gastritis, when gastric cancer arises within the fundic gland region, the size of the lesion determines whether it is possible to detect cancer by serum pepsinogen screening.CONCLUSIONPepsinogen screening has many advantages, including its suitability for combination with other screening methods because it is simple and inexpensive.

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Serum pepsinogen I and pepsinogen II levels and its ratio in patients with gastric cancer: a case control study

International Surgery Journal ◽

10.18203/2349-2902.isj20164469 ◽

2016 ◽

Vol 4 (1) ◽

pp. 356

Author(s):

Amal Abraham ◽

T. U. Girish ◽

B. J. Sharathchandra ◽

Subbarao V. Madhunapantula ◽

Manish Kumar Yadav ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Early Stage ◽

Developed Countries ◽

Screening Tools ◽

P Value ◽

Serum Pepsinogen ◽

Pepsinogen I ◽

Gastric Cancer Patients ◽

Pepsinogen Ii

Background:Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The incidence of gastric cancer is found to increase in the developing countries like India due to change in the life style like having smoked food containing nitrates, smoking , alcoholism and consumption of large amount of red chillies. The objective of this study was to measure the serum pepsinogen I and pepsinogen II levels and its ratio in gastric cancer patients admitted in JSS hospital and Bharath Cancer Centre during the period October 2012 to October 2014 and to compare with controls.Methods: 80 patients - 40 patients with gastric cancer and 40 patients control were studied. Serum pepsinogen I (PG I) and pepsinogen II (PG II) levels were measured using ELISA.Results:The mean PG I levels for cancer patients and controls were 93.98μg/dl and 82.156μg/dl respectively, the mean PG II levels were 42.67 μg/dl and 18.79 μg/dl respectively. The PG I/II ratio in cancer patients is 2.75 and 5.73 in controls, the ratio was significantly lower in cancer patients (P value significant).Conclusions:The ultimate aim in the management of carcinoma stomach is the early detection of the disease. At present endoscopy and biopsy is the gold standard of diagnosis. Different screening tools are under development for the diagnosis of the disease. Our study evaluates a test which can be recommended as an alternative to the diagnosis of gastric carcinoma at an early stage.

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Implications of Serum Pepsinogen I in Early Endoscopic Diagnosis of Gastric Cancer and Dysplasia

Scandinavian Journal of Gastroenterology ◽

10.1080/003655200750023011 ◽

2000 ◽

Vol 35 (9) ◽

pp. 950-956 ◽

Cited By ~ 73

Author(s):

K. Varis, P. Sipponen, F. Laxén, I.

Keyword(s):

Gastric Cancer ◽

Endoscopic Diagnosis ◽

Serum Pepsinogen ◽

Pepsinogen I

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Serum Pepsinogen I, Pepsinogen II, and Gastrin 17 in Relatives of Gastric Cancer Patients: Comparative Study With Type and Severity of Gastritis

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2007.11.016 ◽

2008 ◽

Vol 6 (2) ◽

pp. 174-179 ◽

Cited By ~ 30

Author(s):

Arghavan Haj–sheykholeslami ◽

Naser Rakhshani ◽

Aliakbar Amirzargar ◽

Reza Rafiee ◽

S. Mehdi Shahidi ◽

...

Keyword(s):

Gastric Cancer ◽

Comparative Study ◽

Cancer Patients ◽

Serum Pepsinogen ◽

Pepsinogen I ◽

Gastric Cancer Patients ◽

Pepsinogen Ii

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Only serum pepsinogen I and pepsinogen I/II ratio are specific and sensitive biomarkers for screening of gastric cancer

BioMolecular Concepts ◽

10.1515/bmc-2019-0010 ◽

2019 ◽

Vol 10 (1) ◽

pp. 82-90 ◽

Cited By ~ 1

Author(s):

Fariborz Mansour-Ghanaei ◽

Farahnaz Joukar ◽

Massood Baghaee ◽

Masood Sepehrimanesh ◽

Amineh Hojati

Keyword(s):

Gastric Cancer ◽

Plasma Levels ◽

Serum Levels ◽

Normal Weight ◽

Control Group ◽

Case Group ◽

Serum Pepsinogen ◽

Lower Plasma ◽

Pepsinogen I ◽

Pepsinogen Ii

AbstractPurposeWe aimed to determine optimal cut-off points of plasma levels of ghrelin and serum levels of pepsinogen I, II, and their ratio for screening of gastric cancer (GC).MethodsBlood samples were taken from 41 patients with confirmed gastric cancer along with 82 patients without malignancy. Serum levels of pepsinogen I and II, plus plasma levels of acylated ghrelin were measured using commercial ELISA kits.ResultsThe case group had significant lower plasma levels of ghrelin, pepsinogen I, and pepsinogen I/II ratio in comparison to the control group (P<0.001). In the control group, there was significant higher serum pepsinogen I (P=0.028) and pepsinogen II (P=0.003) and lower pepsinogen I/II ratio (P=0.020) in males versus females; significantly higher serum pepsinogen II (P=0.047) and lower pepsinogen I/II ratio (P=0.030) in overweight compared to normal weight patients; and significantly lower pepsinogen I/II ratio (P=0.030) in smokers versus non-smoker. In the case group, there was only significantly lower pepsinogen I (P=0.006) in males versus females, and significantly lower plasma ghrelin (P=0.017) in overweight compared to normal weight patients. The characteristic curve analysis indicated that pepsinogen I at a cut-off of 70.95 μg/L and pepsinogen I/II ratio at cut-off of 2.99, had good sensitivity and specificity.ConclusionsJust serums levels of pepsinogen I and the ratio of pepsinogen I/II can be used as biomarker to screen GC.

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