A case of gastric cancer with high pepsinogen II levels in both serum and ascites

Muto, Manabu; Saito, Yasutoshi; Koike, Tomoyuki

doi:10.1046/j.1443-1661.2000.00004.x

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…In any particular mass screening area, we have to select the best screening system, depending on each individual case, according to the prevalence of gastric cancer, especially in the early stages [45,86]. Although gastric cancer cells are found to produce pepsinogen II more often than pepsinogen I [14][15][16], elevated pepsinogen values in serum are extremely rare, and only one case has ever been reported in such patients [89], because the amount of pepsinogens which are produced by gastric cancer cells is too small compared to the amount of pepsinogen I and II which are normally secreted into gastric lumen and only 1% of the amount secreted enters the circulation.…”

Section: Usefulness Of Gastric Cancer Screening Using the Serum Pepsimentioning

confidence: 99%

Gastric cancer screening using the serum pepsinogen test method

2006

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The current status of gastric cancer screening, worldwide, as well as in Japan, using the serum pepsinogen test method, was reviewed. We performed a metaanalysis of sensitivity and specificity results from 42 individual studies (27 population-based screening studies: n = 296 553 and 15 selected groups: n = 4 385). Pooled pairs of sensitivity and false-positive rates (FPr) for pepsinogen I level < or = 70 ng/ml; pepsinogen I/II ratio < or = 3, had a sensitivity of 77%/FPr27%. The positive predictive value varied between 0.77% and 1.25%, and the negative predictive value varied between 99.08% and 99.90%. Therefore, we concluded that the definition of the pepsinogen test should include the pepsinogen I/II ratio, as consistency was obtained for both the population-based studies and the selected groups for those studies that used pepsinogen I serum levels together with the pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Individuals testing positive for extensive atrophic gastritis by serum pepsinogen levels undergo endoscopic examination to test for the presence of gastric cancer. We should increase the efficacy and cost-effectiveness of the gastric cancer screening system, by the identification of groups, at low-risk, as well as those at high-risk, of developing gastric cancer, using a combination of assays of serum Helicobacter pylori antibody titers and the concentration of pepsinogen I and II. In conclusion, the pepsinogen test method can be used as a screening test for high-risk subjects, rather than as a tool for screening for cancer itself. I hope that this pepsinogen test method will become a world standard for gastric cancer prevention in the near future, in other countries, as well as in Japan.

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Section: Usefulness Of Gastric Cancer Screening Using the Serum Pepsimentioning

confidence: 99%

Gastric cancer screening using the serum pepsinogen test method

2006

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“…9,17,20,24,26 Well-differentiated adenocarcinoma may present with a negative pepsinogen test depending on the tumor’s pattern, location, and the neighboring lesions. 36 The serum pepsinogen test can be negative in participants with a depressed or ulcer-type morphology, when the tumor is located in the distal stomach, when the cancer cells produce pepsinogen, or when the patient takes PPIs. In cases of diffuse or poorly differentiated adenocarcinoma, the serum pepsinogen test can also be negative because this cancer type does not follow a cancer development cascade, and researchers proposed that the etiology is genetic and chronic atrophic gastritis is not required for development.…”

Section: Discussionmentioning

confidence: 99%

Gastric cancer detection using the serum pepsinogen test method

Trivanović

Pleština²,

Honović

et al. 2021

Tumori

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Background: Gastric cancer (GC) is the eighth most common cause of cancer deaths in Croatia and one of the most common causes of cancer deaths worldwide. A reliable diagnostic tool for the early detection of GC is essential. Objective: We previously suggested a pepsinogen test method to reduce the mortality from GC by allowing early detection. Here, we report an updated analysis from a prospective single-center clinical study to evaluate the sensitivity and specificity of the pepsinogen test method and to determine whether this test can be used as a part of routine laboratory assessment of high-risk patients. Methods: We present mature data of the pepsinogen test method in the Croatian population after a median follow-up of 36 months. Statistical analyses were performed using a Mann-Whitney U test, multiple logistic regression, and receiver operating characteristics (ROC) to evaluate the predictive power of the assayed biomarkers. Results: Of the 116 patients, 25 patients had GC and 91 demonstrated a nonmalignant pathology based on tissue biopsy. Cutoff values were pepsinogen I ⩽70 and pepsinogen I/II ratio ⩽3.0. Using ROC curve analysis, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were determined to be 87.22%, 78.12%, 90.10%, 71.43%, and 92.86%, respectively, for the diagnosis of GC. The area under the curve was 0.700 (95% confidence interval 0.57–0.83). Conclusion: Pepsinogen tests are valuable for screening a population in need of further diagnosis and could help to avoid unnecessary invasive endoscopic procedures.

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Serum pepsinogen test for early detection of gastric cancer in a European Country

Lomba‐Viana

Dinis-Ribeiro

Fonseca

et al. 2012

European Journal of Gastroenterology & Hepatology

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Inhabitants of this high-risk region showed good adherence rate to a gastric cancer detection program based on a PG test followed by upper gastrointestinal endoscopy implemented for the first time. Accuracy estimates were similar to those in Japanese reports, indicating that this methodology could also be used effectively in Western countries with high rates of gastric cancer. Further formal cost-effective studies are however needed.

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A case of gastric cancer with high pepsinogen II levels in both serum and ascites

Cited by 5 publications

References 18 publications

Gastric cancer screening using the serum pepsinogen test method

Gastric cancer screening using the serum pepsinogen test method

Gastric cancer detection using the serum pepsinogen test method

Serum pepsinogen test for early detection of gastric cancer in a European Country

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