Assessing the utility of pepsinogens and gastrin-17 in gastric cancer detection

Abstract

ObjectivesThe aim of the study was to determine the proportion of gastric cancer patients with decreased levels of pepsinogen and gastrin-17 in plasma, with the goal of providing indirect evidence of the sensitivity of these biomarkers when applied in a cancer screening setting. MethodsThe levels of pepsinogens I and II, gastrin-17, and Helicobacter pylori immunoglobulin antibodies in plasma samples of gastric cancer patients were evaluated using the GastroPanel test system (Biohit Oyj, Helsinki, Finland). A decreased level of the pepsinogen I/ II ratio was defined as less than three, while a decrease in gastrin-17 was defined as less than 1 pmol/L. Univariate analysis using non-parametric tests was used to investigate differences between normal and low concentrations of biomarkers. ResultsIn total, 481 plasma samples from patients (59.9% male) with a median age of 64 years (ranging from 27 to 88 years) were analyzed. Out of the 400 cases of gastric cancer (83.2% of the total), 182 were categorized as the intestinal type, 141 as the diffuse type, 60 as the mixed type, and 17 as indeterminate according to the Lauren classification system. The H. pylori immunoglobulin test was positive in 74.0% of the patients. Pepsinogen I/ II ratio was decreased in 32.4% (36.8% of the intestinal type); gastrin-17 in 12.3% (10.1% of the antral region) of all cases. ConclusionThe majority of gastric cancer patients had normal levels of pepsinogen and gastrin-17, suggesting that these biomarkers have limited application as screening tools in the Caucasian population. European

Comparison between the GastroPanel test and the serum pepsinogen assay interpreted with the ABC method—A prospective study

“…19,20 Another study concluded that the GastroPanel test is insufficient for cancer screening because only 32.4% of gastric cancer patients showed low I/II ratios of <3. 21 In our study, low I/II ratios and high G-17 levels correlated well with atrophy and IM scores according to the Kyoto classification. This discrepancy from the aforementioned studies may arise from the different methods used for diagnosing atrophy.…”

“…Recent studies reported that I/II ratios did not correlate with the severity or location of atrophy when using the GastroPanel test 19,20 . Another study concluded that the GastroPanel test is insufficient for cancer screening because only 32.4% of gastric cancer patients showed low I/II ratios of <3 21 . In our study, low I/II ratios and high G‐17 levels correlated well with atrophy and IM scores according to the Kyoto classification.…”

Pepsinogen I, pepsinogen II, gastrin-17, and Helicobacter pylori serological biomarkers in the diagnosis of precursor lesions of gastric cancer

“…In this patient, the PgII value was slightly low, and H. pylori antibodies were high, suggesting H. pylori infection alone (premalignant lesions such as AG were discarded), and the GastroPanel could not identify GC. Other studies have shown that the GastroPanel is not useful for GC diagnosis because of its limited application as a screening tool for GC [ 13 ].…”