Serum pepsinogens as a gastric cancer and gastritis biomarker in South and Southeast Asian populations

Abstract

Serum pepsinogens have been widely acknowledged as gastric mucosal biomarkers; however, a multicountry report on the benefits of pepsinogens as biomarkers has not yet been published. We analyzed 1,206 sera and gastric mucosal samples collected from Bangladesh, Bhutan, Indonesia, Myanmar, Nepal and Thailand then assessed the association between gastric mucosal changes and Helicobacter pylori infection. The new cutoff values for serum pepsinogen values were evaluated using a receiver operating characteristic analysis. The participants with H. pylori infection had significantly lower pepsinogen I and higher pepsinogen II values, but a lower pepsinogen I/II ratio than participants without the infection (all P < .001). The pepsinogen I and pepsinogen I/II values were significantly higher and lower, respectively, in individuals with atrophic gastritis than in those without (both P < .001). Among uninfected individuals, only the pepsinogen I/II ratio was significantly lower in atrophic individuals. Pepsinogen I/II ratio also were significantly different between disease among H. pylori-positive and H. pylori-negative individuals, suggesting the pepsinogen I/II ratio is a robust biomarker for determining both chronic and atrophic gastritis. The cutoffs for detecting chronic and atrophic gastritis for the pepsinogen I/II ratio were 4.65 and 4.95, respectively. In conclusion, pepsinogen levels are useful biomarker for both chronic gastritis and atrophic gastritis, but they should be used with caution. Population-based validation is

Preliminary Study on Reference Interval of Serum Pepsinogen in Healthy Subjects

“…The serum PG can directly reflect the functional state and morphology of the gastric mucosa as well as the number of glands and cells and is an important serum marker for the diagnosis of atrophic gastritis and monitoring of early gastric cancer. [5][6][7] Some studies have shown that there are obvious differences in PG among healthy subjects in different countries and regions. It may be due to the different detection methods and reagents, the differences in the HP infection situation of the population in each region, gender, age composition and other factors.…”

Application of serum pepsinogen and carbohydrate antigen 72-4 (CA72-4) combined with gastrin-17 (G-17) detection in the screening, diagnosis, and evaluation of early gastric cancer

“…PG is a pepsin precursor that secreted by the main cells of the gastric mucosa, and can be transformed into active pepsin through hydrochloric acid and activated pepsin in the stomach. PGI and PGII are the main members of the PG family (14). PG is almost exclusively secreted by the stomach, and the secretion amount will also change during the secretion stage.…”

Serum pepsinogen: A potential non-invasive screening method for moderate and severe atrophic gastritis among an asian population

“…Serum pepsinogen (PG) has been identified and considered the most effective non-invasive biomarker available for diagnosis of severe atrophic gastritis or gastric cancer in the community [ [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ]. PG can be classified immunologically into two types: pepsinogen I (PGI) and pepsinogen II (PGII) and the pepsinogen ratio (PGR: PGI/PGII) was also calculated [ 11 ].…”

“…PG can be classified immunologically into two types: pepsinogen I (PGI) and pepsinogen II (PGII) and the pepsinogen ratio (PGR: PGI/PGII) was also calculated [ 11 ]. However, the use of it is still controversial [ 17 , 18 ], since it is also recommended to use with cautions [ 13 ] and its cut-off values vary from population to population [ 9 , 19 , 20 ]. Recently, the cut-off values of PGI ≤70 ng/ml and/or PGR ≤3 were widely accepted [ 12 , 21 ] while the best cut-off value for atrophy gastritis was PGI ≤50.3 ng/ml and the cut-off point for severe atrophy was PGR ≤4.28 in China [ 10 ].…”