The serum pepsinogen levels for risk assessment of gastric neoplasms

Cho, Jun-Hyung; Jeon, Seong Ran; Kim, Hyun Gun; Jin, So-Young; Park, Suyeon

doi:10.1097/md.0000000000007603

Cited by 23 publications

(16 citation statements)

References 49 publications

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“…The similar benefit for gastric cancer screening was also reported in Bangladesh, but validation is required [14]. Additionally, the serum PGI/II ratio also had a significant association to the increasing risk of gastric cancer in Korean population [15]. In addition to the benefit for the gastric cancer screening tools, serum pepsinogen was also had benefit in the detecting H. pylori eradication status and gastric acidity.…”

Section: Introductionmentioning

confidence: 53%

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

et al. 2020

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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

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Section: Introductionmentioning

confidence: 53%

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

et al. 2020

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“…From the 43 studies [21,26,27,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73] for the diagnosis of gastric neoplasm, we identified a total of 114,448 patients (4689 patients with GC, 430 patients with neoplasm, 130 patients with dysplasia vs. 109,199 patients without gastric neoplasm). Among them, 20 [26,27,34,36,37,40,43,44,45,54,55,56,57,58,61,62,64,67,68,72] were case–control studies, whereas 18 [35,39,41,42,46,47,48,49,…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of the enrolled population ranged from 33.4 to 68.2 years. Most of the studies showed male predominance except 11 studies [21,27,38,42,53,59,60,66,67,70,73] showing female predominance. For detection of sPGA, most studies used RIA, whereas nine studies [21,27,50,54,59,64,65,69,70] used ELISA, eight studies [45,52,55,61,67,71,72,73] used L-TIA, four studies [49,56,57,62] used chemiluminescent immunoassay (CLIA), two studies [43,68] used enzyme immunoassay (EIA), and one study [48] used either RIA or L-TIA (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Prediction of Chronic Atrophic Gastritis and Gastric Neoplasms by Serum Pepsinogen Assay: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

Bang

Lee

Baik

2019

JCM

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Serum pepsinogen assay (sPGA), which reveals serum pepsinogen (PG) I concentration and the PG I/PG II ratio, is a non-invasive test for predicting chronic atrophic gastritis (CAG) and gastric neoplasms. Although various cut-off values have been suggested, PG I ≤70 ng/mL and a PG I/PG II ratio of ≤3 have been proposed. However, previous meta-analyses reported insufficient systematic reviews and only pooled outcomes, which cannot determine the diagnostic validity of sPGA with a cut-off value of PG I ≤70 ng/mL and/or PG I/PG II ratio ≤3. We searched the core databases (MEDLINE, Cochrane Library, and Embase) from their inception to April 2018. Fourteen and 43 studies were identified and analyzed for the diagnostic performance in CAG and gastric neoplasms, respectively. Values for sensitivity, specificity, diagnostic odds ratio, and area under the curve with a cut-off value of PG I ≤70 ng/mL and PG I/PG II ratio ≤3 to diagnose CAG were 0.59, 0.89, 12, and 0.81, respectively and for diagnosis of gastric cancer (GC) these values were 0.59, 0.73, 4, and 0.7, respectively. Methodological quality and ethnicity of enrolled studies were found to be the reason for the heterogeneity in CAG diagnosis. Considering the high specificity, non-invasiveness, and easily interpretable characteristics, sPGA has potential for screening of CAG or GC.

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“…PGI is secreted from the gastric fundus gland, whilst PGII is secreted from the glandular body and the pylorus glands in the antrum and proximal duodenum [33]. The majority of PGs directly enter the stomach cavity, but a small amount also enters the gastric mucosal capillaries and into the bloodstream, which can then be detected in serum.…”

Section: Discussionmentioning

confidence: 99%

The Value of Pepsinogen in GC Screening: A Systematic Review and Meta-Analysis

Liu

Lang

Jin

et al. 2019

Gastroenterology Research and Practice

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Background The current gold standard for gastric cancer (GC) screening is pathology or a barium meal followed by X-ray. This is not applicable to a wide range of screening capabilities due to the lack of operability. This article used a meta-analysis to evaluate the value of pepsinogen (PG) screening for GC. Methods PubMed, EMbase, the Cochrane Library, CNKI, WanFang, VIP, and CBM databases were systematically searched for published studies that used serum PG to diagnose GC. Articles were searched from January 2003 to January 2018. Two reviewers independently screened the literature according to specified inclusion and exclusion criteria. The data were extracted and evaluated, and the quality of the methodologies evaluated using the QUADAS entry. The meta-analysis (MA) was performed using Meta-DiSc 1.4 software. Stata 12.0 software was used to assess publication bias. Results A total of 19 studies were finally included from a total of 169,009 cases. The MA showed a combined sensitivity and specificity of 0.56 (95% CI (0.53–0.59), P < 0.01) and 0.71 (95% CI (0.70-0.71), P < 0.01), respectively. The combined likelihood ratios were +LR = 2.82 (95% CI (2.06–3.86), P < 0.01) and −LR = 0.56 (95% CI (0.45–0.68), P < 0.01). The combined DOR was 5.41 (95% CI (3.64~ 8.06), P < 0.01), and the area under the SROC curve was 0.7468. Conclusions Serum PG provides medium levels of sensitivity and specificity for GC assessment. To be used in a clinical setting, further high-quality research must be performed and verified.

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The serum pepsinogen levels for risk assessment of gastric neoplasms

Cited by 23 publications

References 49 publications

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

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

Prediction of Chronic Atrophic Gastritis and Gastric Neoplasms by Serum Pepsinogen Assay: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

The Value of Pepsinogen in GC Screening: A Systematic Review and Meta-Analysis

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