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. 2010 Apr;42(1):15-8.
doi: 10.5152/eajm.2010.05.

Usefulness of serum pepsinogen levels as a screening test for atrophic gastritis and gastric cancer

Metin Agkoc  1 , Hakan Dursun  1 , Fatih Albayrak  1 , Omer Yilmaz  1 , Ahmet Kiziltunc  2 , Arif Yilmaz  1 , Cemal Gundogdu  3
Affiliations

Usefulness of serum pepsinogen levels as a screening test for atrophic gastritis and gastric cancer

Metin Agkoc et al. Eurasian J Med. 2010 Apr.

Abstract
in English, Turkish

Objective: The purpose of our study was to research the applicability of measuring serum pepsinogen I (PG I) and PG I/pepsinogen II (PG II) ratios as screening tests for atrophic gastritis, which is the most important predisposition for stomach cancer.

Materials and methods: We measured serum pepsinogen levels in non-specific gastritis, atrophic gastritis and gastric cancer using a radioimmunoassay method. We included in this study 30 healthy control, 30 nonspecific gastritis, 30 atrophic gastritis and 50 gastric cancer cases.

Results: The serum PG I level was statistically higher in the control group and in the patient group with chronic nonspecific gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p<0.05). The best cutoff values for diagnosing stomach cancer using serum PG I and PG I / PG II ratios were found to be <25 ng/ml for PG I and <3.0 for PG I / PG II. The same cut-off values were also most effective for the patients with atrophic gastritis.

Conclusions: Serum pepsinogen screening was shown to be a practical predictor of stomach cancer and atrophic gastritis, the most important predisposing lesion for stomach cancer. Although the diagnosis of stomach cancers localized in the pylorus and cardia via this method is difficult, we believe that the detection of early-stage cancers that develop following chronic atrophic gastritis in particular will be possible, and therefore the morbidity and mortality of stomach cancer will be decreased.

Amaç: Bu çalışmada amacımız serum pepsinojen I (PG I) ve PG I / pepsinojen II (PG II) düzeylerinin mide kanseri ve onun en önemli predispozan faktörü olan atrofik gastrit ile ilişkisini incelemekti.

Gereç ve yöntem: Çalışmamızda sağlıklı kontrol 30, nonspesifik gastritli 30, atrofik gastritli 30 ve mide kanserli 50 hastada serum pepsinojen düzeylerini radioimmunoassay yöntemi ile ölçtük.

Bulgular: Çalışmamızın sonucunda serum PG I düzeyleri atrofik gastrit ve mide kanserli olgularda sağlıklı kontrollere göre düşük bulduk. Mide kanseri ve atrofik gastrit tanısı için kullanılabilecek en iyi sınır değerler PG I için <25 ng/ml, PG I / II için <3.0 olarak tespit ettik.

Sonuç: Serum pepsinojen taramasının, mide kanserinin en önemli predispoze lezyonu olan atrofik gastrit ve mide kanserinin pratik bir göstergesi olduğu gösterildi. Her ne kadar pilor ve kardiyada lokalize mide kanserlerinin tanısı bu yöntemle zor olsa dahi, özellikle atrofik gastriti izleyen mide kanserlerinin erken dönemde tespiti mümkün olabilecektir ve böylece mide kanserlerinin mortalite ve morbiditesinin azaltacağını düşünmekteyiz.

Keywords: Gastritis; Pepsinogen; Stomach cancer.

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Figures

Figure 1.
Figure 1.
Serum PG I levels in the patient and control groups (Group 1: Control, Group 2: Chronic nonspecific gastritis, Group 3: Chronic atrophic gastritis, Group 4: Stomach cancer, PG I: pepsinogen I)
Figure 2.
Figure 2.
Serum PG I / PG II ratios in the patient and control groups (Group 1: Control, Group 2: Chronic nonspecific gastritis, Group 3: Chronic atrophic gastritis, Group 4: Stomach cancer, PG I: pepsinogen I, PG II: pepsinogen II)
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