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. 2024 Dec 27;16(12):3729-3736.
doi: 10.4240/wjgs.v16.i12.3729.

Value of serum pepsinogen ratio screening for early gastric cancer and precancerous lesions in Youcheng area

Xue Han  1 , Wei Yu  2
Affiliations

Value of serum pepsinogen ratio screening for early gastric cancer and precancerous lesions in Youcheng area

Xue Han et al. World J Gastrointest Surg. .

Abstract

Background: The 5-year survival rate of patients with advanced gastric cancer remains extremely low (< 15%), whereas the 5-year survival rate of patients with early gastric cancer (EGC) is > 90%. Consequently, strengthening the screening of patients with EGC and precancerous lesions (PCLs) is essential.

Aim: To identify the value of serum pepsinogen ratio (PGR) screening for EGC and PCLs in the Shengli Oilfield Central Hospital.

Methods: We first selected 385 patients with gastric lesions in the Youcheng area, determining benign lesions, PCLs, and EGC in 135, 123, and 127 cases, respectively, based on endoscopy and case diagnosis. The positive rates of pepsinogen I, pepsinogen II and Helicobacter pylori (H. pylori) in the three groups were detected, and the PGR was calculated. Subsequently, we plotted receiver operating characteristic curves to analyze the screening value of PGR and H. pylori-positive rates for PCLs and EGC.

Results: PGR expression demonstrated a decreasing trend in patients with benign lesions, PCLs, and EGC successively according to the detection results, whereas the H. pylori-positive rate was notably increased in patients with PCLs and EGC compared to those with benign lesions. The area under the curves (AUCs) of PGR, H. pylori, and their combination in differentiating patients with benign lesions from those with PCLs were 0.611, 0.582, and 0.689, respectively; PGR, H. pylori, and their combination had an AUC of 0.618, 0.502, and 0.618 in distinguishing PCL patients from EGC patients, respectively; the AUCs of PGR, H. pylori, and their combination in discriminating patients with benign lesions from those with EGC were 0.708, 0.581, and 0.750, respectively.

Conclusion: PGR has great screening potential for patients with EGC and PCLs in the Youcheng area, and the screening efficiency is further improved by combining the H. pylori-positive rate.

Keywords: Early gastric cancer; Pepsinogen; Pepsinogen ratio; Precancerous lesions; Screening value.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Pepsinogen ratio and Helicobacter pylori-positive rates of three groups of patients. A: Pepsinogen ratio of three groups of patients; B: Helicobacter pylori-positive rates of three groups of patients. aP < 0.05 and bP < 0.01 in the inter-group comparison or in the comparison with benign lesions. PGR: Pepsinogen ratio; GC: Gastric cancer; HP: Helicobacter pylori.
Figure 2
Figure 2
Receiver operating characteristic curves analysis of the effectiveness of pepsinogen ratio and Helicobacter pylori in distinguishing benign lesions from precancerous lesions. A: Receiver operating characteristic (ROC) curves analysis of the effectiveness of pepsinogen ratio in differentiating benign lesions from precancerous lesions (PCLs); B: ROC curves analysis of the effectiveness of Helicobacter pylori in distinguishing benign lesions from PCLs; C: ROC curves analysis of the effectiveness of pepsinogen ratio + Helicobacter pylori in distinguishing benign lesions from PCLs. PGR: Pepsinogen ratio; HP: Helicobacter pylori.
Figure 3
Figure 3
Receiver operating characteristic curves. A: The receiver operating characteristic (ROC) curve of pepsinogen ratio in differentiating precancerous lesions from early gastric cancer (EGC); B: The ROC curve of Helicobacter pylori in distinguishing precancerous lesions from EGC; C: The ROC curve of the combined detection in differentiating precancerous lesions from EGC; D: The ROC curve of pepsinogen ratio in distinguishing benign lesions from EGC; E: The ROC curve of Helicobacter pylori in differentiating benign lesions from EGC; F: The ROC curve of the combined detection in distinguishing benign lesions from EGC. PGR: Pepsinogen ratio; HP: Helicobacter pylori.
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