PGII Higher than PGI: a Case Analysis and Literature Review

Abstract

Background: Serum pepsinogen (PG) testing, including PGI and PGII, is widely used for early screening, diagnosis, and prognostic assessment of gastric cancer. PGI mainly reflects the state of the gastric corpus mucosa, while PGII mainly reflects the state of the gastric fundus mucosa. The levels of PGI and PGII can reflect the degree of gastric mucosal atrophy, and when gastric mucosal lesions occur, the content of PGI and PGII in the serum will also change. In gastric cancer screening, serum pepsinogens can be used to judge the patient's condition through changes in PGI, PGII, and the PGI/PGII index, which is considered as "serological gastroscopy".

Methods: Chemiluminescence assay was used to detect serum pepsinogen I (PGI) and pepsinogen II (PGII) and to explore their clinical value before and after treatment.

Results: The PGI was measured at 89.45 ng/mL (reference range 70 - 240 ng/mL), PGII at 505.4 ng/mL (reference range 0 - 13 ng/mL), and PGR PGI/II at 0.18 (reference range greater than 3). The patient underwent endoscopic local surgery and two weeks later, the PGI was measured at 56.53 ng/mL, PGII at 81.58 ng/mL, and PGR PGI/II at 0.69. The PGI and PGII measurement method was Mindray (Shenzhen, China) chemiluminescence assay. The patient's endoscopic biopsy report indicated precancerous gastric lesions.

Conclusions: For the 70-year-old male patient mentioned in the document, the test results of PGI and PGII, as well as the PGR value, all suggest the risk of precancerous gastric lesions. After treatment, although PGI and PGII decreased, PGII is still higher than PGI, and PGR has improved, indicating that the patient still has the possibility of cancer development and requires further endoscopic examination and treatment.