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The role of serum pepsinogen and gastrin test for the detection of gastric cancer in Korea

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Authors
Kang, Jung Mook; Kim, Nayoung; Yoo, Ji Youn; Park, Young Soo; Lee, Dong Ho; Kim, Hyun Young; Lee, Hye Seung; Choe, Gheeyoung; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung
Issue Date
2008-03-05
Publisher
Wiley-Blackwell
Citation
Helicobacter 2008;13:146-56
Keywords
pepsinogen; Helicobacter pylori; gastric cancer; dysplasia; atrophic gastritis
Abstract
BACKGROUND AND AIM: This study was performed to determine whether serum pepsinogen (PG) and gastrin testing can be used to detect gastric cancer in Korea.
METHODS: Serum levels of PG I (sPGI) and sPGII, PG I/II ratios, and gastrin levels were measured in 1006 patients with gastroduodenal diseases including cancer. Follow-up tests were performed 1 year after Helicobacter pylori eradication.
RESULTS: sPGI and sPGII levels increased and PG I/II ratios decreased in line with the severity of activity, chronic inflammation, and the presence of H. pylori (p < .01). In contrast, sPGI levels and PG I/II ratios decreased in proportion with the severity of atrophic gastritis (AG)/intestinal metaplasia (p < .01). Gastrin levels were found to be correlated with chronic inflammation negatively in the antrum but positively in the corpus. H. pylori eradication reduced sPGI, sPGII, and gastrin levels, and increased PG I/II ratios to the levels of H. pylori-negative patients, and was found to be correlated with reductions in activity and chronic inflammation of gastritis. The sensitivity and specificity of a PG I/II ratio of < or = 3.0 for the detection of dysplasia or cancer were 55.8-62.3% and 61%, respectively. In addition, sPGI and sPGII levels of intestinal-type cancer were significantly lower than those of the diffuse type, respectively (p = .008 and p = .05, respectively). Gastric cancer risk was highest in the H. pylori-positive, low PGI/II ratio (< or = 3.0) group with an odds ratio of 5.52 (confidence interval: 2.83-10.77).
CONCLUSION: PG I/II ratio (< or = 3.0) was found to be a reliable marker for the detection of dysplasia or gastric cancer, especially of the intestinal type. This detection power of PG I/II ratio (< or = 3.0) significantly increased in the presence of H. pylori, and thus, provides a means of selecting those at high risk of developing gastric cancer in Korea.
ISSN
1523-5378 (online)1083-4389 (print)
Language
English
URI
http://hdl.handle.net/10371/3863
DOI
https://doi.org/10.1111/j.1523-5378.2008.00592.x
https://doi.org/10.1111/j.1523-5378.2008.00592.x
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College of Medicine/School of Medicine (의과대학/대학원)Pathology (병리학전공)Journal Papers (저널논문_병리학전공)
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