Original articles

The potential value of serum pepsinogen in screening of chronic atrophic gastritis among population with high risk for gastric cancer of Shanghai central urban area

Expand
  • 1. Department of Gastroenterology, Jing'an District Central Hospital, Fudan University, Shanghai 200040, China
    2. General Practitioner of Traditional Chinese Medicine, Community Health Service Center, 2nd Shimen Road, Jin'an District, Shanghai 200041, China
    3. Department of Radiology Center for Community Health Service, West Nanjing Road Sub-District, Jin'an District, Shanghai 200041, China

Received date: 2019-08-20

  Online published: 2019-10-25

Abstract

Objective: To evaluate the value of measurement of serum pepsinogen(PG) for the screening of chronic atrophic gastritis(CAG) in gastric cancer high risk people. Methods: A symptomatic subjects with high risk for gastric cancer lived in Shanghai central urban area were enrolled to measure serum PG, Helicobacter pylori antibody and conduct endoscopy and biopsy. According to histological results, CAG were divided to no atrophy group, antrum predominant group, corpus predominant group and entire stomach gastricatrophy group. Results: Of the 178 cases enrolled, corpus predominant group and entire stomach group exhibited a significantly lower PGR(PGⅠ∶Ⅱ ratio)when compared with the no atrophy group and antrumpredominant group (P<0.05). The cut-off value of PGR ≤5.16 demonstrated a sensitivity of 91.8%, specificity of 61.9% and area under the receiver operating characteristic curve 0.794 in detecting entire stomach gastric atrophy. The cut-off value of PGR ≤6.43 demonstrated a sensitivity of 78.7%, specificity of 65.5% and area under the receiver operating characteristic curve 0.750 in detecting entire stomach gastric atrophy. Conclusions: Serum PGR is a sensitive and specific marker for detecting corpus involved CAG. PGR might be potentially used as a non-invasive biomarker for detecting CAG among population with high risk for gastric cancer.

Cite this article

ZHOU Lei, WANG Hong, XU Huiming, YE Tao, GAO Jianping, SUN Yijun, XIE Jun . The potential value of serum pepsinogen in screening of chronic atrophic gastritis among population with high risk for gastric cancer of Shanghai central urban area[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(05) : 570 -574 . DOI: 10.16150/j.1671-2870.2019.05.016

References

[1] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424.
[2] 国家消化系统疾病临床医学研究中心, 中华医学会消化内镜学分会, 中华医学会健康管理学分会, 等. 中国早期胃癌筛查流程专家共识意见(草案)(2017年,上海)[J]. 胃肠病学, 2018, 23(2):92-97.
[3] Venerito M, Nardone G, Selgrad M, et al. Gastric cancer--epidemiologic and clinical aspects[J]. Helicobacter, 2014, 19(Suppl 1):32-37.
[4] Islami F, Sheikhattari P, Ren JS, et al. Gastric atrophy and risk of oesophageal cancer and gastric cardia adenocarcinoma--a systematic review and meta-analysis[J]. Ann Oncol, 2011, 22(4):754-760.
[5] Kikuchi R, Abe Y, Iijima K, et al. Low serum levels of pepsinogen and gastrin 17 are predictive of extensive gastric atrophy with high-risk of early gastric cancer[J]. Tohoku J Exp Med, 2011, 223(1):35-44.
[6] Vannella L, Lahner E, Annibale B. Risk for gastric neoplasias in patients with chronic atrophic gastritis: a critical reappraisal[J]. World J Gastroenterol, 2012, 18(12):1279-1285.
[7] Hosseini M, Amoueian S, Attaranzadeh A, et al. Serum gastrin 17, pepsinogen I and pepsinogen II in atrophic gastritis patients living in North-East of Iran[J]. J Res Med Sci, 2013, 18(3):225-229.
[8] Lomba-Viana R, Dinis-Ribeiro M, Fonseca F, et al. Serum pepsinogen test for early detection of gastric cancer in a European country[J]. Eur J Gastroenterol Hepatol, 2012, 24(1):37-41.
[9] Nasrollahzadeh D, Aghcheli K, Sotoudeh M, et al. Accuracy and cut-off values of pepsinogens I, II and gastrin 17 for diagnosis of gastric fundic atrophy: influence of gastritis[J]. PLoS One, 2011, 6(10):e26957.
[10] Graham DY, Nurgalieva ZZ, El-Zimaity HM, et al. Noninvasive versus histologic detection of gastric atrophy in a Hispanic population in North America[J]. Clin Gastroenterol Hepatol, 2006, 4(3):306-314.
[11] Samloff IM. Pepsinogens I and II: purification from gastric mucosa and radioimmunoassay in serum[J]. Gastroenterology, 1982, 82(1):26-33.
[12] Gritti I, Banfi G, Roi GS. Pepsinogens: physiology, pharmacology pathophysiology and exercise[J]. Pharmacol Res, 2000, 41(3):265-281.
[13] Sipponen P. Update on the pathologic approach to the diagnosis of gastritis, gastric atrophy, and Helicobacter pylori and its sequelae[J]. J Clin Gastroenterol, 2001, 32(3):196-202.
[14] Hansen S, Vollset SE, Derakhshan MH, et al. Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status[J]. Gut, 2007, 56(7):918-925.
[15] Bornschein J, Selgrad M, Wex T, et al. Serological assessment of gastric mucosal atrophy in gastric cancer[J]. BMC Gastroenterol, 2012, 12:10.
[16] Leja M, Kupcinskas L, Funka K, et al. The validity of a biomarker method for indirect detection of gastric muco-sal atrophy versus standard histopathology[J]. Dig Dis Sci, 2009, 54(11):2377-2384.
[17] Kikuchi S, Kato M, Katsuyama T, et al. Design and planned analyses of an ongoing randomized trial asses-sing the preventive effect of Helicobacter pylori eradication on occurrence of new gastric carcinomas after endoscopic resection[J]. Helicobacter, 2006, 11(3):147-151.
[18] He CY, Sun LP, Gong YH, et al. Serum pepsinogen II: a neglected but useful biomarker to differentiate between diseased and normal stomachs[J]. J Gastroenterol Hepatol, 2011, 26(6):1039-1046.
[19] Chae H, Lee JH, Lim J, et al. Clinical utility of serum pepsinogen levels as a screening test of atrophic gastritis[J]. Korean J Lab Med, 2008, 28(3):201-206.
[20] Zoalfaghari A, Aletaha N, Roushan N, et al. Accuracy of pepsinogens for early diagnosis of atrophic gastritis and gastric cancer in Iranian population[J]. Med J Islam Repub Iran, 2014, 28:150.
[21] Chae H, Lee JH, Lim J, et al. Clinical utility of serum pepsinogen levels as a screening test of atrophic gastritis[J]. Korean J Lab Med, 2008, 28(3):201-206.
[22] Zoalfaghari A, Aletaha N, Roushan N, et al. Accuracy of pepsinogens for early diagnosis of atrophic gastritis and gastric cancer in Iranian population[J]. Med J Islam Repub Iran, 2014, 28:150.
[23] Pimentel-Nunes P, Libanio D, Marcos-Pinto R, et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019[J]. Endoscopy, 2019, 51(4):365-388.
[24] Lomba-Viana R, Dinis-Ribeiro M, Fonseca F, et al. Serum pepsinogen test for early detection of gastric cancer in a European country[J]. Eur J Gastroenterol Hepatol, 2012, 24(1):37-41.
Outlines

/