Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 28, 2012; 18(48): 7357-7361
Published online Dec 28, 2012. doi: 10.3748/wjg.v18.i48.7357
Serum pepsinogen II is a better diagnostic marker in gastric cancer
Xue-Yuan Cao, Zhi-Fang Jia, Mei-Shan Jin, Dong-Hui Cao, Fei Kong, Jian Suo, Jing Jiang
Xue-Yuan Cao, Jian Suo, Department of Gastrointestinal Surgery, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Zhi-Fang Jia, Dong-Hui Cao, Fei Kong, Jing Jiang, Division of Clinical Epidemiology, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Mei-Shan Jin, Division of Pathology, Jilin University First Hospital, Changchun 130021, Jilin Province, China
Author contributions: Cao XY and Jiang J designed the study and carried out most of the study; Cao XY, Jia ZF and Jiang J wrote the first draft of the manuscript; Jin MS analyzed the pathological data; Cao DH and Kong F collected patients’ clinical information; Jiang J performed statistical analysis; and Suo J provided valuable suggestions in the preparation of the manuscript.
Supported by National Natural Science Foundation of China, No. 30972476 and 81072369
Correspondence to: Jing Jiang, MD, PhD, Division of Clinical Epidemiology, Jilin University First Hospital, 71Xin min Street, Changchun 130021, Jilin Province, China. ccmzc32jdyycao@yahoo.com.cn
Telephone: +86-431-88783953 Fax: +86-431-887832889
Received: September 24, 2012
Revised: November 6, 2012
Accepted: November 24, 2012
Published online: December 28, 2012
Processing time: 128 Days and 19.8 Hours
Abstract

AIM: To investigate screening makers for gastric cancer, we assessed the association between gastric cancer and serum pepsinogens (PGs).

METHODS: The subjects comprised 450 patients with gastric cancer, 111 individuals with gastric atrophy, and 961 healthy controls. Serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG), PGIand PG II were detected by enzyme-linked immunosorbent assay. Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations. Odds ratios and 95%CIs were calculated using multivariate logistic regression.

RESULTS: Rates of H. pylori infection remained high in Northeastern China. Rates of H. pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group (69.1% and 75.7% vs 49.7%, P < 0.001). Higher levels of PG II (15.9 μg/L and 13.9 μg/L vs 11.5 μg/L, P < 0.001) and lower PGI/PG II ratio (5.4 and 4.6 vs 8.4, P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls, whereas no correlation was found between the plasma PGIconcentration and risk of gastric cancer (P = 0.537). In addition, multivariate logistic analysis indicated that H. pylori infection and atrophic gastritis were independent risk factors for gastric cancer. Lower plasma PGI/PG II ratio was associated with higher risks of atrophy and gastric cancer. Furthermore, plasma PG II level significantly correlated with H. pylori-infected gastric cancer.

CONCLUSION: Serum PG II concentration and PGI/PG II ratio are potential biomarkers for H. pylori-infected gastric disease. PG II is independently associated with risk of gastric cancer.

Keywords: Gastric cancer, Pepsinogens, Helicobacter pylori, Gastric atrophy, Screening