Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3729-3736
Published online Dec 27, 2024. 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, Wei Yu
Xue Han, Department of General Practice, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
Wei Yu, Health Management Center, Shengli Oilfield Central Hospital, Dongying 257000, Shandong Province, China
Author contributions: Han X designed the study, collected and analyzed data, and wrote the manuscript; Han X and Yu W participated in the conception of the study, data collection, design, and provided guidance; and all authors read and approved the final version.
Institutional review board statement: This study was approved by the Ethic Committee of Shengli Oilfield Central Hospital, approval No. 202403.
Informed consent statement: The requirement for written informed consent was not needed due to retrospective design of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Yu, Health Management Center, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying District, Dongying 257000, Shandong Province, China. 13371542609@163.com
Received: August 28, 2024
Revised: October 16, 2024
Accepted: October 28, 2024
Published online: December 27, 2024
Processing time: 91 Days and 1.6 Hours
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: Pepsinogen; Pepsinogen ratio; Early gastric cancer; Precancerous lesions; Screening value

Core Tip: To improve the 5-year survival rate of patients with gastric cancer and the detection rate of early gastric cancer (EGC), this study gathered the screening of patients with EGC and precancerous lesion (PCL) as a breakthrough for relevant research. We included 385 patients with gastric lesions in the Youcheng area for clinical analysis and revealed that pepsinogen ratio has the highest diagnostic efficiency in differentiating patients with benign lesions from those with EGC, followed by differentiating patients with PCL from those with EGC and finally distinguishing patients with benign lesions from those with PCL. The combined pepsinogen ratio and Helicobacter pylori detection exhibited a significant efficacy improvement effect in distinguishing patients with benign lesions from those with PCL, as well as differentiating patients with benign lesions from those with EGC.