Evaluation of pepsinogen A and gastrin-17 as markers of gastric cancer and high-risk pathologic conditions.
BACKGROUND
Gastric cancer remains a major cause of mortality and will remain so for the lifetime of current clinicians. Many cancers are diagnosed at a stage when current therapy cannot provide the hope of cure. A method for early detection of gastric cancer which can be widely applied is needed. The serum levels of pepsinogen A and gastrin-17 have been shown to vary in the presence of pathologic conditions of the gastric mucosa and may provide such a tool.


METHODS
Serum samples were obtained from 432 patients undergoing endoscopy for undiagnosed dyspepsia. The levels of pepsinogen I and gastrin-17 were estimated by radioimmunoassay and compared with the final diagnosis. Discriminant analysis was performed to assess the value of the peptides predicting the presence of gastric cancer and the high-risk mucosal changes.


RESULTS
Abnormal levels of gastrin-17 or pepsinogen A were found in 60% of patients with gastric cancer and 60% of those with one of the high-risk mucosal changes, the latter figure rising to 75% when the changes were in the upper third of the stomach. Discriminant analysis showed the log of gastrin-17 and log of pepsinogen A to be the best predictors of the high-risk mucosal changes, gastric cancer, and benign disease.


CONCLUSIONS
These results confirm gastrin-17 and pepsinogen A as markers of pathologic gastric conditions and suggest that these peptides are potential screening tools worthy of further assessment.
Hallissey
M T
MT
Dept. of Surgical Oncology, Queen Elizabeth Hospital, Birmingham, UK.
Dunn
J A
JA
Fielding
J W
JW
D000328:Adult; D015415:Biomarkers / Q000097:blood; D004415:Dyspepsia / Q000097:blood / Q000209:etiology; D005753:Gastric Mucosa / Q000473:pathology; D005755:Gastrins / Q000097:blood*; D005773:Gastroscopy; D006801:Humans; D008403:Mass Screening; D010435:Pepsinogens / Q000097:blood*; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control
D015415:Biomarkers; D005755:Gastrins; D010435:Pepsinogens; C013550:gastrin 17