Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis.
OBJECTIVE
First-degree relatives of gastric cancer patients are at risk for developing precancerous conditions. The aim of this study was to investigate the potential of biomarkers pepsinogen I (PGI), pepsinogen II (PGII), their ratio (PG I:II), as well as gastrin 17 for screening of precancerous conditions and corpus predominant gastritis.


METHODS
First-degree relatives of gastric cancer patients underwent endoscopy. Three biopsy specimens from the antrum and 3 from the corpus were evaluated according to the Sydney classification. Serum was taken for the measurement of fasting PGI, PGII, and gastrin 17 by enzyme-linked immunosorbent assay kits.


RESULTS
A total of 481 patients were examined (age, 47.8 +/- 6.7 y). With the extension of gastritis, PGII was increased up to 2.5 times (6.6 +/- 2.8 microg/mL in normal mucosa, 9.5 +/- 6.7 microg/mL in antral gastritis, and 16.9 +/- 12.4 microg/mL in corpus-predominant gastritis; P < .01), PGI increased slightly (88.3 +/- 29.4 microg/mL in normal mucosa and 111.2 +/- 71.4 microg/mL in corpus-predominant gastritis), and gastrin 17 was increased substantially in corpus-predominant gastritis (15.3 +/- 19.5 pmol/mL vs 3.8 +/- 5.7 pmol/mL in normal mucosa). By using a cut-off value of 7.5 microg/mL for PGII, any type of gastritis from normal mucosa can be diagnosed with a sensitivity and specificity of 80%. The sensitivity and specificity of the PG I:II ratio (< or =3) and gastrin 17 (>17 pmol/mL) together were 9.4% and 99% for screening corpus-predominant gastritis and 14.8% and 97.8%, respectively, for screening intestinal metaplasia in the corpus.


CONCLUSIONS
PGII is a suitable marker for screening any gastritis from normal mucosa, but neither PGI, the PG I:II ratio, gastrin 17, nor their combination were able to select those with precancerous conditions and corpus-predominant gastritis among the first-degree relatives of gastric cancer patients.
Haj-Sheykholeslami
Arghavan
A
Department of Gastroenterology, Digestive Disease Research Center, Shariati Hospital, Tehran, Iran.
Rakhshani
Naser
N
Amirzargar
Aliakbar
A
Rafiee
Reza
R
Shahidi
S Mehdi
SM
Nikbin
Behrouz
B
Khosravi
Farideh
F
Massarrat
Sadegh
S
D000328:Adult; D015415:Biomarkers; D001706:Biopsy; D004797:Enzyme-Linked Immunosorbent Assay; D005190:Family; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D012680:Sensitivity and Specificity; D044967:Serum / Q000737:chemistry*; D013274:Stomach Neoplasms / Q000175:diagnosis*
D015415:Biomarkers; D005755:Gastrins; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A