title: Characteristics of the serum pepsinogen (Pg) test, and the relationship between Pg test results and gastric cancer outcomes.
abstract: OBJECTIVE
  The serum pepsinogen (Pg) test is considered to be a high-risk marker for gastric cancer, so that it is intended that it will be gradually adopted for mass surveys in Japan. This manuscript examines the characteristics of the preoperative Pg test and the relationship between its results and the postoperative outcomes of gastric cancer cases in relation to the neutrophil/lymphocyte ratio (NLR) as a prognostic -marker.
  
  
  METHODS
  Peripheral blood samples were taken within 1 week before gastrectomy for the Pg test and NLR.
  
  
  RESULTS
  The Pg test identified 128 (+) cases (59.0%) and 89 (-) cases (41.0%). In three of all cases, cancer had not been detected by an upper gastrointestinal series (UGI) in the previous year (every case showed Pg (+)). Five-year survival was 80.5% in the Pg (+) group, 60.7% in the Pg (-) group, 85.6% in the NLR (<5.0) group, and 29.9% in the NLR (5.0) group, but 14.3% in the NLR (5.0) plus Pg (-) group, and 89.5% in the NLR (<5.0) plus Pg (+) group. The differences in the 5-year survivals were statistically significant.
  
  
  CONCLUSIONS
  A mass survey using the Pg test alone is inadequate, but the Pg test may be an important adjunct to the conventional methods. Gastric cancer with Pg (-) may have a higher potential for malignancy than cancer with Pg (+).
authors.affiliation: Fourth Department of Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan. h-ubu@tokyo-med.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Ubukata
authors.forename: S
authors.initials: S
authors.lastname: Konishi
authors.forename: T
authors.initials: T
authors.lastname: Nakachi
authors.forename: G
authors.initials: G
authors.lastname: Motohashi
authors.forename: Y
authors.initials: Y
authors.lastname: Goto
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: I
authors.initials: I
authors.lastname: Nakada
authors.forename: T
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020116:Pepsinogen A