title: Serum pepsinogen II: a neglected but useful biomarker to differentiate between diseased and normal stomachs.
abstract: OBJECTIVE
  Serum pepsinogen II (sPGII) is underutilized and considered an inconspicuous biomarker in clinical practice. We refocused on this neglected but novel biomarker and conducted the present study, aiming to elucidate the normal level of sPGII in healthy Chinese patients and to investigate the clinical utility of sPGII for gastric disease screening.
  
  
  METHODS
  In 2008-2009, a total of 2022 participants from northern China were selected and enrolled in the study. sPGII and Helicobacter pylori (H. pylori)-immunoglobulin G were measured with ELISA.
  
  
  RESULTS
  sPGII showed a normal value of 6.6 microg/L in a total of 466 patients with endoscopically- and histologically-normal stomachs. A small sex difference was observed: the average value of sPGII was 7 microg/L and 6 microg/L in males and females, respectively (P < 0.001). In the differentiation between healthy and diseased (endoscopically-diseased stomach or gastritis/atrophic gastritis in endoscopic biopsies) stomach mucosae, the best sPGII cut-off value was 8.25 microg/L (sensitivity 70.6%, specificity 70.8%). In screening the H. pylori seropositivity, the optimum cut-off sPGII value was 10.25 microg/L (sensitivity 71.6%, specificity 70.1%).
  
  
  CONCLUSIONS
  We demonstrated that the mean values of sPGII in a healthy Chinese population are 7 microg/L and 6 microg/L for males and females, respectively. sPGII significantly increases in diseased and H. pylori-infected stomach, and the best sPGII cut-off value is 8.25 microg/L in the differentiation between patients with healthy and diseased stomach mucosae. Furthermore, Chinese patients with sPGII greater than 10.25 microg/L are at greater risk of various H. pylori-related gastropathies, and are therefore prior candidates for gastro-protection therapy.
authors.affiliation: Tumor Etiology and Screening Department of Cancer Institute and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Cai-yun
authors.initials: CY
authors.lastname: He
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Sun
authors.forename: Yue-hua
authors.initials: YH
authors.lastname: Gong
authors.forename: Qian
authors.initials: Q
authors.lastname: Xu
authors.forename: Nan-nan
authors.initials: NN
authors.lastname: Dong
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002681:China; D004796:Clinical Enzyme Tests; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005753:Gastric Mucosa / Q000201:enzymology* / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D020115:Pepsinogen C / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D007074:Immunoglobulin G; D020115:Pepsinogen C