title: Serum pepsinogen II is a better diagnostic marker in gastric cancer.
abstract: OBJECTIVE
  To investigate screening makers for gastric cancer, we assessed the association between gastric cancer and serum pepsinogens (PGs).
  
  
  METHODS
  The subjects comprised 450 patients with gastric cancer, 111 individuals with gastric atrophy, and 961 healthy controls. Serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG), PGI and PG II were detected by enzyme-linked immunosorbent assay. Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations. Odds ratios and 95%CIs were calculated using multivariate logistic regression.
  
  
  RESULTS
  Rates of H. pylori infection remained high in Northeastern China. Rates of H. pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group (69.1% and 75.7% vs 49.7%, P < 0.001). Higher levels of PG II (15.9 μg/L and 13.9 μg/L vs 11.5 μg/L, P < 0.001) and lower PGI/PG II ratio (5.4 and 4.6 vs 8.4, P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls, whereas no correlation was found between the plasma PGI concentration and risk of gastric cancer (P = 0.537). In addition, multivariate logistic analysis indicated that H. pylori infection and atrophic gastritis were independent risk factors for gastric cancer. Lower plasma PGI/PG II ratio was associated with higher risks of atrophy and gastric cancer. Furthermore, plasma PG II level significantly correlated with H. pylori-infected gastric cancer.
  
  
  CONCLUSIONS
  Serum PG II concentration and PGI/PG II ratio are potential biomarkers for H. pylori-infected gastric disease. PG II is independently associated with risk of gastric cancer.
authors: Department of Gastrointestinal Surgery, Jilin University First Hospital, Changchun 130021, Jilin Province, China.
authors: Xue-Yuan
authors: XY
authors: Cao
authors: Zhi-Fang
authors: ZF
authors: Jia
authors: Mei-Shan
authors: MS
authors: Jin
authors: Dong-Hui
authors: DH
authors: Cao
authors: Fei
authors: F
authors: Kong
authors: Jian
authors: J
authors: Suo
authors: Jing
authors: J
authors: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D004724:Endoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005757:Gastritis, Atrophic / Q000097:blood / Q000382:microbiology; D015972:Gene Expression Regulation, Neoplastic; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D016017:Odds Ratio; D020115:Pepsinogen C / Q000097:blood*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology
chemical_list: D014408:Biomarkers, Tumor; D020115:Pepsinogen C
keywords: Gastric atrophy; Gastric cancer; Helicobacter pylori; Pepsinogens; Screening