title: Serum gastrin and the pepsinogen I/II ratio as markers for diagnosis of premalignant gastric lesions.
abstract: BACKGROUND
  Iran is a country with very high incidences of stomach cancer, especially in Northern parts. Here we assessed prognostic value of serum screening biomarkers among people >50 years old for early detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran.
  
  
  METHODS
  A cross- sectional population-based survey was conducted on 1,390 residents of Lashtenasha city with the mean age (SD) of 61.8 (9.02) years old (50.8% females) to assess the association of gastrin and the pepsinogen (PG) I/II ratio with premalignant gastric lesions. Blood samples were taken for CBC, blood group, and serologic exams (PGI, PGII, and gastrin 17) from each subject. Expert gastroenterologists performed upper GI endoscopy and ROC curves were generated to determine appropriate cutoff points.
  
  
  RESULTS
  Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose atrophy and intestinal metaplasia, a significantly higher AUC was observed for the PGI/PGII ratio (70 and 72%, respectively) compared to the PGI (56, 55%), PGII (63, 64%) and gastrin (59, 61%) (all p<0.001).
  
  
  CONCLUSIONS
  Biomarker tests such as the PGI/II ratio can be used in the screening and diagnosis of subjects at high gastric cancer risk in our region.
authors.affiliation: Division of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Shafaghi
authors.forename: Fariborz
authors.initials: F
authors.lastname: Mansour-Ghanaei
authors.forename: Farahnaz
authors.initials: F
authors.lastname: Joukar
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharafkhah
authors.forename: Alireza
authors.initials: A
authors.lastname: Mesbah
authors.forename: Kurosh
authors.initials: K
authors.lastname: Askari
authors.forename: Siamak
authors.initials: S
authors.lastname: Geranmayeh
authors.forename: Alireza
authors.initials: A
authors.lastname: Mehrvarz
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Souti
authors.forename: Homayoon
authors.initials: H
authors.lastname: Sokhanvar
authors.forename: Saba
authors.initials: S
authors.lastname: Fakhrieh
authors.forename: Keyvan
authors.initials: K
authors.lastname: Aminian
authors.forename: Mahmud
authors.initials: M
authors.lastname: Yousefi-Mashhour
authors.forename: Mahmud
authors.initials: M
authors.lastname: Khosh-Sorur
authors.forename: Javid
authors.initials: J
authors.lastname: Rasoulian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D014408:Biomarkers, Tumor / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology; D005755:Gastrins / Q000097:blood*; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007492:Iran; D008297:Male; D008679:Metaplasia / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D011230:Precancerous Conditions / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D005755:Gastrins; D020115:Pepsinogen C; D020116:Pepsinogen A