title: A comprehensive evaluation of fasting serum gastrin-17 as a predictor of diseased stomach in Chinese population.
abstract: OBJECTIVE
  Fasting serum gastrin-17 (FsG17) is considered as a noninvasive biomarker reflecting the structure and functional status of gastric mucosa, but its clinical utility remains unclear. This study aimed to evaluate FsG17 comprehensively: establish the ranges and cut-off points of FsG17 levels in different gastric diseases, identify their influencing factors, and investigate the accuracy of FsG17 for identifying diseased stomach.
  
  
  METHODS
  The study included 4064 participants from Northern China between 2008 and 2013. FsG17 and serum Helicobacter pylori IgG antibody levels were measured by enzyme-linked immunosorbent assay. Diagnostic accuracy was assessed by receiver operator characteristic curves. Multivariate logistic regression analysis was performed to determine the best predictors of gastric histopathological conditions.
  
  
  RESULTS
  Median FsG17 levels in healthy, non-atrophic, atrophic, and cancerous stomachs were 1.8, 4.0, 3.8, and 6.1 pmol/l, respectively. Age, smoking status, alcohol consumption, H. pylori infection, and predominant lesion site were factors that affected FsG17 levels. The optimal cut-off values for FsG17 were 3.0 pmol/l (sensitivity of 59.3% and specificity of 67.3%) for discriminating between healthy stomach and diseased stomach and 10.7 pmol/l (sensitivity of 37% and specificity of 83.7%) for discriminating between cancerous stomach and cancer-free stomach; the screening accuracy was higher (sensitivity of 50.0% and specificity of 83.0%) for gastric cancer in the corpus. Multivariate analysis showed that FsG17, gender, age, and H. pylori infection were independent predictors of cancerous stomach.
  
  
  CONCLUSIONS
  With the progression from health stomach to malignancy, FsG17 levels significantly increased and were influenced by other factors. FsG17 combined with age, gender, and H. pylori infection could distinguish between cancerous stomach and cancer-free stomach. The results will enhance our understanding of the potential clinical utility of FsG17.
authors.affiliation: Tumor Etiology and Screening Department of Cancer Institute and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention (China Medical University), Liaoning Provincial Education Department , Shenyang, Liaoning , China.
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.forename: Huakang
authors.initials: H
authors.lastname: Tu
authors.forename: Jingwei
authors.initials: J
authors.lastname: Liu
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Gong
authors.forename: Qian
authors.initials: Q
authors.lastname: Xu
authors.forename: Jingjing
authors.initials: J
authors.lastname: Jing
authors.forename: Nannan
authors.initials: N
authors.lastname: Dong
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000097:blood; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002681:China; D005215:Fasting / Q000097:blood*; D005260:Female; D005755:Gastrins / Q000097:blood*; D005757:Gastritis, Atrophic / Q000097:blood*; D016481:Helicobacter Infections / Q000097:blood*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012907:Smoking / Q000097:blood; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D015415:Biomarkers; D005755:Gastrins; D007074:Immunoglobulin G; C013550:gastrin 17
keywords: Helicobacter pylori; diseased stomach; gastric cancer; gastrin-17