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 detectionof precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran.
Methods: A crosssectionalpopulation-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 ratiowith 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 ROCcurves were generated to determine appropriate cutoff points.
Results: Mean values of PGI, PGII, PGI/PGIIand gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). Todiagnose 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 athigh gastric cancer risk in our region.

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