Cancer Research Lab

Serum pepsinogen and gastrin-17 levels may be useful in screening for atrophic gastritis and gastric cancer, according to a report in the January issue of the Chinese Journal of Digestive Diseases.

“As serum biomarkers are useful to detect atrophic gastritis and the location of atrophic lesions (antrum or corpus), it is feasible to carry out the serum test for outpatients who may suffer from gastric cancer, in particular in high-risk areas of gastric cancer,” Dr. Shu Dong Xiao from Shanghai Jiaotong University, China.

Dr. Xiao and colleagues evaluated the use of serum pepsinogen I (PGI), the pepsinogen I/II ratio (PGR), gastrin-17, and Helicobacter pylori-IgG antibodies for screening for atrophic gastritis and gastric cancer in symptomatic patients who had been diagnosed by gastroscopy.

PGI and PGR were significantly decreased in atrophic gastritis and gastric cancer patients, the authors report, compared with healthy controls and patients with gastric or duodenal ulcers.

PGI and PGR levels were lower in atrophic corpus gastritis than in atrophic antral gastritis, the results indicate, and lower in advanced gastric cancer than early stage gastric cancer.

Gastrin-17 level was significantly increased in gastric cancer, without regard to cancer stage, the researchers note. In contrast, gastrin-17 levels were significantly lower in patients with multifocal atrophic gastritis and antral atrophic gastritis than in patients with atrophic corpus gastritis.

All four patient groups (gastritis, cancer, duodenal ulcer, and gastric ulcer) had higher H. pylori positivity rates than the control group, the report indicates.

“Serodiagnosis could be used as a screening method for atrophic gastritis and gastric cancer in large-scale population screening because of its obvious advantages, such as its convenience, relative cheapness, and safety,” the authors conclude.

“If the patient is presenting with alarm symptoms, such as loss of weight, melena, anemia, which are suggestive of gastric malignancy or other GI diseases, endoscopy should be performed without first measuring the serum biomarkers,” Dr. Xiao said.

“We have planned to carry out a research of the healthy subjects over 40 years on whether eradication of H. pylori could prevent the development of gastric cancer in Shanghai,” Dr. Xiao added. “The total number of subjects studied probably would be over 10,000. We will use serum H. pylori IgG antibodies, pepsinogen I and II, and gastrin-17 to pick out those with atrophic gastritis (low serum pepsinogen I and low I/II ratio).”