Serum pepsinogen potential biomarker for Kazakh early gastric cancer
The serum pepsinogen test—which is relatively simple, inexpensive, sensitive and specific—is a potentially viable method for the screening and detection of Kazakh early gastric cancer, a new study claims.
The study included 464 participants who received endoscopic examination from gastrointestinal clinics. Those with prior histories of gastric surgery, chemotherapy, infections by Heliobacter pylori, severe systemic diseases and anti-coagulant therapy were excluded from the study.
Of the participants, 106 had gastric cancer 160 served as normal controls. Patients with gastric cancer were divided into two, according to the progression of the cancer: early gastric cancer and advanced gastric cancer. Enzyme-linked immunosorbent assay and flow fluorescence assays were used to measure the serum pepsinogen levels.
According to the Lauren classification, 52 participants (49.1 percent) had intestinal cancers and 50 (47.2 percent) had diffuse type cancers.
In the gastric cancer and atrophic gastritis groups, the levels of pepsinogen I and the pepsinogen I/pepsinogen II ratio were significantly higher than those in the superficial gastritis group (p<0.05). There was no significant difference observed between the early and advanced gastric cancer groups.
Further analysis revealed that the sensitivity of serum pepsinogen in diagnosing gastric cancer was 80.5 percent while the specificity was 89.8 percent. These were obtained using ≤64 ng/mL and ≤4.5 as the cut-off points for pepsinogen I concentration and pepsinogen I/pepsinogen II ratio, respectively.
Finally, the area under the curve for using the pepsinogen I/pepsinogen II ratio to diagnose gastric cancer was found to be 0.949. This ratio was also found to be significantly lower in Kazakh early gastric cancer compared to superficial and atrophic gastritis.
The findings thus show that serum pepsinogen may be a viable circulating biomarker for diagnosing Kazakh early gastric cancer.