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 24 January 2018

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News

Pepsinogen A, pepsinogen C, and gastrin as markers of atrophic chronic gastritis

The pepsinogen A/pepsinogen C ratio is a biomarker for precancerous lesions of the stomach, and may be useful as a screening test, finds researchers in the latest issue of the British Journal of Cancer.

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Serum levels of pepsinogen and gastrin can be used as biomarkers for gastric mucosa.

In this study, researchers from Europe sought to validate these biomarkers (pepsinogen A (PGA), pepsinogen C (PGC), PGA/PGC ratio, and gastrin) as screening tests for precancerous lesions. Either for atrophic chronic gastritis (ACG) or Helicobacter pylori-related corpus-predominant or multifocal atrophy.

The team assessed a subset of 284 patients, taken from 451 included in the Eurohepygast cohort, between 1995 and 1997.

They measured concentrations of PGA, PGC, and gastrin using radioimmunoassays.

Mean of each biomarker:
- PGA = 77.4 mug l-1
- PGC = 13.2 mug l-1
- PGA/PGC = 6.7
- gastrin = 62.4 ng l-1
British Journal of Cancer

The researchers considered histological diagnosis as the gold standard.

They calculated cut-off points using receiving operator characteristics (ROC) curves.

Factors linked to variation of biomarkers were identified using multivariate linear regression.

The mean of each biomarker in the sample was PGA = 77.4 mug l-1, PGC = 13.2 mug l-1, PGA/PGC = 6.7, and gastrin = 62.4 ng l-1.

The researchers found that for ACG patients, the areas under the PGA, PGC, PGA/PGC, and gastrin ROC curves were 0.55, 0.62, 0.73, and 0.58, respectively.

They determined that the best cut-off point for PGA/PGC was 5.6, with sensitivity 65% and specificity 78%.

For H. pylori-related corpus-predominant or multifocal atrophy, the areas under the respective ROC curves were 0.57, 0.67, 0.84, and 0.69.

The best cut-off point for PGA/PGC was 4.7, with sensitivity 77% and specificity 87%.

Dr Broutet's team concluded, "The results suggested that only the PGA/PGC ratio can be considered as a biomarker for precancerous lesions of the stomach, and may be useful as a screening test".

Br J Cancer 2003; 88(8): 1239-47
24 April 2003

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