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Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

  • Shafaghi, Afshin (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Mansour-Ghanaei, Fariborz (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Joukar, Farahnaz (Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences) ;
  • Sharafkhah, Maryam (Biostatistics, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital) ;
  • Mesbah, Alireza (Razi Pathobiology Laboratory, Tehran University of Medical Sciences, Shariati Hospital) ;
  • Askari, Kurosh (Pathology Department, Guilan University of Medical Sciences) ;
  • Geranmayeh, Siamak (Sina Pathobiology Laboratory, Tehran University of Medical Sciences, Shariati Hospital) ;
  • Mehrvarz, Alireza (Afra Pathobiology Laboratory, Rasht, Tehran University of Medical Sciences, Shariati Hospital) ;
  • Souti, Fatemeh (Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences) ;
  • Sokhanvar, Homayoon (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Fakhrieh, Saba (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Aminian, Keyvan (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Yousefi-Mashhour, Mahmud (Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences) ;
  • Khosh-Sorur, Mahmud (Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences) ;
  • Rasoulian, Javid (Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences)
  • Published : 2013.06.30

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 detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran. Methods: A cross-sectional population-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 ratio with 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 ROC curves were generated to determine appropriate cutoff points. Results: Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose 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 at high gastric cancer risk in our region.

Keywords

Gastrin;pepsinogen I;pepsinogen II;preneoplastic lesion;gastric cancer;Northern Iran

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