The diagnostic value of serum pepsinogen I, pepsinogen II and the pepsinogen I/II ratio combined with Helicobacter pylori tests in patients with early gastric cancer

Objective: To explore the diagnostic value of serum pepsinogen I (PGI), pepsinogen II (PGII), and the PG I/II ratio combined with Helicobacter pylori (Hp) tests for early gastric cancer screening. Methods: A total of 270 patients who underwent gastroscopy from October 2016 to October 2019 were recruited and divided into three groups: the gastric cancer group (n=90), the chronic gastritis group (n=90), and the healthy control group (n=90). The clinical data were retrospectively analyzed, and the serum levels of PGI and PGII, the PG I/II ratio and Hp infection were determined. Results: The serum PGI level and the PG I/II ratio were lower in the gastric cancer group than they were in the chronic gastritis and healthy control groups, and lower in the chronic gastritis group than in the healthy control group (P<0.001). The serum PGII levels were higher in the gastric cancer and the chronic gastritis groups than they were in the healthy control group (P<0.001). A receiver operator characteristic curve analysis revealed that PGI and the PG I/II ratio are essential in diagnosing gastric cancer. The sensitivity of PGI and the PG I/II ratio for gastric cancer were 0.656 and 0.622, respectively; the specificity of PGI and the ratio were 0.889 and 0.911, respectively. Moreover, the Hp infection rate was higher in the gastric cancer group than in the chronic gastritis and healthy control groups (P<0.01), and higher in the chronic gastritis group than in the healthy control group (P<0.001). The PGI level and PG I/II ratio in the Hp positive group were lower than they were in the Hp negative group (P<0.001). In addition, the PGI level and the PG I/II ratio in the early gastric cancer group were higher than they were in the advanced gastric cancer group (P<0.05), but no statistically significant difference was found in the PGII levels (P>0.05). The Hp infection rate in the advanced gastric cancer group was higher than it was in the early gastric cancer group (P<0.05). Conclusion: The serum levels of PGI and PGII combined with Hp tests have a certain diagnostic value and may be serological markers for early gastric cancer.