The Role of Pepsinogen Tests in Detection of Gastric Atrophy, Intestinal Metaplasia, Gastric Adenoma and Gastric Cancer by GastroPanel.

Background/Aims This study aimed to evaluate the efficacy of serum pepsinogen (PG) testing for gastric atrophy (AG), intestinal metaplasia (IM), gastric adenoma and cancer by GastroPanel kit. In addition, these results were compared with Latex-enhanced Turbidimetric Immunoassay (L-TIA) kit for correlation between two kits. Methods Serum levels of PG I (sPGI) and sPGII, and PG I/II ratios were measured using both kits in 2,204 patients including 753 controls, 356 peptic ulcer diseases, 316 gastric adenomas and 779 gastric cancers. Results sPGI, sPGII, and PG I/II ratios measured using these two kits showed high concordance. sPGI 70 of the L-TIA kit corresponded to 100 of the Gastropanel kit and PG I/II ratio 3 corresponded to 5.3, respectively, in the analysis using receiver operating characteristic curves. GastroPanel results showed that sPGI was highest in normal control, and decreased in the gastric adenoma and cancer groups; sPGII decreased in the adenoma group while it increased in the cancer group in comparison to control; PG I/II ratios were significantly lower in the adenoma and the cancer groups, especially the intestinal type cancer group (Figure). The senilities and the specificities calculated using the GastroPanel kit were slightly higher in the diagnosis of AG, IM, and adenoma than those of L-TIA kit without statistical difference (Table). Conclusion PG I/II ratio (≤ 5.3) could be a reliable biomarker for the detection of gastric adenoma and gastric cancer. The GastroPanel kit showed non-inferiority compared to the L-TIA kit in the detection of AG or IM. [ABSTRACT FROM AUTHOR]