Consideration of pepsinogen (PG) levels in gastric cancer detected by medical checkup in our hospital

Abstract

The pepsinogen (PG) method is useful for identifying the population at high risk of gastric cancer, however not only patients positive for PG but those who are negative also often develop gastric cancer. Recently, among patients diagnosed as gastric cancer from the complete medical checkup in our hospital, we examined PG levels in 52 patients whose pretreatment PG level was known. Of 52 patients, 30 were positive for PG (57.7%) and 22 were negative (42.3%). The incidence of gastric cancer was higher in patients associated with atrophy classified as O-1 and O-2. Open-type atrophy was observed in 90.0% of PG-positive patients and 50.0% of PG-negative patients. Among 50 patients with a confirmed pathological diagnosis, 37 had differentiated cancer and 13 had undifferentiated cancer. According to tumor differentiation, 64.9% of patients were positive for PG in the differentiated-cancer group but 53.8% were negative in the undifferentiated-cancer group. We also studied PG levels in 20 gastric cancer patients who were negative for PG and as a result, 75.0% of them showed a low level of PG I (40 or lower) or a low PG I/II ratio (4 or lower). Although PG-positive patients are at high risk of gastric cancer, it may be important to take account of the possibility of gastric cancer in patients negative for PG.