Clinical values of gastrin 17 and pepsinogen in gastric cancer and precancerous lesion screening

Objective: This study aims to investigate the clinical significance of gastrin 17 and pepsinogen in gastric cancer and precancerous lesion screening. Methods: We used ELISA to measure the levels of gastrin 17 and pepsinogen in serum from the medical examination population, which compared to endoscopic results. Then statistical analysis was performed. Results: The classical method by testing pepsinogen (PG<70 μg/l and PGR<7) is highly specific in screening early gastric cancer and precancerous lesion, but with low sensitivity of 21.2%. Most of the population could be missed diagnosed as well as the positive predictive value is low. If we use pepsinogen combined with gastrin 17 for screening early gastric cancer and precancerous lesion, the screening positive predictive value can be improved while the specificity and sensitivity will not be changed at the same time. The disadvantage of this method is that the sensitivity is still very low. Therefore, most of the population will be missed diagnosed. If two of three indicators, PG I, PGR and G-17, is abnormal in screening early gastric cancer and precancerous lesion, the sensitivity increased from 21.2% to 79.9% while high specificity could also be kept at the same time. Conclusions: Further examination of gastroscope for screening early gastric cancer or precancerous lesions is recommended, if two of PG I, PGR and G-17 are abnormal, making early diagnose and treatment of gastric cancer and precancerous lesions possible.