SIGNIFICANCE OF SERUM MARKERS PEPSINOGEN-I AND PEPSINOGEN-II FOR CHRONIC ATROPHIC GASTRITIS, PEPTIC-ULCER, AND GASTRIC-CANCER

Chronic atrophic gastritis (CAG) is closely correlated with gastric ca ncer and is predominant in Japan. Epidemiologically, food habits are t he primary factor in both CAG and gastric cancer. Two potential serum markers for CAG have recently been investigated, i.e., the concentrati on of serum pepsinogen (PG) and the presence of serum antibodies again st Helicobacter pylori. Serum PG I and II and the PG I:PG II ratio hav e been reported to be useful as indicators of recurrent peptic ulcer a nd for screening of patients at risk from gastric cancer. In this stud y, we examined PG I and II in serum from 483 patients by RIA (DAINABOT ), and endoscopic examination performed in the same patients before se rological assay revealed CAG in 68, peptic ulcer in 91, and gastric ca ncer in 48. Analysis of the mean values according to patients age show ed that CAG patients in their forties to eighties had low (<40 ng/ml) levels of PG I, peptic ulcer patients in their teens to eighties had h igh (greater-than-or-equal-to 70 ng/ml) levels, except for those in th eir seventies, and gastric cancer patients in their twenties to sixtie s had low (<3.0) PG I:PG II ratios. except for those in their sixties. Thus serum PG assay has potential utility for detection of CAG, pepti c ulcer, and gastric cancer.