Diagnostic performances of pepsinogens and gastrin-17 for atrophic gastritis and gastric cancer in Mongolian subjects

Ganchimeg Dondov; Dashmaa Amarbayasgalan; Batbold Batsaikhan; Tegshjargal Badamjav; Batchimeg Batbaatar; Baljinnyam Tuvdenjamts; Nasanjargal Tumurbat; Bayar Davaa; Erkhembulgan Purevdorj; Bayarmaa Nyamaa; Tulgaa Lonjid

doi:10.1371/journal.pone.0274938

Diagnostic performances of pepsinogens and gastrin-17 for atrophic gastritis and gastric cancer in Mongolian subjects

PLoS One. 2022 Oct 17;17(10):e0274938. doi: 10.1371/journal.pone.0274938. eCollection 2022.

Affiliations

¹ Department of Internal Medicine, Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
² Department of Gastroenterology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
³ Department of Radiology, National Cancer Center, Ulaanbaatar, Mongolia.
⁴ Central Research Laboratory, Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.

Abstract

In Mongolia, gastric cancer morbidity and mortality are high, and more than 80 percent of cases are diagnosed at an advanced stage. This study aimed to evaluate pepsinogens (PGIs) and gastrin-17 (G-17) levels and to determine the diagnostic performances for gastric cancer and chronic atrophic gastritis among Mongolian individuals. We enrolled a total of 120 subjects, including gastric cancer (40), atrophic gastritis (40), and healthy control (40), matched by age (±2) and sex. Pepsinogen I (PGI), Pepsinogen II (PGII), G-17, and H. pylori IgG levels were measured using GastroPanel ELISA kit (Biohit, Helsinki, Finland). Also, PGI to PGII ratio (PGR) was calculated. For atrophic gastritis, when the optimal cut-off value of PGI was ≤75.07 ng/ml, the sensitivity and specificity were 75% and 50%, respectively; when the optimal cut-off value of PGR was ≤6.25, sensitivity and specificity were 85% and 44.7%, respectively. For gastric cancer, when the optimal cut-off value of PGI was ≤35.25 ng/ml, the sensitivity and specificity were 47.2% and 86.8%, respectively; when the optimal cut-off value of PGR was ≤5.27, sensitivity and specificity were 75% and 60.5%, respectively. Combinations of biomarkers with risk factors could improve diagnostic accuracy (AUC for atrophic gastritis 74.8, 95% CI 64.0-85.7, p<0.001; AUC for gastric cancer 75.5, 95% CI 64.2-86.8, p<0.001). PGI, PGR biomarkers combined with the risk of age, family history of gastric cancer, and previous gastric disease could not be an alternative test for upper endoscopy but might be a supportive method which is identifying individuals at medium- and high risk of gastric cancer and precancerous lesions who may need upper endoscopy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Gastrins
Gastritis, Atrophic* / diagnosis
Gastritis, Atrophic* / pathology
Helicobacter Infections* / diagnosis
Helicobacter pylori*
Humans
Immunoglobulin G
Pepsinogen A
Pepsinogen C
Stomach Neoplasms* / diagnosis
Stomach Neoplasms* / pathology

Substances

Biomarkers
Gastrins
Immunoglobulin G
gastrin 17
Pepsinogen C
Pepsinogen A

Associated data

Dryad/10.5061/dryad.6wwpzgn1t

Grants and funding

Tulgaa Lonjid and Erkhembulgan Purevdorj received grant and supervised study.The current study was funded by Science and Technology Foundation, Ulaanbaatar, Mongolia (Grant No: SHUSs2018/15). URL: http://stf.mn/en/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.