Assessing the utility of pepsinogens and gastrin-17 in gastric cancer detection.
Journal
European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
ISSN: 1473-5709
Titre abrégé: Eur J Cancer Prev
Pays: England
ID NLM: 9300837
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
medline:
1
8
2023
pubmed:
14
3
2023
entrez:
13
3
2023
Statut:
ppublish
Résumé
The aim of the study was to determine the proportion of gastric cancer patients with decreased levels of pepsinogen and gastrin-17 in plasma, with the goal of providing indirect evidence of the sensitivity of these biomarkers when applied in a cancer screening setting. The levels of pepsinogens I and II, gastrin-17, and Helicobacter pylori immunoglobulin antibodies in plasma samples of gastric cancer patients were evaluated using the GastroPanel test system (Biohit Oyj, Helsinki, Finland). A decreased level of the pepsinogen I/II ratio was defined as less than three, while a decrease in gastrin-17 was defined as less than 1 pmol/L. Univariate analysis using non-parametric tests was used to investigate differences between normal and low concentrations of biomarkers. In total, 481 plasma samples from patients (59.9% male) with a median age of 64 years (ranging from 27 to 88 years) were analyzed. Out of the 400 cases of gastric cancer (83.2% of the total), 182 were categorized as the intestinal type, 141 as the diffuse type, 60 as the mixed type, and 17 as indeterminate according to the Lauren classification system. The H. pylori immunoglobulin test was positive in 74.0% of the patients. Pepsinogen I/II ratio was decreased in 32.4% (36.8% of the intestinal type); gastrin-17 in 12.3% (10.1% of the antral region) of all cases. The majority of gastric cancer patients had normal levels of pepsinogen and gastrin-17, suggesting that these biomarkers have limited application as screening tools in the Caucasian population.
Identifiants
pubmed: 36912185
doi: 10.1097/CEJ.0000000000000791
pii: 00008469-990000000-00046
doi:
Substances chimiques
gastrin 17
60748-06-3
Pepsinogen A
9001-10-9
Gastrins
0
Biomarkers
0
Antibodies, Bacterial
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
478-484Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Agréus L, Kuipers EJ, Kupcinskas L, Malfertheiner P, Di Mario F, Leja M, et al. (2012). Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers. Scand J Gastroenterol 47:136–147.
Alam M, Howes N, Stephens N, Pritchard DM (2022). Review: gastric malignancies – clinical aspects & prevention. Microb Health Dis 3:1–9.
Bang CS, Lee JJ, Baik GH (2019). Prediction of chronic atrophic gastritis and gastric neoplasms by serum pepsinogen assay: a systematic review and meta-analysis of diagnostic test accuracy. J Clin Med 8:657.
Banks M, Graham D, Jansen M, Gotoda T, Coda S, di Pietro M, et al. (2019). British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 68:1545–1575.
Bornschein J, Selgrad M, Wex T, Kuester D, Malfertheiner P (2012). Serological assessment of gastric mucosal atrophy in gastric cancer. BMC Gastroenterol 12:10.
Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM (2005). Gastric adenocarcinoma: review and considerations for future directions. Ann Surg 241:27–39.
Dinis-Ribeiro M, Yamaki G, Miki K, Costa-Pereira A, Matsukawa M, Kurihara M (2004). Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen 11:141–147.
Duan S, Rico K, Merchant JL (2022). Gastrin: from physiology to gastrointestinal malignancies. Function 3:zqab062.
Gasenko E, Leja M, Polaka I, Hegmane A, Murillo R, Bordin D, et al. (2020). How do international gastric cancer prevention guidelines influence clinical practice globally? Eur J Cancer Prev 29:400–407.
Han M-L, Liou J-M, Ser K-H, Chen J-C, Chen S-C, Lee W-J (2021). Changes of serum pepsinogen level and ABC classification after bariatric surgery. J Formos Med Assoc 120:1377–1385.
Hansen S, Vollset SE, Derakhshan MH, Fyfe V, Melby KK, Aase S, et al. (2007). Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status. Gut 56:918–925.
Hu H-M, Tsai H-J, Ku H-Y, Lo S-S, Shan Y-S, Chang H-C, et al. (2021). Survival outcomes of management in metastatic gastric adenocarcinoma patients. Sci Rep 11:23142.
Huang Y, Yu J, Kang W, Ma ZQ, Ye X, Tian SB, et al. (2015). Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis. PLoS One 10:e0142080.
Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F (2014). Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev 23:700–713.
Kikuchi R, Abe Y, Iijima K, Koike T, Ara N, Uno K, et al. (2011). Low serum levels of pepsinogen and gastrin 17 are predictive of extensive gastric atrophy with high-risk of early gastric cancer. Tohoku J Exp Med 223:35–44.
Kurilovich S, Belkovets A, Reshetnikov O, Openko T, Malyutina S, Ragino Y, et al. (2016). Stomach-specific biomarkers (GastroPanel) can predict the development of gastric cancer in a caucasian population: a longitudinal nested case-control study in Siberia. Anticancer Res 36:247–253.
Leja M, Linē A (2021). Early detection of gastric cancer beyond endoscopy - new methods. Best Pract Res Clin Gastroenterol 50-51:101731.
Leja M, Kupcinskas L, Funka K, Sudraba A, Jonaitis L, Ivanauskas A, et al. (2011). Value of gastrin-17 in detecting antral atrophy. Adv Med Sci 56:145–150.
Leja M, You W, Camargo MC, Saito H (2014). Implementation of gastric cancer screening – the global experience. Best Pract Res Clin Gastroenterol 28:1093–1106.
Li Y, Feng A, Zheng S, Chen C, Lyu J (2022). Recent estimates and predictions of 5-year survival in patients with gastric cancer: a model-based period analysis. Cancer Control 29:10732748221099228.
Lin Z, Bian H, Chen C, Chen W, Li Q (2021). Application of serum pepsinogen and carbohydrate antigen 72-4 (CA72-4) combined with gastrin-17 (G-17) detection in the screening, diagnosis, and evaluation of early gastric cancer. J Gastrointest Oncol 12:1042–1048. https://jgo.amegroups.com/article/view/52743 . [Accessed 6 March 2022].
Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R (2020). Gastric cancer: epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci 21:4012.
Malfertheiner P, Megraud F, Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. (2017). Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut 66:6–30.
Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou JM, Schulz C, et al. (2022). Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut 71:1724–1762.
Mendes-Rocha M, Figueiredo J, Ferreira RM (2022). Review: gastric malignancies – bugs, pathways and molecular programs. Microb Health Dis 4:1–8.
Miki K (2011). Gastric cancer screening by combined assay for serum anti-Helicobacter pylori IgG antibody and serum pepsinogen levels – ‘ABC method’. Proc Jpn Acad Ser B Phys Biol Sci 87:405–414.
Morgan E, Arnold M, Camargo MC, Gini A, Kunzmann AT, Matsuda T, et al. (2022). The current and future incidence and mortality of gastric cancer in 185 countries, 2020 & 2013; 40: a population-based modelling study. EClinicalMedicine 47:101404.
Petrelli F, Berenato R, Turati L, Mennitto A, Steccanella F, Caporale M, et al. (2017). Prognostic value of diffuse versus intestinal histotype in patients with gastric cancer: a systematic review and meta-analysis. J Gastrointest Oncol 8:148–163. https://jgo.amegroups.com/article/view/11973 . [Accessed 7 February 2022].
Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, et al. (2019). Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Port. Endoscopy 51:365–388. https://www.thieme-connect.com/products/ejournals/html/10.1055/a-0859-1883 . [Accessed 6 March 2022].
doi: 10.1055/a-0859-1883
Rowbotham DJ, Kimpson PM, Thompson HM. Chapter 61 - Gut motility and secretions. In: Hemmings HC, Hopkins PMBT-F of A (Second Edition) editors. Mosby; 2006. p. 7. doi: 10.1016/B978-0-323-03707-5.50067-X
Sasazuki S (2016). The ABC method and gastric cancer: evidence from prospective studies. J Epidemiol 26:611–612.
Shen H, Xiong K, Wu X, Cheng S, Lou Q, Jin H, et al. (2021). The diagnostic value of serum gastrin-17 and pepsinogen for gastric cancer screening in Eastern China. Gastroenterol Res Pract 2021:6894248.
Skrebinska S, Megraud F, Daugule I, Santare D, Isajevs S, Liepniece-Karele I, et al. (2022). Who could be blamed in the case of discrepant histology and serology results for helicobacter pylori detection? Diagnostics (Basel) 12:133.
Smith JP, Nadella S, Osborne N (2017). Gastrin and gastric cancer. Cell Mol Gastroenterol Hepatol 4:75–83.
Song DH, Rana B, Wolfe JR, Crimmins G, Choi C, Albanese C, et al. (2003). Gastrin-induced gastric adenocarcinoma growth is mediated through cyclin D1. Am J Physiol Gastrointest Liver Physiol 285:G217–G222.
Song M, Camargo MC, Weinstein SJ, Murphy G, Freedman ND, Koshiol J, et al. (2018). Serum pepsinogen 1 and anti-Helicobacter pylori IgG antibodies as predictors of gastric cancer risk in Finnish males. Aliment Pharmacol Ther 47:494–503.
Wang TC, Dangler CA, Chen D, Goldenring JR, Koh T, Raychowdhury R, et al. (2000). Synergistic interaction between hypergastrinemia and Helicobacter infection in a mouse model of gastric cancer. Gastroenterology 118:36–47.
Wang Z, Mo T-M, Tian L, Chen J-Q (2021). Gastrin-17 combined with CEA, CA12-5 and CA19-9 improves the sensitivity for the diagnosis of gastric cancer. Int J Gen Med 14:8087–8095.
Yamaguchi Y, Nagata Y, Hiratsuka R, Kawase Y, Tominaga T, Takeuchi S, et al. (2016). Gastric cancer screening by combined assay for serum anti- Helicobacter pylori IgG antibody and serum pepsinogen levels - the ABC method. Digestion 93:13–18.
Yu G, Wang GX, Wang HG, Mo FF, Tang BB (2019). The value of detecting pepsinogen and gastrin-17 levels in serum for pre-cancerous lesion screening in gastric cancer. Neoplasma 66:637–640.
Zagari RM, Rabitti S, Greenwood DC, Eusebi LH, Vestito A, Bazzoli F (2017). Systematic review with meta-analysis: diagnostic performance of the combination of pepsinogen, gastrin-17 and anti-Helicobacter pylori antibodies serum assays for the diagnosis of atrophic gastritis. Aliment Pharmacol Ther 46:657–667.