Diagnostic Value of Serum Pepsinogen and Helicobacter pylori Infection in Gastric Cancer Screening in Western Zhejiang.

Abstract

Objective: The aim of this study is to assess the screening value of serum pepsinogen (PG) expression and Helicobacter pylori (Hp) infection for gastric cancer (GC) in western Zhejiang.

Methods: A retrospective analysis was conducted on patients who underwent gastroscopy at the First People's Hospital of Jiande between July 2020 and July 2023. Participants were classified into four groups: chronic nonatrophic gastritis, chronic atrophic gastritis, peptic ulcer, and GC, which included early gastric cancer (EGC) and advanced GC. Serum pepsinogen I (PGI), pepsinogen II (PGII), pepsinogen ratio (PGR), and anti-Helicobacter pylori immunoglobulin G (Hp-IgG) levels were measured. Group differences were assessed, and receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of PG alone and in combination with Hp-IgG, age, and sex for GC and EGC.

Results: Significant differences were observed among the four groups in PGI, PGII, PGR, Hp infection rate, age, and sex (p < 0.01). In benign gastric diseases, PGI and PGII levels increased with the severity and activity of gastric mucosal inflammation (p < 0.05). PGII levels were associated with tumor size and Lauren classification (p < 0.05), while PGR was associated with GC stage (p = 0.021). The area under the ROC curve (AUC) for PG alone in differentiating GC/EGC from benign gastric diseases ranged from 0.598 to 0.813, whereas the model incorporating PG, Hp-IgG, age, and sex achieved an AUC of 0.851.

Conclusion: Serum PG expression and Hp infection rates differed between patients with GC and those with benign gastric diseases in western Zhejiang. Models combining PG with demographic variables demonstrated a good diagnostic value for GC, including EGC, supporting their potential application in noninvasive GC screening.