Development of a New Combination Platform for the Early Screening of Gastric Cancer Using Serum Biomarkers

Objective: The combination of pepsinogens (PG I/II) and gastrin-17 (G17) has been used to screen GC in many countries, without satisfactory levels of sensitivity or specificity. The aim of this study was to find a better marker and a new modality in screening early GC. Methods: We measured the serum levels of PG I/II, G17, and prealbumin (PA) from the serum of 481 healthy individuals, 407 benign gastric diseases (BGD), and 416 GC patients using a latex particle-enhanced turbidimetric immunoassay and Sandwich ELISA. Logistic regression analysis was used to obtain the sensitivity and specificity of the combined detection model. Results: When PA was combined with the other biomarkers, the sensitivity and specificity were significantly improved in the ROC curve. The combination of PA+G17+PGI+PGR was the best diagnostic combination for both early and late GC. The AUC, sensitivity, and specificity of the combination for discriminating between early GC and healthy individuals were 0.796, 72.1% and 74.2% respectively. For distinguishing patients with early GC from BGD, the AUC, sensitivity and specificity of the combination were 0.696, 66.7% and 65.4%, respectively. The combination of PA+G17+PGI+PGR improved both the sensitivity and the specificity of GC diagnosis compared with those of the traditional combination of G17+PGI+ PGII +PGR. Conclusion: PA is a valuable indicator for GC and interacts synergistically with PG and G17 in screening for early GC. The new combination platform PA+G17+PGI+PGR may be a potential way for the early screening of GC.