Serum pepsinogenⅠandⅡin residents from Zhuanghe county in North China / 中华消化杂志

ABSTRACT

Objective To determine the serum level of pepsinogenⅠ,Ⅱ(PGⅠ,PGⅡ) and PGⅠ/Ⅱin the residents from Zhuanghe county,a high risk area of gastric cancer in North China,and to explore their distribution as well as related factors.Methods Serum PGⅠand PGⅡlevels were detec- ted with ELISA method in 6990 subjects.Gastric diseases were diagnosed by endoscopy and histopatho- logic examination.Serum H.pylori-IgG antibody was determined by ELISA method.Results The me- dian values for PGⅠ,PGⅡ,PGⅠ/Ⅱwere 86.9/?g/L,10.6/zg/L and 8.1 respectively.Serum PGⅠand PGⅡin male(95.2?g/L,12.1?g/L) were significantly higher than those in female(79.7?g/L, 9.4?g/L;P=0.000),PGⅠ/Ⅱratio(7.9) was significantly lower in male (8.3,P=0.000).There were significantly decrease in PGⅠ/Ⅱratio along with age increase.PGⅠ/Ⅱratio decreased signifi- cantly following with progression of gastric mucosa from normal (10.4) to non-atrophic lesions(8.8) and to atrophic lesions (6.6).Serum PGⅠand PGⅡin H. pylori positive subjects (88.7?g/L,11.4?g/L) were significantly higher than those in H.pylori negative subjects (81.4?g/L,8.4?g/L;P= 0.000),PGⅠ/Ⅱratio(7.7) was significantly lower in H.pylori positive subjects (9.6,P=0.000). For patients with atrophic lesions,the area under the PGⅠ/ⅡROC curve was 0.622.The best cut-off point for PGⅠ/Ⅱwas 6.9,with sensitivity of 53.2%,and specificity of 67.5%.Factors linked to PGⅠ/Ⅱwere identified using multinomial logistic regressionmale (OR1.151,95% CI1.042—1.272, P=0.006),age=61(OR1.358,95% CI1.188—1.553,P=0.000),atrophic lesion(OR2.075,95% CI1.870—2.302,P=0.000),and H.pylori infection (OR1.546,95% CI1.368—1.748,P= 0.000).Conclusions The serum PG levels are significantly skewed from normal distrubition in the residents of Zhuanghe county,and affected by age and gender,as well as associated with gastric diseases and H.pylori in- fection.Compared with PGⅠand PGⅡalone,PGⅠ/Ⅱis more suitable for screening gastric cancer.