Diagnostic value of serum pepsinogen, gastrin, and carbohydrate antigens in gastric ulcer and gastric cancer.

BACKGROUND

Emerging evidence suggests that serum levels of pepsinogen (PG), gastrin-17 (G17), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4 may aid in distinguishing gastric cancer (GC) from gastric ulcer (GU).

AIM

To assess serum PG, G17, CEA, CA19-9, and CA72-4 in diagnosing GU and optimizing GC detection.

METHODS

A retrospective analysis was conducted from 263 patients treated at the Third People's Hospital of Hefei, who were classified into three groups: Chronic non-atrophic gastritis (CG), GU, and GC. Fasting serum levels of PG, G17, CEA, CA19-9, and CA72-4 were measured and compared across the groups.

RESULTS

Serum levels of PGII and G17 were significantly elevated in both the GU and GC groups compared to the CG group ( < 0.01), whereas the PGI/PGII ratio was markedly decreased ( < 0.01). Levels of CEA, CA19-9, and CA72-4 were significantly higher in the GC group than in the CG and GU groups ( < 0.01). Receiver operating characteristic curve analysis identified the optimal diagnostic cut-off values for GU and GC as follows: PGI (169.855 pmol/L), PGII (30.555 μg/L), PGI/PGII ratio (16.529), G17 (6.435 pmol/L), CEA (2.005 ng/mL), CA19-9 (16.65 U/mL), and CA72-4 (2.075 U/mL). The area under the curve for combined detection was 0.826 ( < 0.001), indicating good diagnostic performance.

CONCLUSION

Serological biomarkers effectively distinguish GC from GU, with combined detection of PGII, PGI/PGII ratio, G17, and tumor markers enhancing diagnostic accuracy.