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World J Gastroenterol. Jan 14, 2027; 33(2): 124537
Published online Jan 14, 2027. doi: 10.3748/wjg.124537
Published online Jan 14, 2027. doi: 10.3748/wjg.124537
Serum pepsinogen combined with computed tomography imaging for diagnosing recurrence of gastric cancer after total gastrectomy
Jiu-Ru Zhang, Zhi-Hong Zhu, Department of Nuclear Medicine, Changshu No. 1 People’s Hospital, Changshu 215500, Jiangsu Province, China
Xue-Wen Xu, Jia-Meng Liu, Chao-Ming Mao, Department of Nuclear Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu Province, China
Co-first authors: Jiu-Ru Zhang and Xue-Wen Xu.
Author contributions: Zhang JR and Xu XW performed the experiments, analyzed the data, and drafted the manuscript; Liu JM and Zhu ZH participated in data collection and interpretation; Mao CM designed and supervised the study, and revised the manuscript. All authors have read and approved the final manuscript. Zhang JR and Xu XW contributed equally to this work as co-first authors.
AI contribution statement: AI tools (ChatGPT and DeepSeek) were used solely for language polishing. No AI was used for data generation, analysis, or figure creation. All authors take full responsibility for the content.
Supported by National Natural Science Foundation of China, No. 81370889; and the Key Research and Development Plan of Zhenjiang City, No. SH2022046 and No. JDYY2023006.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of the Affiliated Hospital of Jiangsu University (Approval No. KY2023K0603) and conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Complete information disclosure was provided to all participants. The requirement for written informed consent was waived by the Ethics Committee of the Affiliated Hospital of Jiangsu University owing to the retrospective nature of the study and the exclusive use of anonymized data.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The corresponding author will share the de-identified dataset underlying this article upon reasonable request.
Corresponding author: Chao-Ming Mao, PhD, Academic Fellow, Professor, Department of Nuclear Medicine, Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Jingkou District, Zhenjiang 212000, Jiangsu Province, China. jq1001@ujs.edu.cn
Received: June 18, 2026
Revised: July 22, 2026
Accepted: July 29, 2026
Published online: January 14, 2027
Processing time: 141 Days and 22.4 Hours
Revised: July 22, 2026
Accepted: July 29, 2026
Published online: January 14, 2027
Processing time: 141 Days and 22.4 Hours
Core Tip
Core Tip: This study evaluated the combined diagnostic performance of serum pepsinogen (PG) and computed tomography (CT) imaging for detecting recurrence after total gastrectomy. We found that serum PG and CT imaging play complementary roles, with PG providing early functional warning by reflecting secretory tumor burden and CT imaging offering anatomical confirmation. Importantly, PG expression varied substantially by histological differentiation, and this heterogeneity directly influenced the diagnostic sensitivity of serum PG. These findings support a histology-stratified, PG-centered surveillance strategy that integrates functional and morphological information for personalized postoperative follow-up.