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World J Gastrointest Oncol. Jul 15, 2023; 15(7): 1174-1181
Published online Jul 15, 2023. doi: 10.4251/wjgo.v15.i7.1174
Clinical value of serum pepsinogen in the diagnosis and treatment of gastric diseases
Yuan Qin, Jia-Xin Geng, Biao Huang
Yuan Qin, Jia-Xin Geng, Biao Huang, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou 310018, Zhejiang Province, China
Author contributions: Huang B and Qin Y designed this study; Qin Y and Geng JX conducted the reference analyses, drafted the initial version of the paper, and received contributions from all authors.
Supported by the National Natural Science Foundation of China, No. 82172336; “Pioneer” and “Leading Goose” R&D Program of Zhejiang, No. 2022C03118 and No. 2023C03075; Natural Science Foundation of Zhejiang Province, No. LQ23H050005; and Scientific Research Project of Zhejiang Provincial Education Department, No. Y202250731.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Biao Huang, PhD, Professor, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, No. 928, No. 2 Street, Qiantang District, Hangzhou 310018, Zhejiang Province, China. jswxhb@163.com
Received: March 28, 2023
Peer-review started: March 28, 2023
First decision: May 12, 2023
Revised: May 28, 2023
Accepted: June 14, 2023
Article in press: June 14, 2023
Published online: July 15, 2023
Abstract

Pepsinogen, secreted from the gastric mucosa, is the precursor of pepsin. It is categorized as pepsinogen 1 and pepsinogen 2 based on its immunogenicity. The pepsinogen content that can enter the blood circulation through the capillaries of the gastric mucosa is approximately 1% and remains stable all the time. The pepsinogen content in serum will change with the pathological changes of gastric mucosa. Therefore, the level of pepsinogen in serum can play a role in serologic biopsy to reflect the function and morphology of different regions of gastric mucosa and serve as an indicator of gastric disease. This study conducts relevant research on serum pepsinogen 1, pepsinogen 2, and the ratio of pepsinogen 1 to pepsinogen 2, and reviews their important value in clinical diagnosis of Helicobacter pylori infection, gastric ulcer, and even gastric carcinoma, providing ideas for other researchers.

Keywords: Pepsinogen 1, Pepsinogen 2, Gastric diseases, Serological marker, Serological biopsy

Core Tip: Pepsinogen is the precursor of pepsin, including pepsinogen 1 and pepsinogen 2. Serum pepsinogen has certain clinical value in determining Helicobacter pylori (H. pylori) infection and its treatment monitoring, in identifying the location and extent of gastric mucosal lesions, and in diagnosing and screening ongoing gastric cancer and precancerous lesions. This work summarizes the clinical value of serum pepsinogen 1, pepsinogen 2, and the ratio of pepsinogen 1 to pepsinogen 2 in the diagnosis of H. pylori infection, atrophic gastritis, and gastric cancer to provide readers with research ideas.