Xu J, Li SX, Liu D, Chen LX, Chen X. Diagnostic value of serum pepsinogen, gastrin, and carbohydrate antigens in gastric ulcer and gastric cancer. World J Gastrointest Oncol 2025; 17(6): 105931 [DOI: 10.4251/wjgo.v17.i6.105931]
Corresponding Author of This Article
Xi Chen, MD, PhD, Professor, Senior Researcher, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. ayfychenxi@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2025; 17(6): 105931 Published online Jun 15, 2025. doi: 10.4251/wjgo.v17.i6.105931
Diagnostic value of serum pepsinogen, gastrin, and carbohydrate antigens in gastric ulcer and gastric cancer
Juan Xu, Shao-Xue Li, Dong Liu, Li-Xin Chen, Xi Chen
Juan Xu, Xi Chen, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Juan Xu, Shao-Xue Li, Dong Liu, Li-Xin Chen, Department of Gastroenterology, The Third People’s Hospital of Hefei, The Third Clinical Medical College of Hefei of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Chen X and Xu J designed the research study; Xu J, Li SX, Liu D, and Chen LX performed the research; Xu J, Li SX, and Chen X analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Supported by Chinese Medicine Research Project of Anhui Chinese Medicine Society, No. 2024ZYYXH135.
Institutional review board statement: The study was reviewed and approved by the Third People’s Hospital of Hefei Institutional Review Board (Approval No. 2024 LLWL041).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at ayfychenxi@163.com.
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: Xi Chen, MD, PhD, Professor, Senior Researcher, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. ayfychenxi@163.com
Received: February 11, 2025 Revised: April 9, 2025 Accepted: May 15, 2025 Published online: June 15, 2025 Processing time: 123 Days and 4 Hours
Abstract
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 (P < 0.01), whereas the PGI/PGII ratio was markedly decreased (P < 0.01). Levels of CEA, CA19-9, and CA72-4 were significantly higher in the GC group than in the CG and GU groups (P < 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 (P < 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.
Core Tip: This study determined that the ratio of pepsinogen I/II was low, and the levels of pepsinogen II, gastrin-17, carbohydrate antigen 19-9, carcinoembryonic antigen and carbohydrate antigen 72-4 were increased as auxiliary serological biomarkers for the differentiation of gastric ulcer and gastric cancer. The diagnostic accuracy of combined application for gastric cancer and gastric ulcer was high, and the area under the curve was 0.826.
