Influence of a diet meal plan on pepsinogen I and II,gastrin-17,and nutritional status in gastric ulcer patients

BACKGROUND Gastric ulcers(GUs)have a high risk of clinical morbidity and recurrence,and further exploration is needed for the prevention,diagnosis,and treatment of the disease.AIM To investigated the effects of a diet plan on pepsinogen(PG)I,PG II,gastrin-17(G-17)levels and nutritional status in patients with GUs.METHODS A total of 100 patients with GUs treated between May 2022 and May 2023 were enrolled,with 47 patients in the control group receiving routine nursing and 53 patients in the experimental group receiving dietary nursing intervention based on a diet plan.The study compared the two groups in terms of nursing efficacy,adverse events(vomiting,acid reflux,and celialgia),time to symptom improvement(burning sensation,acid reflux,and celialgia),gastric function(PG I,PG II,and G-17 levels),and nutritional status[prealbumin(PA)and albumin(ALB)levels].RESULTS The experimental group showed a markedly higher total effective rate of nursing,a significantly lower incidence of adverse events,and a shorter time to symptom improvement than the control group.Additionally,the experimental group’s post-intervention PG I,PG II,and G-17 levels were significantly lower than preintervention or control group levels,whereas PA and ALB levels were significantly higher.CONCLUSION The diet plan significantly reduced PG I,PG II,and G-17 levels in patients with GUs and significantly improved their nutritional status.

Clinical value of serum pepsinogen in the diagnosis and treatment of gastric diseases

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.

Efficacy and safety of endoscopic submucosal dissection for early gastric cancer and precancerous lesions in elderly patients

BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients.METHODS Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were se-lected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022.Among them,39 patients treated with ESD were included in an experimental group,and 39 patients treated with endoscopic mucosal resection(EMR)were included in a control group.We compared the basic intraoperative conditions,postoperative short-term recovery,long-term recovery effects and functional status of gastric mucosa between the two groups;the basic intraoperative conditions included lesion resection,intra-operative bleeding and operation time;the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complic-ations;and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoper-atively;and we compared the preoperative and predischarge serum pepsinogen I(PG I)and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge.RESULTS The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group.The intraoperative bleeding volume was higher in the experimental group than in the control group.The operation time was longer in the experimental group than that in the control group,and the rate for base residual focus was lower in the experimental group than that of the control group,and the differences were all statistically significant(all P<0.05).The length of hospital stay was longer in the experi-mental group than in the control group,and the incidence of surgical complications,1-year postoperative recu-rrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group,and the differences were statistically significant(all P<0.05).However,the difference in the 1-year postoperative survival rate was not statistically significant between the two groups(P>0.05).Before discharge,PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period,and the above indexes were higher in the experimental group than those in the control group,and the differences were statistically significant(both P<0.05).Moreover,before discharge,PG II level was lower in both groups compared with the preoperative period,and the level was lower in the experimental group than in the control group,and the differences were all statistically significant(all P<0.05).CONCLUSION Compared with EMR,ESD surgery is more thorough.It reduces the rate of base residual focus,recurrence rate,surgical complications,and promotes the recovery of gastric cells and glandular function.It is safe and suitable for clinical application.

The ontogeny of acidic digestive tract in larval turbot Scophthalmus maximus based on H+/K+-ATPase and pepsinogen

Acidic digestion is an important digestive process of marine fish.In fish stomach,two enzymes are involved in the secretion of hydrochloric acid(HCl)and proteomic digestion:H^(+)/K^(+)-ATPase and pepsinogen.However,the starting of digestive function in fish is still unclear.To reveal the details of acidic digestion of turbot Scophthalmus maximus in early development,a 40 day of turbot larvae culture was conducted.The H^(+)/K^(+)-ATPase gene from the turbot S.maximus(smH^(+)/K^(+)-ATPase)was identified and characterized.Based on our previous discription on pepsinogen of turbot S.maximus,we combined pepsinogen and H^(+)/K^(+)-ATPase and analyzed the mechanism of acidic digestion in turbot.Results show that the spatial and temporal expression profiles of H^(+)/K^(+)-ATPase agreed with pepsinogen A and C in turbot,indicating a synergetic action between H^(+)/K^(+)-ATPase and pepsinogen during the acidic digestion process.In addition,the turbot juveniles showed a faster growth after the expressions of H^(+)/K^(+)-ATPase gene and pepsinogen gene,demonstrating that pepsin had a higher digestive efficiency,for which a compound diet should be provided to the fish from Day 22 onward.This study provided a reference for biology research and aquaculture of turbot and other marine fishes.

Postprandial gastrin-17 level is a useful dynamic marker for atrophic gastritis

Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy.Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify patients for endoscopy to detect early gastric cancer.These non-invasive biomarkers have been endorsed and recommended by many international consensus guidelines.In this letter,we reviewed the literature and evidence supporting the use of serum biomarkers as a dynamic test to monitor the status of atrophic gastritis.

CONTRASTIVE STUDY OF THE TISSUE EXPRESSION AND SERUM CONCENTRATION OF PEPSINOGEN C IN GASTRIC MUCOSA DISEASES

Objective： To estimate the practical values of pepsinogen C （PGC） dynamic expression and the levels of serum pepsinogens in gastric cancer screening and diagnosis. Methods： 129 cases gastric mucosa biopsies and serum specimens were examined. The expression of PGC in stomach mucosa was detected by immunohistochemistry. The serum concentration of pepsinogen A （sPGA） and pepsinogen C （sPGC） were determined by ELISA. Results： The positive rate of PGC antigen expression decreased in superficial gastritis （100%）, gastric ulcer or erosion （80.00%）, atrophic gastritis （34.48%） and gastric cancer （11.43%） in sequence （P〈0.05）. There was no statistics difference in concentration of sPGA and sPGC among the above 4 groups. The ratio of sPGA/sPGC decreased in superficial gastritis, gastric ulcer or erosion, atrophic gastritis and gastric cancer in sequence （P〈0.05）. There was specific correlation between the expression of PGC in stomach mucosa and the levels of sPGA/sPGC ratio in serum （rs =0.297, P=0.001）. Conclusion： Tissue expression of PGC has close relationship with different gastric diseases. The ratio of sPGA/sPGC is relative with the tissue expression of PGC antigen and may be a convenient and economic maker in screening and diagnosis of gastric cancer.

Pepsinogen C Gene Expression in Epithelial Cells of Rat Stomach During Development

Pepsinogens are zymogens of pepsins,aspecific proteases working as digestive enzymes in vertebrate stomach,of which biological and molecular properties have been extensively studied.Several exhaustive studies have been performed in the pepsinogen producing cells in developing rat stomachs,but little is known about the expression of pepsinogen gene in these cells.In this study,the ontogeny of pepsinogen producing cells in rat fundic glands was studied by in situ hybridization using a digoxigenin-labeled RNA probe.The rat gastric epithelium was stratified but was morphologically undifferentiated at the stage of 18.5 days of gestation.The pepsinogen mRNA was expressed both in chief cells and mucous neck cells in adult rats,which was first detected by in situ hybridization in the stomach of the rats at 3.5 days after birth.The development of pepsinogen producing cells could be classified into four stages:(1) 18.5 days of gestation to 0.5 day after birth;(2) 3.5 days to 2 weeks after birth;(3) 3～4 weeks after birth;(4) 8 weeks after birth.Pepsinogen expression is strictly limited to these cells,the distribution of which shown a developmental stage-specific manner.We concluded the pepsinogen C could offer excellent molecular markers of differentiation during stomach epithelial cellulur development.

Serum pepsinogen levels and their influencing factors:A population-based study in 6990 Chinese from North China

AIM: To explore the essential characteristics of serum pepsinogen (PG) levels in Chinese people, by analyzing the population-based data on the serum levels of PG Ⅰ and Ⅱ and the PGⅠ/Ⅱ ratio, and their influencing factors in Chinese from North China. METHODS: A total of 6990 subjects, who underwent a gastric cancer screening in North China from 1997 to 2002, were collected in this study. Serum pepsinogen levels were measured by enzyme-linked immunosorbent assay (ELISA). H pylori status was determined by histological examination and H pylori-IgG ELISA. The cut-off point was calculated by using receiving operator characteristics (ROC) curves. Factors linked to serum PG Ⅰ/Ⅱ ratio were identified using a multivariate logistic regression. RESULTS: The serum PGⅠ and PGⅡ levels were significantly higher in males than in females (95.2 μg/L vs 79.7 μg/L, P < 0.01; 12.1 μg/L vs 9.4 μg/L, P < 0.01), PGⅠ/Ⅱ ratio was significantly lower in males than in females (7.9 vs 8.3, P < 0.01). The PG Ⅰ/Ⅱ ratio decreased significantly in the aged groups following the progression of gastric mucosa from normal to non-atrophic and atrophic lesions (10.4, 8.8, and 6.6, respectively). The serum PGⅠand Ⅱ levels were significantly higher in patients with H pylori infection than in those without H pylori infection (88.7 μg/L vs 81.4 μg/L, P < 0.01; 11.4 μg/L vs 8.4 μg/L, P < 0.01), while the PGⅠ/Ⅱ ratio was significantly lower in patients with H pylori infection than in those without H pylori infection (7.7 vs 9.6, P < 0.01). For patients with atrophic lesions, the area under the PGⅠ/Ⅱ ROC curve was 0.622. The best cut-off point for PGⅠ/Ⅱ was 6.9, with a sensitivity of 53.2%, and a specificity of 67.5%. Factors linked to PGⅠ/Ⅱ were sensitive to identified PG using a multinomial logistic regression relying on the following inputs: males (OR: 1.151, 95% CI: 1.042-1.272, P = 0.006), age ≥ 61 years (OR: 1.358, 95% CI: 1.188-1.553, P = 0.000), atrophic lesion (OR: 2.075, 95% CI: 1.870-2.302, P = 0.000), and H pylori infection (OR: 1.546, 95% CI: 1.368-1.748, P = 0.000). CONCLUSION: The essential characteristics of serum PG levels in Chinese are significantly skewed from the normal distribution, and influenced by age, sex, gastric mucosa lesions and H pylori infection. PGⅠ/Ⅱ ratio is more suitable for identifying subgroups with different influence factors compared with PGⅠor PGⅡ alone.

Type Ⅰ and type Ⅱ Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area

BACKGROUND Type I Helicobacter pylori(H.pylori)infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis.However,its infection status in stepwise gastric disease progression in this gastric cancer prevalent area has not been evaluated;it is also not known its impact on commonly used epidemiological gastric cancer risk markers such as gastrin-17(G-17)and pepsinogens(PGs)during clinical practice.AIM To explore the prevalence of type I and type II H.pylori infection status and their impact on G-17 and PG levels in clinical practice.METHODS Thirty-five hundred and seventy-two hospital admitted patients with upper gastrointestinal symptoms were examined,and 523 patients were enrolled in this study.H.pylori infection was confirmed by both 13C-urea breath test and serological assay.Patients were divided into non-atrophic gastritis(NAG),nonatrophic gastritis with erosion(NAGE),chronic atrophic gastritis(CAG),peptic ulcers(PU)and gastric cancer(GC)groups.Their serological G-17,PG I and PG II values and PG I/PG II ratio were also measured.RESULTS A total H.pylori infection rate of 3572 examined patients was 75.9%,the infection rate of 523 enrolled patients was 76.9%,among which type I H.pylori infection accounted for 72.4%(291/402)and type II was 27.6%;88.4%of GC patients were H.pylori positive,and 84.2%of them were type I infection,only 11.6%of GC patients were H.pylori negative.Infection rates of type I H.pylori in NAG,NAGE,CAG,PU and GC groups were 67.9%,62.7%,79.7%,77.6%and 84.2%,respectively.H.pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio.Both types of H.pylori induced higher G-17 level,but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG,NAGE and CAG groups over uninfected controls.Overall PG I levels showed no difference among all disease groups and in the presence or absence of H.pylori;in stratified analysis,its level was increased in GC and PU patients in H.pylori and type I H.pylori-positive groups.CONCLUSION Type I H.pylori infection is the major form of infection in this geographic region,and a very low percentage(11.6%)of GC patients are not infected by H.pylori.Both types of H.pylori induce an increase in G-17 level,while type I H.pylori is the major strain that affects PG I and PG IIs level and PG I/PG II ratio in stepwise chronic gastric disease.The data provide insights into H.pylori infection status and indicate the necessity and urgency for bacteria eradication and disease prevention in clinical practice.

Simultaneous detection of different serum pepsinogens and its primary application

AIM: To develop the simple, rapid and sensitive dual-label time-resolved fluoroimmunoassay for pepsinogens in human serum.METHODS: Based on two-site sandwich protocol, mono-clonal antibodies (McAbs) against pepsinogen Ⅰ (PG Ⅰ) and PG Ⅱ were co-coated in 96 microtitration wells, and tracer McAbs against PG Ⅰ and PG Ⅱ were labeled with europium (Eu) and samarium (Sm) chelate, respectively. Diluted serum samples of Eu3+- and Sm3+-McAbs were added into microtitration wells simultaneously. After washing, fluorescence of bound Sm3+ and Eu3+ tracers was detected. RESULTS: The detection limit was 0.2 μg/L for PG Ⅰ and 0.05 μg/L for PG Ⅱ. The assay range was 5.0-320.0 μg/Lfor PG Ⅰ and 1.0-55.0 μg/L for PG Ⅱ. The average re-covery rate was 102.7% for PG Ⅰ and 98.8% for PG Ⅱ. Sera from healthy controls and patients with gastric dis-ease were analyzed. The PG detected by dual-label as-say was in good agreement with that detected by single-label assay or by enzyme-linked immunosorbent assay. CONCLUSION: Dual-label assay can provide high-throughput serological screening for gastric diseases.

Dynamic expression of pepsinogen C in gastric cancer, precancerous lesions and Helicobacter pylori associated gastric diseases

AIM:To investigate the relationship between the expression of pepsinogen C (PGC) and gastric cancer, precancerous diseases, and Helicobacter pylori (H pylori) infection. METHODS: The expression of PGC was determined by immunohistochemistry method in 430 cases of gastric mucosa. H3 Pylori infection was determined by HE staining, PCR and ELISA in 318 specimens. RESULTS: The positive rate of PGC expression in 54 cases of normal gastric mucosa was 100%. The positive rates of PGC expression in superficial gastritis or gastric ulcer or erosion, atrophic gastritis or gastric dysplasia and gastric cancer decreased significantly in sequence (P<0.05; 100%/89.2% vs 14.3%/15.2% vs 2.4%). The over-expression rate of PGC in group of superficial gastritis with H pyloriinfection was higher than that in group without H pylori infection (P<0.05; x2= 0.032 28/33 vs 15/25). The positive rate of PGC expression in group of atrophic gastritis with H pylori infection was lower than that in group without H pylori infection (P<0.01; x2 = 0.003 4/61 vs9/30), and in dysplasia and gastric cancer. CONCLUSION: The level of PGC expression has a close relationship with the degree of malignancy of gastric mucosa and development of gastric lesions. There is a relationship between H pylori infection and expression of antigen PGC in gastric mucosa, the positive rate of PGC expression increases in early stage of gastric lesions with H pylori infection such as gastric inflammation and decreases during the late stage such as precancerous diseases and gastric cancer. PGC-negative cases with H py/ori-positive gastric lesions should be given special attention.

Gastric cancer in a Caucasian population: Role of pepsinogen C genetic variants

AIM： To study the role of an insertion/deletion polymorphism in the pepsinogen C （PGC） gene, an effective marker for terminal differentiation of the stomach mucosa, in the susceptibility to the development of gastric lesions. METHODS： The study was performed with 99 samples of known gastric lesions and 127 samples without evidence of neoplastic disease. PCR was employed and the 6 polymorphic alleles were amplified： Allele 1 （510 bp）, Allele 2 （480 bp）, Allele 3/4 （450/460 bp）, Allele 5 （400 bp） and Allele 6 （310 bp）. RESULTS： Our results revealed that Allele 6 carriers seemed to have protection against the development of any gastric lesion （OR = 0.34; P 〈 0.001）, non-dysplastic lesions associated with gastric adenocarcinoma such as atrophy or intestinal metaplasia （OR = 0.28; P 〈 0.001） or invasive GC （OR = 0.39; P = 0.004）. CONCLUSION： Our study reveals that the Allele 6 carrier status has a protective role in the development of gastric lesions, probably due to its association with higher expression of PGC. Moreover, the frequency of Allele 6 carriers in the control group is far higher than that obtained in Asian populations, which might represent a genetic gap between Caucasian and Asian populations.

Serum pepsinogen Ⅱ is a better diagnostic marker in gastric cancer

AIM:To investigate screening makers for gastric cancer,we assessed the association between gastric cancer and serum pepsinogens(PGs).METHODS:The subjects comprised 450 patients with gastric cancer,111 individuals with gastric atrophy,and 961 healthy controls.Serum anti-Helicobacter pylori(H.pylori) immunoglobulin G(IgG),PGⅠand PG Ⅱ were detected by enzyme-linked immunosorbent assay.Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations.Odds ratios and 95%CIs were calculated using multivariate logistic regression.RESULTS:Rates of H.pylori infection remained high in Northeastern China.Rates of H.pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group(69.1% and 75.7% vs 49.7%,P < 0.001).Higher levels of PG Ⅱ(15.9 μg/L and 13.9 μg/L vs 11.5 μg/L,P < 0.001) and lower PGⅠ/PG Ⅱ ratio(5.4 and 4.6 vs 8.4,P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls,whereas no correlation was found between the plasma PGⅠconcentration and risk of gastric cancer(P = 0.537).In addition,multivariate logistic analysis indicated that H.pylori infection and atrophic gastritis were independent risk factors for gastric cancer.Lower plasma PGⅠ/PG Ⅱ ratio was associated with higher risks of atrophy and gastric cancer.Furthermore,plasma PG Ⅱ?level?significantly?correlated?with?H.pyloriinfected gastric cancer.CONCLUSION:Serum PG Ⅱ concentration and PG Ⅰ/PG Ⅱ ratio are potential biomarkers for H.pyloriinfected gastric disease.PG Ⅱ is independently associated with risk of gastric cancer.

Association of serum pepsinogen with degree of gastric mucosal atrophy in an asymptomatic population

BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.

Eu-Chelate Construct Ultrasensitive Time-Resolved Fluoroimmunoassay-Assay of Pepsinogen I

Eu-chelate were used to construct a two-site sandwich-type assay for pepsinogen Ⅰ （PGI） with time-resolved fluoroimmunoassay （TRFIA） as a detection technique. On the noncompetitive assay, captured monoclonal antibodies （McAbs） coated on wells were directed against a specific antigenic site on the PGI. Another McAbs, called as labeling McAbs, were prepared with the Eu-chelate of N-（p-isothiocyanatobenzyl）-diethylenetriamine-N, N, N, N-tetraacetic acid and directed against a different antigenic site on the PGI. The fluorescence counts of bound Eu^3＋ -McAbs were measured with the auto DELFIA1235 system. The PGI in sera from healthy volunteers were determined by PGI-TRFIA. The within-run and between-run CVs of the PGI-TRFIA were 1.9% and 4.7%, respectively, and the recovery rate was 102.65%. The assay had a detection limit of 0.05 μg· L^-1. The PGI-TRFIA provided a linear response from 3.5 to 328 μg· L^-1. The cross-reacting rate with pepsinogen Ⅱ was negligible. The linear correlation of PGI-TRFIA and radioimmunassay measurements resulted in a correlation coefficient of 0.977. The means of healthy volunteers were 154 ±43 μg·L^-1 for serum PGI. The availability of a highly sensitive, reliable, and convenient method for quantifying PGI will allow investigations into the possible diagnostic value of this analyte in various clinical conditions, including gastric carcinoma, duodenal ulcer, gastritis and severe atrophic gastritis.

Clinical value of serum pepsinogen levels for the diagnosis of esophageal squamous cell carcinoma

Objective Pepsinogens have been previously studied as markers of gastric atrophy. The objective of this study was to investigate the clinical significance of the serum levels of pepsinogen(PG) I and II, as well as the pepsinogen I/II ratio(PGR) in the diagnosis of esophageal squamous cell carcinoma. Methods A retrospective data analysis of patients who underwent gastroscopy and PG examination in Renmin Hospital was performed. The subjects were grouped into cancer and healthy control groups, and the differences in the serum levels of PGI and PGII, as well as the PGRs were compared. The receiver operating curve and the area under the curve(AUC) were also compared between the groups.Results A total of 351 Chinese patients were enrolled in the study, 209 with esophageal squamous cell carcinoma and 142 healthy controls. Overall, the levels of PGI(P < 0.0001) and PGII(P = 0.0007), as well as the PGR(P = 0.007) of the cancer group were lower than those of the control group. Male subjects in the cancer group had lower PGI(P < 0.0001), PGII(P < 0.0001), and(P = 0.0138). The subjects < 65 years old in the cancer group showed lower PGI(P < 0.0001), PGII(P = 0.001), and PGR(P = 0.0087).Overall, these results show that the levels of PGI(AUC 0.64) and PGII(AUC 0.60) have a predictive ability for discriminating esophageal carcinoma. Moreover, in males < 65 years old, PGI(AUC 0.73) and PGII(AUC 0.69) also showed to have a predictive ability for discriminating esophageal carcinoma.Conclusion Serum PG levels in patients with esophageal squamous cell carcinoma, especially in males aged < 65 years old, are lower than those in healthy people. PGI and PGII are useful for screening esophageal squamous cell carcinoma.

Value of gastroscopy combined with serum pepsinogen in the diagnosis of high risk Hp related gastric cancer

Objective:To explore the value of Helicobacter pylori antibody (Hp-IgG) and serum pepsinogen (PG) combined with gastroscopy for screening early gastric cancer and precancerous lesions in high-risk groups, so as to provide references for early clinical prevention and diagnosis.Methods: A retrospective analysis of our hospital from December 2014 to December 2017 were elderly patients with gastric cancer 304 cases, selected admitted 122 cases of elderly patients with gastric precancerous lesion (divided into superficial gastritis group, 70 cases of chronic atrophic gastritis group 52 cases) and 156 cases to the hospital in healthy volunteers as the control group. The status and the positive rate of Helicobacter pylori 13C urea breath test and compared two groups of patients with infection;using enzyme-linked immunosorbent assay of serum pepsinogen I (PG I), II (PG II) and pepsin Hp-IgG quantitative and qualitative diagnosis of individual and combined diagnostic efficiency and the comparison of three kinds of index.Results: The four groups were compared, the serum PG level of I from high to low were superficial gastritis group, normal control group, atrophic gastritis group and gastric cancer group, the differences were statistically significant;serum PG II levels from high to low in gastric cancer group and superficial gastritis group. Atrophic gastritis group, normal control group, the differences were statistically significant. Compared with the three groups, the positive rate of Hp-IgG was 90.7% in the gastric cancer group, 45.6% in the superficial gastritis group, 52.5% in the atrophic gastritis group, and the gastric cancer group was higher than that in the precancerous lesion group, but there was no difference between the precancerous lesions group. In terms of diagnostic efficacy, the specificity and sensitivity of Helicobacter pylori combined with pepsinogen were higher than those of the single diagnosis. Conclusion: Hp-IgG and PG combined with gastroscopy in screening high-risk gastric cancer and its precancerous lesions are of high specificity, high sensitivity and can be popularized in clinic.

EXPRESSION OF PEPSINOGEN Ⅰ AND Ⅱ IN HUMAN GASTRIC CARCINOMA AND PRECARCINOUS LESION

The antibodies to Pgl and Pgll are used to do the immunohistochemical study In human gastric carcinoma and precarcinous lesion. The results show that in embryo gastric mucosa the expression of PgI is positive while Pgll Is negative: In normal gastric mucosa both Pgs are positive expression: In precarclnous lesion of stomach the positive rate of both Pgs decrease strikingly, and decrease further to the lowest level when the gastric cancer occurs. It is suggested that Pgl and Pgll are the special marker of normal gastric mucosa. There Is no obvious difference of Pgl and PgII In the various types of gastric carcinoma. Both Pgs levels in advanced gastric cancer are higher than that in early stage. Pgll expression is more In gastric cancer accompanied by lymphatic metastasis, which may be beneficial to the estimate of gastric carcinoma prognosis.

Value of serum pepsinogenⅠ andⅡ ratio for evaluating the malignant biological behaviors in gastric cancer lesions

Objective:To study the value of serum pepsinogenⅠ andⅡ ratio (PGR) for evaluating the malignant biological behaviors in gastric cancer lesions.Methods:The patients with gastric cancer who underwent radical surgery in 363 Hospital between July 2015 and February 2018 were selected as the gastric cancer group in the study, and the volunteers who had physical examination in 363 Hospital during the same period were selected as the control group. Serum was collected to measure pepsinogenⅠ and pepsinogenⅡ and then calculate the PGR;gastric cancer lesions were collected to measure the expression of oncogenes and angiogenesis genes.Results:Serum PGR level of the gastric cancer group was significantly lower than that of the control group, serum PGR level of the patients with moderately-highly differentiated gastric cancer was significantly higher than that of the patients with lowly differentiated gastric cancer, serum PGR level of the patients with TNM stage III gastric cancer was significantly lower than that of the patients with TNM stage I+II gastric cancer, and serum PGR level of the gastric cancer patients with lymph node metastasis was significantly lower than that of the gastric cancer patients without lymph node metastasis;PGR=3.8 was taken as the cutoff point, and p53 and TXNIP mRNA expression in the lesions of the gastric cancer patients with PGR < 3.8 were significantly lower than those of the gastric cancer patients with PGR > 3.8 while Bcl-2,β-catenin, Survivin, COX-2, HIF-1α, VEGF, c-Met and CNPY2 mRNA expression were significantly higher than those of the gastric cancer patients with PGR > 3.8.Conclusion:The decrease of PGR in serum of patients with gastric cancer is valuable for evaluating the pathological process and malignant biological behaviors.

Correlation of serum pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content with malignant proliferation of cancer cells in patients with gastric cancer

Objective: To investigate the correlation of serum pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content with malignant proliferation of cancer cells in patients with gastric cancer. Methods:Superficial gastritis group (n=247), gastric ulcer group (n=159) and gastric cancer group (n=97) who were pathologically diagnosed by gastroscopy in Chongqing wanzhou district people's hospital of 5 between August 2016 and August 2017 were selected, and the differences in serum pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content as well as proliferation and apoptosis gene expression in lesion tissue were compared among the three groups. Pearson test was used to evaluate the correlation of pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content with malignant proliferation activity of cancer cells in patients with gastric cancer. Results: Serum pepsinogenⅠ/Ⅱ ratio and gastrin-17 content in gastric cancer group were lower than those in gastric ulcer group and superficial gastritis group. Proliferation genes EIF5A2, MACF1 and PIK3CD mRNA expression levels in gastric cancer group were higher than those in gastric ulcer group and superficial gastritis group whereas SIRT1 mRNA expression level was lower than that in gastric ulcer group and superficial gastritis group;apoptosis gene Livin mRNA expression level was higher than that in gastric ulcer group and superficial gastritis group whereas Bad and Noxa mRNA expression levels were lower than those in gastric ulcer group and superficial gastritis group;serum pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content in gastric cancer group were negatively correlated with EIF5A2, MACF1, PIK3CD and Livin mRNA expression levels, and positively correlated with SIRT1, Bad and Noxa mRNA expression levels. Conclusion: The serum pepsinogen Ⅰ/Ⅱ ratio and gastrin-17 content abnormally reduce in patients with gastric cancer, and the specific levels are directly correlated with gastric cancer cell proliferation and apoptosis activity.