-
Cancer Cell International 2017Pepsinogen C (PGC) belongs to the aspartic protease family and is secreted by gastric chief cells. PGC could be activated to pepsin C and digests polypeptides and amino... (Review)
Review
Pepsinogen C (PGC) belongs to the aspartic protease family and is secreted by gastric chief cells. PGC could be activated to pepsin C and digests polypeptides and amino acids, but as a zymogen PGC's functions is unclear. In normal physiological conditions, PGC is initially detected in the late embryonic stage and is mainly expressed in gastric mucosa. The in situ expression of PGC in gastric mucosa is decreased considerably in the process of superficial gastritis → atrophic gastritis → gastric cancer (GC), proving that PGC is a comparatively ideal negative marker of GC. Serum PGC, and PGA levels and the PGA/PGC ratio have satisfactory sensitivity, specificity and price-quality ratio for predicting high GC risk. Ectopic PGC expression is significantly increased in prostate cancer, breast cancer, ovary cancer and endometrial cancer. In those sex-related cancers high level PGC expression indicates better prognosis and longer survival. The regulation of PGC expression involves genetic and epigenetic alteration of the encoding gene, hormones modulation and interactions between PGC with other transcription factors and protein kinases. More and more research evidence hinted that PGC has strong correlation with cancer. In the systematic review, we respectively elaborate the structure, potential physiological functions, expression characteristics and regulation of PGC, and especially focus on the relationship between PGC expression and cancer to highlight the role of PGC in the tumorigenesis and its application value in clinical practice.
PubMed: 28546787
DOI: 10.1186/s12935-017-0426-6 -
Preventive Medicine Sep 2023Gastric cancer continues to be a significant health concern in China, with a high incidence rate. To mitigate its impact, early detection and treatment is key. However,...
Development and validation of LightGBM algorithm for optimizing of Helicobacter pylori antibody during the minimum living guarantee crowd based gastric cancer screening program in Taizhou, China.
Gastric cancer continues to be a significant health concern in China, with a high incidence rate. To mitigate its impact, early detection and treatment is key. However, conducting large-scale endoscopic gastric cancer screening is not feasible in China. Instead, a more appropriate approach would be to initially screen high-risk groups and follow up with endoscopic testing as needed. We conducted a study on 25,622 asymptomatic participants aged 45-70 years from a free gastric cancer screening program in the Taizhou city government's Minimum Living Guarantee Crowd (MLGC) initiative. Participants completed questionnaires, blood tests, and underwent gastrin-17 (G-17), pepsinogen I and II (PGI and PGII), and H. pylori IgG antibody (IgG) assessments. Using the light gradient boosting machine (lightGBM) algorithm, we developed a predictive model for gastric cancer risk. In the full model, F1 score was 2.66%, precision was 1.36%, and recall was 58.14%. In the high-risk model, F1 score was 2.51%, precision was 1.27%, and recall was 94.55%. Excluding IgG, the F1 score was 2.73%, precision was 1.40%, and recall was 68.62%. We conclude that H. pylori IgG appears to be able to be excluded from the prediction model without significantly affecting its performance, which is important from a health economic point of view. It suggests that screening indicators can be optimized, and expenditures reduced. These findings can have important implications for policymakers, as we can focus resources on other important aspects of gastric cancer prevention and control.
Topics: Humans; Stomach Neoplasms; Helicobacter pylori; Pepsinogen A; Early Detection of Cancer; Pepsinogen C; Immunoglobulin G
PubMed: 37419420
DOI: 10.1016/j.ypmed.2023.107605 -
Cancers Mar 2024Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining... (Review)
Review
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti- IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. In terms of the indications for endoscopic resection, the likelihood of lymph node metastasis and technical difficulties in en bloc resection is considered, and they are divided into absolute, expanded, and relative indications. Endoscopic mucosal resection and endoscopic submucosal dissection are the main treatment modalities nowadays. After endoscopic resection, curability is evaluated histologically as endoscopic curability (eCura) A, B, and C (C-1 and C-2). Recent evidence suggests that the outcomes of endoscopic resection for many EGCs are comparable to those of gastrectomy and that endoscopic resection is the gold standard for node-negative early gastric cancers. Personalized medicine is also being developed to overcome the unmet needs in treatments of EGC, for example the further expansion of indications and newer resection techniques, such as full-thickness resection.
PubMed: 38473395
DOI: 10.3390/cancers16051039 -
Frontiers in Microbiology 2020() is well-known to be involved in gastric carcinogenesis, associated with deregulation of cell proliferation and epigenetic changes in cancer-related genes. infection... (Review)
Review
() is well-known to be involved in gastric carcinogenesis, associated with deregulation of cell proliferation and epigenetic changes in cancer-related genes. infection is largely acquired during childhood, persisting long-term in about half of infected individuals, a subset of whom will go on to develop peptic ulcer disease and eventually gastric cancer, however, the sequence of events leading to disease is not completely understood. Knowledge on carcinogenesis and gastric damage-related biomarkers is abundant in adult populations, but scarce in children. We performed an extensive literature review focusing on gastric cancer related biomarkers identified in adult populations, which have been detected in children infected with . Biomarkers were related to expression levels (RNA or protein) and/or methylation levels (DNA) in gastric tissue or blood of infected children as compared to non-infected controls. In this review, we identified 37 biomarkers of which 24 are over expressed, three are under expressed, and ten genes are significantly hypermethylated in -infected children compared to healthy controls in at least 1 study. Only four of these biomarkers (pepsinogen I, pepsinogen II, gastrin, and SLC5A8) have been studied in asymptomatically infected children. Importantly, 13 of these biomarkers (β-catenin, C-MYC, GATA-4, DAPK1, CXCL13, DC-SIGN, TIMP3, EGFR, GRIN2B, PIM2, SLC5A8, CDH1, and VCAM-1.) are consistently deregulated in infected children and in adults with gastric cancer. Future studies should be designed to determine the clinical significance of these changes in infection-associated biomarkers in children and their persistence over time. The effect of eradication therapy over these biomarkers in children if proven significant, could lead to modifications in treatment guidelines for younger populations, and eventually promote the development of preventive strategies, such as vaccination, in the near future.
PubMed: 32117120
DOI: 10.3389/fmicb.2020.00090 -
Journal of the Formosan Medical... Jun 2021Very few studies have explored the changes of serum pepsinogen after bariatric surgery and no research has evaluated the feasibility of ABC classification to predict...
BACKGROUND
Very few studies have explored the changes of serum pepsinogen after bariatric surgery and no research has evaluated the feasibility of ABC classification to predict gastric cancer risk after bariatric surgery.
METHODS
We enrolled 94 obese subjects that received bariatric surgery, including 41 sleeve gastrectomy (SG) and 53 Roux-en-Y gastric bypass (RYGB). The serum pepsinogen I (PGI), pepsinogen II (PGII), PGI/II ratio and seropositivity of Helicobacter pylori ( H. pylori ) were measured before and one year after surgery. Patients were classified according to ABC classification and post-operative change was evaluated.
RESULTS
Preoperatively, four (4.2%) patients were classified into high risk group (classification C and D) for gastric cancer. Significant reduction of PGI, PGII and decrease of PGI/II ratio were noted after bariatric surgery. H. pylori seropositive patients had a greater postoperative change of PGI (-38.6μg/L vs -22.1μg/L, p=0.003) and PGII (-8.0μg/L vs -2.5μg/L, p <0.001) but a less postoperative change of PGI/II ratio (-0.6 vs -2.1, p =0.04) than H. pylori seronegative patients. One year after surgery, the portion of high risk group of ABC classification for gastric cancer increased markedly from 4.2% to 23.7%.
CONCLUSION
Both of SG and RYGB resulted in significant reduction of serum PGI and PGII after bariatric surgery, and significantly influenced the ABC classification. The application of ABC classification for gastric cancer screening was limited after bariatric surgery.
Topics: Bariatric Surgery; Helicobacter Infections; Helicobacter pylori; Humans; Pepsinogen A; Pepsinogen C
PubMed: 33199102
DOI: 10.1016/j.jfma.2020.10.029 -
Scientific Reports Mar 2022Simple objective modalities are required for evaluating suspected autoimmune gastritis (AIG). This cross-sectional study aimed to examine whether pepsinogen, gastrin,...
Simple objective modalities are required for evaluating suspected autoimmune gastritis (AIG). This cross-sectional study aimed to examine whether pepsinogen, gastrin, and endoscopic findings can predict AIG. The diagnostic performance of endoscopic findings and serology in distinguishing AIG was evaluated. AIG was diagnosed in patients (N = 31) with anti-parietal cell antibody and/or intrinsic factor antibody positivity and histological findings consistent with AIG. Non-AIG patients (N = 301) were seronegative for anti-parietal cell antibodies. Receiver operating characteristic curve analysis of the entire cohort (N = 332) identified an endoscopic atrophic grade cutoff point of O3 on the Kimura-Takemoto classification (area under the curve [AUC]: 0.909), while those of pepsinogen-I, I/II ratio, and gastrin were 20.1 ng/mL (AUC: 0.932), 1.8 (AUC: 0.913), and 355 pg/mL (AUC: 0.912), respectively. In severe atrophy cases (≥ O3, N = 58, AIG/control; 27/31), the cutoff values of pepsinogen-I, I/II ratio, and gastrin were 9.8 ng/mL (AUC: 0.895), 1.8 (AUC: 0.86), and 355 pg/mL (AUC: 0.897), respectively. In conclusion, endoscopic atrophy is a predictor of AIG. High serum gastrin and low pepsinogen-I and I/II ratio are predictors even in the case of severe atrophy, suggesting their usefulness when the diagnosis of AIG is difficult or as serological screening tests.
Topics: Atrophy; Autoantibodies; Autoimmune Diseases; Cross-Sectional Studies; Gastrins; Gastritis, Atrophic; Helicobacter Infections; Humans; Pepsinogen A
PubMed: 35273265
DOI: 10.1038/s41598-022-07947-1 -
Veterinary Parasitology Feb 2022In the majority of mixed or sequential gazing studies with sheep, cattle performance remained unaffected. However, the treatment regime of the sheep in these studies was...
In the majority of mixed or sequential gazing studies with sheep, cattle performance remained unaffected. However, the treatment regime of the sheep in these studies was often intense and this may have limited cross-transmission of nematodes from sheep to cattle. We conducted a sequential grazing trial with cattle and sheep with moderate anthelmintic intervention. Twenty first season grazing steers were stratified to 10 couples according to their origin, egg excretion per gram faeces (EPG), metabolic weight and previous weight gain record. Thirty naturally infected ewe lambs were stratified to 5 groups according to metabolic live weight and EPG. Five pairs of the steers were sequentially grazed with the 5 groups of lambs whereas another five pairs of steers served as control. Grazing duration was 70 days with a subsequent indoor period of additional 35 days for the steers. Weight and EPG was recorded 3 days before and 27, 49, 70 and 105 days after trial start. The recorded live-weight of the sequentially grazed steers was 182 ± 14, 191 ± 11, 205 ± 15, 219 ± 15 and 236 ± 18 and the live-weight of the control steers was 180 ± 18, 193 ± 19, 203 ± 21, 217 ± 24 and 234 ± 24 kg respectively. The EPG of the sequentially grazed steers 3 days before grazing start and at day 27, 49, 70 and 105 was 94 ± 100, 95 ± 48, 49 ± 42, 58 ± 41 and 140 ± 73 EPG respectively. The EPG of the control steers at the same dates was 96 ± 82, 98 ± 24, 104 ± 77, 98 ± 71 and 270 ± 287 EPG respectively. The sequentially grazed steer groups did not differ from the control groups with regard to EPG, live weight and daily weight gain. However, the sequentially grazed steers showed elevated pepsinogen levels compared to the control steers (e.g. 3.34 ± 1.05 units tyrosine and 1.29 ± 0.50 units tyrosine after 70 days of grazing, respectively). Larval samples from individual steer coprocultures of both groups were tested PCR-positive for Cooperia oncophora, Ostertagia ostertagi and Haemonchus contortus. We conclude that short term sequential grazing of first season grazing steers with lambs excreting mainly eggs of Haemonchus spp. did not adversely affect steer performance despite increased pepsinogen values. However, hot and dry conditions may have had a suppressive effect on larval development, migration and finally uptake by the steers.
Topics: Animals; Anthelmintics; Cattle; Feces; Female; Haemonchus; Nematoda; Ovum; Parasite Egg Count; Sheep
PubMed: 35030350
DOI: 10.1016/j.vetpar.2021.109645 -
Frontiers in Cellular and Infection... 2022Association of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti- IgG antibody have been extensively studied. However, the association of...
BACKGROUND
Association of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti- IgG antibody have been extensively studied. However, the association of serum pepsinogen and gastrin-17 with infection has not been studied in a large population.
AIM
To investigate the impact of infection on serum levels of pepsinogens and gastrin-17.
METHODS
A total of 354, 972 subjects who underwent health check-ups were included. Serum levels of pepsinogens and gastrin-17 were measured using the enzyme-linked immunosorbent assay infection was detected using C-urea breath test (UBT). Multivariable logistic regression analysis was used to investigate the association of serum pepsinogen and gastrin-17 with infection.
RESULTS
prevalence was 33.18% in this study. The mean levels of pepsinogens and gastrin-17 were higher, while the mean pepsinogen-I/II ratio were lower among -positive than -negative subjects. In -positive subjects, pepsinogen and gastrin-17 levels correlated positively, whereas the pepsinogen-I/II ratio correlated negatively with UBT values (e.g., the mean serum level of pepsinogen-I in subjects with UBT values in the range of 100-499dpm, 500-1499dpm, and ≥1500dpm was 94.77 ± 38.99, 102.77 ± 43.59, and 111.53 ± 47.47 ng/mL, respectively). Compared with -negative subjects, the adjusted odds ratio (aOR) of having pepsinogen-I ≤ 70 ng/mL in the three -positive but with different UBT value groups was 0.31 (<0.001), 0.16 (<0.001), and 0.08 (<0.001), respectively; while the aOR of having G-17>5.70 pmol/L was 4.56 (<0.001), 7.43 (<0.001), and 7.12 (<0.001). This suggested that -positive subjects with higher UBT values were less likely to have pepsinogen-I ≤70 ng/mL (a serum marker for gastric atrophy), but more likely to have gastrin-17 >5.70 pmol/L (a marker for peptic ulcer).
CONCLUSIONS
-positive subjects with higher UBT values are unlikely to have gastric atrophy, but may have greater risk of severe gastritis or peptic ulcers. Our study suggests that -positive patients with high UBT values may benefit the most from eradication.
Topics: Atrophy; Biomarkers; Breath Tests; Gastrins; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Pepsinogen A; Urea
PubMed: 36051244
DOI: 10.3389/fcimb.2022.980399 -
Iranian Journal of Public Health Aug 2022We aimed to analyze the predictive role of serum test and questionnaire in Early Gastric Cancer in The First Affiliated Hospital of Xingtai Medical College, Hebei...
BACKGROUND
We aimed to analyze the predictive role of serum test and questionnaire in Early Gastric Cancer in The First Affiliated Hospital of Xingtai Medical College, Hebei Province from 2019 to 2020.
METHODS
In this prospective study, 280 medical examiners underwent questionnaire, serum test and gastroscopy. They were divided into Gastric cancer (GC) and Non-Gastric cancer (NGC) group. NGC group was divided into Low-grade intraepithelial neoplasia (LGIN), Chronic atrophic gastritis (CAG) and Non-chronic atrophic gastritis (NCAG) group.
RESULTS
Age, drinking, sex and Gastrin-17(G-17) was respectively independent risk factors for GC. Age, drinking and G-17 was independent risk factors for GC in men. G-17 of GC group was higher than that of LGIN and NCAG group (<0.05). Pepsinogen I/II ratio (PGR) of GC was lower than that of NCAG group (<0.05). There was no significant difference between Pepsinogen I (PGI) and Pepsinogen II (PGII) in the four groups. -immunoglobulin G antibodies (-IgG) of LGIN group was significantly higher than that of CAG and NCAG group in gastritis group (P<0.008). G-17≥42.95 pmol/L, age≥69years, male and drinking can predict GC.
CONCLUSION
Older, drinking, men and high G-17 could respectively predict GC. Especially in men, older, drinking and high G-17 could affect the occurrence of GC. G-17, age, drinking and sex used respectively to screen high-risk populations for GC were more efficient than combined screening. GC had a higher serum G-17 and a lower PG than other gastric diseases.
PubMed: 36249096
DOI: 10.18502/ijph.v51i8.10267 -
Disease Markers 2015The "ABC method" is a serum gastric cancer screening method, and the subjects were divided based on H. pylori serology and atrophic gastritis as detected by serum... (Review)
Review
The "ABC method" is a serum gastric cancer screening method, and the subjects were divided based on H. pylori serology and atrophic gastritis as detected by serum pepsinogen (PG): Group A [H. pylori (-) PG (-)], Group B [H. pylori (+) PG (-)], Group C [H. pylori (+) PG (+)], and Group D [H. pylori (-) PG (+)]. The risk of gastric cancer is highest in Group D, followed by Groups C, B, and A. Groups B, C, and D are advised to undergo endoscopy, and the recommended surveillance is every three years, every two years, and annually, respectively. In this report, the reported results with respect to further risk stratification by anti-H. pylori antibody titer in each subgroup are reviewed: (1) high-negative antibody titer subjects in Group A, representing posteradicated individuals with high risk for intestinal-type cancer; (2) high-positive antibody titer subjects in Group B, representing active inflammation with high risk for diffuse-type cancer; and (3) low-positive antibody titer subjects in Group C, representing advanced atrophy with increased risk for intestinal-type cancer. In these subjects, careful follow-up with intervals of surveillance of every three years in (1), every two years in (2), and annually in (3) should be considered.
Topics: Antibodies, Bacterial; Biomarkers, Tumor; Early Detection of Cancer; Helicobacter pylori; Humans; Serologic Tests; Stomach Neoplasms
PubMed: 26494936
DOI: 10.1155/2015/156719