Serum Pepsinogens in Relation in a Population at High

Concentrations of serum pepsinogens (PG) I and II were determined for 3252 randomly selected adults who participated in a population-based gastroscopic screening in an area of China with one of the world’s highest rates of gastric cancer. PG I and II concentrations in both sexes tended to be higher than reported in other countries, with levels generally higher among males than females. PG I tended to decrease and PG II to increase with age, but the most pronounced associations were between PG 1:11 ratios and gastric histology. Median PG 1:11 ratios monotonically declined from 9.1 to 7.2 to 5.7 to 5.4 to 3.8 among those with superficial gastritis, chronic atrophic gastritis, intestinal met-aplasia, dysplasia, and stomach cancer, respectively. The prevalence of dysplasia was nearly 3 times greater among those with PG 1:11 ratios less than 3 compared with those whose PG 1:11 ratios were greater than 10. While average levels differed significantly among the histologic groups, the PG 1:11 ratios were neither sensitive nor specific markers of an individual’s likelihood of advanced gastric lesions in this population