A Clinical Study on Serum Pepsinogen in 81 Patients Undergoing Gastric Examination

The serum pepsinogen (PG) level was determined in 81 patients undergoing gastric examination, and the results were clinically compared with the results of the conventional primary screening for gastric cancer based on the inquiry and radiography of the upper digestive tract. The values of PG I and PG II in patients whose stomach was found to be normal (normal group) were almost the same as the reported values, but their PG I /PG II ratio was somewhat smaller than the reported value. The PG levels in the gastric ulcer, erosive gastritis and gastric polyp groups did not significantly differ from those in the normal group, while the screening based on the PG level was suggested to be potentially useful for discovery of atrophic gastritis, post-gastrectomy abnormality and duodenal ulcer. Gastric cancer was discovered in four of the 81 cases (early cancer in one case and advanced cancer in three cases), and all were poorly-differentiated adenocarcinoma. When compared with the normal group, only the PG III ratio was smaller in this group. If this PG method is employed for the primary screening, the false-positive rate is 35.5% (falsenegative rate:75% ), an 46.9% of subjects undergoing this screening will require a second examination. The discrepancy between the results of this study and those reported earlier was surmised to be partly attributable to the facts that histological type was poorly-differentiated adenocarcinoma in all the patients with gastric cancer in this study and the mean age of all subjects was more than 10 year higher than that in the earlier report. Compared with the conventional screening method, the percentage of subjects requiring a second examination was higher by more than 20%. It was concluded that further studies are necessary, including review of the criteria for judgment of gastric cancer