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Open Access Research article

The value of serum pepsinogen levels for the diagnosis of gastric diseases in Chinese Han people in midsouth China

Xiao-mei Zhang1*, Jia-xin Li2, Gui-ying Zhang1, Xin-hua Li1 and Huan Gu1

Author Affiliations

1 Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province China

2 Department of Pediatrics, Huai'an First People’s Hospital, Nanjing Medical University, 6 Beijing Road West, Huai'an 223300, China

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BMC Gastroenterology 2014, 14:3  doi:10.1186/1471-230X-14-3

Published: 3 January 2014



Serum pepsinogen (PG) levels are valuable in the diagnosis of gastric diseases. However, PG levels are affected by many factors such as the area and race. This study aimed to investigate serum PG levels in patients with different gastric diseases who were Chinese Han people in Hunan Province, midsouth China.


A total of 248 gastric disease patients and 34 healthy controls were enrolled. The patients included those with non-atrophic and chronic atrophic gastritis, gastric and duodenal ulcer, early and advanced gastric cancer. Serum PG I and II levels were detected by Biohit ELISA kit (Finland), and PG I/II ratio was calculated. Differences in patients with gastric disease and healthy controls were analyzed using paired t-test.


Compared with controls, patients with early and advanced gastric cancer had a significantly lower PG I level and PG I/II ratio (p <0.005). In contrast, patients with gastric and duodenal ulcer had a significantly higher PG I level (p <0.005). Compared with atrophic gastritis patients, patients with early and advanced carcinoma of the stomach had a significantly lower PG I/II ratio (p < 0.001). Combination of the cut-off levels of PG I (70 μg/L) and PG I/II ratio (6) provided 62.1% sensitivity of and 94.2% specificity for the diagnosis of gastric cancer.


Decreased PG I level and PG I/II ratio are risk factors for gastric cancer. Combined use of serum PG I level and PG I/II ratio may help the early diagnosis of gastric cancer.

Gastritis; Stomach; Gastric cancer; Peptic ulcer; Serum pepsinogen