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Article

Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study

1
Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France
2
Cancer Epidemiology Research Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain
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Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia
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Department of Research, Riga East University Hospital, 1038 Riga, Latvia
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Digestive Diseases Centre GASTRO, 1586 Riga, Latvia
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Academic Histology Laboratory, 1073 Riga, Latvia
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Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá 11001, Colombia
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Agencia Costarricense de Investigaciones Biomedicas, Fundacion INCIENSA, San Jose 2250, Costa Rica
*
Author to whom correspondence should be addressed.
Academic Editor: Luca Morelli
Diagnostics 2022, 12(7), 1746; https://doi.org/10.3390/diagnostics12071746
Received: 16 April 2022 / Revised: 6 July 2022 / Accepted: 13 July 2022 / Published: 19 July 2022
(This article belongs to the Special Issue Advances in the Detection and Screening of Gastric Cancer)
Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage. View Full-Text
Keywords: serum pepsinogens; gastrin-17; gastric cancer prevention; screening; public health serum pepsinogens; gastrin-17; gastric cancer prevention; screening; public health
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MDPI and ACS Style

Robles, C.; Rudzite, D.; Polaka, I.; Sjomina, O.; Tzivian, L.; Kikuste, I.; Tolmanis, I.; Vanags, A.; Isajevs, S.; Liepniece-Karele, I.; Razuka-Ebela, D.; Parshutin, S.; Murillo, R.; Herrero, R.; Young Park, J.; Leja, M. Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study. Diagnostics 2022, 12, 1746. https://doi.org/10.3390/diagnostics12071746

AMA Style

Robles C, Rudzite D, Polaka I, Sjomina O, Tzivian L, Kikuste I, Tolmanis I, Vanags A, Isajevs S, Liepniece-Karele I, Razuka-Ebela D, Parshutin S, Murillo R, Herrero R, Young Park J, Leja M. Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study. Diagnostics. 2022; 12(7):1746. https://doi.org/10.3390/diagnostics12071746

Chicago/Turabian Style

Robles, Claudia, Dace Rudzite, Inese Polaka, Olga Sjomina, Lilian Tzivian, Ilze Kikuste, Ivars Tolmanis, Aigars Vanags, Sergejs Isajevs, Inta Liepniece-Karele, Danute Razuka-Ebela, Sergej Parshutin, Raul Murillo, Rolando Herrero, Jin Young Park, and Marcis Leja. 2022. "Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study" Diagnostics 12, no. 7: 1746. https://doi.org/10.3390/diagnostics12071746

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