Evaluation of pepsinogen A and gastrin-17 as markers of gastric cancer and high-risk pathologic conditions

Scand J Gastroenterol. 1994 Dec;29(12):1129-34. doi: 10.3109/00365529409094899.


Background: Gastric cancer remains a major cause of mortality and will remain so for the lifetime of current clinicians. Many cancers are diagnosed at a stage when current therapy cannot provide the hope of cure. A method for early detection of gastric cancer which can be widely applied is needed. The serum levels of pepsinogen A and gastrin-17 have been shown to vary in the presence of pathologic conditions of the gastric mucosa and may provide such a tool.

Methods: Serum samples were obtained from 432 patients undergoing endoscopy for undiagnosed dyspepsia. The levels of pepsinogen I and gastrin-17 were estimated by radioimmunoassay and compared with the final diagnosis. Discriminant analysis was performed to assess the value of the peptides predicting the presence of gastric cancer and the high-risk mucosal changes.

Results: Abnormal levels of gastrin-17 or pepsinogen A were found in 60% of patients with gastric cancer and 60% of those with one of the high-risk mucosal changes, the latter figure rising to 75% when the changes were in the upper third of the stomach. Discriminant analysis showed the log of gastrin-17 and log of pepsinogen A to be the best predictors of the high-risk mucosal changes, gastric cancer, and benign disease.

Conclusions: These results confirm gastrin-17 and pepsinogen A as markers of pathologic gastric conditions and suggest that these peptides are potential screening tools worthy of further assessment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Dyspepsia / blood
  • Dyspepsia / etiology
  • Gastric Mucosa / pathology
  • Gastrins / blood*
  • Gastroscopy
  • Humans
  • Mass Screening
  • Pepsinogens / blood*
  • Radioimmunoassay
  • Sensitivity and Specificity
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / prevention & control


  • Biomarkers
  • Gastrins
  • Pepsinogens
  • gastrin 17