TY - JOUR
T1 - Serum pepsinogens as a gastric cancer and gastritis biomarker in South and Southeast Asian populations
AU - Miftahussurur, Muhammad
AU - Agung Waskito, Langgeng
AU - Aftab, Hafeza
AU - Vilaichone, Rathakorn
AU - Subsomwong, Phawinee
AU - Nusi, Iswan Abbas
AU - Syam, Ari Fahrial
AU - Ratanachu-Ek, Thawee
AU - Doohan, Dalla
AU - Siregar, Gontar
AU - Rezkitha, Yudith Annisa Ayu
AU - Fauzia, Kartika Afrida
AU - Mahachai, Varocha
AU - Yamaoka, Yoshio
N1 - Funding Information:
Funding:Thisworkwassupportedinpartby grantsfromtheNationalInstitutesofHealth (DK62813)andGrants-in-AidforScientific ResearchfromtheMinistryofEducation,Culture, Sports,Science,andTechnology(MEXT)ofJapan (15H02657,16H05191,16H06279,18KK0266and 19H03473)(YY).Itwasalsosupportedbythe JapanSocietyforthePromotionofScience(JSPS)
Publisher Copyright:
© 2020 Miftahussurur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020
Y1 - 2020
N2 - Serum pepsinogens have been widely acknowledged as gastric mucosal biomarkers; however, a multicountry report on the benefits of pepsinogens as biomarkers has not yet been published. We analyzed 1,206 sera and gastric mucosal samples collected from Bangladesh, Bhutan, Indonesia, Myanmar, Nepal and Thailand then assessed the association between gastric mucosal changes and Helicobacter pylori infection. The new cutoff values for serum pepsinogen values were evaluated using a receiver operating characteristic analysis. The participants with H. pylori infection had significantly lower pepsinogen I and higher pepsinogen II values, but a lower pepsinogen I/II ratio than participants without the infection (all P < .001). The pepsinogen I and pepsinogen I/II values were significantly higher and lower, respectively, in individuals with atrophic gastritis than in those without (both P < .001). Among uninfected individuals, only the pepsinogen I/II ratio was significantly lower in atrophic individuals. Pepsinogen I/II ratio also were significantly different between disease among H. pylori-positive and H. pylori-negative individuals, suggesting the pepsinogen I/II ratio is a robust biomarker for determining both chronic and atrophic gastritis. The cutoffs for detecting chronic and atrophic gastritis for the pepsinogen I/II ratio were 4.65 and 4.95, respectively. In conclusion, pepsinogen levels are useful biomarker for both chronic gastritis and atrophic gastritis, but they should be used with caution. Population-based validation is necessary to determine the best cutoff values. Among all pepsinogen values, the pepsinogen I/II ratio was the most reliable gastric mucosal-change biomarker.
AB - Serum pepsinogens have been widely acknowledged as gastric mucosal biomarkers; however, a multicountry report on the benefits of pepsinogens as biomarkers has not yet been published. We analyzed 1,206 sera and gastric mucosal samples collected from Bangladesh, Bhutan, Indonesia, Myanmar, Nepal and Thailand then assessed the association between gastric mucosal changes and Helicobacter pylori infection. The new cutoff values for serum pepsinogen values were evaluated using a receiver operating characteristic analysis. The participants with H. pylori infection had significantly lower pepsinogen I and higher pepsinogen II values, but a lower pepsinogen I/II ratio than participants without the infection (all P < .001). The pepsinogen I and pepsinogen I/II values were significantly higher and lower, respectively, in individuals with atrophic gastritis than in those without (both P < .001). Among uninfected individuals, only the pepsinogen I/II ratio was significantly lower in atrophic individuals. Pepsinogen I/II ratio also were significantly different between disease among H. pylori-positive and H. pylori-negative individuals, suggesting the pepsinogen I/II ratio is a robust biomarker for determining both chronic and atrophic gastritis. The cutoffs for detecting chronic and atrophic gastritis for the pepsinogen I/II ratio were 4.65 and 4.95, respectively. In conclusion, pepsinogen levels are useful biomarker for both chronic gastritis and atrophic gastritis, but they should be used with caution. Population-based validation is necessary to determine the best cutoff values. Among all pepsinogen values, the pepsinogen I/II ratio was the most reliable gastric mucosal-change biomarker.
UR - http://www.scopus.com/inward/record.url?scp=85083007246&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0230064
DO - 10.1371/journal.pone.0230064
M3 - Article
C2 - 32271765
AN - SCOPUS:85083007246
SN - 1932-6203
VL - 15
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e0230064
ER -
