Abstract:

Objective   To analyze the influence of proton-pump inhibitors (PPIs) or histamine 2-receptor antagonists(H2RAs) on diagnosis efficiency based on serum pepsinogens (PGs， PGI & PGII) and gastrin-17( G-17). Methods   The serum PGs and G-17 levels were measured in 190 patients (102 in the gastric cancer group， 30 in precancerous lesion group, and 58 in control group) by chemiluminescence microparticle immunoassay and ELISA, respectively. Values of PGR (PGI/PGII) and GPR (G-17/PGI) were calculated. Results   The median levels of PGs and G-17 were significantly (P<0.05) increased among patients who used PPIs but  not H2RAs, compared to non-users. PGR and GPR values were similar between PPI users and non-users. Use of H2RAs did not cause significant changes in these values either. Gastric cancer patients had significantly lower PGR and higher GPR than those in the other two groups(P<0.05). ROC curve analysis showed that AUC for PGR and GPR were 0.836 and 0.720, respectively. The best cutoff values of PGR and GPR for detecting gastric cancer calculated by ROC curve were 5.9 and 90， respectively, with moderate diagnostic sensitivity (76.5％ and 60.8％， respectively) and specificity (70.5％). Conclusion   PPIs, but not H2RAs, markedly increased the fasting levels of serum pepsinogens and G-17, independent of gastric mucosa changes.Meanwhile， PGR and GPR values could remain stable with the assumption of acid-inhibitory drugs. PGR and GPR can be used for gastric cancer diagnosis in populations with interference from acid-inhibitory drugs.

Key words:  Stomach neoplasm； Precancerous lesion; Pepsinogens； Gastrins；  Proton-pump inhibitors