Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: A population-based study

Olga Sjomina (Coresponding Author), Jelizaveta Pavlova, Ilva Daugule, Pavel Janovic, Ilze Kikuste, Aigars Vanags, Ivars Tolmanis, Dace Rudzite, Inese Polaka, Ilona Kojalo, Inta Liepniece-Karele, Sergejs Isajevs, Daiga Santare, Valdis Pirags, Jelena Pahomova, Vilnis Dzerve, Lilian Tzivian, Andrejs Erglis, Marcis Leja

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

Original languageEnglish
Article number4
Pages (from-to)11-17
Number of pages7
JournalJournal of Gastrointestinal and Liver Diseases
Issue number1
Publication statusPublished - Mar 2018
Externally publishedYes


  • Atrophy
  • Follow-up
  • Gastric cancer
  • H.Pylori
  • Pepsinogens
  • Screening

Field of Science*

  • 3.1 Basic medicine
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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