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Research Article
Serum Pepsinogen as a Biomarker of Gastrointestinal Stromal Tumors (GIST) in Stomach
Yi Ba
Tianjin Medical University Cancer Institute and Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
No biomarker was identified for gastric GISTs(GG) detection. We first observed that glands surrounding GG are regionally atrophic. We hypothesize that this local atrophy may mildly reduce pepsinogen Ⅰ(PGⅠ) but the PGⅠ/PGII ratio remains normal. To test our hypothesis, a retrospective analysis was conducted to evaluate the diagnostic efficiency of PG in GG detection.
Methods
We retrospectively analyzed a cohort of consecutive GG and gastric cancer(GC) patients at our center. Pathologic confirmed GG patients and GC patients with tested PG levels before medical intervention were included. Three criteria were assessed: 1.Serum PGI≤70ng/ml; 2.Positive-Gastric-GIST-PG(PGⅠ≤70 ng/ml and PGI/PGII ratio>3.0); and 3.Positive-Gastric-GIST-PG-CEA(Positive-Gastric-GIST-PG plus normal CEA). Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and overall accuracy(OA) were calculated. A Chi-square test was applied to detect the differences.
Results
After screened 562 GG and 1090 GC, 100 GG and 174 GC samples were included. For PGI≤70ng/ml, the Positive-Gastric-GIST-PG and the Positive-Gastric-GIST-PG-CEA criteria discriminating GG from GC, the sensitivities were 75%(95%CI 66-82),70%(60-78) and 68%(58-76), respectively; the specificities were 50%(43-57), 70%(62-76), and 78%(71-83), respectively; the PPV were 46%(39-54), 57%(48-65), and 64%(55-73), respectively; the NPV were 78%(69-84), 80%(73-86), 81%(74-86), respectively; and the OA were 59%(53-65), 70%(64-75), and 74%(69-79), respectively. There was statistic difference in sensitivities between GG and GC for Positive-Gastric-GIST-PG-CEA criterion(68% for GG vs. 22% for GC, P<0.0001).
Conclusion
Serum PGs are useful for both detecting GG and distinguishing GG from GC. Integrating our criteria into current PG test scheme of gastric precancerous screening will be helpful for early GG detection without additional economic expense.
Keywords
GIST, stomach, serum pepsinogen, biomarker, gastric atrophy
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Serum Pepsinogen as a Biomarker of Gastrointestinal Stromal Tumors (GIST) in Stomach
Yi Ba
Tianjin Medical University Cancer Institute and Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 23 Feb, 2021
No community comments so far
Reviewers invited
Invitations sent on 24 Feb, 2021
Editor assigned
On 18 Feb, 2021
Editor invited
On 17 Feb, 2021
Submission checks complete
On 17 Feb, 2021
First submitted
On 08 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cancer Biology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
No biomarker was identified for gastric GISTs(GG) detection. We first observed that glands surrounding GG are regionally atrophic. We hypothesize that this local atrophy may mildly reduce pepsinogen Ⅰ(PGⅠ) but the PGⅠ/PGII ratio remains normal. To test our hypothesis, a retrospective analysis was conducted to evaluate the diagnostic efficiency of PG in GG detection.
Methods
We retrospectively analyzed a cohort of consecutive GG and gastric cancer(GC) patients at our center. Pathologic confirmed GG patients and GC patients with tested PG levels before medical intervention were included. Three criteria were assessed: 1.Serum PGI≤70ng/ml; 2.Positive-Gastric-GIST-PG(PGⅠ≤70 ng/ml and PGI/PGII ratio>3.0); and 3.Positive-Gastric-GIST-PG-CEA(Positive-Gastric-GIST-PG plus normal CEA). Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and overall accuracy(OA) were calculated. A Chi-square test was applied to detect the differences.
Results
After screened 562 GG and 1090 GC, 100 GG and 174 GC samples were included. For PGI≤70ng/ml, the Positive-Gastric-GIST-PG and the Positive-Gastric-GIST-PG-CEA criteria discriminating GG from GC, the sensitivities were 75%(95%CI 66-82),70%(60-78) and 68%(58-76), respectively; the specificities were 50%(43-57), 70%(62-76), and 78%(71-83), respectively; the PPV were 46%(39-54), 57%(48-65), and 64%(55-73), respectively; the NPV were 78%(69-84), 80%(73-86), 81%(74-86), respectively; and the OA were 59%(53-65), 70%(64-75), and 74%(69-79), respectively. There was statistic difference in sensitivities between GG and GC for Positive-Gastric-GIST-PG-CEA criterion(68% for GG vs. 22% for GC, P<0.0001).
Conclusion
Serum PGs are useful for both detecting GG and distinguishing GG from GC. Integrating our criteria into current PG test scheme of gastric precancerous screening will be helpful for early GG detection without additional economic expense.
Figure 1
Figure 2