Digestive Diseases and Sciences

, Volume 55, Issue 8, pp 2275–2282 | Cite as

Predictive Power of Serum Pepsinogen Tests for the Development of Gastric Cancer in Comparison to the Histologic Risk Index

  • Min Sun Kwak
  • Nayoung KimEmail author
  • Hye Seung Lee
  • Hee Eun Lee
  • Hyun Chae Jung
  • In Sung Song
Original Article


Background and Aim

The selection of a high-risk group of gastric cancer is important. This study was performed to compare the efficacy of non-invasive gastric cancer screening through the measurement of pepsinogen (PG) I/II ratio and endoscopic screening using histologic criteria (Meining’s risk index for gastric cancer) in Korean patients.


Included in the study were 460 gastric cancer patients and 460 control cases who underwent upper endoscopy between June 2003 and July 2008 at Seoul National University Bundang Hospital. Serum PG I/II ratio and histologic characteristics were evaluated for each participant. Multivariate logistic regression was performed to compare the predictive power for gastric cancer of both the PG II/I ratio (the inverse form of PG I/II ratio) and the histologic gastric cancer risk index.


A higher PG II/I ratio was significantly associated with a higher risk for gastric cancer (odds ratio of highest quartile for cancer vs. lowest quartile, 3.51; 95% confidence interval, 2.29–5.36) in the multivariate logistic model. The validity (in terms of calibration and discrimination) of the PG-including multivariate logistic model was comparable to the histologic gastric cancer risk index model. The results were similar regardless of the staging of the cancer, Lauren’s histologic classification, and the location of the cancer.


These results suggest that non-invasive measurement of serum PG I/II ratio is as effective as Meining’s histologic gastric cancer risk index in predicting gastric cancer occurrence.


Gastric cancer Risk index Screening Pepsinogen I/II ratio 



This study was supported by the Korean Health 21 R & D Project, Ministry of Health & Welfare, Republic of Korea (#A060266).

Conflict of interest and financial support

None of the authors had conflicts of interest that potentially influence the described research, and there was no external financial support.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Min Sun Kwak
    • 1
  • Nayoung Kim
    • 1
    • 2
    Email author
  • Hye Seung Lee
    • 3
  • Hee Eun Lee
    • 3
  • Hyun Chae Jung
    • 1
  • In Sung Song
    • 1
  1. 1.Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulSouth Korea
  2. 2.Department of Internal MedicineSeoul National University Bundang HospitalGyeonggi-doSouth Korea
  3. 3.Department of PathologySeoul National University Bundang HospitalGyeonggi-doSouth Korea

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