ArticleDiagnostics (Basel, Switzerland)2022
Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment-Results from the GISTAR Pilot Study.
Article in Diagnostics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 17 citations in OpenAlex.
- Serum Protein Profiling of Patients at Risk to Develop Gastric Disease Based on a DSC Test.International journal of molecular sciences · 2026Article
- A tissue-to-blood mRNA classifier enables early detection of gastric cancer risk in precancerous lesions.Die Naturwissenschaften · 2026Article
- The role of hematological biomarkers as diagnostic tool in pre-cancerous patients.Discover oncology · 2026Review
- Stratified management of residual gastric cancer risk afterFrontiers in microbiology · 2026Article
- Positive association between anti-Helicobacter pylori IgG antibody titers and atrophic gastritis in a Latvian cohort.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025Article
- Diagnostic value of serum pepsinogen, gastrin, and carbohydrate antigens in gastric ulcer and gastric cancer.World journal of gastrointestinal oncology · 2025Article
- Partial verification bias correction using scaled inverse probability resampling for binary diagnostic tests.PloS one · 2025Article
- Review
- A Global Perspective on Gastric Cancer Screening: Which Concepts Are Feasible, and When?Cancers · 2023Review
- Partial Verification Bias Correction Using Inverse Probability Bootstrap Sampling for Binary Diagnostic Tests.Diagnostics (Basel, Switzerland) · 2022Article
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Authors and funding
16 authors at 6 institutions in 5 countries.
Funding
Abstract
Introduction−−Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods−−Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results−−Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4−31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33−45% while specificity decreased (range: 61.1−62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions−−Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.
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