Pepsinogen I ≤ 70 ng/L and Pepsinogen I/II ratio ≤ 3.0 are associated with an increased risk for gastric cancer.

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What does a low Pepsinogen I index indicate?​

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Hello doctor. The last time I went for a health check at the company, the index:
PGI was 36.0 ng/ml. PGII is 4.9 ng/ml PGI/PGII is 7.3 Since I haven't been able to go to the doctor again, I want to ask the doctor if such an indicator is dangerous? I really appreciate the doctor and look forward to hearing from you.
Pham Duc Phong (1989)
Reply
Hello! Pepsinogen (PG) is a proenzyme (proenzyme) of pepsin - a proteolytic enzyme - that is secreted by the mucosal cells of the stomach. Pepsinogen exists in two forms: pepsinogen I (PG I) and pepsinogen II (PG II). Pepsinogen I is synthesized by the principal cells of the mucosa in the basal region of the stomach, while PG II is synthesized by the mucosal cells of all the cardia, basal, antrum, and duodenum regions. colon.
The levels of serum pepsinogen I and II reflect the morphological and functional status of different parts of the gastroduodenal mucosa. When gastric basal mucosal activity is reduced, serum pepsinogen I levels decrease, whereas serum PGII levels are generally less variable. As a result, a gradual decrease in the PGI/PGII ratio is closely related to the progressive progression from the normal basal mucosa to atrophic gastritis, at which time the number of primary cells is reduced. Therefore, a decrease in the serum pepsinogen I level and the PGI/II ratio can be used to assess the risk and detect early gastric cancer in patients.
The normal value of serum pepsinogen I level in normal healthy subjects widely used in many countries around the world is > 70 ng/mL, of pepsinogen II is 7.5 ng/mL and of PGI/II ratio is > 3 . The levels of pepsinogen I, pepsinogen II and the PGI/II ratio did not differ by age and sex.
A serum pepsinogen I level with a value of ≤ 70 ng/mL is considered a positive value for precancerous diseases of stomach and gastric cancer.
A ratio of PGI/II with a cutoff value of ≤ 3 is considered positive for precancerous diseases and gastric cancer.
His test results show that this PGI/II ratio is within the normal value and only pepsinogen I is low, so it only reflects possibly atrophy of the gastric fundus. Thus, to confirm the risk of stomach cancer or not, it is necessary to do some other gastric cancer markers such as CA 72-4, CA 19-9, CEA and to confirm the need for a gastroscopy to find a tumor. and biopsies the suspected cancer sites on the tumor to confirm the diagnosis by histopathology.
Thank you for your question to Vinmec Health System. Best regards!
Doctor Tran Thi Huyen Trang - Laboratory Doctor - Laboratory Department - Vinmec Times City International Hospita

 

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His test results show that this PGI/II ratio is within the normal value and only pepsinogen I is low, so it only reflects possibly atrophy of the gastric fundus. Thus, to confirm the risk of stomach cancer or not, it is necessary to do some other gastric cancer markers such as CA 72-4, CA 19-9, CEA and to confirm the need for a gastroscopy to find a tumor. and biopsies the suspected cancer sites on the tumor to confirm the diagnosis by histopathology.

Why none of my doctors did these pepsinogen 1/2 and CA 72-4 tests for me?

 

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