Published online Jun 15, 2025. doi: 10.4251/wjgo.v17.i6.105931
Revised: April 9, 2025
Accepted: May 15, 2025
Published online: June 15, 2025
Processing time: 123 Days and 4 Hours
Emerging evidence suggests that serum levels of pepsinogen (PG), gastrin-17 (G17), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4 may aid in distinguishing gastric cancer (GC) from gastric ulcer (GU).
To assess serum PG, G17, CEA, CA19-9, and CA72-4 in diagnosing GU and optimizing GC detection.
A retrospective analysis was conducted from 263 patients treated at the Third People’s Hospital of Hefei, who were classified into three groups: Chronic non-atrophic gastritis (CG), GU, and GC. Fasting serum levels of PG, G17, CEA, CA19-9, and CA72-4 were measured and compared across the groups.
Serum levels of PGII and G17 were significantly elevated in both the GU and GC groups compared to the CG group (P < 0.01), whereas the PGI/PGII ratio was markedly decreased (P < 0.01). Levels of CEA, CA19-9, and CA72-4 were significantly higher in the GC group than in the CG and GU groups (P < 0.01). Receiver operating characteristic curve analysis identified the optimal diagnostic cut-off values for GU and GC as follows: PGI (169.855 pmol/L), PGII (30.555 μg/L), PGI/PGII ratio (16.529), G17 (6.435 pmol/L), CEA (2.005 ng/mL), CA19-9 (16.65 U/mL), and CA72-4 (2.075 U/mL). The area under the curve for combined detection was 0.826 (P < 0.001), indicating good diagnostic performance.
Serological biomarkers effectively distinguish GC from GU, with combined detection of PGII, PGI/PGII ratio, G17, and tumor markers enhancing diagnostic accuracy.
Core Tip: This study determined that the ratio of pepsinogen I/II was low, and the levels of pepsinogen II, gastrin-17, carbohydrate antigen 19-9, carcinoembryonic antigen and carbohydrate antigen 72-4 were increased as auxiliary serological biomarkers for the differentiation of gastric ulcer and gastric cancer. The diagnostic accuracy of combined application for gastric cancer and gastric ulcer was high, and the area under the curve was 0.826.