• Gastric cancer
• Group I pepsinogen (PG I)
• Group II pepsinogen (PG II)
• Pepsinogen (PG)
• Postoperative biochemical recurrence
• Total gastrectomy

• 81370889 National Natural Science Foundation of China
• SH2022046 the key research and development plan of Zhenjiang city
• YLJ202101 the key research and development plan of Zhenjiang city
• JDYY2023006 the key research and development plan of Zhenjiang city

• biomarkers
• circulating biomarkers
• exosomes
• gastric cancer
• liquid biopsy
• plasma proteins
• proteomics
• saliva proteins
• serum proteins
• urine proteins

• Humans
• Stomach Neoplasms/pathology
• Biomarkers, Tumor/metabolism
• Proteomics/methods
• Extracellular Vesicles/metabolism

• Ricerca Corrente Ministero della Salute

• Humans
• Male
• Middle Aged
• Female
• Pepsinogen A
• Stomach Neoplasms/diagnosis
• Helicobacter pylori
• Helicobacter Infections/epidemiology
• Gastrins
• Biomarkers
• Antibodies, Bacterial

• biomarkers
• cancer diagnosis
• exhaled breath
• gastric-endoluminal gas
• upper gastrointestinal cancer

• Humans
• Breath Tests/methods
• Gas Chromatography-Mass Spectrometry/methods
• Mass Spectrometry
• Volatile Organic Compounds/analysis
• Lung Neoplasms/diagnosis
• Exhalation

Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete. The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer, while mild to moderate atrophy has a low risk. The updated Kimura-Takemoto classification of atrophic gastritis considers five histological types of multifocal corpus atrophic gastritis according to stages C2 to O3. This method of morphological diagnosis of atrophic gastritis increases sensitivity by 2.4 times for severe atrophy compared to the updated Sydney system. This advantage should be considered when stratifying the high risk of gastric cancer. The updated Kimura-Takemoto classification of atrophic gastritis should be used as a reference standard (gold standard) in studies of morpho-functional relationships to identify serological markers of atrophic gastritis with evidence-based effectiveness. The use of artificial intelligence in the serological screening of atrophic gastritis makes it possible to screen a large number of the population. During serological screening of atrophic gastritis and risk stratification of gastric cancer, it is advisable to use the Kyoto classification of gastritis with updated Kimura-Takemoto classification of atrophic gastritis.

• Atrophic gastritis
• Cancer risk stratification
• Gastric cancer prevention
• Classification of gastritis

The early screening of cancer has always been the focus of cancer research. As a common cancer in the world, gastric cancer has had a high incidence rate and mortality for many years, and canceration is difficult to detect. Current detection methods are not ideal for early detection of gastric cancer and precancerous lesions.

To assess the value of detection of serum pepsinogen (PG), gastrin (G-17), and hepato-intestinal cadherin-17 (CDH-17) combined with narrowband imaging magnifying endoscopy in the identification of early gastric cancer and precancerous lesions.

The clinical data of patients with early gastric cancer (106 cases) and precancerous lesions (134 cases) at our hospital from January 2018 to January 2021 were retrospectively analyzed. All patients underwent narrow-band imaging magnifying endoscopy and detection of serum PG (including PGⅠ and PGⅡ), G-17, and CDH-17 levels. The sensitivity, specificity, and accuracy of PG, G-17, CDH-17, and narrow-band imaging magnifying endoscopy, alone and in combination, in the diagnosis of early gastric cancer and precancerous lesions were calculated.

In the early gastric cancer group, the incidence of lesions with border limits, mucosal microvascular irregularities, irregular surface ducts, and increased glandular spacing as detected by narrow-band imaging magnifying endoscopy was higher than that in the precancerous lesion group (P < 0.05). The diagnostic coincidence rates of magnifying endoscopy for early gastric cancer and precancerous lesions were 83.02% and 85.07%, respectively, and the difference was not statistically significant (P > 0.05). Serum PGⅠ level in the early gastric cancer group was lower than that of the precancerous lesion group, but there was no significant difference in serum PGⅡ between the two groups (P > 0.05); serum G-17 and CDH-17 levels were higher than those of the precancerous lesion group (P < 0.05). There was no statistically significant difference in the diagnostic coincidence rates of serum PGI, G-17, and CDH-17 alone (P > 0.05). The sensitivity, specificity and accuracy of serum PGⅠ, G-17, and CDH-17 combined with narrow-band imaging magnifying endoscopy in the diagnosis of early gastric cancer and precancerous lesions were higher than those of any serum index alone (PGⅠ/G-17/CDH-17) or narrowband imaging magnifying endoscopy alone (P < 0.05).

The detection of serum PG, G-17, and CDH-17 combined with narrow-band imaging magnifying endoscopy has high sensitivity, specificity, and accuracy in the differential diagnosis of early gastric cancer and precancerous lesions.

• PG
• G-17
• CDH-17
• Narrowband imaging magnifying endoscopy
• Early gastric cancer
• Precancerous lesions

We aimed to evaluate the clinical applicability of a new scoring system that comprises the variables age, sex, pepsinogen ratio (PGR), gastrin-17 (G-17), and Helicobacter pylori (Hp) infection for gastric cancer (GC) screening in the Wannan region, China. We also explored the risk factors of GC in the Wannan region.

We prospectively enrolled asymptomatic participants from January 1, 2019 to June 30, 2021 at the First Affiliated Hospital of Wannan Medical College. We used a receiver operating characteristic (ROC) curve to estimate the screening value of combined measurements of pepsinogen I, PGII, PGR, G-17, and Hp. Univariate analysis and multivariate analysis were used to explore the independent risk factors of GC.

A total of 25,194 asymptomatic patients were eventually screened. The area under the ROC curve (AUC) of combined measurements was 0.817 (95% confidence interval [CI] 0.721–0.913), the sensitivity was 81.5%, and the specificity was 77.8%. The detection rate of this new scoring system for GC screening in low-, medium-, and high-risk groups was 0%, 1.63%, and 9%, respectively (P < 0.001). Multivariate analysis showed that age (odds ratio [OR], 5.934; 95% CI 3.695–9.529; P < 0.001), sex (OR 5.721; 95% CI 2.579–12.695; P < 0.001), Hp infection (OR 1.992; 95% CI 1.255–3.163; P = 0.003), a history of smoking (OR 2.028; 95% CI 1.213–3.392; P = 0.007), consuming a high-salt diet (OR 2.877; 95% CI 1.807–4.580; P < 0.001), frequently eating pickled foods (OR 1.873; 95% CI 1.125–3.120; P = 0.016), and frequently eating fried foods (OR 2.459; 95% CI 1.384–4.369; P = 0.002) were independent risk factors for GC and precancerous lesions. However, frequent consumption of green vegetables (OR 0.388; 95% CI 0.242–0.620; P < 0.001) was an independent protective factor against GC and precancerous lesions.

The new scoring system for GC screening was feasible in the Wannan region, especially in high-risk populations. Frequent consumption of green vegetables was an independent protective factor against GC and precancerous lesions.

The online version contains supplementary material available at 10.1186/s12876-022-02384-w.

• Gastric cancer
• Gastroscopy
• New scoring system

Sancao Tiaowei Decoction (SCTWD), a traditional Chinese medicine created by Professor Chen Weijian, has been used in the prevention and treatment of precancerous lesions of gastric carcinoma (PLGC). However, its mechanism has not been made clear. This study aimed to evaluate the therapeutic effect of SCTWD on 1-methyl-3-nitro-1-nitrosoguanidine-induced PLGC in rats and the mechanism of this effect. We found that SCTWD effectively repaired gastric mucosal injury, reversed the process of PLGC, and inhibited the occurrence of gastric cancer to some extent. In the results of hematoxylin-eosin (HE) staining, the number and arrangement of mucosal glands and the number of mononuclear cells in the lamina propria were improved in varying degrees; the enzyme-linked immunosorbent assay (ELISA) showed that the PG I and PGR of the medication treatment group were significantly higher; a Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test showed that SCTWD could significantly upregulate the expression levels of Shh, Ptch, and Gli-1 in the gastric tissue of rats. The immunohistochemical method showed that SCTWD could significantly upregulate the protein expressions of Shh, Gli-1, Smo, cyclin D1, CDKN2A/p16INK4a, and NF-κBP65 and could reduce the expression of Ptch at the same time. Through the preliminary analysis of 75 compounds screened by UPLC-Q-TOF-MS, the main components, such as organic acids, esters and anhydrides, flavonoids, phenols, tanshinones, and so on, have anti-inflammatory and anti-tumor pharmacological effects. The results of KEGG enrichment analysis showed that 5 signaling pathways related to this project were found, and 33 differential genes were presented to construct the interaction network. These results suggested that SCTWD had a good regulatory effect on PLGC and thus may have a multi-targeted effect; SCTWD can not only significantly improve the pathological changes of gastric mucosa in rats with PLGC but also exert a strong effect of the regulation of the hedgehog signaling pathway.

• SMO (sliding mode observer)
• Sancao Tiaowei decoction
• hedgehog signaling pathway
• inflammation to cancer
• multi-targeted
• precancerous lesions of gastric carcinoma

Screening for gastric cancer is an effective method for early diagnosis of gastric cancer. Studies at home and abroad have found significant differences in serum gastrin-17, pepsinogen Ⅰ, Ⅱ and Helicobacter pylori (H. pylori) IgG (Hp-IgG) antibody levels between patients with gastric cancer and precancerous lesions. It is speculated that screening can be used in the diagnosis and evaluation of gastric cancer.

To explore the screening of gastric cancer and precancerous lesions by serum gastrin-17 (G-17), pepsinogen (PG) I, PG II, Hp-IgG antibody levels value and its relationship with the depth of tumor invasion.

From August 2019 to March 2021, 90 patients with gastric cancer in our hospital were selected as the research group, 90 patients with gastric precancerous lesions during the same period were selected as the control group A, and 90 healthy subjects were selected as the control group B. Compare 3 groups of general information, serum G-17, PG Ⅰ, PG Ⅱ levels, Hp-IgG positive rate, compare serum G-17, PG Ⅰ, PG Ⅱ levels of Hp-IgG positive and negative patients, and analyze serum G-17, PG Ⅰ, PG Ⅱ The relationship between the level and Hp-IgG positive, analyze the value of each index in the diagnosis of gastric cancer and the relationship with the depth of gastric cancer tumor invasion.

Serum G-17, PGII levels and Hp-IgG positive rate in the study group were all > control group A > control group B, serum PG Ⅰ level < control group A < control group B (P < 0.05); the serum G-17 and PGⅡ levels of Hp-IgG positive patients in the study group Both were higher than in negative patients, and serum PG Ⅰ levels were lower than in negative patients (P < 0.05); serum G-17 and PG Ⅱ levels were positively correlated with Hp-IgG positive, and serum PG Ⅰ was negatively correlated with Hp-IgG positive (P < 0.05); The area under curve (AUC) of serum G-17, PG Ⅰ, PG Ⅱ, and Hp-IgG positive diagnosis of gastric cancer were 0.828, 0.845, 0.821, 0.650, respectively. The combined diagnosis of each index had the largest AUC, which was 0.887. The best diagnostic sensitivity and specificity The levels were 80.03% and 84.46%, respectively; serum G-17, PG Ⅱ levels, and Hp-IgG positive rates gradually increased with the increase of gastric cancer tumor invasion depth, and serum PG Ⅰ levels gradually decreased with the increase of gastric cancer tumor invasion depth (P < 0.05); The depth of gastric cancer tumor invasion was positively correlated with serum G-17, PG Ⅱ, Hp-IgG positive, and negatively correlated with serum PG Ⅰ (P < 0.05).

Serum levels of G-17, PG Ⅰ, PG Ⅱ, and Hp-IgG have certain diagnostic value in the screening of gastric cancer and precancerous lesions, and are closely related to the depth of gastric cancer tumor invasion.

• Gastric cancer
• Precancerous lesions
• Gastrin-17
• Pepsinogen
• Helicobacter pylori antibody
• Tumor infiltration

• diagnosis
• gastric cancer
• gastrin
• tumor marker

• National Natural Science Foundation of China
• the Natural Science Foundation of Guangxi

• Atrophic gastritis
• Gastrin-17 (G-17)
• Immunomagnetic beads
• Time-resolved fluorescence immunoassay

The present study aimed to evaluate the clinical value of the combined detection of soluble T cell immunoglobulinand mucin domain molecule 3 (sTim-3) and pepsinogen (PG) in sera for gastric cancer (GC) diagnosis.

The double antibody sandwich method was used to establish a highly sensitive time-resolved fluorescence immunoassay for the detection of sTim-3. Serum sTim-3, PGI, and PGII levels in 149 GC patients (123 first-diagnosis GC patients and 26 post-GC patients), 81 patients with benign gastric disease (BGD), and 73 healthy controls were quantitatively detected. The clinical diagnostic value of the combined detection of sTim-3 and PG in GC was analyzed.

Serum sTim-3 levels in GC (20.41 ± 9.55 ng/mL) and BGD (16.50 ± 9.76 ng/mL) patients were significantly higher (P < 0.001) than those in healthy controls (9.22 ± 3.40 ng/mL). Combined detection of sTim-3 and PGI/PGII (AUC: 0.9330, sensitivity: 86.44%, and specificity: 91.78%) showed a high diagnostic value for GC. When the level of PGI/PGII was less than 12.11 and that of sTim-3 was greater than 14.30 ng/mL, the positive rate of the control group was reduced to 0%, and the positive detection rate of GC was 54.47%. In addition, in post-operative patients, serum sTim-3 levels in the recurrence group (33.56 ± 4.91 ng/mL) were significantly higher than those in the no recurrence group (11.95 ± 5.16 ng/mL).

sTim-3 levels in BGD and GC sera were significantly higher than those in the control group sera. Additionally, sTim-3 serum levels can predict recurrence in post-operative patients. Compared with PG alone, the combined detection of serum PG and sTim-3 can significantly improve the detection sensitivity and specificity of BGD and GC.

• T cell immunoglobulin and mucin domain molecule 3
• biomarker
• gastric cancer
• time-resolved fluorescence immunoassay

To identify differentially expressed proteins (DEPs) in sera of patients with chronic atrophic gastritis (CAG) using isobaric tags for relative and absolute quantitation (iTRAQ) and to explore acupuncture's mechanism in CAG.

Peripheral sera from 8 healthy volunteers (HC), 8 chronic nonatrophic gastritis (NAG) patients, 8 CAG patients, and 8 CAG patients who underwent acupuncture treatment (CAG + ACU) were collected followed by labeling with iTRAQ reagent for protein identification and quantification using two-dimensional liquid chromatography-tandem mass spectrometry (2D-LC-MS/MS). Representative DEPs were selected through bioinformatics, and proteins were verified by enzyme-linked immunosorbent assay (ELISA).

A total of 4,448 unique peptides were identified, corresponding to 816 nonredundant proteins. A 1.4-fold difference was used as the threshold. Compared with the HC group, 75 and 106 DEPs were identified from CAG and NAG groups, respectively. Compared with the CAG group, 110 and 66 DEPs were identified from the NAG and CAG + ACU groups, respectively. The DEPs were mainly involved in protein binding and the Notch signaling pathway-related proteins, and the upregulated proteins included actin-binding proteins (thymosin beta-4, tropomyosin-4, profilin-1, transgelin-2), while the downregulated proteins included Notch2 and Notch3. After acupuncture, the expression of these proteins in CAG patients was less differentiated from that in healthy people. The level of the above 6 proteins were verified by ELISA, and the results were similar to the results of iTRAQ analysis.

Actin-binding proteins and Notch signaling pathway-related proteins were correlated with the development and progression of CAG and thus are potential diagnostic markers for CAG. Acupuncture may play a role in regulating actin-binding proteins and Notch signaling pathway-related proteins to play a therapeutic role in CAG.

• Serum pepsinogen (serum PG)
• carbohydrate antigen 72-4 (CA72-4)
• early gastric cancer
• gastric cancer screening
• gastrin-17 (G-17)

• CLSI-C28-A3
• chemiluminescent microparticle immunoassay
• pepsinogen
• reference interval

• no funding to report

The aim of this study was to investigate the value of the combined expression of the gastric mucosal differentiation protein pepsinogen C (PGC) and gastric cancer (GC)-associated antigen MG7 for the diagnosis of GC and prediction of the development from precancerous conditions to GC.

The gastric mucosal biopsies of 285 subjects enrolled from a region with a high incidence of GC were obtained and histopathologically examined. Subjects testing negative for GC (n=208) were followed up from 1998 to 2015. The levels of PGC and MG7 in the biopsies were determined by immunohistochemistry.

PGC was positive in 91.4% of the non-atrophic gastritis, 26.5% of the atrophic gastritis, and 0% of the GC. MG7 was positive in 15.0% of the non-atrophic gastritis, 82.4% of the atrophic gastritis, and 94.8% of the GC. The non-atrophic gastritis group was predominantly “PGC+MG7−”. The atrophic gastritis and GC groups were predominantly “PGC−MG7+”. The rate of GC in subjects with “PGC−MG7+” staining was 113.4-fold higher [95% confidence interval (95% CI): 15.3−869.4, P<0.001] than that in subjects with other staining patterns. The sensitivity and specificity of the “PGC−MG7+” pattern were 92.2% and 78.8% for the detection of GC and 77.2% and 97.9% for GC and precancerous disease, respectively. In the follow-up cohort of non-GC subjects, the risk of developing GC was higher in those with the “PGC−MG7+” staining pattern.

Our data suggest that the “PGC−MG7+” pattern can be employed as a useful follow-up panel for detecting individuals with a high risk of GC, and the dynamic assessment of the follow-up panel needs multi-centre large-scale validation in the future.

• Pepsinogen C
• carcinogenesis
• diagnosis
• gastric cancer
• gastric cancer-associated antigen MG7

• predictive markers
• gastrointestinal diseases

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers
• Cross-Sectional Studies
• Female
• Gastrins/blood
• Gastritis, Atrophic/blood
• Gastritis, Atrophic/diagnosis
• Gastritis, Atrophic/epidemiology
• Humans
• Male
• Middle Aged
• Odds Ratio
• Prevalence
• Prognosis
• ROC Curve
• Young Adult

• Ministry of Health of China | Wu Jieping Medical Foundation