{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:44:41Z","timestamp":1785843881082,"version":"3.56.0"},"reference-count":35,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>Low serum pepsinogen I (PGI) and low pepsinogen I\/pepsinogen II ratio (PGI\/II ratio) are markers of gastric fundic atrophy. We aimed to prospectively test the association between serum PGI\/II ratio and risks of gastric non-cardia adenocarcinoma, gastric cardia adenocarcinoma, and oesophageal squamous cell carcinoma (OSCC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Case\u2013cohort study nested in a prospective cohort with over 15 years of follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Rural region of the People\u2019s Republic of China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects:<\/jats:title>\n                  <jats:p>Men and women aged 40\u201369 years at study baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures:<\/jats:title>\n                  <jats:p>Adjusted hazard ratios and 95% confidence intervals for the association between serum PGI\/II ratio and cancer risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Compared to subjects with PGI\/II ratio of &gt;4, those with \u2a7d4 had hazard ratios (HRs) (95% CIs) of 2.72 (1.77 to 4.20) and 2.12 (1.42 to 3.16) for non-cardia and cardia gastric adenocarcinomas, respectively. Risk of both cancers was also increased when we used other cut points ranging from 3 to 6, or quartile models, or nonlinear continuous models. Risk of OSCC was marginally increased in those with PGI\/II ratio \u2a7d4, with HR (95% CI) of 1.56 (0.99 to 2.47), but quartile models and continuous models showed no increased risk. The nonlinear continuous models suggested that any single cut point collapsed subjects with dissimilar gastric adenocarcinoma risks, and that using cut points was not an efficient use of data in evaluating these associations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>In this prospective study, we found similar and significantly increased risks of non-cardia and cardia gastric adenocarcinomas in subjects with low PGI\/II ratio but little evidence for an association with the risk of OSCC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/gut.2008.168641","type":"journal-article","created":{"date-parts":[[2009,1,9]],"date-time":"2009-01-09T20:26:51Z","timestamp":1231532811000},"page":"636-642","source":"Crossref","is-referenced-by-count":76,"title":["Serum pepsinogens and risk of gastric and oesophageal cancers in the General Population Nutrition Intervention Trial cohort"],"prefix":"10.1136","volume":"58","author":[{"given":"J-S","family":"Ren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Kamangar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y-L","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P R","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Dawsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J-H","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C C","family":"Abnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,1,9]]},"reference":[{"key":"2025090712055923000_58.5.636.1","first-page":"215","article-title":"Pepsinogens, pepsins, and peptic ulcer.","volume":"10","author":"Samloff","year":"1987","journal-title":"Clin Invest Med"},{"key":"2025090712055923000_58.5.636.2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/S0016-5085(19)33241-X","article-title":"Chronological transition of the fundic-pyloric border determined by stepwise biopsy of the lesser and greater curvatures of the stomach.","volume":"63","author":"Kimura","year":"1972","journal-title":"Gastroenterology"},{"key":"2025090712055923000_58.5.636.3","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/0016-5085(82)90176-7","article-title":"Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia.","volume":"83","author":"Samloff","year":"1982","journal-title":"Gastroenterology"},{"key":"2025090712055923000_58.5.636.4","first-page":"107","article-title":"Screening markers for chronic atrophic gastritis in Chiapas, Mexico.","volume":"10","author":"Ley","year":"2001","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025090712055923000_58.5.636.5","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23539"},{"key":"2025090712055923000_58.5.636.6","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-05-0931"},{"key":"2025090712055923000_58.5.636.7","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh057"},{"key":"2025090712055923000_58.5.636.8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.026"},{"key":"2025090712055923000_58.5.636.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.1995.tb02989.x"},{"key":"2025090712055923000_58.5.636.10","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.3748\/wjg.v11.i7.1032","article-title":"Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma.","volume":"11","author":"Kokkola","year":"2005","journal-title":"World J Gastroenterol"},{"key":"2025090712055923000_58.5.636.11","doi-asserted-by":"publisher","DOI":"10.1086\/430353"},{"key":"2025090712055923000_58.5.636.12","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20852"},{"key":"2025090712055923000_58.5.636.13","first-page":"113","article-title":"Serum pepsinogens in relation to precancerous gastric lesions in a population at high risk for gastric cancer.","volume":"2","author":"You","year":"1993","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025090712055923000_58.5.636.14","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(87)90022-2"},{"key":"2025090712055923000_58.5.636.15","first-page":"461","article-title":"Helicobacter pylori, pepsinogen, and risk for gastric adenocarcinoma.","volume":"2","author":"Parsonnet","year":"1993","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025090712055923000_58.5.636.16","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11680"},{"key":"2025090712055923000_58.5.636.17","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.055400"},{"key":"2025090712055923000_58.5.636.18","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj088"},{"key":"2025090712055923000_58.5.636.19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018833819860"},{"key":"2025090712055923000_58.5.636.20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/00004836-199307000-00020","article-title":"Atrophic chronic gastritis in patients with epidermoid carcinoma of the esophagus.","volume":"17","author":"Rakic","year":"1993","journal-title":"J Clin Gastroenterol"},{"key":"2025090712055923000_58.5.636.21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01257.x"},{"key":"2025090712055923000_58.5.636.22","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.111385"},{"key":"2025090712055923000_58.5.636.23","doi-asserted-by":"crossref","unstructured":"de Vries AC Capelle LG Looman CWN . Increased risk of esophageal squamous cell carcinoma in patients with gastric atrophy: Independent of the severity of atrophic changes. Int J Cancer Published Online First: 26 August 2008. doi:10.1002\/ijc.23955.","DOI":"10.1016\/S0016-5085(08)60355-8"},{"key":"2025090712055923000_58.5.636.24","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(93)90078-I"},{"key":"2025090712055923000_58.5.636.25","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.18.1483"},{"key":"2025090712055923000_58.5.636.26","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/73.1.1"},{"key":"2025090712055923000_58.5.636.27","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603517"},{"key":"2025090712055923000_58.5.636.28","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.114504"},{"key":"2025090712055923000_58.5.636.29","first-page":"176","article-title":"Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China.","volume":"113","author":"Tran","year":"2004","journal-title":"Int J Cancer"},{"key":"2025090712055923000_58.5.636.30","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23918"},{"key":"2025090712055923000_58.5.636.31","doi-asserted-by":"publisher","DOI":"10.1258\/0969141041732184"},{"key":"2025090712055923000_58.5.636.32","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.137364"},{"key":"2025090712055923000_58.5.636.33","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-2-4"},{"key":"2025090712055923000_58.5.636.34","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyn017"},{"key":"2025090712055923000_58.5.636.35","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.3.457"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.2008.168641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T19:06:08Z","timestamp":1757271968000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.2008.168641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1,9]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2009,4,9]]},"published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1136\/gut.2008.168641"],"URL":"https:\/\/doi.org\/10.1136\/gut.2008.168641","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,1,9]]}}}