{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:31:44Z","timestamp":1789576304700,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hangzhou Medical and Health Science and Technology Plan","award":["A20200174"],"award-info":[{"award-number":["A20200174"]}]},{"name":"Hangzhou Medical and Health Science and Technology Plan","award":["OO20190610"],"award-info":[{"award-number":["OO20190610"]}]},{"name":"Hangzhou Medical and Health Science and Technology Plan","award":["2016ZD01"],"award-info":[{"award-number":["2016ZD01"]}]},{"name":"Hangzhou Medical and Health Science and Technology Plan","award":["2019RC068"],"award-info":[{"award-number":["2019RC068"]}]},{"name":"Hangzhou Medical and Health Science and Technology Plan","award":["WKJ-ZJ-2136"],"award-info":[{"award-number":["WKJ-ZJ-2136"]}]},{"name":"Zhejiang Medical and Health Science and Technology Plan","award":["A20200174"],"award-info":[{"award-number":["A20200174"]}]},{"name":"Zhejiang Medical and Health Science and Technology Plan","award":["OO20190610"],"award-info":[{"award-number":["OO20190610"]}]},{"name":"Zhejiang Medical and Health Science and Technology Plan","award":["2016ZD01"],"award-info":[{"award-number":["2016ZD01"]}]},{"name":"Zhejiang Medical and Health Science and Technology Plan","award":["2019RC068"],"award-info":[{"award-number":["2019RC068"]}]},{"name":"Zhejiang Medical and Health Science and Technology Plan","award":["WKJ-ZJ-2136"],"award-info":[{"award-number":["WKJ-ZJ-2136"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gastroenterology Research and Practice"],"published-print":{"date-parts":[[2021,4,12]]},"abstract":"<jats:p>Objective. To evaluate the diagnostic value of gastrin-17 (G-17) and pepsinogen (PG) in gastric cancer (GC) screening in China, especially eastern China, and to determine the best diagnostic combination and threshold (cutoff values) to screen out patients who need gastroscopy. Methods. The serum concentrations of G-17 and pepsinogen I and II (PGI and PGII) in 834 patients were analyzed, and the PGI\/PGII ratio (PGR) was calculated. According to pathological results, patients can be divided into chronic nonatrophic gastritis (NAG)\/chronic atrophic gastritis (CAG)\/intraepithelial neoplasia (IN)\/GC groups. The differences in G-17, PG, and PGR in each group were analyzed, and their values in GC diagnosis were evaluated separately and in combination. Results. There were differences in serum G-17, PGII, and PGR among the four groups (NAG\/CAG\/IN\/GC) (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>\u2264<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). In total, 54 GC cases were diagnosed, of which 50% were early GC. There was no significant difference in the PGI levels among the four groups (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.377<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). NAG and CAG composed the chronic gastritis (CG) group. The G-17 and PGII levels in the IN and GC groups were higher than those in the CG group (both <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>\u2264<\/e:mo>\n                        <e:mtext>oth<\/e:mtext>\n                        <e:mtext>\u2009<\/e:mtext>\n                        <e:mi>C<\/e:mi>\n                     <\/e:math>\n                  <\/jats:inline-formula>), while the PGR levels were lower (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>\u2264<\/g:mo>\n                        <g:mtext>lower<\/g:mtext>\n                     <\/g:math>\n                  <\/jats:inline-formula>). When distinguishing NAG from CAG, the best cutoff value for G-17 was 9.25\u2009pmol\/L, PGII was 7.06\u2009\u03bcg\/L, and PGR was 12.07. When distinguishing CG from IN, the best cutoff value for G-17 was 3.86\u2009pmol\/L, PGII was 11.92\u2009\u03bcg\/L, and PGR was 8.26. When distinguishing CG from GC, the best cutoff value for G-17 was 3.89\u2009pmol\/L, PGII was 9.16\u2009\u03bcg\/L, and PGR was 14.14. The sensitivity, specificity, accuracy, and positive and negative predictive values of G-17\/PGII\/PGR for GC diagnosis were 83.3%\/70.4%\/79.6%, 51.8%\/56.3%\/47.8%, 53.8%\/57.2%\/49.9%, 10.7%\/10.9%\/9.6%, and 97.8%\/96.5%\/97.1%, respectively. The sensitivity, specificity, accuracy, and positive predictive and negative predictive values of PGII\/G-17 vs. PGR\/G-17 vs. PGR\/PGII in the diagnosis of GC were 63.0% vs. 70.4% vs. 64.8%, 70.5% vs. 70.1% vs. 60.4%, 70.0% vs. 70.1% vs. 60.7%, 12.9% vs. 14.0% vs. 10.2%, and 96.5% vs. 97.2% vs. 96.1%, respectively. Conclusion. The PGII and G-17 levels in patients with gastric IN and GC were significantly increased, while the serum PGR level was significantly decreased. Serological detection is effective for screening GC. The combination of different markers can improve the diagnostic efficiency. The highest diagnostic accuracy was G-17 combined with PGR, and the best cutoff values were <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mtext>G<\/i:mtext>\n                        <i:mo>\u2212<\/i:mo>\n                        <i:mn>17<\/i:mn>\n                        <i:mo>&gt;<\/i:mo>\n                        <i:mn>3.89<\/i:mn>\n                        <i:mtext>\u2009<\/i:mtext>\n                        <i:mtext>pmol<\/i:mtext>\n                        <i:mo>\/<\/i:mo>\n                        <i:mtext>L<\/i:mtext>\n                     <\/i:math>\n                  <\/jats:inline-formula> and <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mtext>PGR<\/k:mtext>\n                        <k:mo>&lt;<\/k:mo>\n                        <k:mn>14.14<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>.<\/jats:p>","DOI":"10.1155\/2021\/6894248","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T16:50:29Z","timestamp":1618246229000},"page":"1-8","source":"Crossref","is-referenced-by-count":23,"title":["The Diagnostic Value of Serum Gastrin-17 and Pepsinogen for Gastric Cancer Screening in Eastern China"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1275-2862","authenticated-orcid":true,"given":"Hongzhang","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hangzhou First People\u2019s Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kangwei","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Huai\u2019an Hospital Affiliated to Xuzhou Medical University and Huai\u2019an Second People\u2019s Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sile","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hangzhou First People\u2019s Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qifeng","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hangzhou First People\u2019s Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5746-1612","authenticated-orcid":true,"given":"Hangbin","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hangzhou First People\u2019s Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-0274","authenticated-orcid":true,"given":"Xiaofeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hangzhou First People\u2019s Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21338"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2013.05.002"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.47.5.618"},{"key":"4","first-page":"9","article-title":"How to improve the diagnosis rate of early gastric cancer in China","volume":"44","author":"W.-B. 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