{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T01:36:25Z","timestamp":1775784985522,"version":"3.50.1"},"reference-count":0,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2004,9,1]],"date-time":"2004-09-01T00:00:00Z","timestamp":1093996800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Screen"],"published-print":{"date-parts":[[2004,9,1]]},"abstract":"<jats:p> Aim: To assess the validity of the measurement of pepsinogen I and II as a screening test for gastric cancer and pre-malignant lesions, namely low-grade dysplasia, both in the general population and in selected groups of patients. <\/jats:p><jats:p> Methods: A meta-analysis of sensitivity and specificity results from individual papers on the use of the pepsinogen test. An intrinsic cut-off effect was assumed and a random effect model was used for pooling. <\/jats:p><jats:p> Results: Forty-two data sets were included: 27 (64%) population-based screening studies (n=296,553) and 15 (36%) sets of selected individuals (n=4385). Homogenous sensitivity and diagnostic odds ratio (DOR) estimates were found in studies using both pepsinogen I levels and pepsinogen I\/II ratio calculations. Pooled pairs of sensitivity and false positive rates (FPr) for pepsinogen I \u2264 70; pepsinogen I\/II ratio \u2264 3, pepsinogen I \u226450; pepsinogen I\/II ratio \u2264 3, and pepsinogen I \u2264 30; pepsinogen I\/II ratio \u2264 2, were sensitivity 77%\/FPr 27%, sensitivity 68%\/FPr 31%, and sensitivity 52%\/FPr 84%, respectively. Positive predictive values (PPV) varied between 0.77% and 1.25%, and negative predictive values (NPV) varied between 99.08% and 99.90%. In selected groups, pooling was only possible when considering pepsinogen I \u2264 70; pepsinogen I\/II ratio \u2264 3: giving sensitivity 57%, specificity 80%, PPV 15% and NPV 83%. As for the diagnosis of dysplasia, studies considering pepsinogen I &lt;50; pepsinogen I\/II ratio &lt;3 obtained sensitivity 65% and specificity ranging from 74%\u201385%, both with NPV &gt;95%. <\/jats:p><jats:p> Conclusion: Pepsinogen test definition should include pepsinogen I\/II ratio as consistency was obtained, both in population based studies and in selected groups for those studies that used pepsinogen I serum levels together with pepsinogen I\/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Further studies of this test in the management of high-risk patients seem to be worthwhile. <\/jats:p>","DOI":"10.1258\/0969141041732184","type":"journal-article","created":{"date-parts":[[2004,8,22]],"date-time":"2004-08-22T00:55:26Z","timestamp":1093136126000},"page":"141-147","source":"Crossref","is-referenced-by-count":166,"title":["Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening"],"prefix":"10.1177","volume":"11","author":[{"given":"M","family":"Dinis-Ribeiro","sequence":"first","affiliation":[{"name":"Showa University, Tokyo, Japan; Department of Gastroenterology, Portuguese Oncology Institute Francisco Gentil, Porto, Portugal; Department of Biostatistics and Medical Informatics, Porto Faculty of Medicine, Porto, Portugal"}]},{"given":"G","family":"Yamaki","sequence":"additional","affiliation":[{"name":"Showa University, Tokyo, Japan"}]},{"given":"K","family":"Miki","sequence":"additional","affiliation":[{"name":"Tokyo University, Tokyo, Japan"}]},{"given":"A","family":"Costa-Pereira","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, Porto Faculty of Medicine, Porto, Portugal"}]},{"given":"M","family":"Matsukawa","sequence":"additional","affiliation":[{"name":"Showa University, Tokyo, Japan"}]},{"given":"M","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Showa University, Tokyo, Japan"}]}],"member":"179","published-online":{"date-parts":[[2004,9,1]]},"container-title":["Journal of Medical Screening"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/0969141041732184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/0969141041732184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T13:13:13Z","timestamp":1738069993000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1258\/0969141041732184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,9,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,9,1]]}},"alternative-id":["10.1258\/0969141041732184"],"URL":"https:\/\/doi.org\/10.1258\/0969141041732184","relation":{},"ISSN":["0969-1413","1475-5793"],"issn-type":[{"value":"0969-1413","type":"print"},{"value":"1475-5793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,9,1]]}}}