{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:00Z","timestamp":1790312400619,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While endoscopy is considered the gold standard for diagnosing chronic atrophic gastritis (CAG), serum biomarkers such as pepsinogen I (PG1), pepsinogen \u2161 (PG2), the PG\u2160\/PG\u2161 ratio, and gastrin-17 (G-17) have been investigated for their diagnostic value in CAG. However, studies to date have reported inconsistent results regarding their accuracy and clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All 567 participants underwent upper gastrointestinal endoscopy and serum biomarkers were examined for PG1, PG2 and G-17 using Gastric Function Triple-Parameter test kit (Biohan Biotechnology Co., Ltd). The general characteristics of the participants were derived from the physical examination data from Qilu Hospital of Shandong University.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age was identified as a risk factor of CAG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). By incorporating sex and age as covariates into the ROC curve analysis, The serum gastric function biomarkers could serve as diagnostic tools for AG, particularly among female under 60 years old. Within this subgroup, a PG2 cut-off value of \u22656.145\u2005\u03bcg\/L (AUC\u2009=\u20090.807, sensitivity\u2009=\u20090.762, specificity\u2009=\u20090.800) and a PG1\/PG2 ratio cut-off of \u226420.67 (AUC\u2009=\u20090.806, sensitivity\u2009=\u20090.762, specificity\u2009=\u20090.722) showed the strongest discriminatory performance for diagnosing CAG. Meanwhile, PG1 and the PG1\/PG2 ratio were significantly associated with the severity of inflammation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002 and 0.008, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serum gastric function biomarkers could serve as diagnostic tools for AG, particularly among female patients under 60 years old of age. Meanwhile, PG1 and the PG1\/PG2 ratio were significantly associated with the severity of inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1945445","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:07Z","timestamp":1790310427000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of a serum four-biomarker panel for atrophic gastritis in women under 60 years of age"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenqiao","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Health Management Center, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Health Management Center, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","article-title":"Atrophic gastritis","volume-title":"StatPearls","author":"Raza","year":"2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"331","DOI":"10.31557\/APJCP.2020.21.2.331","article-title":"Screening, monitoring, and treatment of precancerous atrophic gastritis in the prospective study for seven years","volume":"21","author":"Kotelevets","year":"2020","journal-title":"Asian Pac J Cancer Prev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"13B","DOI":"10.1155\/2003\/350347","article-title":"Role of bacterial overgrowth in the stomach as an additional risk factor for gastritis","volume":"17","author":"Naylor","year":"2003","journal-title":"Can J Gastroenterol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1053\/j.gastro.2024.11.001","article-title":"AGA clinical practice update on screening and surveillance in individuals at increased risk for gastric cancer in the United States: expert review","volume":"168","author":"Shah","year":"2025","journal-title":"Gastroenterology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ajg.2023.11.004","article-title":"Correlation of chronic atrophic gastritis with gastric-specific circulating biomarkers","volume":"25","author":"Yu","year":"2024","journal-title":"Arab J Gastroenterol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.3892\/etm.2021.10782","article-title":"Value of GastroPanel in the diagnosis of atrophic gastritis","volume":"22","author":"Grad","year":"2021","journal-title":"Exp Ther Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"462","DOI":"10.4253\/wjge.v16.i8.462","article-title":"Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention","volume":"16","author":"Kotelevets","year":"2024","journal-title":"World J Gastrointest Endosc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e183","DOI":"10.1038\/ctg.2016.42","article-title":"Pepsinogens to distinguish patients with gastric intestinal metaplasia and helicobacter pylori infection among populations at risk for gastric cancer","volume":"7","author":"De Re","year":"2016","journal-title":"Clin Transl Gastroenterol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1097\/00000478-199610000-00001","article-title":"Classification and grading of gastritis. The updated Sydney system. International workshop on the histopathology of gastritis, Houston 1994","volume":"20","author":"Dixon","year":"1996","journal-title":"Am J Surg Pathol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1053\/j.gastro.2022.11.034","article-title":"AGA clinical practice update on diagnosis and management of acute hepatic porphyrias: expert review","volume":"164","author":"Wang","year":"2023","journal-title":"Gastroenterology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1016\/j.dld.2019.09.016","article-title":"Chronic atrophic gastritis: natural history, diagnosis and therapeutic management. A position paper by the Italian society of hospital gastroenterologists and digestive endoscopists [AIGO], the Italian society of digestive endoscopy [SIED], the Italian society of gastroenterology [SIGE], and the Italian society of internal medicine [SIMI]","volume":"51","author":"Lahner","year":"2019","journal-title":"Dig Liver Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.dld.2013.12.017","article-title":"Changing prevalence patterns in endoscopic and histological diagnosis of gastritis? Data from a cross-sectional central European multicentre study","volume":"46","author":"Wolf","year":"2014","journal-title":"Dig Liver Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"100273","DOI":"10.1016\/j.jtauto.2025.100273","article-title":"Monitoring the follow-up of autoimmune chronic atrophic gastritis using parietal cell antibodies and markers of gastric function","volume":"10","author":"Panozzo","year":"2025","journal-title":"J Transl Autoimmun"},{"key":"B14","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1053\/j.gastro.2008.01.071","article-title":"Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in The Netherlands","volume":"134","author":"de Vries","year":"2008","journal-title":"Gastroenterology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1055\/s-0031-1291491","article-title":"Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European society of gastrointestinal endoscopy (ESGE), European helicobacter study group (EHSG), European society of pathology (ESP), and the sociedade portuguesa de endoscopia digestiva (SPED)","volume":"44","author":"Dinis-Ribeiro","year":"2012","journal-title":"Endoscopy"},{"key":"B16","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/apt.14248","article-title":"Systematic review with meta-analysis: diagnostic performance of the combination of pepsinogen, gastrin-17 and anti-helicobacter pylori antibodies serum assays for the diagnosis of atrophic gastritis","volume":"46","author":"Zagari","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"key":"B17","doi-asserted-by":"publisher","first-page":"17562848211038771","DOI":"10.1177\/17562848211038771","article-title":"Autoimmune gastritis, with or without pernicious anemia: epidemiology, risk factors, and clinical management","volume":"14","author":"Rustgi","year":"2021","journal-title":"Therap Adv Gastroenterol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1016\/j.dld.2023.03.015","article-title":"Serum pepsinogens can help to discriminate between H. Pylori-induced and auto-immune atrophic gastritis: results from a prospective multicenter study","volume":"55","author":"Chapelle","year":"2023","journal-title":"Dig Liver Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2784","DOI":"10.3390\/diagnostics12112784","article-title":"The diagnostic value of anti-parietal cell and intrinsic factor antibodies, pepsinogens, and gastrin-17 in corpus-restricted atrophic gastritis","volume":"12","author":"Kri\u0137e","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"502214","DOI":"10.1016\/j.gastrohep.2024.502214","article-title":"The endoscopic model for gastric carcinogenesis and helicobacter pylori infection: a potential visual mind-map during gastroscopy examination","volume":"47","author":"Delgado-Guillena","year":"2024","journal-title":"Gastroenterol Hepatol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1159\/000544812","article-title":"Annual trends in the diagnosis of autoimmune gastritis over 11 years at a single facility in Japan","volume":"106","author":"Nakano","year":"2025","journal-title":"Digestion"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1945445\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:08Z","timestamp":1790310428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1945445\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":21,"alternative-id":["10.3389\/fmed.2026.1945445"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1945445","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"1945445"}}