Biomarker: Pepsinogen

Piecing together the risk factors for stomach cancer

Pepsinogen is a precursor of pepsin, a protease secreted in stomach, and is immunologically categorized into two main classes, pepsinogenⅠand pepsinogen Ⅱ. PepsinogenⅠ exists in fundic gland mucosa, while pepsinogenⅡ exists more broadly, in organs including fundic gland mucosa, cardiac glandpyloric gland, duodenal gland.1 Pepsinogen I value and pepsinogenⅠ/ pepsinogenⅡ ratio both correlate with extent of the fundic gland area expansion, and it is useful as a marker of chronic atrophic gastritis progression. Atrophic gastritis progressions is strongly related with stomach cancer,2 and those with severe atrophic change have higher frequency of cancer being found. 3-4 


  1. Sanloff IM, et al. Relationships among serum pepsinogen I, serum pepsinogen II and gastric mucosal histology. Gastroenterology, 83: 204-209, 1982.

  2. Correa P. The gastric precancerous process. Cancer Survey, 2: 438-450, 1983.

  3. Miki K. Gastric Cancer Screening Using Serum Tests (Stomach Dry Dock) -Study of the Systems of the First Screening for Cancer-susceptible Subjects by Serum Pepsinogen Levels and the Secondary Close-examination by Every-Other-Year Panendoscopy. Nippon Shokaki shudankenshin gakkaishi, 84: 141-144, 1989.

  4. Nishizawa M. An outlook of gastric mass screening (1st report). Nippon Shokaki shudankenshin gakkaishi, 84: 141-144, 1989.

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