Significance of Serum Pepsinogens as a Biomarker of Gastric Cancer and Atrophic Gastritis Screening: A Systematic Review and Meta-Analysis

Author:  Ya-kai Huang et al - PLOS ONE - DOI: 10.1371/journal.pone 0142080 - November 10 - 2015

Ya-kai Huang et al,
PLOS ONE, DOI: 10.1371/journal.pone 0142080, November 10, 2015


Human pepsinogens are considered promising serological biomarkers for the screening of atrophic gastritis (AG) and gastric cancer (GC). However, there has been controversy in the literature with respect to the validity of serum pepsinogen (SPG) for the detection of GC and AG. Consequently, we conducted a systematic review and meta-analysis to assess the diagnostic accuracy of SPG in GC and AG detection.

We searched PubMed, Embase, and the Chinese National Knowledge Infrastructure  (CNKI) for correlative original studies published up to September 30, 2014. The summary sensitivity, specificity, positive diagnostic likelihood ratio (DLR+), negative diagnostic likelihood ratio (DLR-), area under the summary receiver operating characteristic curve (AUC) and diagnostic odds ratio (DOR) were used to evaluate SPG in GC and AG screening based on bivariate random effects models. The inter-study heterogeneity was evaluated by the I2 statistics and publication bias was assessed using Begg and Mazumdar’s test. Metaregression and subgroup analyses were performed to explore study heterogeneity.


SPG has great potential as a noninvasive, population-based screening tool in GC and AG screening. In addition, given the potential publication bias and high heterogeneity of the included studies, further high quality studies are required in the future.


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