Evaluación de la concentración sérica de pepsinógeno como método de tamizaje para gastritis atrófica y cáncer gástrico

gastric cancer has become a health problem in colombia, because of its very high incidence and late diagnosis. only 5% of all gastric cancers reported are diagnosed at an early stage. for these reasons a sensitive, adequated cost-effectiveness and with compliance screening program is required. in japan the i and ii pepsinogen tests have proved to be more effective than the fluoroscopic method for the detection of gastric cancer, the rate of detection being of 0.168% vs the 0.066% obtained fluoroscopically. based on this evidence, we decided to evaluate the use of the pepsinogen tests in two groups as follows: 66 gastric cancer patients and 110 members of the general population. from all of them we obtained blood samples for testing pep i and h. pylori antibodies, followed by endoscopy and biopsies. we defined the best cut-off point for pep i using a roc curve and found that < 150ng/ml was the best cut-off point with sensitivity of 84.3% and specificity of 71.3%. thus we concluded that pep i is a good method for detecting chronic atrophic gastritis and gastric cancer, but also due to the high h. pylori infection prevalence (97%) found the pep ii test must be performed in our population.