Pepsinogen I (PG I)

• ISI Order Code:

  PG I

• CPT Code:

  83520

Clinical Significance of Pepsinogen I

Pepsinogen I (PGI) is an inactive precursor of the proteolytic enzyme pepsin and is produced primarily by chief cells and mucous neck cells in the gastric fundic glands. After secretion into the gastric lumen, pepsinogen is converted to pepsin in the acidic environment of the stomach, where it participates in protein digestion. A small proportion of circulating pepsinogen enters the bloodstream and can be measured in serum. Serum PGI concentrations reflect the functional and structural status of the gastric fundic mucosa and are influenced by gastric mucosal integrity and secretory activity.

Pepsinogen I is commonly used as a biomarker of gastric mucosal status. Decreased PGI levels, particularly when accompanied by a reduced PGI/PGII ratio, are associated with gastric fundic gland atrophy and chronic atrophic gastritis. These conditions are recognized risk factors for gastric cancer. Measurement of pepsinogens has therefore been used in some populations as part of noninvasive screening strategies for gastric atrophy and gastric cancer risk. Interpretation should consider clinical history and other diagnostic findings, as levels may also be influenced by factors such as Helicobacter pylori infection and gastric inflammation.

Reference Range, Procedure & Expected Results

• Reference Range:

  Serum/Plasma: 24 – 214 ng/ml

• Procedure:

  Pepsinogen I is measured by direct ELISA.

• Expected Turnaround Time:

  7 Business Days

Turnaround time is defined as the usual number of days from the date of receipt of a specimen for testing to when the result is released to the ordering facility.

• Report:

  Sample Report

Pre-Test Preparation Guidelines

Patient should be fasting 10 – 12 hours prior to collection of specimen.  Antacids or other medications affecting stomach acidity or gastrointestinal motility should be discontinued, if possible, for at least 48 hours prior to collection.

Specimen Collection Instructions

3 ml serum or EDTA plasma should be collected and separated as soon as possible.  Freeze specimens immediately after separation.  Minimum specimen size is 1 ml.

Pepsinogen I Assay Rejection Criteria

Gross hemolysis/lipemia/icteric

Shipping and Handling Instructions for Pepsinogen I Assay Specimens

Special Specimens:

For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.

Shipping Instructions:

Ship specimens frozen in dry ice.

References:

1 Miki, K. (2006). Gastric cancer screening using the serum pepsinogen test method. Gastric Cancer, 9(4), 245–253.

2 Dinis-Ribeiro, M., Yamaki, G., Miki, K., Costa-Pereira, A., Matsukawa, M., & Kurihara, M. (2004). Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia, and chronic atrophic gastritis screening. Journal of Medical Screening, 11(3), 141–147.

3 Samloff, I. M. (1971). Pepsinogens, pepsins, and pepsin inhibitors. Gastroenterology, 60(4), 586–604.