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Three Examinations of Gastric Function: a Powerful Tool for Accurate Diagnosis of Early Gastric Cancer

1. Serum gastric function test


Serum gastric function test is a method of extracting 2-3ml of human venous blood (fasting), measuring gastrin 17 (G-17), pepsinogen I, II (PG I, II), and comprehensively analyzing it to assist diagnosis. The method for gastric mucosal disease, whose core index is G-17, is a non-invasive, painless, safe and economical method for gastric disease detection.


2. Serum gastrin gastric function test


Serum gastrin is a gastrointestinal hormone mainly secreted by gastric antrum and duodenal G cells, which plays an important role in regulating the function of the digestive tract. More than 95% of the biologically active gastrin in the human body is α-amidated gastrin, of which 80% to 90% are G-17 and 5% to 10% are G-34.


In atrophic gastritis dominated by gastric antrum atrophy, gastric mucosal atrophy can lead to a decrease in the number of G cells and a decrease in the secretion of G-17, thereby reducing the content of G-17 in the blood circulation.


Therefore, the level of serum G-17 can be used as a serum marker for gastric antral atrophic gastritis. Studies have shown that the optimal critical value of G-17 gastric function test for the diagnosis of atrophic gastritis is 5.1 pmol/L. G-17 is related to the severity of gastric antral atrophy negatively correlated.


3. PG gastric function test (pepsinogen)


PG (pepsinogen) is an aspartic protease gland secreted by the gastric mucosa. It is mainly divided into PG I and PG II. PG I is mainly secreted by chief cells and gastric fundic gland mucous neck cells;


In addition to the secretion of PG II by chief cells, pepsinogen II can also be produced by mucous neck cells of fundic glands, mucous cells of cardia and pyloric glands, and Brunner's glands in the upper duodenum.


PG not only helps to determine whether the gastric mucosa is atrophic, but also to determine the involved location and severity of atrophy. Studies have shown that the levels of PG I and PG II are positively correlated with the activity and degree of chronic inflammation in the gastric antrum and gastric corpus, and the pepsinogen ratio PGR (PG I/PG II) is negatively correlated with the latter two.


Studies have shown that low serum PG I levels and PGR are biological markers of gastric corpus atrophy, and serum PG I levels gradually decrease with the increase in the severity of mucosal atrophy, especially PGR.


Therefore, in order to further reduce the missed diagnosis rate of early gastric cancer, the clinical diagnosis of early gastric cancer can be carried out according to the "ABC method plus endoscopy".


If there are obvious abnormalities in the three gastric function tests, further fine endoscopy can be performed, including narrow-band imaging (NBI), intelligent electronic spectroscopy (FICE), and intelligent electronic chromoendoscopy (I-SCAN), which can not only reduce the number of patients Pain and waste of medical resources can improve the diagnosis rate of early gastric cancer.

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