In order to evaluate its clinical usefulness, serum
pepsinogen I level was measured in a prospective study in unselected patients affected by endoscopically and histologically confirmed gastric or
duodenal diseases. The mean level in controls was 63 +/- 26 ng/ml (M +/- SD) with no statistical difference between males and females, while it was significantly higher in smokers than in non-smokers (respectively 69 +/- 25 and 56 +/- 25 ng/ml). On the average in
gastric ulcer patients it overlapped with controls (69 +/- 34 ng/ml), but in prepyloric
ulcers its value was higher (81 +/- 45 ng/ml) than that found in
ulcer of the gastric corpus (66 +/- 30 ng/ml). Serum
pepsinogen I level was significantly higher in
duodenal ulcer patients (81 +/- 33 ng/ml), in males as compared to females and in smokers as compared to non-smokers (respectively 91 +/- 32 and 67 +/- 26 ng/ml). Higher than normal values were found in one subject affected by the
Zollinger-Ellison syndrome, and in patients with severe
renal failure. Low and very low levels were found after partial and total
gastrectomies and in A type
atrophic gastritis. In the case of
duodenal ulcer, serum
pepsinogen I determination showed a 16 p. 100 sensitivity and a 96 p. 100 specificity, while for
atrophic gastritis it showed an 87 p. 100 sensitivity and a 100 p. 100 specificity. It is concluded that, at present, the most important clinical application seems to be its screening value in the detection of
atrophic gastritis and consequently its potential use to detect populations at increased risk for
gastric cancer.