As no comparative study is available on the categorized serum
pepsinogen A and C concentrations, we have measured serum
pepsinogens in patients with
gastric diseases and after gastric surgery. Hyperpepsinogenemia A (> 120 micrograms/l) occurred frequently in patients with the
Zollinger-Ellison syndrome (71%) and hypertrophic gastropathy (100%), whereas hypopepsinogenemia
A (< 17 micrograms/l) was found mostly in patients with
achlorhydria (87%) and after total
gastrectomy (100%). Patients with the
Zollinger-Ellison syndrome frequently (58%) had hyperpepsinogenemia C (> 40 micrograms/l), which was also the case in all patients with hypertrophic gastropathy who had in addition a low
pepsinogen A:C ratio (< 1.6). Patients with
achlorhydria, hypertrophic gastropathy, or after total
gastrectomy fell into an aberrant category. From this study we conclude that measurement of serum
pepsinogen A and C and calculation of their ratio yield information useful for differentiation of gastric abnormalities.