Tu168 - Evaluation and Establishment of Serum Pepsinogen Levels in Health Checkup Patients Using the MAGLUMI® X3 Analyzer

Ja Young Seo, MD – Department of Laboratory Medicine – Gachon University Gil Medical Center; Jeong-Yeal Ahn, MD – Department of Laboratory Medicine – Gachon University Gil Medical Center; Jun-Won Chung, MD – Department of Internal Medicine – Gachon University Gil Medical Center; Pil-Whan Park, MD – Department of Laboratory Medicine – Gachon University Gil Medical Center; Yiel-Hea Seo, MD – Department of Laboratory Medicine – Gachon University Gil Medical Center; Daewon Kim, MD – Department of Laboratory Medicine – Gachon University Gil Medical Center

Abstract Text: Serum pepsinogen(PG) I and PG I/II ratio are associated with Helicobacter pylori infection, serving as valuable indicators for screening precancerous lesions like atrophic gastritis. Although commonly accepted cutoff values for atrophic gastritis are 70 ng/mL for PG I and 3.0 for PG I/II ratio, these values still need standardization across different methods and vendors. PG I and PG II, and H. pylori IgG were measured in 154 healthy adults using MAGLUMI® X3 analyzer(SNIBE Co., Ltd, China) based on the CLIA. H. pylori IgG testing revealed 58 positive and 96 negative cases. In the H. pylori positive group, both PG I(114.24±80.22 vs. 80.48±39.70 ng/mL) and PG II(15.38±10.65 vs. 7.78±3.99 ng/mL) significantly increased, while the PG I/II ratio decreased(8.11±3.31 vs. 10.36±1.8)(P < 0.001). In endoscopic findings, 46 patients showed atrophic gastritis, while 108 displayed other findings such as erosive or superficial gastritis. Only PG II(14.08±7.69 vs. 9.18±7.87 ng/mL) and PG I/II ratio(8.22±2.89 vs. 10.07±2.43) significantly increased in patients with atrophic gastritis(P < 0.001). Serum PG effectively reflects gastric corpus atrophy but may not always consistent with atrophic gastritis found by endoscopy. Relying solely on traditional reference values should be challenging in populations with a high H. pylori prevalence or healthy individuals. PG level cannot replace endoscopic examination entirely. Thus, a comprehensive assessment, including serologic and endoscopic examinations alongside H. pylori testing, is beneficial for a more comprehensive understanding of health status. Also, optimal cutoff values for MAGLUMI Pepsinogen II and Pepsinogen I/II ratio were established as 12.38 ng/mL and 7.56 for atrophic gastritis through this study.