Plasma ghrelin concentration and pepsinogen I/II ratio as noninvasive markers for upper gastrointestinal malignancy

Abstract

Malignancy in the upper gastrointestinal tract is an important health problem worldwide. It is often detected late because there aren't typical early symptoms. If the cancer is caught soon enough with identifying useful diagnostic and prognostic markers, patients can have a high survival rate through endoscopy-assisted treatment and surgical therapy. This cross sectional study was done on 308 referred patients to an endoscopy department of a University hospital affiliated in Iran. Demographic data (age, gender), body weight, stature and any history of systemic disorder were recorded. The blood samples were collected to measure C-reactive protein, fasting blood sugar, Albumin, complete blood count, serum pepsinogen I and II and ghrelin plasma levels after 12 hours of fasting, before upper gastrointestinal endoscopy was performed. Enzyme-linked immunosorbent assay was used to measure serum pepsinogen I and II and ghrelin plasma levels. The patients were divided into three groups: patients with cancer (14.6%), patients with benign lesions (27.6%), and others with normal endoscopy. Patients with malignancy showed significant lower levels of PGI (median, 73 ng/ml), ratios of PGI/PGII (median, 4.29) and ghrelin (4.94 pg/ml). The average of ghrelin level and PGI/PGII ratio in the women was significantly higher than in the men. The mean of ghrelin level was significantly lower in the stomach lesions than in the esophagus and antrum lesions. Inverse associations between ghrelin in addition to the PGI/II ratio and some gastrointestinal cancers suggest a potential role for serum ghrelin and in addition to the PGI/II ratio, as two biomarkers of upper gastrointestinal cancers.