Prediction of the risk of gastric cancer development and early diagnosis of gastric cancer in van and surrounding provinces with high incidence of gastric cancer with stomach specific biomarkers (gastropanel)

Gastric cancer is a cancer type that is often diagnosed in its advanced stages and has a high mortality rate. Early diagnosis significantly reduces the mortality associated with gastric cancer. This study aims to investigate the effectiveness of Gastropanel biomarkers in predicting the risk of gastric cancer and in early diagnosis in the provinces around Van, where the incidence of gastric cancer is high. The study examines the role of biomarkers such as Pepsinogen A (1), Pepsinogen C (2), Pepsinogen A (1)/C (2) ratio, H. pylori IgG, H. pylori IgA, and Gastrin-17 in the early detection of individuals at risk for gastric cancer. Patients and Methods: A total of 88 patients, aged 18–99 years, with upper gastrointestinal (GI) symptoms, were included in this study at the General Surgery Clinic of the Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine. In this study, patients presenting with upper GI symptoms were enrolled after obtaining informed consent. Endoscopic examination was performed on all patients, and simultaneously, a blood sample was taken for biochemical analysis. The blood samples were centrifuged, and the plasma was stored at -22°C. According to the pathology reports, 41 patients were classified as the malignant group, and 47 patients were classified as the benign group. The relationships between demographic characteristics (age, gender), pathological results, and gastric-specific biomarkers (H. pylori IgG, H. pylori IgA, Gastrin-17, Pepsinogen A (I), Pepsinogen C (II), Pepsinogen A (I)/C (II) ratio) were investigated. The data were analyzed using SPSS 15.0 for Windows. Descriptive statistics, Chi-square test, Mann-Whitney U test, multivariate logistic regression analysis, and ROC curve analysis were employed. The cutoff values and correct classification rates were determined. Results: A total of 88 patients, including 44 women and 44 men, were included in the study. Of the patients, 47 had benign pathology and 41 had malignant pathology. The average age of malignant patients was 65.4 ± 10.0 years, while the average age of benign patients was 43.7 ± 15.7 years. The average age and male gender ratio of malignant patients were significantly higher compared to benign patients (both p < 0.001). According to pathological evaluation, the majority of malignant patients had adenocarcinoma (97.6%), while the majority of benign patients were diagnosed with mild chronic gastritis (68.1%). According to the Gastropanel biomarker results, the Pepsinogen C (II) level was significantly higher in malignant patients (p < 0.001), while the Pepsinogen A (I)/C (II) ratio was lower in the malignant group (p < 0.001). The levels of H. pylori IgG and H. pylori IgA were similar in both groups, but Gastrin-17 levels were higher in the malignant group. Multivariate logistic regression analysis revealed that age and Pepsinogen C (II) level were significant factors in predicting malignancy (p < 0.001 and p = 0.006). These results indicate that age and Pepsinogen C (II) play an important role in determining the risk of gastric cancer. According to ROC Curve analysis, the AUC value for Pepsinogen C (II) was 0.761 (p < 0.0001) with a cutoff value of 465.4. This biomarker is a strong tool for predicting gastric cancer risk, with high sensitivity (68.29) and specificity (87.23). The AUC value for the Pepsinogen A (I)/C (II) ratio was 0.705 (p = 0.0013) with a cutoff value of 0.23. The sensitivity (70.73) and specificity (80.85) rates were also quite high. In the benign group, patients who were H. pylori positive had significantly lower Pepsinogen A (I) levels compared to those who were negative for H. pylori (p = 0.010). There was no statistically significant difference in the biomarker results between patients with and without intestinal metaplasia. For the benign group, Pepsinogen A (I) was found to be a significant biomarker for predicting H. pylori infection, with an ROC Curve analysis showing 85% sensitivity and 71.43% specificity at a cutoff value of ≤103.5. These results suggest that Pepsinogen A (I) could be a potential marker for detecting H. pylori infection in benign patients. Conclusion: The study demonstrated that Gastropanel biomarkers, particularly Pepsinogen C (II) levels, play a significant role in predicting gastric cancer risk. Additionally, the Pepsinogen A (I)/C (II) ratio and H. pylori IgG, H. pylori IgA biomarkers are important for early detection strategies. Biomarkers such as Gastrin-17 and Pepsinogen A (I) should be further investigated in clinical applications. These findings may guide the increased applicability of Gastropanel biomarkers in the early diagnosis of high-risk patients.