Biemond I, Kreuning J, Jansen JBMJ, Lamers CBHW. Serum pepsinogens in patients with gastric diseases or after gastric surgery. Scand J Gastroenterol 1994;29:238-242.

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 (>120ug/l) occurred frequently in patients with the Zollinger-EUison syndrome (71%) and hypertrophic gastropathy (100%), whereas hypopepsinogenemia A (<17 μg/1) 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 μg/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.