Gastric Cancer Detection Using Gastric Juice Pepsinogen and Melanoma-Associated Gene RNA

Objectives: To develop a new method for gastric cancer detection with gastric juice using melanoma-associated gene (MAGE) RNA and pepsinogen (PG). Methods: In total, 183 gastric juice and paired serum specimens were obtained from 134 patients with gastric cancer and 49 healthy individuals. The gastric juice specimens were analyzed with MAGE A1 to A6 nested reverse transcription–polymerase chain reaction. The serum and gastric juice PG were measured with a PG I and II immunoassay. Results: The gastric juice PG I and PG I/II ratios were more accurate than those of serum. The combination test using the gastric PG I/II ratio and MAGE was the most accurate, with a sensitivity of 77.6% and a specificity of 87.8%. The sensitivity was 78.8% for stage I gastric cancer and not influenced by cancer location or pathologic type. Conclusions: The combination test is potentially an additional tool for gastric cancer detection.