AIM:To investigate screening makers for gastric cancer,we assessed the association between gastric cancer and serum pepsinogens(PGs).METHODS:The subjects comprised 450 patients with gastric cancer,111 individuals with gastric atrophy,and 961 healthy controls.Serum anti-Helicobacter pylori(H.pylori) immunoglobulin G(IgG),PGⅠand PG Ⅱ were detected by enzyme-linked immunosorbent assay.Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations.Odds ratios and 95%CIs were calculated using multivariate logistic regression.RESULTS:Rates of H.pylori infection remained high in Northeastern China.Rates of H.pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group(69.1% and 75.7% vs 49.7%,P < 0.001).Higher levels of PG Ⅱ(15.9 μg/L and 13.9 μg/L vs 11.5 μg/L,P < 0.001) and lower PGⅠ/PG Ⅱ ratio(5.4 and 4.6 vs 8.4,P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls,whereas no correlation was found between the plasma PGⅠconcentration and risk of gastric cancer(P = 0.537).In addition,multivariate logistic analysis indicated that H.pylori infection and atrophic gastritis were independent risk factors for gastric cancer.Lower plasma PGⅠ/PG Ⅱ ratio was associated with higher risks of atrophy and gastric cancer.Furthermore,plasma PG Ⅱ?level?significantly?correlated?with?H.pyloriinfected gastric cancer.CONCLUSION:Serum PG Ⅱ concentration and PG Ⅰ/PG Ⅱ ratio are potential biomarkers for H.pyloriinfected gastric disease.PG Ⅱ is independently associated with risk of gastric cancer. AIM: To investigate screening makers for gastric cancer, we assessed the association between gastric cancer and serum pepsinogens (PGs). METHODS: The subjects comprised 450 patients with gastric cancer, 111 individuals with gastric atrophy, and 961 healthy controls. Serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG), PG I and PG II were detected by enzyme-linked immunosorbent assay. Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations. Odds ratios and 95% CIs were calculated using multivariate logistic regression. RESULTS: Rates of H. pylori infection remained high in Northeastern China. Rates of H. pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group (69.1% and 75.7% vs 49.7%, P <0.001) .Higher levels of PG II (15.9 μg / L and 13.9 μg / L vs 11.5 μg / L, P <0.001) and lower PG Ⅰ / PG Ⅱ ratios (5.4 and 4.6 vs 8.4, P <0.001) were found in patients with gastric cancer or gastric atrophy compar ed to healthy controls, and no correlation was found between the plasma PGIconcentration and risk of gastric cancer (P = 0.537) .In addition, multivariate logistic analysis indicated that H.pylori infection and atrophic gastritis were independent risk factors for gastric cancer. PGI / PGII ratio was associated with higher risks of atrophy and gastric cancer. Fluorrthermore, plasma PGII? Level? Significantly? Correlated? H.pylori in gastric cancer. CONCLUSION: Serum PGII concentration and PGI / PGII ratio are potential biomarkers for H. pylori in gastric fluid. PGII is independently associated with risk of gastric cancer.