Objective To assess the value of a model based on helicobacter pylori (Hp) status and peripheral blood levels of pepsinogen I (PGⅠ), PGⅡ, and gastrin-17 (G-17) for predicting disease progression in high-risk populations for gastric cancer.

Methods Retrospective selection of clinical data from 126 high-risk individuals for gastric cancer who underwent PGI, PGII, G-17, and C14 urea breath tests and gastroscopy tissue biopsy at Tianjin University Jinnan Hospital from January 2023 to January 2024, Based on pathological biopsy results using gastric cancer tissues obtained by gastroscopy, the high-risk population for gastric cancer was assigned into normal control, precancerous lesion, and early gastric cancer groups. The diagnostic efficacies of PGⅠ, PGⅡ, G-17, C14 urea breath, and other indicators in each patient group were determined, and a predictive model was constructed.

Results The HP-positivity rate (82.35%) and PGⅡ level (22.73 ng/mL) in the early gastric cancer group were higher than those in the precancerous lesion and control groups. The PGI level (51.36 ng/mL) was lower in early gastric cancer than in precancerous lesions and control tissues. The G-17 level (5.17 pmol/L) was lower in the precancerous lesion group than in the control and early gastric cancer groups (P<0.05). Combined use of PGⅠ、PGⅡ、G-17and Hp , the area under curve (AUC) can reach 0.899, a sensitivity of 94.12%, and a specificity of 95.65%, making these factors ideal diagnostic tools for gastric cancer. According to the prediction model, the threshold for precancerous lesions was 10 points, and the critical value for early cancer was 19 points.

Conclusions Implementation of the C14 urea breath test combined with PGⅠ, PGⅡ, and G-17 detection in high-risk populations for gastric cancer can help monitor disease progression in high-risk populations for gastric cancer.