A double-threshold score of serum pepsinogen combined with serum albumin improves the screening ability of peptic ulcer

Abstract Background and purpose: Quickly screening of high-risk of peptic ulcer (PU) is of great significance to avoid gastrointestinal bleeding after antiplatelet therapy. In this study, we hoped to find a fast and less invasive method for PU screening. Methods: The clinical data of health examined population who were admitted for taking gastroscopic assessment in our hospital, from January 2019 to June 2020, was prospectively collected. PU was defined as a gastric or duodenal mucosal defect >5mm in diameter on gastroscopic assessment. Results: A total of 902 blood samples were enrolled into analysis. Blood indices showed that PGI and albumin (ALB) were both independently associated with PU (all P <0.05). Based on this, we proposed a PGI and ALB Composite Score (PACS), ranged from 0-2. The ROC analysis showed that PACS had a good diagnostic ability for PU (AUC=0.774, P <0.001). The probability of PU was significantly elevated with the increase of PACS score (PACS 0 vs 1 vs 2=7.9% vs 28.6% vs 62.2%, P <0.001). Conclusion: Both serum PGI and ALB were associated with the increased rate of PU in health examined population, and the PACS score based on these two items may be used to identify the population with high risk of PU.