Serum pepsinogen I levels of gastric ulcer patients are determined by the location of the ulcer crater.

To examine the relation between gastric ulcer (GU) location and serum pepsinogen I (PGI) level, we measured this marker in 284 endoscopically proved GU patients. Their ulcer locations were further divided according to Johnson's criteria modified to the corpus (type 1a), gastric angle (type 1b), combined with duodenal ulcer (type 2) and prepyloric area (type 3). The number of each subset were 96, 81, 58 and 49, respectively. Mean serum PGI level (99.6 +/- 44.8 ng/ml) of all GU patients showed no difference from that of their sex and age matched controls. Mean serum PGI levels in both type 1a and 1b patients, did not differ from each other but were significantly lower than in controls, in contrast to those in type 2 and 3 patients which were significantly higher than in controls and comparable to the PGI levels of patients with duodenal ulcer. Smoking did not affect mean serum PGI levels in all subsets except the smoking type 2 patients who manifested a significantly higher mean PGI level. Helicobacter pylori infection did not show different serum PGI levels in any subset. In conclusion, different location of ulcer in the stomach results in a characteristic serum PGI level.