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Test Code MISC1WARDEPGII Pepsinogen II (PG II)



Reference Lab Test Number


Collection Requirements

Patient should be fasting 10 – 12 hours prior to collection of specimen. Antacids or other medications affecting stomach acidity or gastrointestinal motility should be discontinued, if possible, for at least 48 hours prior to collection.

For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.

Primary Collection Container

Red (No Gel)

Alternate Collection Container

Lavender 4 mL (K3EDTA)


Serum or plasma frozen

Preferred Transport Temperature



3 ml serum or EDTA plasma should be collected and separated as soon as possible. Freeze specimens immediately after separation. Minimum specimen size is 1 ml.



Minimum Testing Volume

1.0 mL

Reference Range

Up to 22 ng/ml


Direct RIA


9-10 days

CPT Codes


Additional Information

Testing forwarded to ISI by Warde Medical Laboratory.

The Pepsinogens are gastric acid protease zymogens. They are divided into two distinct immunochemical groups: Pepsinogen I and II. Pepsinogen II is one of four aspartic proteinases: PG I, PG II, Cathepsin E and D. Pepsinogen II is produced primarily in the Oxyntic gland mucosa of the stomach, the gastric antrum and the duodenum. It is secreted mainly into the gastric lumen and into circulation. Pepsinogen II has little or no biological activity but in acid is converted to the active enzyme Pepsin which exhibits proteolytic actions. Unlike Pepsinogen I, Pepsinogen II is not normally found in the urine. Patients with pernicious anemia have low to non-detectable levels of Pepsinogen I but normal levels of Pepsinogen II. Pepsinogen II levels are slightly elevated in gastric ulcer. Patients with Zollinger-Ellison’s syndrome exhibit greatly elevated levels.