Identification of a high risk gastric cancer group using serum pepsinogen after successful eradication of Helicobacter pylori

Background and Aim Pepsinogen (PG) method is widely used to identify high risk groups of gastric cancer. It is very useful before Helicobacter pylori eradication, but after eradication the method becomes useless because the PGI, PGII, PGI/II ratios change. Therefore, we aimed to identify a high risk...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2013-01, Vol.28 (1), p.78-83
Main Authors: Haneda, Masahira, Kato, Mototsugu, Ishigaki, Saori, Suzuki, Mio, Takahashi, Masakazu, Nakagawa, Manabu, Ono, Shouko, Mori, Yasuaki, Mabe, Katsuhiro, Nakagawa, Shouichi, Kudo, Takahiko, Shimizu, Yuichi, Asaka, Masahiko
Format: Article
Language:English
Subjects:
Aged
Confidence Intervals
Data processing
Female
Gastric cancer
gastric cancer screening
gastric carcinoma
Gastroscopy
Helicobacter Infections - drug therapy
Helicobacter pylori
Helicobacter pylori eradication
Hospitals
Humans
Immunoassays
Male
Middle Aged
Odds Ratio
Pepsinogen A - blood
Pepsinogen C - blood
pepsinogen I/II
Protons
Renal failure
Risk Assessment
Risk Factors
Risk groups
ROC Curve
Serum levels
Statistics, Nonparametric
Stomach Neoplasms - blood
Time Factors
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Summary:Background and Aim Pepsinogen (PG) method is widely used to identify high risk groups of gastric cancer. It is very useful before Helicobacter pylori eradication, but after eradication the method becomes useless because the PGI, PGII, PGI/II ratios change. Therefore, we aimed to identify a high risk group for gastric cancer using serum pepsinogen after successful eradication of H. pylori. Methods A total of 261 participants were enrolled after successful eradication of H. pylori in Hokkaido University Hospital from 1995 to 2010. Participants with renal failure, taking proton pump inhibitors, and those with advanced gastric cancer were excluded. Serum levels of PGI and II were measured using chemiluminescent immunoassay method. Results Receiver operating characteristic curves using cancerous and non‐cancerous data in post‐eradication determined the optimal cut‐off value of PGI/II as 4.5. The sensitivity and the specificity were 65.9% and 79.3%, respectively. The usual PG method includes 48.9% of cancer cases, and the PGI/II ≤ 4.5 in post‐eradication includes 65.9% of them, and it includes approximately half of the high risk group of diffuse type cancer. PGI/II ≤ 4.5 in post‐eradication included many gastric cancer cases detected after eradication (12/16 = 75%). Conclusion In the identification of a high risk group for gastric cancer, we suggest that the optimal cut‐off value of PGI/II after successful eradication of H. pylori is 4.5. PGI/II ≤ 4.5 in post‐eradication includes more gastric cancer cases compared with the traditional PG method, and 75% of gastric cancer cases detected after eradication.
ISSN:0815-9319
1440-1746
DOI:10.1111/j.1440-1746.2012.07285.x