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Serological Evaluation of Gastric Cancer Risk Based on Pepsinogen and Helicobacter pylori Antibody: Relationship to Endoscopic Findings

Authors
  • Kotachi, Takahiro
  • Ito, Masanori
  • Yoshihara, Masaharu
  • Boda, Tomoyuki
  • Kiso, Mariko
  • Masuda, Kazuhiko
  • Matsuo, Taiji
  • Tanaka, Shinji
  • Chayama, Kazuaki
Type
Published Article
Journal
Digestion
Publisher
S. Karger AG
Publication Date
Jun 02, 2017
Volume
95
Issue
4
Pages
314–318
Identifiers
DOI: 10.1159/000477239
PMID: 28571035
Source
Karger
Keywords
License
Green
External links

Abstract

Backgrounds and Aims: The serological risk-prediction system combined the pepsinogen (PG) test, and anti-Helicobacter pylori antibody is available for evaluation of gastric cancer risk. In this system, chronic atrophic gastritis (CAG) or H. pylori infection is diagnosed. Subjects with H. pylori negative and PG test negative (group A) are supposed to be those who have never been infected with H. pylori and are at extremely low risk for gastric cancer. However, a certain proportion of patients with CAG has been identified as the extremely low-risk group (group A). Here we examined endoscopic atrophy and investigated its relationship with the ABC classification system. Methods: We examined 540 patients. All patients underwent an endoscopic examination for evaluating corpus atrophy. Fasting sera were collected and serum PGs and anti-H. pylori antibody (Hp-Ab) titer (E-plate Eiken) were evaluated. Results: Of the 540 patients, 306 were classified into group A. However, 136 of them showed signs of endoscopic atrophy (group A with CAG). Group A with CAG frequently comprised the elderly. A new titer cut-off (<3 U/mL) of the Hp-Ab improved the discrimination of group A with CAG by 8%. Conclusion: The prevalence of group A with CAG patients is a critical problem, especially in elderly subjects.

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