Establish a Scoring Model for High-Risk Population of Gastric Cancer and Study on the Pattern of Opportunistic Screening

Abstract

Objective. To investigate and study the related risk factors of gastric cancer (GC) patients, to establish a high-risk scoring model of GC by multiple logistic regression analysis, and to explore the establishment of a GC screening mode with clinical opportunistic screening as the main method, and by using the pattern of opportunistic screening to establish the screening of high-risk GC patients and the choice of screening methods in the clinical outpatient work. Methods. Collected the epidemiological questionnaire of 99 GC cases and 284 non-GC patients (other chronic gastric diseases and normal) diagnosed by the General Hospital of Ningxia Medical University from October 2017 to March 2019. Serum pepsinogen (PG) levels were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed Helicobacter pylori (Hp) infection in gastric mucosa tissues by Giemsa staining. Determined the high-risk factors and established a scoring model through unconditional logistic regression model analysis, and the ROC curve determined the cut-off value. Then, we followed up 26 patients of nongastric cancer patients constituted a validation group, which validated the model. Results. The high-risk factors of GC included age≥55, male, drinking cellar or well water, family history of GC, Hp infection, PGI≤43.6 μg/L, and PGI/PGII≤2.1. Established the high-risk model: Y=A×age+30×gender+30×drinking water+30×Hp infection+50×family history of GC+B×PG level. The ROC curve determined that the cut-off value for high-risk GC population was ≥155, and the area under the curve (AUC) was 0.875, the sensitivity and specificity were 87.9% and 71.5%. Conclusions. According to the risk factors of GC, using statistical methods can establish a high-risk scoring model of GC, and the score≥155 is divided into the screening cut-off value for high-risk GC population. Using this model for clinical outpatient GC screening is cost-effective and has high sensitivity and specificity.

Comparison of different risk stratifications for gastric cancer and establishing a simplified risk‐scoring model based on the Kyoto classification

“…We all know that GC is strongly associated with gene expression, Hp infection, lifestyle, and so on 18 . Consistent with a previous study, 19 age and high salt diet showed differences between the GC and NGC groups. It has been concluded that long‐term excessive salt intake may enhance the carcinogenic pathway by inducing Hp proliferation and colonization and that preserved vegetables often contain excessive amounts of nitrate and nitrite carcinogens in addition to high salt content, which together form nitroso complexes with irreversible effects on the cellular activity cycle 20…”

“…This study followed the ethical principles of medical research involving human subjects in the Declaration of Helsinki and was approved by the ethics committee of our hospital (Quick-PJ-2022- [11][12][13][14][15][16][17][18][19][20][21][22].…”

What is the general Chinese public’s awareness of and attitudes towardsHelicobacter pyloriscreening and associated health behaviours? A cross-sectional study

“… 13 14 Such opportunistic screening is performed on a voluntary basis, based on an individual or physician’s request. 14 The screening rate for HP in China (21.7%) is far from satisfactory, 15 and the general population’s lack of awareness of HP risk factors or symptoms and negative attitude towards screening contribute to delays in diagnosis. 11 …”

“…However, although eradication of HP to prevent GC has a cost–benefit advantage,10 China lacks national policies or protocols for HP in GC screening 11. HP infection is usually asymptomatic,12 and China has a large population and relatively poor medical and health resources; therefore, opportunistic screening of asymptomatic people is currently the main approach 13 14. Such opportunistic screening is performed on a voluntary basis, based on an individual or physician’s request 14.…”

“…HP infection is usually asymptomatic,12 and China has a large population and relatively poor medical and health resources; therefore, opportunistic screening of asymptomatic people is currently the main approach 13 14. Such opportunistic screening is performed on a voluntary basis, based on an individual or physician’s request 14. The screening rate for HP in China (21.7%) is far from satisfactory,15 and the general population’s lack of awareness of HP risk factors or symptoms and negative attitude towards screening contribute to delays in diagnosis 11…”