Identification of a high risk gastric cancer group using serum pepsinogen after successful eradication of <i><scp>H</scp>elicobacter pylori</i>

Haneda, Masahira; Kato, Mototsugu; Ishigaki, Satoko; Suzuki, Motofumi; Takahashi, Masakazu; Nakagawa, Manabu; Ono, Shouko; Mori, Yusaku; Mabe, Katsuhiro; Nakagawa, Souichi; Kudo, Takahiko; Shimizu, Yuichi; Asaka, M

doi:10.1111/j.1440-1746.2012.07285.x

Cited by 11 publications

(7 citation statements)

References 33 publications

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“…Haneda et al . [ 92 ] suggested that the optimal cutoff value of PG I/II in posteradication is 4.5, including more gastric cancer cases compared with the traditional PG method. All in all, the prognosis improvement of gastric cancer depends on the early detection and diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

Chen

Huang

et al. 2018

Chinese Medical Journal

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Objective:Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources:The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords “Helicobacter pylori,” “Pepsinogens,” and “Stomach Neoplasms.”Study Selection:Original articles and reviews on the topics were selected.Results:Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions:The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

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Section: Discussionmentioning

confidence: 99%

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

Chen

Huang

et al. 2018

Chinese Medical Journal

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“…Haneda et al 19 reported that a serum PG I/II ratio ≤ 4.5 is a useful cutoff to select those at risk for gastric cancer after eradication of H. pylori. The sensitivity of this cutoff value for the development of gastric cancer after eradication of H. pylori was reported to be 65.9%.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we demonstrated that the probability of open gastric atrophy could be estimated by serum PG I/II ratio measured after eradication of H. pylori. Usually, the optimal cutoff value is set to select the subjects at highest gastric cancer risk [19][20][21] . However, there are some patients who could not be selected based on the cutoff value.…”

Section: Discussionmentioning

confidence: 99%

Estimation of the degree of gastric mucosal atrophy based on serum pepsinogen levels after eradication of Helicobacter pylori

Suzuki¹,

Higuchi²,

Kagami³

et al. 2020

Preprint

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Background Serum pepsinogen (PG) levels correlate with the degree of gastric mucosal inflammation and atrophy, which correlate with gastric cancer risk, in patients infected with Helicobacter pylori (H. pylori). Serum PG levels change after eradication of H. pylori, but it is not known if there are corresponding changes in the gastric mucosa. We examined whether the degree of gastric atrophy correlated with PG levels measured after eradication of H. pylori. Methods We retrospectively examined the relationship between gastric atrophy and serum levels of PG I, PG II and PG I/II ratios measured after eradication of H. pylori. The degree of gastric mucosal atrophy before H. pylori eradication was scored (0, 1, 2) according to the Kyoto classification of gastritis. Results A total of 430 treated patients were enrolled. Serum levels of PG I (ρ = − 0.362 and P < 0.001), PG II (ρ = − 0.158 and P = 0.001) and PG I/II ratio (ρ = − 0.337 and P < 0.001) all correlated negatively with atrophy scores. When PG I/II was less than 3.4, 5.4 or 6.7, the probability of the open type of gastric atrophy was estimated to be 75%, 50%, or 25%, respectively. Conclusion Our results suggest that serum PG levels measured after H. pylori eradication can be used to estimate the degree of gastric mucosal atrophy and are useful for selecting individuals with a high risk of gastric cancer after H. pylori eradication.

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“…However PG values and ratios change after H. pylori eradication[ 73 ], and the usefulness of the PG method in H. pylori- eradicated patients was not evident. Haneda et al[ 62 ]. examined PG levels in post-eradication cases with and without gastric cancer, and found that the optimal cut-off value for the PGI/II ratio was 4.5 (instead of the usual 3.0).…”

Section: Predictors Of Primary Gastric Cancer After H Pylomentioning

confidence: 99%

“…If there is little change in the metaplasia after eradication, then assessment of histology after eradication may be used as a substitute, but this would need to be evaluated by independent studies. Risk stratification by pepsinogen levels after eradication has been reported[ 62 ], but further validation studies are necessary. Some researchers have focused on endoscopic changes after H. pylori eradication that was accompanied with cancer[ 74 ].…”

Section: Perspectivesmentioning

confidence: 99%

Characteristics and predictors of gastric cancer after Helicobacter pylori eradication

Shichijo¹,

Hirata²

2018

WJG

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Helicobacter pylori (H. pylori) eradication can reduce gastric cancer. However, gastric cancer still develops after eradication, and cases who received eradication therapy are increasing. In this study, we have reviewed the characteristics and predictors of primary gastric cancer developing after H. pylori eradication. In terms of the characteristics, endoscopic, histologic, and molecular characteristics are reported. Endoscopically, gastric cancer after eradication is often depressed-type and shows a gastritis-like appearance, which sometimes makes the diagnosis difficult. Histologically, most gastric cancer after eradication is intestinal type, and non-neoplastic epithelium, also called epithelium with low-grade atypia, is frequently seen over the tumor, which is presumably the cause of the endoscopic gastritis-like appearance. As for molecular characteristics, some markers, such as Ki67, MUC2, and Wnt5a expression, are lower in cancer from patients in whom H. pylori has been eradicated. In terms of predictors, several Japanese studies have reported that severe endoscopic atrophy at eradication is a risk factor for gastric cancer development. Histologic intestinal metaplasia, especially in the corpus, and long-term use of proton pump inhibitors, are also reported as risk factors for gastric cancer after H. pylori eradication. These studies on the characteristics and predictors of gastric cancer development will become the cornerstone for establishing a novel surveillance program based on the gastric cancer risk stratification specific to H. pylori-eradicated patients.

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

Cited by 11 publications

References 33 publications

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

Estimation of the degree of gastric mucosal atrophy based on serum pepsinogen levels after eradication of Helicobacter pylori

Characteristics and predictors of gastric cancer after Helicobacter pylori eradication

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