Usefulness of gastric cancer screening using the serum pepsinogen test method

Morita, Masuo; Sasajima, Masahiko; Hoshina, Reiko; Kanda, Eiko; Urita, Yoshihisa

doi:10.1016/s0002-9270(03)00128-x

Cited by 67 publications

(112 citation statements)

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“…[15] In a cohort study, mass screening for gastric cancer was performed using both serum PG measurements and X-ray methods; 23.6% of those screened by serum PG measurements, and 11.7% screened by X-ray, required further endoscopic screening. [16] In total, 10 gastric cancers were detected. The measurement of serum PG showed a higher rate of gastric cancer detection (0.18%) than the X-ray method (0.05%).…”

Section: Discussionmentioning

confidence: 99%

The serum pepsinogen levels for risk assessment of gastric neoplasms

Cho

Jeon²,

Kim³

et al. 2017

Medicine

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To decrease the gastric cancer related mortality rate, endoscopic screening is widely performed in Korea. However, a precise method for identifying those at a high risk of gastric neoplasms has not been established. This study aims to evaluate serum pepsinogen (PG) levels for risk assessment of gastric neoplasms. Between August 2014 and March 2016, a total of 398 subjects, including 87 with gastric neoplasms, were enrolled in this study. On the basis of the serum PG I/II ratio, the enrolled subjects were classified into 4 groups: group A, PG I/II ratio >4; group B, >3 and ≤4; group C, >2 and ≤3; group D, ≤2. Compared with group A, a stepwise increase in the risk of gastric neoplasm was observed from group B [odds ratio (OR) = 9.9, 95% confidence interval (95% CI) = 4.0–24.4] to group C (OR = 20.9, 95% CI = 8.7–50.5) to group D (OR = 37.3, 95% CI = 14.3–97.4). The optimal cutoff value of the serum PG I/II ratio for predicting gastric neoplasms was 4.5, with a sensitivity of 97.7% and a specificity of 57.6%. A decrease in the serum PG I/II ratio was strongly associated with an increased risk of gastric neoplasms. The serum PG I/II ratio can be used to identify those at a high risk of gastric neoplasms in Korean population.

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Section: Discussionmentioning

confidence: 99%

The serum pepsinogen levels for risk assessment of gastric neoplasms

Cho

Jeon²,

Kim³

et al. 2017

Medicine

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“…One study showed that when pepsinogen-I <50 ng/ml and the pepsinogen-I/II ratio <3 were taken to indicate extensive atrophic gastritis, the percentage of those screened who needed further examination was 19.5%. The cancer detection rate was 0.28%, and 83% of the cancers detected by the pepsinogen test were of the intestinal type [30]. Thus, the pepsinogen test is extremely useful for detecting the well-differentiated histological type (very similar to the intestinal type) of gastric carcinoma in asymptomatic subjects with small, early, intestinal-type cancers, particularly in Japan, where the incidence of gastric atrophy is extremely high.…”

Section: Discussionmentioning

confidence: 99%

Serum Nitrate/Nitrite Concentration Correlates with Gastric Juice Nitrate/Nitrite: A Possible Marker for Mutagenesis of the Proximal Stomach

Kishikawa¹,

Nishida²,

Ichikawa³

et al. 2011

Digestion

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Background/Aims: In the normal acid-secreting stomach, luminally generated nitric oxide, which contributes to carcinogenesis in the proximal stomach, is associated with the concentration of nitrate plus nitrite (nitrate/nitrite) in gastric juice. We investigated whether the serum nitrate/nitrite concentration is associated with that of gastric juice and whether it can be used as a serum marker. Methods: Serum and gastric juice nitrate/nitrite concentration, Helicobacter pylori antibody, and gastric pH were measured in 176 patients undergoing upper endoscopy. Results: Multiple regression analysis revealed that serum nitrate/nitrite concentration was the best independent predictor of gastric juice nitrate/nitrite concentration. On single regression analysis, serum and gastric juice nitrate/nitrite concentration were significantly correlated, according to the following equation: gastric juice nitrate/nitrite concentration (µmol/l) = 3.93 – 0.54 × serum nitrate/nitrite concentration (µmol/l; correlation coefficient = 0.429, p < 0.001). In analyses confined to subjects with gastric pH less than 2.0, and in those with serum markers suggesting normal acid secretion (pepsinogen-I >30 ng/ml and negative H. pylori antibody), the serum nitrate/nitrite concentration was an independent predictor of the gastric juice nitrate/nitrite concentration (p < 0.001). Conclusion: Measuring the serum nitrate/nitrite concentration has potential in estimating the gastric juice nitrate/nitrite concentration. The serum nitrate/nitrite concentration could be useful as a marker for mutagenesis in the proximal stomach.

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“…In addition, fasting pepsinogen (PG) I and II levels were assayed using the chemiluminescence enzyme immunoassay for determination of serum atrophy in patients who did not have a history of use of antacids within the previous 2 weeks [21]. Serum samples were collected before ESD.…”

Section: Methodsmentioning

confidence: 99%

Frequency of Helicobacter pylori-Negative Gastric Cancer and Gastric Mucosal Atrophy in a Japanese Endoscopic Submucosal Dissection Series Including Histological, Endoscopic and Serological Atrophy

Ono

Kato²,

Suzuki³

et al. 2012

Digestion

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Background: The definition of Helicobacter pylori-negative gastric cancer depends on the accuracy of diagnosis of H. pylori infection. The aim of this study was to determine the frequency of H. pylori-negative gastric cancer and to clarify relationships with histological atrophy, endoscopic atrophy, and serological atrophy. Methods: A total of 240 early gastric cancers were included in this study. The status of H. pylori infection was determined from the rapid urease test, ¹³C-urea breath test, H. pylori culture, histopathological examination and examination of IgG antibodies. In H. pylori-negative gastric cancer, histological atrophy and intestinal metaplasia, endoscopic atrophy and serological atrophy were assessed by pepsinogen. Results: The rate of H. pylori infection was 77.9% and 19 patients (7.9%) had a history of eradication. 34 patients (14.2%) were diagnosed with H. pylori-negative gastric cancer using diagnostic tools of H. pylori. However, most of the patients with H. pylori-negative gastric cancer had histological atrophy and intestinal metaplasia. Only 1 gastric cancer (0.42%) occurred in the mucosa without histological atrophy, endoscopic atrophy or serological atrophy. Conclusion: Early gastric cancers in the Japanese endoscopic submucosal dissection series were strongly related to current or past infection with H. pylori and to gastric mucosal atrophy.

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Usefulness of gastric cancer screening using the serum pepsinogen test method

Abstract: The pepsinogen test method can be used as a screening test for high-risk subjects with atrophic gastritis, rather than as a tool for cancer itself. Systemic endoscopic surveillance of this group is also useful.

Cited by 67 publications

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The serum pepsinogen levels for risk assessment of gastric neoplasms

The serum pepsinogen levels for risk assessment of gastric neoplasms

Serum Nitrate/Nitrite Concentration Correlates with Gastric Juice Nitrate/Nitrite: A Possible Marker for Mutagenesis of the Proximal Stomach

Frequency of Helicobacter pylori-Negative Gastric Cancer and Gastric Mucosal Atrophy in a Japanese Endoscopic Submucosal Dissection Series Including Histological, Endoscopic and Serological Atrophy

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