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J Dig Dis. 2014 Jun;15(6):293-8. doi: 10.1111/1751-2980.12144.

Combining the serum pepsinogen level and Helicobacter pylori antibody test for predicting the histology of gastric neoplasm.

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1
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Abstract

OBJECTIVE:

To determine whether the combination test of serum pepsinogen (PG) levels and Helicobacter pylori (H. pylori) antibody was effective for predicting the incidence and histology of gastric neoplasms.

METHODS:

This study included asymptomatic Korean adults who underwent esophagogastroduodenoscopy with blood tests for PG levels and H. pylori immunoglobulin G antibody test on the same day. Participants with extragastric malignancy, history of H. pylori eradication or gastric neoplasms, or recent antacid medication were excluded. Gastric atrophy was defined as a serum PG I/II ratio ≤3.0 and PG I ≤70 ng/mL. The participants were classified into four groups according to the presence (+) or absence (-) of gastric atrophy and H. pylori infection.

RESULTS:

Of the 3328 included participants, 17 were incidentally diagnosed as having either gastric adenoma or carcinoma. The incidence of gastric neoplasm was highest in the gastric atrophy (+)/H. pylori (-) group (4.17%; OR 25.8, P = 0.009), but the neoplasm exhibited the least advanced histology. The gastric atrophy (-)/H. pylori (-) group exhibited the lowest incidence of gastric neoplasm (0.17%) but the most advanced histology.

CONCLUSION:

A combination of serum PG levels and H. pylori antibody test is useful for detecting gastric neoplasms based on the slow gastric carcinogenesis pathway progressing from gastric adenoma to Lauren's intestinal-type gastric cancer, but not for those with advanced histology such as Lauren's diffuse-type gastric cancer.

KEYWORDS:

Helicobacter pylori; atrophy; pepsinogen; screening; stomach neoplasm

PMID:
24602176
DOI:
10.1111/1751-2980.12144
[Indexed for MEDLINE]
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