Abstract
The purpose of the present study was to point out the problems of urinary Helicobacter pylori (Hp) antibody testing and serum pepsinogens (PG) testing for gastric cancer mass screening programs which include many senile subjects. A total of 295 gastric cancer patients (mean age 65.2±8.7 years) whose cancers were detected by gastroroentgenography during mass screening, were examined using both the quantitative immunoblot test for urinary Hp antibody and the serological PG level (the positive detection ; PG I<=70ng/ml and PG I/II<=3.0). The positive rate for PG, urinary Hp antibody and their combination was 70.7, 78.9 and 93.2%, respectively. The Hp+/PG- group, which showed low levels of gastric mucosal atrophy, contained an increasing number of younger subjects, poorly differentiated types and advanced-stage gastric cancers as compared with the other groups. The Hp+/PG+ and Hp-/PG+ groups were advanced in age and were mainly composed of well-differentiated types and early-stage cancers. The double negative Hp-/PG- group accounted for 6.8% of the gastric cancers. The majority of Hp-/PG- cases belonged to the aged generation but showed low levels of gastritis and atrophy. The combination of urine Hp antibody testing and serum PG testing seemed effective for gastric cancer screening. However, the occurrence of false negative cases for both tests is still problematic; therefore, the introduction of a highly sensitive Hp infection test and careful judgment of the serum PG test would be required for the achievement of efficient gastric cancer mass screening.
