Abstract
[Purpose] Detailed examination is not indicated for persons assigned to Group A on risk evaluation for gastric cancer. However, some gastric cancer patients with marked atrophy of the gastric mucosa are included in Group A. To decrease the number of such patients assigned to Group A, we examined the cut-off value of the pepsinogen (PG) method.
[Methods] Subjects 1 consisted of 761 who underwent endoscopic screening at the Health Checkup Center of our hospital. Subjects 2 consisted of 186 who underwent risk evaluation held by regional physicians' associations, as well as endoscopy in our hospital. Subjects in whom the grade was evaluated as O2 or higher according to the Kimura and Takemoto classification were regarded as showing marked atrophy of the gastric mucosa.
[Results] The sensitivity and specificity of the reference range of the PG method (PG I≤70 ng/ml and PG I /II ratio≤3) to marked atrophy were 56 and 99%, respectively, in the Helicobacter pylori (Hp) antibody-negative group, consisting of Subjects 1. They were 44 and 93%, respectively, in the Hp antibody-negative group, consisting of Subjects 2. We calculated an optimal cut-off value for marked atrophy using ROC analysis and discriminant analysis. In Subjects 1, the sensitivity and specificity of PG I≤37 ng/ml were 88 and 81%, respectively. In Subjects 2, those of the discriminant function (0.009PG I + 0.321PGI/II ratio≤1.9) were 100 and 80%, respectively.
[Conclusion] The sensitivity of risk evaluation for gastric cancer may be improved by dividing Hp antibody-negative subjects into Groups A and D using the cut-off value of the PG method, which is appropriate for the evaluation of marked atrophy.
