Abstract
Seven hundred and fifty-five candidates, who underwent not only a barium X-ray examination but also a combination test of using a urine anti-Helicobacter pylori IgG antibody (H.p test) and serum pepsinogen levels (PG method), were analyzed. X-ray films were checked without the result of the combination test. When X-ray films of subjects were judged as infection-free, they were classified as Group A1. When X-ray films were judged as chronic atrophic gastritis (CAG), they were classified as Group C. Additionally, according to the degree of the spread of atrophy, it was described as C2-4. The PG method is widely known as a serum marker of atrophic gastritis, which is a precancerous change in the stomach. There are several cut-off points, and PGI<=70.0 and PGI/II ratio<=3.0 are recommended as positive by Miki. The candidates were divided into positive adaptations of Miki's criterion.
Six hundred and fifty-one candidates (86.2%) did not have history of the eradication. Depending on the age of the candidates, a negative proportion of the H.p test was 75% in those under 40, 61% in those aged 40-49, 44% in those aged 50-59, and 31% in those aged over 60 years old. Two hundred and seventy-five cases were classified as the A1 group depending on the X-ray film, and 95% (261/275) were negative for both the H.p test and PG method (H.p-/PG-). Three hundred and fifty-four cases were classified as the C group, and 91% (322/354) were positive for the H.p test or PG method.
Most cases of infection-free subjects were both negative for the H.p test and PG method (Miki's criterion). The criterion of a normal stomach, which was classified on X-ray films, has to be adopted for these infection-free subjects. They do not need to be recommended for an annual examination.
If there aren't enough doctors who can classify X-ray films as either infection-free subjects or chronic atrophic gastritis, a combination test using both the H.p test and PG method will be administered as part of the first step in gastric cancer screening, because a combination test is simple without requiring both images and judgment from X-ray films.
