2017 Volume 55 Issue 1 Pages 21-30
We investigated the optimal positive standards for gastric cancer risk assessment (ABC classification system) while considering the efficient screening modalities for gastric cancer, and comparing endoscopic gastric mucosal atrophy with the gastric cancer assessment findings. This study included 1125 individuals who underwent medical checkups at our hospital. According to the positive standards defined by Miki et al., gastric mucosal atrophy was endoscopically detected in 99 out of 560 patients (17.6%) in group A (“pseudo A” group), while among 467 patients who endoscopically demonstrated no gastric mucosal atrophy, one patient (0.2%) belonged to group D (“pseudo D” group). After changing the positive H. pylori antibody values to more than 3.0, the gastric cancer assessment finding decreased to 40 out of 467 patients (8.5%). Furthermore, by changing the positive pepsinogen (PG) values to PGI<=70ng/ml and PGI/II ratio<=3.5, the “pseudo A” group and “pseudo D” group comprised 36 out of 459 (7.8%), and 5 out of 467 (1.0%), respectively. For gastric cancer risk assessment, changing the positive values thus resulted in a reduction of the “pseudo A” group, while suppressing an increase of the “pseudo D” group. This adjustment in the screening system is therefore expected to make it possible to obtain more accurate risk assessment findings and thereby establish a more efficient endoscopic screening system.
