Abstract
The aim of this study was to clarify the usefulness of the combined use of the serum pepsinogen (PG) method and the Helicobacter pylori (Hp) antibody value as a screening method for gastric cancer. The evaluation was performed on 1, 218 people (808 male, 410 female, 30-89 years old, mean age 522 years) who underwent the PG test and the Hp antibody value test from April 1996 to March 1997. We defined those subjects who had levels of PG I lower than 70 ng/ml and a PG I/II ratio of less than 3.0 as positive for PG. Consequently, all subjects were classified into 3 groups on the basis of the blood test results for Hp antibody and the PG test: group A consisted of the subjects with negative Hp antibody (-) and negative PG (-) ; group B consisted of the subjects with positive Hp antibody (+) and negative PG (-) ; group C consisted of the subjects who had positive PG (+). There were 260 cases (21.3%) in group A, 571 cases (46.9%) in group B, and 312 cases (25.6%) in group C. There were also 75 cases (62%) which were indeterminable in the HP test. We investigated the development of gastric cancer and adenoma after the blood test by reviewing endoscopic files and pathological files dated up to March 2003. Thirteen gastric cancer cases were found in the follow-up examination, of which 7 cases belonged to group C and 6 cases to group B; no gastric cancer case belonged to group A. The detection rate for gastric cancer was 224% in group C, 1.05% in group B, 0% in group A. In the follow-up examination, 5 cases of gastric adenoma were found, all in the group C. These results suggest that the combined use of the serum PG method and the Hp antibody value test is useful for gastric cancer screening. And we consider that the evaluation of gastric health in the subjects is possible by checking the presence of Hp infection and gastric mucosal atrophy with a blood test.
