We investigated the Helicobacter pylori stool antigen (HpSA) test in comparison with gastric endoscopy and serum pepsinogens(PGs). Ninety-four people (60 males and 34 females; mean age 53.1 y.o., range 35-74 y.o.) were recruited in human dry dock of Matsue Red Cross Hospital. The stool antigen test was performed using the HpSA ELISA (Premier Platium HpSA, Meridian Diagnostics). According to manufacture's instructions, an absorbance at 450/630nm of &lt;0.100 and _0.120 was defined as negative and positive, respectively. Serum pepsinogens were measured by enzyme immunoassay. We defined those subjects as positive for PG as those who had levels of PG I lower than 70ng/ml and a PG I/II ratio of less than 3.0. The HpSA positive rate in 92 cases except 2 cases after Helicobacter Pylori (Hp) eradication was 59.8%. Two cases after eradication were both HpSA negative. In 37 HpSA negative cases, endoscopical atrophic pattern were all C0 & Cl. On the other hand, in 52 HpSA positive cases, endoscopical atrophic pattern were C0 & C1 in 4 cases (7.7%), C2 & C3 in 28 cases (53.8 %), O1 & O2 in 18 cases (34.6%), and O3 & Op in 2 cases (3.8%). PG II level was higher in HpSA positive than in HpSA negative, significantly (p<0.01). PG I/II ratio was lower in HpSA positive than in HpSA negative, significantly (p<0.01). There was no PG method positive case in 37 HpSA negative cases, but 17 cases (32.7%) were PG method positive in 52 HpSA positive cases. In conclusion, gastric mucosa of HpSA negative cases was healthy without gastric atrophy, and HpSA test may be useful for screening of gastric cancer.

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Five out of 17.951 persons who underwent a medical check-up at our hospital were found to have mass-forming intrahepatic cholangiocarcinoma by ultrasonography (US)(detection: 0.03%). Of them, four underwent partial hepatectomy, and three are still under observation with no signs of recurrence (7 to 9 years after check-up). US proved useful in the early detection of intrahepatic cholangiocarcinoma. The US images were virtually identical in the three cases with no recurrence. But in some cases, the US images showed an atypical 15-mm hyperechoic hepatic hemangioma and in others the fatty liver presented spreading of a focal lesion. Therefore, it is important to perform examinations while always keeping in mind the existence of atypical US images.

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