Validity of serum pepsinogen levels and quininium resin test combined for gastric cancer screening.
BACKGROUND
To investigate the feasibility of combining several serum markers into a valid serum screening tool for gastric cancer, we performed a study evaluating the association between gastric cancer and precancerous conditions and a blood test for gastric acidity (the blood quininium resin test [QRT]) combined with serum pepsinogen levels.


METHODS
We performed immunoradiometric assays of serum pepsinogen I (PG I), II (PG II) levels, and QRT's in 10 endoscopically normal subjects, in 20 patients with chronic atrophic gastritis, and in 13 patients with biopsy-confirmed gastric adenocarcinoma.


RESULTS
Serum PG I, II levels, I/II ratio were significantly different among normal, gastritis, and cancer patients. Serum PG I/II ratios were much lower in cancer patients. Serum quinine levels by QRT were correlated with PG I/II ratio (rs=0.39, p<0.01). Age was negatively correlated both with PG I/II ratio (rs=-0.58, p<0.01) and serum quinine level (rs=-0.45, p<0.01). The screening using serum PG levels was more valid (sensitivity of 69%, specificity of 77%) than that using QRT alone. The combination of serum PG levels and QRT increased specificity for detecting gastric cancer to 87% without altering sensitivity.


CONCLUSIONS
Although blood QRT is a useful addition to other serum screening tests for gastric cancer, these tests alone are not sufficiently accurate as screening tools for gastric cancer.
Kim
Jang-Rak
JR
Department of Preventive Medicine, College of Medicine, Institute of Health Sciences, Gyeongsang National University, 92 Chilam-Dong, Jinju 660-751, South Korea. jrkim@gsnu.ac.kr
Lee
Kyongwu
K
Jung
Woon-Tae
WT
Lee
Ok-Jae
OJ
Kim
Tae-Hyo
TH
Kim
Hyun-Jin
HJ
Lee
Jong-Sil
JS
Passaro
Douglas J
DJ
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005745:Gastric Acidity Determination; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D011230:Precancerous Conditions / Q000097:blood / Q000175:diagnosis; D011803:Quinine / Q000097:blood; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis*
D020116:Pepsinogen A; D011803:Quinine