title: The serum pepsinogen test as a predictor of gastric cancer: the Hisayama study.
abstract: The authors examined whether a serum pepsinogen test (SPT) based on the combination of the serum pepsinogen I level and pepsinogen I/II ratio is a good predictor of gastric cancer occurrence in a general Japanese population. A total of 2,446 subjects aged > or =40 years were classified into negative, positive, and strong-positive SPT groups and were followed prospectively for 14 years (1988-2002). Compared with that for the negative SPT group (26 men, 10 women), gastric cancer incidence increased significantly for both men (n = 17; age-adjusted hazard ratio = 4.56, 95% confidence interval: 2.42, 8.60) and women (n = 6; age-adjusted hazard ratio = 5.84, 95% confidence interval: 2.00, 17.11) in the strong-positive SPT group. It was also significantly higher in the positive SPT group for men (n = 23; age-adjusted hazard ratio = 3.91, 95% confidence interval: 2.23, 6.86). These associations did not attenuate even after adjustment for other comprehensive risk factors. Stratified analysis revealed significant associations between the SPT and development of intestinal-type gastric cancer as well as of cancer in both Helicobacter pylori-negative and -positive subjects. These findings suggest that the SPT can serve as a predictor of intestinal-type gastric cancer, irrespective of H. pylori infection.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. oishi@intmed2.med.kyushu-u.ac.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Oishi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Michiaki
authors.initials: M
authors.lastname: Kubo
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yumihiro
authors.initials: Y
authors.lastname: Tanizaki
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shikata
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shirota
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D010435:Pepsinogens