title: Plasma pepsinogens, antibodies against Helicobacter pylori, and risk of gastric cancer in the Shanghai Women's Health Study Cohort.
abstract: BACKGROUND
  Circulating pepsinogens can indicate atrophic gastritis, a precursor of gastric cancer. We tested the association between gastric cancer and plasma pepsinogens and antibodies against Helicobacter pylori in a case-control study nested in a prospective cohort.
  
  
  METHODS
  We selected 141 gastric cancer cases and 282 incidence-density sampled controls. Plasma concentrations of pepsinogens 1 and 2 were measured using ELISA kits, and anti-H. pylori antibodies were measured using a kit specific to Chinese strains. Associations were estimated using conditional logistic regression models adjusted for potential confounders.
  
  
  RESULTS
  Gastric cancer subjects were more likely to be anti-H. pylori positive than controls, 97 vs 92%. A plasma pepsinogen 1 (PG1) concentration <50 ng ml(-1) (15% of cases) was associated with a significantly increased risk of gastric cancer (OR 4.23; (95% CI: 1.86-9.63), whereas a plasma pepsinogen 2 (PG2) concentration >6.6 ng ml(-1) (75% of cases) was also associated with a significantly increased risk of gastric cancer (OR 3.62; (95% CI: 1.85-7.09). We also found that the PG1 : 2 ratio had a nearly linear association with gastric cancer risk.
  
  
  CONCLUSIONS
  Lower plasma PG1 : 2 ratios are associated with a higher risk of gastric cancer. Furthermore, it appears that circulating pepsinogens 1 and 2 may be independently associated with the risk of gastric cancer.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza South, Room 320, 6120 Executive Boulevard, MSC 7232, Rockville, MD 20852, USA. abnetc@mail.nih.gov
authors.forename: C C
authors.initials: CC
authors.lastname: Abnet
authors.forename: W
authors.initials: W
authors.lastname: Zheng
authors.forename: W
authors.initials: W
authors.lastname: Ye
authors.forename: F
authors.initials: F
authors.lastname: Kamangar
authors.forename: B-T
authors.initials: BT
authors.lastname: Ji
authors.forename: C
authors.initials: C
authors.lastname: Persson
authors.forename: G
authors.initials: G
authors.lastname: Yang
authors.forename: H-L
authors.initials: HL
authors.lastname: Li
authors.forename: N
authors.initials: N
authors.lastname: Rothman
authors.forename: X-O
authors.initials: XO
authors.lastname: Shu
authors.forename: Y-T
authors.initials: YT
authors.lastname: Gao
authors.forename: W-H
authors.initials: WH
authors.lastname: Chow
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D044466:Asian People / Q000706:statistics & numerical data*; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D010435:Pepsinogens / Q000097:blood*; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000453:epidemiology / Q000382:microbiology*; D016387:Women's Health
chemical_list: D000907:Antibodies, Bacterial; D014408:Biomarkers, Tumor; D010435:Pepsinogens; D020115:Pepsinogen C; D020116:Pepsinogen A