title: The combination of serum trefoil factor 3 and pepsinogen testing is a valid non-endoscopic biomarker for predicting the presence of gastric cancer: a new marker for gastric cancer risk.
abstract: BACKGROUND
  A valid biomarker for predicting the presence of gastric cancer may contribute to reducing deaths from this disease. Although pepsinogen (PG) testing has been introduced as a predictor, its predictive power is not satisfactory. We examined whether serum trefoil factor (TFF) could be a non-endoscopic predictor of the presence of gastric cancer.
  
  
  METHODS
  Gastric cancer patients who underwent preoperative endoscopy were sequentially recruited. Individuals who underwent a thorough medical checkup were enrolled as non-cancer controls. Serum levels of TFF1, TFF2, TFF3, Helicobacter pylori antibody, PG I, and PG II were examined.
  
  
  RESULTS
  We studied 192 gastric cancer patients aged 64.3 ± 9.7 years and 1254 non-cancer controls aged 52.3 ± 12.4 years. In the age/gender-matched analysis (187 cases and 561 controls), significant relationships were demonstrated between gastric cancer presence and TFF3 (P < 0.0001), the PGI/II ratio (P < 0.0001), H. pylori antibody (P = 0.001), TFF1 (P = 0.012), and TFF2 (P = 0.020). The area under the receiver-operating characteristic curve for predicting gastric cancer presence was comparably high for all factors (0.893) and for the combination of TFF3 and the PG test (0.883), but was significantly (P < 0.0001) lower for the PG test alone (0.823). A positive PG test showed a sensitivity of 67% and specificity of 82%, whereas a combination of TFF3 and PG testing showed a sensitivity of 80% and specificity of 80% in predicting the presence of gastric cancer.
  
  
  CONCLUSIONS
  The combination of serum TFF3 and PG testing might be a valid non-endoscopic biomarker for predicting the presence of gastric cancer.
authors: Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan. kaise@toranomon.gr.jp
authors: Mitsuru
authors: M
authors: Kaise
authors: Jun
authors: J
authors: Miwa
authors: Jun
authors: J
authors: Tashiro
authors: Yasukazu
authors: Y
authors: Ohmoto
authors: Shingo
authors: S
authors: Morimoto
authors: Masayuki
authors: M
authors: Kato
authors: Mitsuyoshi
authors: M
authors: Urashima
authors: Masahiro
authors: M
authors: Ikegami
authors: Hisao
authors: H
authors: Tajiri
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3
chemical_list: D014408:Biomarkers, Tumor; D010455:Peptides; C000604007:TFF2 protein, human; C082495:TFF3 protein, human; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D020116:Pepsinogen A