title: Identification of a high risk gastric cancer group using serum pepsinogen after successful eradication of Helicobacter pylori.
abstract: OBJECTIVE
  Pepsinogen (PG) method is widely used to identify high risk groups of gastric cancer. It is very useful before Helicobacter pylori eradication, but after eradication the method becomes useless because the PGI, PGII, PGI/II ratios change. Therefore, we aimed to identify a high risk group for gastric cancer using serum pepsinogen after successful eradication of H. pylori.
  
  
  METHODS
  A total of 261 participants were enrolled after successful eradication of H. pylori in Hokkaido University Hospital from 1995 to 2010. Participants with renal failure, taking proton pump inhibitors, and those with advanced gastric cancer were excluded. Serum levels of PGI and II were measured using chemiluminescent immunoassay method.
  
  
  RESULTS
  Receiver operating characteristic curves using cancerous and non-cancerous data in post-eradication determined the optimal cut-off value of PGI/II as 4.5. The sensitivity and the specificity were 65.9% and 79.3%, respectively. The usual PG method includes 48.9% of cancer cases, and the PGI/II ≤ 4.5 in post-eradication includes 65.9% of them, and it includes approximately half of the high risk group of diffuse type cancer. PGI/II ≤ 4.5 in post-eradication included many gastric cancer cases detected after eradication (12/16 = 75%).
  
  
  CONCLUSIONS
  In the identification of a high risk group for gastric cancer, we suggest that the optimal cut-off value of PGI/II after successful eradication of H. pylori is 4.5. PGI/II ≤ 4.5 in post-eradication includes more gastric cancer cases compared with the traditional PG method, and 75% of gastric cancer cases detected after eradication.
authors.affiliation: Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Masahira
authors.initials: M
authors.lastname: Haneda
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
authors.forename: Saori
authors.initials: S
authors.lastname: Ishigaki
authors.forename: Mio
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Takahashi
authors.forename: Manabu
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Shouko
authors.initials: S
authors.lastname: Ono
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Mori
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mabe
authors.forename: Shouichi
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kudo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Asaka
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000097:blood*; D013997:Time Factors
chemical_list: D020115:Pepsinogen C; D020116:Pepsinogen A