title: Serum pepsinogens and Helicobacter pylori are not associated with esophageal squamous cell carcinoma in a high-risk area in China.
abstract: OBJECTIVE
  The role of serum pepsinogen level and Helicobacter pylori infection in esophageal carcinoma remains controversial. It may be a risk or protective factor, or without association with esophageal carcinoma. We prospectively examined associations between serum pepsinogen status, H pylori infection and the risk of esophageal squamous cell carcinoma in the Chinese population.
  
  
  METHODS
  In the present study, 1501 subjects from a community-based general population of Northern China were included. The incidence of esophageal carcinoma among the subjects was registered during a 15-year follow-up period by annual home visit, and the risks of low serum pepsinogen level and H pylori infection in the development of ESCC were evaluated using logistic regression.
  
  
  RESULTS
  The total accumulated incidence of ESCC in the cohort was 666/100,000 during the 15-year follow-up. Notably, all the cases were verified to be ESCC. Logistic regression analysis showed that age ≥60 (OR = 9.67; 95% CI, 2.797-33.423) was the only risk factor for esophageal squamous cell carcinoma in the population. There was no significant association between sex, H pylori infection, pepsinogen level (PG I ≤70 ng/ml alone, PG I/II ratio ≤3 alone, or PG I ≤70 ng/ml and PG I/II ratio ≤3) and esophageal squamous cell carcinoma.
  
  
  CONCLUSIONS
  In this prospective study, neither H pylori infection nor abnormal pepsinogen status had a predictive role for the development of esophageal squamous cell carcinoma in the rural population of China.
authors.affiliation: Department of Pathology, Hebei Medical University, Shijiazhuang, Hebei, PR China.
authors.forename: Liying
authors.initials: L
authors.lastname: Xue
authors.forename: Lingxiao
authors.initials: L
authors.lastname: Xing
authors.forename: Junling
authors.initials: J
authors.lastname: Wang
authors.forename: Haitao
authors.initials: H
authors.lastname: Shen
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Cui
authors.forename: Jianmin
authors.initials: J
authors.lastname: Mi
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.forename: Junichi
authors.initials: J
authors.lastname: Misumi
authors.forename: Xianghong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000201:enzymology / Q000453:epidemiology* / Q000382:microbiology; D002681:China / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000201:enzymology / Q000453:epidemiology* / Q000382:microbiology; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D020116:Pepsinogen A