Serum trefoil factor 3 is a promising non-invasive biomarker for gastric cancer screening: a monocentric cohort study in China.
BACKGROUND
The search for better non-invasive biomarkers for gastric cancer remains ongoing. We investigated the predictive power of serum trefoil factor (TFF) levels as biomarkers for gastric cancer in comparison with the pepsinogen (PG) test.


METHODS
Patients with gastric cancer, chronic atrophic gastritis (CAG) or chronic non-atrophic gastritis (CNAG), and healthy people were recruited. Serum concentrations of TFFs, PG I, and PG II, as well as the presence of antibodies against Helicobacter pylori, were measured by enzyme-linked immunosorbent assays (ELISA). Receiver operating characteristics (ROC) were used to compare the predictive powers of the selected factors.


RESULTS
The serum concentrations of TFF1, TFF2, and TFF3 in the control groups were significantly lower than those in the gastric cancer group with the exception of TFF2 which was elevated in CAG. The area under the ROC curve for TFF3 was greater than that for the PG I/II ratio (0.81 vs 0.78). TFF3 also had a significantly higher predictive power for distinguishing gastric cancer than the PG test (odds ratio: 10.33 vs 2.57). Moreover, combining the serum TFF3 and PG tests for gastric cancer had better predictive power than either alone.


CONCLUSIONS
Serum TFF3 may be a better predictor of gastric cancer than the PG test, while the combined testing of serum PG and TFF3 could further improve the efficacy of gastric cancer screening.
Department of Gastroenterology, Lihuili Hospital of Ningbo Medical Center, 57# Xingning Road, Ningbo 315000, China. huangzg@foxmail.com.
Zhigang
Z
Huang
Xie
X
Zhang
Hongna
H
Lu
Lina
L
Wu
Danping
D
Wang
Qiubo
Q
Zhang
Huaxin
H
Ding
D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D002681:China; D002908:Chronic Disease; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005756:Gastritis / Q000097:blood; D005757:Gastritis, Atrophic / Q000097:blood; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins / Q000097:blood
D014408:Biomarkers, Tumor; D010455:Peptides; C051838:TFF1 protein, human; C000604007:TFF2 protein, human; C082495:TFF3 protein, human; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins; D020115:Pepsinogen C; D020116:Pepsinogen A