title: Correlation between the ABC classification and radiological findings for assessing gastric cancer risk.
abstract: OBJECTIVE
  To investigate the correlation between ABC risk assessment and radiological findings of gastric mucosa and to propose an improved method for gastric cancer screening.
  
  
  METHODS
  We evaluated 318 participants with Helicobacter pylori (Hp) antibody titers, serum pepsinogen (PG) and upper GI radiography and then classified them into three groups: A, double-negative; B, Hp-positive, PG-negative; C, PG-positive. Group A was subclassified as: A-1, Hp antibody titer <3.0 U/ml; A-2, Hp antibody titer ≥3.0 U/ml. Results for group A and non-A (B or C) participants and radiological findings of gastric mucosa (fold and area gastricae) were analyzed retrospectively.
  
  
  RESULTS
  Radiological findings differed significantly between the 207 A-1 and 98 non-A group. Odds ratios were 17.72 for fold distribution, 10.63 for fold thickness, 6.10 for fold characteristics, and 10.62 for area gastricae. Presence of ≥2 risk factors offered 90.3 % sensitivity, 94.7 % specificity, and 93.3 % accuracy. Nine (69.2 %) of the 13 A-2 group participants and 11 (5.3 %) A-1 group participants had a risk for gastric cancer according to radiological findings.
  
  
  CONCLUSIONS
  A good correlation exists between ABC classifications and radiological findings for gastric cancer risk, but some discrepant cases exist. We recommend both methods as screening for gastric cancer.
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan. titoh@naramed-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Endoscopy and Ultrasound, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Endoscopy and Ultrasound, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Marugami
authors.affiliation: Department of Endoscopy and Ultrasound, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Marugami
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Takahama
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D000328:Adult; D000368:Aged; D001464:Barium; D003287:Contrast Media; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D001464:Barium
keywords: ABC classification; Gastric cancer; Helicobacter pylori; Radiological finding