title: Predictors of Gastric Neoplasia in Cases Negative for Helicobacter pylori Antibody and with Normal Pepsinogen.
abstract: OBJECTIVE
  Individuals negative for Helicbacter pylori antibody and with a normal pepsinogen test (group A) are regarded as being at low risk in serum gastric cancer screening known as the ABC method, and endoscopy is not recommended; however, this group may include 2-10% of gastric cancer cases.
  
  
  METHODS
  A total of 345 individuals who underwent upper gastrointestinal endoscopy and were classified by ABC as group A (H. pylori antibody titer <10 U/ml, and pepsinogen-I >70 ng/ml or I/II ratio >3) were enrolled, and predictors of gastric neoplasia were investigated.
  
  
  RESULTS
  Ten gastric neoplasia cases (gastric cancer and adenoma) were found to be included. Multiple logistic regression analyses identified H. pylori antibody titer ≥3 U/ml (odds ratio=14.4, 95% confidence interval=2.7-76.9; p<0.01) and pepsinogen-I/II ratio ≤4.3 ng/ml (odds ratio=10.0, 95% confidence interval=2.1-47.9; p<0.01), but not age as independent predictive factors of neoplasia.
  
  
  CONCLUSIONS
  Endoscopy should be considered in individuals with H. pylori antibody titer of ≥3 U/ml and a pepsinogen-I/II ratio of ≤4.3 in those classed as group A by ABC method.
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan kisikawa@tdc.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kishikawa
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Arahata
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Takarabe
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kaida
authors.affiliation: Department of Pathology and Laboratory Medicine, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyauchi
authors.affiliation: Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Nishida
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D013274:Stomach Neoplasms / Q000097:blood*
chemical_list: D020116:Pepsinogen A
keywords: ABC method; Gastric cancer; Helicobacter pylori; pepsinogen; screening