title: Comparison of serum trefoil factor 3 with the pepsinogen test for the screening of diffuse-type gastric cancer.
abstract: Emerging data show that serum trefoil factor 3 (TFF3) alone and combined with the serum pepsinogen (PG) test can increase the diagnostic yield of gastric cancer. We aimed to evaluate the diagnostic value of serum TFF3 for the screening of gastric cancer in Korean patients, especially for the screening of the diffuse type of gastric cancer, and compared TFF3 to the serum PG test. We enrolled 25 healthy controls and 79 subjects with gastric cancer who underwent endoscopic resection or surgery from June 2006 to June 2015. Data about age, sex, histological type according to the Lauren classification, stage of gastric cancer, and status of H. pylori were collected. Serum levels of PG I and PG II were measured by the latex-enhanced turbidimetric immunoassay, and serum TFF3 levels were measured by enzyme-linked immunosorbent assay. The optimal cutoff value of serum TFF3 was ≥8.9 ng/mL to diagnose gastric cancer, with 73.4 % sensitivity and 92.0 % specificity, which were higher than those of the serum PG I/II ratio, with 69.6 % sensitivity and 68.0 % specificity. The optimal sensitivity and specificity of serum TFF3 for the diagnosis of diffuse-type gastric cancer were 68.0 and 92.0 %, respectively, which were lower than those for the diagnosis of intestinal-type gastric cancer (75.6 and 100 %, respectively). Serum TFF3 is a more stable and useful marker than the serum PG test for the screening of gastric cancer in Korean patients. Serum TFF3 showed good diagnostic power in detecting both intestinal- and diffuse-type gastric cancer although it showed decreased power in diffuse type.
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea.
authors.forename: Ju Yup
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea. seenae99@dsmc.or.kr.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Institute for Cancer Research, Keimyung University Dongsan Medical Center, Daegu, South Korea.
authors.forename: Hyun-Gyo
authors.initials: HG
authors.lastname: Lee
authors.affiliation: Institute for Cancer Research, Keimyung University Dongsan Medical Center, Daegu, South Korea.
authors.forename: Won-Ki
authors.initials: WK
authors.lastname: Baek
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea.
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Seung-Wan
authors.initials: SW
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019411:Clinical Laboratory Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007723:Korea; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D012680:Sensitivity and Specificity; D044967:Serum / Q000737:chemistry*; D013274:Stomach Neoplasms / Q000175:diagnosis*; D000071165:Trefoil Factor-3 / Q000097:blood*
chemical_list: C082495:TFF3 protein, human; D000071165:Trefoil Factor-3; D020116:Pepsinogen A
keywords: Biomarker; Gastric cancer; Helicobacter pylori; Pepsinogen; Trefoil factor 3