title: Cutoff Pepsinogen Level for Predicting Unintendedly Eradicated Cases of Helicobacter pylori Infection in Subjects with Seemingly Normal Pepsinogen Levels.
abstract: OBJECTIVE
  In the ABC method, which is a method for risk stratification of gastric cancer using serum anti-Helicobacter pylori antibody and pepsinogen (PG) test, subjects with normal PG and seronegative for H. pylori are named as "Group A" and are regarded as having a low risk of gastric cancer. These "Group A" subjects include unintentionally eradicated cases at relatively high risk, and this study aimed to identify these subjects.
  
  
  METHODS
  Of the 109 subjects, 76 were classified as uninfected Group A subjects with negative histologic H. pylori infection and no histologic and endoscopic atrophy, and 33 subjects were classified serologically as Group A after successful eradication, which are serologically equal to the unintendedly eradicated cases in Group A. The usefulness of measuring PG levels to detect post-eradication cases was validated by using a receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  The area under the ROC curve for PGI level was 0.736 ± 0.06 (p < 0.01; cutoff value, 37.0 ng/mL; sensitivity, 77.6%; specificity, 72.7%), and that for the PGI/II ratio was 0.660 ± 0.06 (p < 0.01; cutoff value, 5.1; sensitivity, 84.2%; specificity, 43.4%).
  
  
  CONCLUSIONS
  PGI levels of ≤37 ng/mL and PGI/II ratios of ≤5.1 effectively identified unintendedly eradicated cases in Group A.
authors.affiliation: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kishikawa
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kimura
authors.forename: Asako
authors.initials: A
authors.lastname: Ito
authors.forename: Kyoko
authors.initials: K
authors.lastname: Arahata
authors.forename: Sakiko
authors.initials: S
authors.lastname: Takarabe
authors.forename: Shogo
authors.initials: S
authors.lastname: Kaida
authors.forename: Jun
authors.initials: J
authors.lastname: Miyauchi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.forename: Jiro
authors.initials: J
authors.lastname: Nishida
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood*; D001284:Atrophy / Q000000981:diagnostic imaging; D055088:Early Detection of Cancer / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D020116:Pepsinogen A
keywords: Gastric cancer screening; Helicobacter pylori; Pepsinogen; Risk stratification; Serum antibody