The risk assessment of gastric cancer and precancerous condition using serum pepsinogen and H.pylori antibody test
- VernacularTitle:Ходоодны хорт хавдар, түүний урьдал эмгэгийн эрсдлийг хеликобактерийн эсрэгбие болон ийлдсийн пепсиноген биомаркераар үнэлэх нь
- Author:
Ganchimeg D
1
;
Dashmaa A
2
;
Tegshjargal B
1
;
Batchimeg B
1
;
Baljinnyam T
1
;
Nasanjargal T
1
;
Bayar D
1
;
Batbold B
1
;
Tulgaa L
1
Author Information
1. Institute of Medical Sciences, MNUMS, Ulaanbatar, Mongolia
2. National Cancer Center of Mongolia
- Publication Type:Journal Article
- From:Mongolian Medical Sciences
2021;197(3):33-39
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:The incidence of gastric cancer has been declining worldwide in recent years; on the
contrary, it has increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases
are diagnosed in the late stage. We performed a gastroduodenoscopy for screening and histological
evaluation to diagnose gastric cancer. These methods are an effective diagnostic modality for gastric
diseases; however, invasive and cause discomfort, making it an undesirable procedure for patients.
Aims:To determine serum PGs and H.pylori IgG in atrophic gastritis and gastric cancer patients and
evaluate the risk by ABC(D) classification.
Materials and Methods:We selected 40 atrophic gastritis and 36 newly diagnosed gastric cancer
patients from National Cancer Center of Mongolia, before surgery and other therapies. Besides, we
enrolled population-based 38 healthy controls. Subjects of three groups were matched by age (±1)
and sex. Written informed consents were obtained from all subjects. The fasting blood samples were
collected and tested PGI, PGII, and H.Pylori IgG levels by enzyme-linked immunosorbent assay.
Also, PGI to PGII ratio (PGI/II ratio) was calculated. We classified subjects into four groups based on
ABC(D) classification. All statistical analyses were performed by SPSS (version 26.0, Chicago, IL,
USA) software.
Results:Median age of the subjects was 62, 52.6% (n=60) were male. Proportions of family history
of gastric cancer and previous history of gastric disease were significantly higher in the gastric cancer
group compared with atrophic gastritis and healthy control groups (p<0.05, p<0.05). H.pylori was
positive in 67 (58.8%) subjects according to H.pylori IgG assay and there was no difference between
study groups. The serum PGI level and was significantly decreased in gastric cancer and atrophic
gastritis groups as compared to the healthy control (p<0.05, p<0.05). The PGI/II ratio was significantly
lower in the gastric cancer group compared with the healthy control (p<0.01). The optimal cut off
value of PGI was ≤35.25 ng/ml (AUC 64.3, 95% CI 51.3-77.2, p<0.05) for gastric cancer and PGI was
≤75.07 ng/ml (AUC 65.2, 95% CI 53.0-77.3, p<0.05) for atrophic gastritis. Also, the optimal cut off
value of PGI/II ratio was ≤5.27 (AUC 71.6, 95% CI 69.6-82.8, p<0.01) for gastric cancer and PGI/II
ratio was ≤6.25 (AUC 62.7, 95% CI 50.1-75.3, p<0.05) for atrophic gastritis. According to classification
of atrophic gastritis patients and healthy control, group D had higher proportion of atrophic gastritis
cases than group A, B and C (OR 5.04, 95% CI 1.13-22.50, p<0.05). According to classification of
gastric cancer patients and healthy control, groups C had higher proportion of gastric cancer cases
than group A, B and D (OR 6.19, 95% CI 1.04-36.78, p<0.05).
Conclusion:Our findings suggest that PGs level and H.pylori IgG may predict development of gastric
cancer and could identifying individuals at high risk of gastric cancer and precancerous lesions who
may need endoscopy.
- Full text:2021-197(3)-33-39.pdf
