Relationship between Degree of Atrophy in Gastric Mucosa Seen in Esophagogastroduodenoscopy and Gastric Cancer Risk Determined by Serum Pepsinogen Levels and <i>H.pylori</i> Antibody titers - Reducing Contamination of Moderate-severe Gastric Mucosal Atrophy in Group A -

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  • Fujita Eiki
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Otsuka Hiroki
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Kawamura Masatoshi
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Hagiwara Mio
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Sugawara Tomonori
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Tokuda Takahiro
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Kanno Sotaro
    The Center of Health Promotion, Sekishinkai Sayama General Clinic
  • Onoda Noritaka
    The Center of Health Promotion, Sekishinkai Sayama General Clinic

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  • 胃がんリスク検診と上部消化管内視鏡での胃粘膜萎縮所見との関連 - 中・高度萎縮のA群への混入を減らすために -
  • イガン リスク ケンシン ト ジョウブ ショウカカン ナイシキョウ デ ノ イ ネンマク イシュク ショケン ト ノ カンレン : ナカ ・ コウド イシュク ノ Aグン エ ノ コンニュウ オ ヘラス タメニ

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Abstract

Objective:Our objective was to establish optimal method and criteria for the detection of moderate-severe gastric mucosal atrophy, for which the risk of developing gastric cancer is high, by investigating associations between pepsinogen (PG) levels and Helicobacter pylori (Hp) antibody (Ab) titers measured in gastric cancer risk screening (stratified according to ABC classification) and gastric mucosal atrophy observed in esophagogastroduodenoscopy (EGD). <br>Methods: Our subjects were 175 persons subjected to the ABC classification for the first time at our facility and who replied that they had no history of Hp eradication therapy, selected from 308 persons who underwent the ABC classification and EGD on the same day in the period from April 2011 - March 2014. An association with PG or HpAb was analyzed for those determined to have moderate-severe gastric mucosal atrophy, which was considered to be C-3 and above in the Kimura-Takemoto classification.<br>Results: By the current ABC classification, 15.2% of moderate-severe mucosal atrophy was contaminated in the A group. The optimal point for distinguishing moderate-severe gastric mucosal atrophy was PG I/II 4.7 or less and HpAb 4 - 5 U/mL or greater. In ROC analysis, PG I/II was the most favorable, however there was no significant difference regarding HpAb for distinguishing moderate-severe gastric mucosal atrophy. <br>Conclusion: By the current ABC classification, 15.2% of moderate-severe gastric mucosal atrophy was contaminated in the A group. Defining a tentative ABC classification with cut off points set at 4.7 for PG I/II and 5 U/mL for HpAb could reduce the proportion of moderate-severe gastric mucosal atrophy in Group A to about half (7.8%) without significantly raising the positive rate.

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