AIM: To validate a non-invasive method to detect gastric mucosal atrophy in a Chilean population with high prevalence of gastric cancer and a poor survival rate. METHODS: We first determined the optimal cut-off level of serum pepsinogen (PG)-1, PG-1/PG-2 ratio and 17-gastrin in 31 voluntary symptomatic patients (mean age: 66.1 years), of them 61% had histologically confirmed gastric atrophy. Then, in a population-based sample of 536 healthy individuals (209 residents in counties with higher relative risk and 327 residents in counties with lower relative risk for gastric cancer), we measured serum anti-H pylori antibodies, PG and 17-gastrin and estimated their risk of gastric cancer. RESULTS: We found that serum PG-1 < 61.5 microg/L, PG-1/PG-2 ratio < 2.2 and 17-gastrin > 13.3 pmol/L had a high specificity (91%-100%) and a fair sensitivity (56%-78%) to detect corpus-predominant atrophy. Based on low serum PG-1 and PG-1/PG-2 ratio together as diagnostic criteria, 12.5% of the asymptomatic subjects had corpus-predominant atrophy (0% of those under 25 years and 20.2% over 65 years old). The frequency of gastric atrophy was similar (12% vs 13%) but H pylori infection rate was slightly higher (77% vs 71%) in the high-risk compared to the low-risk counties. Based on their estimated gastric cancer risk, individuals were classified as: low-risk group (no H pylori infection and no atrophy; n = 115; 21.4%); moderate-risk group (H pylori infection but no atrophy; n = 354, 66.0%); and high-risk group (gastric atrophy, with or without H pylori infection; n = 67, 12.5%). The high-risk group was significantly older (mean age: 61.9+/-13.3 years), more frequently men and less educated as compared with the low-risk group. CONCLUSION: We propose to concentrate on an upper gastrointestinal endoscopy for detection of early gastric cancer in the high-risk group. This intervention model could improve the poor prognosis of gastric cancer in Chile.
AIM: To validate a non-invasive method to detect gastric mucosal atrophy in a Chilean population with high prevalence of gastric cancer and a poor survival rate. METHODS: We first determined the optimal cut-off level of serum pepsinogen (PG)-1, PG-1/PG-2 ratio and 17-gastrin in 31 voluntary symptomatic patients (mean age: 66.1 years), of them 61% had histologically confirmed gastric atrophy. Then, in a population-based sample of 536 healthy individuals (209 residents in counties with higher relative risk and 327 residents in counties with lower relative risk for gastric cancer), we measured serum anti-H pylori antibodies, PG and 17-gastrin and estimated their risk of gastric cancer. RESULTS: We found that serum PG-1 < 61.5 microg/L, PG-1/PG-2 ratio < 2.2 and 17-gastrin > 13.3 pmol/L had a high specificity (91%-100%) and a fair sensitivity (56%-78%) to detect corpus-predominant atrophy. Based on low serum PG-1 and PG-1/PG-2 ratio together as diagnostic criteria, 12.5% of the asymptomatic subjects had corpus-predominant atrophy (0% of those under 25 years and 20.2% over 65 years old). The frequency of gastric atrophy was similar (12% vs 13%) but H pylori infection rate was slightly higher (77% vs 71%) in the high-risk compared to the low-risk counties. Based on their estimated gastric cancer risk, individuals were classified as: low-risk group (no H pylori infection and no atrophy; n = 115; 21.4%); moderate-risk group (H pylori infection but no atrophy; n = 354, 66.0%); and high-risk group (gastric atrophy, with or without H pylori infection; n = 67, 12.5%). The high-risk group was significantly older (mean age: 61.9+/-13.3 years), more frequently men and less educated as compared with the low-risk group. CONCLUSION: We propose to concentrate on an upper gastrointestinal endoscopy for detection of early gastric cancer in the high-risk group. This intervention model could improve the poor prognosis of gastric cancer in Chile.
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Authors: A Csendes; G Smok; N Velasco; M Godoy; E Medina; I Braghetto; R Ubilla; O Fernández; J Amat Journal: Rev Med Chil Date: 1980-11 Impact factor: 0.553
Authors: H Watabe; T Mitsushima; Y Yamaji; M Okamoto; R Wada; T Kokubo; H Doi; H Yoshida; T Kawabe; M Omata Journal: Gut Date: 2005-06 Impact factor: 23.059
Authors: H Väänänen; M Vauhkonen; T Helske; I Kääriäinen; M Rasmussen; H Tunturi-Hihnala; J Koskenpato; M Sotka; M Turunen; R Sandström; M Ristikankare; A Jussila; P Sipponen Journal: Eur J Gastroenterol Hepatol Date: 2003-08 Impact factor: 2.566
Authors: Chiara Ricci; Nimish Vakil; Massimo Rugge; Luigi Gatta; Federico Perna; John F Osborn; Valentina M Russo; Andrea Tampieri; Veronica Bernabucci; Mario Miglioli; Dino Vaira Journal: Am J Gastroenterol Date: 2004-10 Impact factor: 10.864
Authors: Benjamin Chun-Yu Wong; Shiu Kum Lam; Wai Man Wong; Jian Shun Chen; Ting Ting Zheng; Rui E Feng; Kam Chuen Lai; Wayne Hsing Cheng Hu; Siu Tsan Yuen; Suet Yi Leung; Daniel Yee Tak Fong; Joanna Ho; Chi Kong Ching; Jun Shi Chen Journal: JAMA Date: 2004-01-14 Impact factor: 56.272
Authors: M Dinis-Ribeiro; M Areia; A C de Vries; R Marcos-Pinto; M Monteiro-Soares; A O'Connor; C Pereira; P Pimentel-Nunes; R Correia; A Ensari; J M Dumonceau; J C Machado; G Macedo; P Malfertheiner; T Matysiak-Budnik; F Megraud; K Miki; C O'Morain; R M Peek; T Ponchon; A Ristimaki; B Rembacken; F Carneiro; E J Kuipers Journal: Virchows Arch Date: 2011-12-22 Impact factor: 4.064
Authors: M Dinis-Ribeiro; M Areia; A C de Vries; R Marcos-Pinto; M Monteiro-Soares; A O'Connor; C Pereira; P Pimentel-Nunes; R Correia; A Ensari; J M Dumonceau; J C Machado; G Macedo; P Malfertheiner; T Matysiak-Budnik; F Megraud; K Miki; C O'Morain; R M Peek; T Ponchon; A Ristimaki; B Rembacken; F Carneiro; E J Kuipers Journal: Endoscopy Date: 2011-12-23 Impact factor: 10.093