Mariko Kiso1, Masaharu Yoshihara2, Masanori Ito1, Kazuhiko Inoue3, Katsuaki Kato4, Shigemi Nakajima5, Katsuhiro Mabe6, Masao Kobayashi7, Naomi Uemura8, Tomoyuki Yada8, Masashi Oka9, Takashi Kawai10, Tomoyuki Boda11, Takahiro Kotachi1, Kazuhiko Masuda1, Shinji Tanaka11, Kazuaki Chayama1. 1. Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan. 2. Health Service Center, Hiroshima University, Higashi-Hiroshima, Japan. myoshih@hiroshima-u.ac.jp. 3. Department of General Medicine, Kawasaki Medical School, Kurashiki, Japan. 4. Department of Cancer Detection Center, Miyagi Cancer Society, Sendai, Japan. 5. Department of General Medicine, Gastroenterology and Health-care, Japan Community Health-care Organization Shiga Hospital, Otsu, Japan. 6. Department of Gastroenterology, National Hospital Organization Hakodate Hospital/Cancer Preventive Medicine, Hokkaido University, Sapporo, Japan. 7. Department of Health Care Division, Kyoto Second Red Cross Hospital, Kyoto, Japan. 8. Department of Gastroenterology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan. 9. Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Kawagoe, Japan. 10. Department of Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan. 11. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Abstract
BACKGROUND AND AIM: The serological risk prediction system combines the pepsinogen test and anti-Helicobacter pylori (H. pylori) antibody determination. In this system, chronic atrophic gastritis (CAG) is diagnosed using the pepsinogen test. Patients who are H. pylori negative and pepsinogen negative are classified into group A, are assumed to be H. pylori uninfected, and are at an extremely low risk for gastric cancer. However, gastric cancers are detected in this group. The aim of this study is to clarify the clinicopathological status of group A patients with gastric cancer. METHODS: A total of 109 gastric cancer patients classified as group A were enrolled in a multicenter study. Group A patients were divided into two subgroups: group AN (H. pylori uninfected) and group AP (H. pylori infected). They were compared to 183 H. pylori-infected gastric cancer patients who were not in group A. RESULTS: Of the 109 patients, only 7 were classified as group AN; the other 102 were classified as group AP. The clinicopathological features of group AP included older age, predominantly differentiated type cancer, endoscopically visualized CAG, and pepsinogen (PG) I/II ratio lower than that of group AN. In group AN, the depressed type was dominant, and the PG I/II ratio was higher than in those gastric cancer patients who were infected with H. pylori. CONCLUSION: Patients in group AP had CAG, and their gastric cancers were similar to those of H. pylori-eradicated patients. Concerning the recent ABC classification system, advanced decision criteria should be proposed to decrease the false-negative evaluation of gastric cancer risk.
BACKGROUND AND AIM: The serological risk prediction system combines the pepsinogen test and anti-Helicobacter pylori (H. pylori) antibody determination. In this system, chronic atrophic gastritis (CAG) is diagnosed using the pepsinogen test. Patients who are H. pylori negative and pepsinogen negative are classified into group A, are assumed to be H. pylori uninfected, and are at an extremely low risk for gastric cancer. However, gastric cancers are detected in this group. The aim of this study is to clarify the clinicopathological status of group A patients with gastric cancer. METHODS: A total of 109 gastric cancerpatients classified as group A were enrolled in a multicenter study. Group A patients were divided into two subgroups: group AN (H. pylori uninfected) and group AP (H. pylori infected). They were compared to 183 H. pylori-infected gastric cancerpatients who were not in group A. RESULTS: Of the 109 patients, only 7 were classified as group AN; the other 102 were classified as group AP. The clinicopathological features of group AP included older age, predominantly differentiated type cancer, endoscopically visualized CAG, and pepsinogen (PG) I/II ratio lower than that of group AN. In group AN, the depressed type was dominant, and the PG I/II ratio was higher than in those gastric cancerpatients who were infected with H. pylori. CONCLUSION:Patients in group AP had CAG, and their gastric cancers were similar to those of H. pylori-eradicated patients. Concerning the recent ABC classification system, advanced decision criteria should be proposed to decrease the false-negative evaluation of gastric cancer risk.
Authors: Lars Agréus; Tom Storskrubb; Pertti Aro; Jukka Ronkainen; Nicholas J Talley; Pentti Sipponen Journal: Scand J Gastroenterol Date: 2009 Impact factor: 2.423
Authors: Maomao Cao; He Li; Dianqin Sun; Lin Lei; Jiansong Ren; Jufang Shi; Ni Li; Ji Peng; Wanqing Chen Journal: Chin J Cancer Res Date: 2020-10-31 Impact factor: 5.087