Daisuke Chinda1, Tadashi Shimoyama2, Tatsuya Mikami3, Tetsu Arai1, Daisuke Chiba1, Yoshio Sasaki4, Kazuo Komai5, Yoshihiko Sawada6, Yoshiharu Saito7, Hironobu Chiba8, Shinsaku Fukuda1. 1. Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan. 2. Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan. tsimo-hki@umin.ac.jp. 3. Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan. 4. Sasaki Clinic of Gastroenterology and Internal Medicine, Aomori, Japan. 5. Komai Clinic of Gastroenterology and Internal Medicine, Aomori, Japan. 6. Sawada Clinic of Internal Medicine, Hirosaki, Japan. 7. Shinjo Clinic of Gastroenterology and Internal Medicine, Aomori, Japan. 8. Chiba Clinic of Gastroenterology and Internal Medicine, Hirosaki, Japan.
Abstract
BACKGROUND: ABC classification has been used to assess the risk for gastric cancer. The current problem of ABC classification is that Group A contains individuals with current and past H. pylori infection. The aims of this study were to assesse the proportion of current and past infection in Group A and to establish a criteria for the identification of subjects with past infection from Group A subjects with negative results of urea breath test (UBT) and/or stool antigen test. METHODS: 201 subjects classified into Group A received UBT and/or stool antigen test, and also subsequent upper gastrointestinal endoscopy. The subjects were classified by the status of H. pylori infection defined by endoscopic findings. Levels of pepsinogen (PG) I, PG II and PG I/II ratio were compared between the groups, and receiver operating characteristic curves were constructed to extract the corresponding cutoff values. RESULTS: 22 subjects were tested positive by UBT and/or stool antigen test. Endoscopic images of 157 out of 179 subjects were studied. 15 of the subjects were regarded to have past H. pylori infection. The optimal cut-off value of PG I and PG I/II ratio for the determination of past H. pylori infection were ≤ 31.2 ng/mL and ≤ 4.6, respectively. CONCLUSIONS: Approximately 20% of Group A subjects have current or past H. pylori infection. Addition of UBT and/or stool antigen test can identify current but not past infection. Serum PG levels would be useful to identify subjects with past H. pylori infection.
BACKGROUND: ABC classification has been used to assess the risk for gastric cancer. The current problem of ABC classification is that Group A contains individuals with current and past H. pyloriinfection. The aims of this study were to assesse the proportion of current and past infection in Group A and to establish a criteria for the identification of subjects with past infection from Group A subjects with negative results of urea breath test (UBT) and/or stool antigen test. METHODS: 201 subjects classified into Group A received UBT and/or stool antigen test, and also subsequent upper gastrointestinal endoscopy. The subjects were classified by the status of H. pyloriinfection defined by endoscopic findings. Levels of pepsinogen (PG) I, PG II and PG I/II ratio were compared between the groups, and receiver operating characteristic curves were constructed to extract the corresponding cutoff values. RESULTS: 22 subjects were tested positive by UBT and/or stool antigen test. Endoscopic images of 157 out of 179 subjects were studied. 15 of the subjects were regarded to have past H. pyloriinfection. The optimal cut-off value of PG I and PG I/II ratio for the determination of past H. pyloriinfection were ≤ 31.2 ng/mL and ≤ 4.6, respectively. CONCLUSIONS: Approximately 20% of Group A subjects have current or past H. pyloriinfection. Addition of UBT and/or stool antigen test can identify current but not past infection. Serum PG levels would be useful to identify subjects with past H. pyloriinfection.
Entities:
Keywords:
Group A of ABC classification; Helicobacter pylori infection; Pepsinogen levels; Upper gastrointestinal endoscopy
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