Risk of gastric cancer in asymptomatic, middle-aged Japanese subjects based on serum pepsinogen and Helicobacter pylori antibody levels

✍ Scribed by Kimihiko Yanaoka; Masashi Oka; Noriko Yoshimura; Chizu Mukoubayashi; Shotaro Enomoto; Mikitaka Iguchi; Hirohito Magari; Hirotoshi Utsunomiya; Hideyuki Tamai; Kenji Arii; Nobutake Yamamichi; Mitsuhiro Fujishiro; Tatsuya Takeshita; Osamu Mohara; Masao Ichinose

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: French
• Weight: 224 KB
• Volume: 123
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.23571

✦ Synopsis

Abstract

A total of 5,209 asymptomatic, middle‐aged subjects, whose serum pepsinogen (PG) and Helicobacter pylori antibody levels had been assessed, were followed for 10 years. Subjects with positive serum H. pylori antibodies (>50 U/mL) had an increased cancer risk (HR = 3.48, 95% CI = 1.26–9.64). Risk of gastric cancer increased as the antibody level increased; the H. pylori‐positive group with antibody levels >500 U/mL had the highest incidence rate (325/100,000 person‐years). Cancer development also increased with a reduced serum PG I level or a reduced PG I/II ratio; the risk was significantly elevated with serum PG I level ≤30 ng/mL (HR = 3.54, 95% CI = 1.95–6.40) or PG I/II ratio ≤3.0 (HR = 4.25, 95% CI = 2.47–7.32). Furthermore, the risk of diffuse‐type cancer increased as PG II level increased; it was significantly elevated with PG II level ≥30 ng/mL (HR = 3.81, 95% CI = 1.10–13.21). Using H. pylori antibody and PG levels, subgroups with an especially high or low cancer incidence rate could be identified. H. pylori‐negative or indeterminate subjects with low PG level (PG I ≤30 ng/mL or PG I/II ratio ≤2.0) or H. pylori‐positive subjects with antibody levels >500 U/mL and a low PG level were among the subgroups with a high cancer incidence rate (over 400/100,000 person‐years). In contrast, __H. pylori‐__negative subjects with a PG I level >70 ng/mL or a PG I/II ratio >3.0 had the lowest risk; none of these subjects developed cancer. Thus, serum PG levels and/or H. pylori antibody levels can be used to predict the risk of cancer in individuals with __H. pylori‐__related gastritis from the general population. © 2008 Wiley‐Liss, Inc.