A Comparison between Three Serological Stratification About Early Screening of Gastric Cancer

Abstract

Objective: This study aimed to compare the effect in early screening of gastric cancer among the ABC method, the new ABC method and new gastric cancer screening scoring system. Methods: The serological examination was first performed in all population groups, and endoscopic and pathological examinations were performed in the high-risk groups. The population was divided into the low-, middle-, and high-risk groups. The ratio of risk stratification and the detection rate of gastric cancer were compared among the three screening methods, and the consistency were evaluated. According the receiver operating characteristic (ROC) curvesi¼Œthe best critical value of gastrin-17 (G-17) and pepsinogen ratio (PGR) for the diagnosis of gastric cancer was calculated. Results: A total of 63,171 patients were included and endoscopic examination was conducted in 4611 patients, confirmed 50 patients with gastric cancer, including 44 with early gastric cancer. In the ABC methods, the detection of gastric cancer in the low-, middle-, and high-risk groups was 8(0.63%), 31(1.21%) 和11 (1.41%), respectively. In the new ABC methods, the detection of gastric cancer in the low-, middle-, and high-risk groups was 24(1.41%), 18(0.72%) 和 8(1.96%), respectively. In the new scoring system, the ratio of risk stratification in the low-, middle-, and high-risk groups was 17i(0.60%), 19(1.32%) 和14(3.92%), respectively. A pair-wise comparison showed poor consistency among the three screening methods. The positive rate of gastric cancer was significantly higher in the high-risk group compared with the other two groups in the new scoring system method. The areas under the curve of G-17 and PGR for the diagnosis of gastric cancer were 0.579 and 0.649, respectively. When PGR <3.89 and PGR <2.39 were the critical values, the incidence of the gastric cancer was found to be higher in the high-risk group compared with the other risk groups. Conclusions: Three screening methods have a poor consistency among. The new scoring system had a high value in early gastric cancer screening. The detection rate of early gastric cancer was higher in the high-risk group compared with the other two groups. Funding: National Natural Science Foundation of China(81673745); Traditional Chinese Medicine Science and Technology Program of Zhejiang Province of China (2016ZA089). Declaration of Interest: The authors have no conflicts of interest to declare. Ethical Approval: This study was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang Chinese Medical University.