Abstract C13: Population-based evaluation of serum pepsinogen, anti-H. pylori IgG antibody and gastrin-17 tests for gastric cancer screening

Abstract

Abstract Objective: This study evaluated the role of multiple serological tests (including serum pepsinogen I (PGI), PGII, PGI/II ratio, anti-H. pylori IgG antibody, and gastrin-17 tests) individually and in combination in gastric cancer (GC) screening. Design: Data were from the Zhuanghe Gastric Cancer Study, a 15-year, population-based endoscopic, gastric diseases screening program in northern China. From 1997 to 2011, esophagogastroduodenoscopies with gastric mucosal biopsies were conducted on 10,693 participants. All serum biomarkers were measured using ELISA, and gastric biopsies were evaluated using standardized criteria. Logistic regression was used to calculate odds ratios (OR) with 95 percent confidence intervals (95% CI) and produce receiver operator characteristic (ROC) curves with corresponding c statistics. In addition, results were replicated in an independent hospital-based population. Results: PGI/II ratio monotonically decreased as gastric mucosa progresses from normal mucosa to precancerous conditions, and to GC, and a low PGI/II ratio (≥ 6.6) was associated with an increased risk of prevalent GC (OR = 2.34, 95% CI: 1.62, 3.39). PGI/II ratio individually or in combination with PGI, PGII, anti-H. pylori IgG antibody and gastrin-17 provided the same c statistic of 0.62 for screening for GC. PGI, PGII, anti-H. pylori IgG antibody or gastrin-17 tests individually provided c statistics less than or equal to 0.55. For identifying abnormal gastric conditions including GC, the five serological tests in combination provided adequate discriminatory performance (c = 0.77), and yielded a sensitivity of 84.0% and specificity of 50.0%. The results from the independent hospital-based population were similar. Conclusion: Our results suggest that serum PGI, PGII, PGI/II ratio, anti-H. pylori IgG and gastrin-17 tests can be used as prescreening tests for patients at high risk for GC. Citation Format: Huakang Tu, Liping Sun, Yuehua Gong, Qian Xu, Qi Long, Roberd Bostick, Yuan Yuan. Population-based evaluation of serum pepsinogen, anti-H. pylori IgG antibody and gastrin-17 tests for gastric cancer screening. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C13.