Abstract
Objective To evaluate the Chinese new gastric cancer screening score (i.e., Li's score) and Kyoto Classification of Gastritis for screening gastric cancer. Methods A total of 702 patients were scored using the two scoring methods. Gastric atrophy, intestinal metaplasia, and gastric cancer (including early gastric cancer) were compared between the two scoring methods. The area under the ROC curve, sensitivity, and specificity of the two scoring methods were evaluated. Results Both of the two scoring methods found that gastric atrophy, intestinal metaplasia, and gastric cancer (including early gastric cancer) were all significantly higher in the medium-risk and high-risk group patients than those in the low-risk group patients. According to the Kyoto Classification of Gastritis, patients in the high-risk group had more gastric atrophy, intestinal metaplasia, and gastric cancer than those in the medium-risk group patients. Gastric atrophy, intestinal metaplasia, and gastric cancer in the low-risk and medium-risk group patients evaluated by the Li score were all significantly higher than those in patients with corresponding risk level evaluated by Kyoto Classification of Gastritis, respectively. The area under the ROC curve of the Li score was 0.702, and the sensitivity and specificity were 57.6% and 85.3%, respectively. The area under the ROC curve of the Kyoto Classification of Gastritis was 0.826, and the sensitivity and specificity were 75.4% and 83.6%, respectively. Conclusion Both Li's score and Kyoto Classification of Gastritis showed good screening value for gastric cancer, but Kyoto Classification of Gastritis was more sensitive than the Li score.
Highlights
Gastric cancer is a common digestive tumor, threatening people’s health, and is the focus of cancer prevention and treatment in the world [1]
The early gastric cancers were pathologically confirmed by endoscopic submucosal dissection (ESD), and advanced gastric cancers were pathologically determined by surgical specimens
Gastric cancer risk stratification in 702 patients according to the Chinese new gastric cancer screening score (i.e., Li’s score) is as follows: 585 low-risk cases (83.33%), 93 medium-risk cases (13.25%) and 24 high-risk cases (3.42%), while according to the Kyoto Classification of Gastritis, it is as follows: 384 low-risk cases (54.70%), 171 medium-risk cases (24.36%), and 147 high-risk cases (20.94%)
Summary
Gastric cancer is a common digestive tumor, threatening people’s health, and is the focus of cancer prevention and treatment in the world [1]. The global distribution of morbidity and mortality associated with gastric cancer is greatly different and with the highest incidence in East Asia [2]. There were 679,000 new cases of gastric cancer and 498,000 deaths in China every year, accounting for 42.6% and 45.0% of the world, respectively. The diagnosis and treatment rate of early gastric cancer in China was less than 10%, much lower than that in Japan (70%) and South Korea (50%) [3–5]. Great progress has been made in the diagnosis and treatment of gastric cancer, gastric cancer still has a high mortality. The 5-year survival rate of advanced gastric cancer was less than 30% in most countries [7]. The 5-year survival rate of early gastric cancer can be as high as 90% and even cured [8]
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