P-0071 - Gastric Cancer Risk Screening with Combined Assay for Serum Anti-Helicobacter Pylori IGG Antibody and Pepsinogen Level, So-Called “ABC Method”; Can We Need Imaging Study for Gastric Cancer Screening?

Abstract

Introduction: Gastric cancer (GC) is the fifth most common cancer (952,000 in 2012) and the second leading cancer deaths (738,000 in 2008) worldwide. The highest incidence rates are in Eastern Asia, Eastern Europe, and South America. Regional variations in part reflect differences in dietary patterns and the Helicobacter pylori (Hp) infection. GC risk screening with combined assay for serum anti-Helicobacter pylori IgG antibody (HpAb) and serum pepsinogen level (PG), so-called “ABC method” classifies population into four different risk groups. Group A, or HpAb(-)PG(-) shows the lowest risk and is expected to have no GC. GC risk increases from B, or HpAb(+)PG(-) to C, or HpAb(+)PG(+). Group D, or HpAb(-)PG(+) reveals the greatest GC risk. Methods: We review the data of endoscopical GC screening program between Jun '12 and Dec '13 in our institute and analyze GC cases detected. Results: ABC method was done to 5850 cases among consecutive 6460 individuals of our endoscopical GC screening program. 70% cases were classified in Group A, 19% in B, 10% in C, and 1% in D. Ten cases of GC were found. Four GC cases belonged to Group A that should have no GC. Two were in B, and four in C. 23% of Group A had Hp eradication history (Hp-er Hx). Three GC cases in Group A experienced Hp eradication. 23% of Group A revealed Hp related findings endoscopically (Hp endo-findings) such as atrophic gastritis. The rest of one GC in Group A had such a condition without Hp-er Hx. No GC was found in all 2885 individuals without Hp-er Hx and Hp endo-findings in Group A. Conclusion: Even Group A in ABC method contains some cases with Hp-er Hx or Hp endo-findings. Such population has certain GC risk. Group A without Hp-er Hx and Hp endo-findings might need no imaging study for GC anymore.