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Risk of gastric cancer in asymptomatic, middle‐aged Japanese subjects based on serum pepsinogen and Helicobacter pylori antibody levels
Author(s) -
Yanaoka Kimihiko,
Oka Masashi,
Yoshimura Noriko,
Mukoubayashi Chizu,
Enomoto Shotaro,
Iguchi Mikitaka,
Magari Hirohito,
Utsunomiya Hirotoshi,
Tamai Hideyuki,
Arii Kenji,
Yamamichi Nobutake,
Fujishiro Mitsuhiro,
Takeshita Tatsuya,
Mohara Osamu,
Ichinose Masao
Publication year - 2008
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.23571
Subject(s) - helicobacter pylori , medicine , gastroenterology , cancer , asymptomatic , antibody , incidence (geometry) , pepsin , immunology , biology , biochemistry , physics , optics , enzyme
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.