Kishikawa Hiroshi, Kimura Kayoko, Ito Asako, Arahata Kyoko, Takarabe Sakiko, Kaida Shogo, Miyauchi Jun, Miura Soichiro, Nishida Jiro
Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan
Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba, Japan.
Anticancer Res. 2015 Dec;35(12):6765-71.
BACKGROUND/AIM: Individuals negative for Helicbacter pylori antibody and with a normal pepsinogen test (group A) are regarded as being at low risk in serum gastric cancer screening known as the ABC method, and endoscopy is not recommended; however, this group may include 2-10% of gastric cancer cases.
A total of 345 individuals who underwent upper gastrointestinal endoscopy and were classified by ABC as group A (H. pylori antibody titer <10 U/ml, and pepsinogen-I >70 ng/ml or I/II ratio >3) were enrolled, and predictors of gastric neoplasia were investigated.
Ten gastric neoplasia cases (gastric cancer and adenoma) were found to be included. Multiple logistic regression analyses identified H. pylori antibody titer ≥3 U/ml (odds ratio=14.4, 95% confidence interval=2.7-76.9; p<0.01) and pepsinogen-I/II ratio ≤4.3 ng/ml (odds ratio=10.0, 95% confidence interval=2.1-47.9; p<0.01), but not age as independent predictive factors of neoplasia.
Endoscopy should be considered in individuals with H. pylori antibody titer of ≥3 U/ml and a pepsinogen-I/II ratio of ≤4.3 in those classed as group A by ABC method.
背景/目的：幽门螺杆菌抗体阴性且胃蛋白酶原检测正常的个体（A组）在血清胃癌筛查的ABC方法中被视为低风险人群，不建议进行内镜检查；然而，该组可能包含2%-10%的胃癌病例。
共有345例行上消化道内镜检查且经ABC法分类为A组（幽门螺杆菌抗体滴度<10 U/ml，胃蛋白酶原I>70 ng/ml或I/II比值>3）的个体纳入研究，调查胃肿瘤的预测因素。
发现其中包含10例胃肿瘤病例（胃癌和腺瘤）。多因素logistic回归分析确定幽门螺杆菌抗体滴度≥3 U/ml（比值比=14.4，95%置信区间=2.7-76.9；p<0.01）和胃蛋白酶原I/II比值≤4.3 ng/ml（比值比=10.0，95%置信区间=2.1-47.9；p<0.01），而非年龄是肿瘤形成的独立预测因素。
对于ABC法分类为A组且幽门螺杆菌抗体滴度≥3 U/ml、胃蛋白酶原I/II比值≤4.3的个体，应考虑进行内镜检查。
