Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong 510515; Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080; Medical College, Shantou University, Shantou, Guangdong 515063, China.
Chin Med J (Engl). 2018 May 20;131(10):1232-1239. doi: 10.4103/0366-6999.231512.
Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.
The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords "Helicobacter pylori," "Pepsinogens," and "Stomach Neoplasms."
Original articles and reviews on the topics were selected.
Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.
The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.
胃镜检查结合胃黏膜活检目前被认为是胃癌诊断的金标准。然而，由于其侵袭性，其在临床实践中的应用受到限制。一种新的非侵入性人群筛选方法，结合抗幽门螺杆菌抗体和血清胃蛋白酶原（PG）检测（ABC 法），用于识别高危人群进行进一步的内镜检查，避免大多数人群进行不必要的胃镜检查，并节省每年的大规模筛查的费用消耗。然而，ABC 法的分组和每个组的内镜监测间隔仍然存在争议。在这篇综述中，我们总结了这些流行的关注话题，为临床医生提供有用的参考。
从创建日期到 2017 年 11 月 22 日，系统地在 PubMed 数据库中使用“Helicobacter pylori”、“Pepsinogens”和“Stomach Neoplasms”关键词进行搜索。
选择了关于这些主题的原始文章和综述。
抗幽门螺杆菌抗体和血清 PG 浓度在不同的幽门螺杆菌感染状态和萎缩性胃炎的进展下显示出显著变化，可用于临床胃癌的风险分层。此外，抗幽门螺杆菌抗体滴度可用于进一步分层胃癌风险，有助于确定更好的内镜监测间隔。
胃癌的早期发现和诊断得益于风险分层，但幽门螺杆菌抗体和血清 PG 浓度的临界值需要进一步修正。
