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Combination of Helicobacter pylori Antibody and Serum Pepsinogen as a Good Predictive Tool of Gastric Cancer Incidence: 20-Year Prospective Data From the Hisayama Study

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ABSTRACT

Background: There is little information regarding whether the combination of Helicobacter pylori (H. pylori) antibody and serum pepsinogen (sPG), which is a marker of the degree of atrophic gastritis, has a discriminatory ability for detecting incident gastric cancer. We examined this issue in a long-term prospective cohort study of a Japanese population.

Methods: A total of 2446 Japanese community-dwelling individuals aged ≥40 years were stratified into four groups according to baseline H. pylori serological status and sPG: Group A (H. pylori[−], sPG[−]), Group B (H. pylori[+], sPG[−]), Group C (H. pylori[+], sPG[+]), and Group D (H. pylori[−], sPG[+]), and participants were followed up prospectively for 20 years.

Results: During the follow-up, 123 subjects developed gastric cancer. Compared with that in Group A, the cumulative incidence of gastric cancer was significantly increased in Groups B, C, and D, whereas no significant difference was found between Groups C and D. The multivariable-adjusted risk of gastric cancer was significantly increased in Group B (hazard ratio [HR], 4.08; 95% confidence interval [CI], 1.62–10.28) and in Groups C and D combined (HR 11.1; 95% CI, 4.45–27.46). When the multivariable model with H. pylori antibody was changed into that with the combination of H. pylori antibody and sPG, the C statistics for developing gastric cancer increased significantly (0.773 vs 0.732, P = 0.005), and the continuous net reclassification improvement value was 0.591 (P < 0.001).

Conclusions: Our findings suggest that the combination of H. pylori antibody and sPG is a useful tool for predicting the development of gastric cancer.

No MeSH data available.


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Mentions: The cumulative incidence of gastric cancer by group is shown in Figure. Groups B, C, and D had significantly higher incidence of gastric cancer than Group A (P < 0.01 for all), but no significant difference in incidence was found between Groups C and D (P = 0.53). Therefore, we combined subjects in Groups C and D for the following analysis. The age- and sex-adjusted incidence and HR of gastric cancer increased significantly from groups A to C and D combined (Table 2). This relationship remained substantially unchanged even after adjustment for the following confounding factors: age, sex, body mass index, total cholesterol, hemoglobin A1c, smoking habits, and total energy and salt intakes. The multivariable-adjusted HR of gastric cancer was 4.08 (95% CI, 1.62–10.28; P = 0.003) in Group B and 11.1 (95% CI, 4.45–27.46; P < 0.001) in Groups C and D combined.


Combination of Helicobacter pylori Antibody and Serum Pepsinogen as a Good Predictive Tool of Gastric Cancer Incidence: 20-Year Prospective Data From the Hisayama Study
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121431&req=5

Mentions: The cumulative incidence of gastric cancer by group is shown in Figure. Groups B, C, and D had significantly higher incidence of gastric cancer than Group A (P < 0.01 for all), but no significant difference in incidence was found between Groups C and D (P = 0.53). Therefore, we combined subjects in Groups C and D for the following analysis. The age- and sex-adjusted incidence and HR of gastric cancer increased significantly from groups A to C and D combined (Table 2). This relationship remained substantially unchanged even after adjustment for the following confounding factors: age, sex, body mass index, total cholesterol, hemoglobin A1c, smoking habits, and total energy and salt intakes. The multivariable-adjusted HR of gastric cancer was 4.08 (95% CI, 1.62–10.28; P = 0.003) in Group B and 11.1 (95% CI, 4.45–27.46; P < 0.001) in Groups C and D combined.

View Article: PubMed Central - PubMed

ABSTRACT

Background: There is little information regarding whether the combination of Helicobacter pylori (H. pylori) antibody and serum pepsinogen (sPG), which is a marker of the degree of atrophic gastritis, has a discriminatory ability for detecting incident gastric cancer. We examined this issue in a long-term prospective cohort study of a Japanese population.

Methods: A total of 2446 Japanese community-dwelling individuals aged &ge;40 years were stratified into four groups according to baseline H. pylori serological status and sPG: Group A (H. pylori[&minus;], sPG[&minus;]), Group B (H. pylori[+], sPG[&minus;]), Group C (H. pylori[+], sPG[+]), and Group D (H. pylori[&minus;], sPG[+]), and participants were followed up prospectively for 20 years.

Results: During the follow-up, 123 subjects developed gastric cancer. Compared with that in Group A, the cumulative incidence of gastric cancer was significantly increased in Groups B, C, and D, whereas no significant difference was found between Groups C and D. The multivariable-adjusted risk of gastric cancer was significantly increased in Group B (hazard ratio [HR], 4.08; 95% confidence interval [CI], 1.62&ndash;10.28) and in Groups C and D combined (HR 11.1; 95% CI, 4.45&ndash;27.46). When the multivariable model with H. pylori antibody was changed into that with the combination of H. pylori antibody and sPG, the C statistics for developing gastric cancer increased significantly (0.773 vs 0.732, P = 0.005), and the continuous net reclassification improvement value was 0.591 (P &lt; 0.001).

Conclusions: Our findings suggest that the combination of H. pylori antibody and sPG is a useful tool for predicting the development of gastric cancer.

No MeSH data available.


Related in: MedlinePlus