| 特集名 | ペプシノゲン -- 基礎，臨床応用，疫学 | |
|---|---|---|
| 題名 | 臨床応用 (1) ペプシノゲン法による胃癌スクリーニングの実際 -- 厚生労働省研究班(平成9～12年度)研究報告書より | |
| 発刊年月 | 2002年 10月 | |
| 著者 | 笹島 雅彦 | 東邦大学医学部第一内科 |
| 著者 | 保科 玲子 | 東邦大学医学部第一内科 |
| 著者 | 三木 一正 | 東邦大学医学部第一内科 |
| 【 要旨 】 | 厚生労働省研究班では，血清ペプシノゲン(PG)値による胃癌スクリーニングのカットオフ値の基準値を「PG I値70micro-g／lかつI／II比3.0以下」とすることを提唱，11,707人の人間ドック受診者に内視鏡とPG法を同時施行した結果から，基準値によるPG法の精度(PPV)は1.5％であることがわかった．また605例の手術胃癌症例のPG値を検討したところ，PG法陽性率は64％であったが，人間ドック発見症例に限ると85％が陽性であり，無症状者のスクリーニングにおけるPG法の有用性が示唆された．研究班協力施設での実施報告から，PG法でスクリーニングされる胃癌と，間接X線検査で見つかる胃癌は異なり，両者を効果的に組み合わせて実施することが有用であることがわかった． | |
| Theme | Pepsinogen -- Basic, Clinical Implications, and Epidemiology | |
|---|---|---|
| Title | Annual Reports (1997-2000) of the Research Committee for Examination on Study of Gastric Cancer Screening Systems Using Serum Pepsinogen | |
| Author | Masahiko Sasajima | First Department of Internal Medicine, Toho University School of Medicine |
| Author | Reiko Hoshina | First Department of Internal Medicine, Toho University School of Medicine |
| Author | Kazumasa Miki | First Department of Internal Medicine, Toho University School of Medicine |
| [ Summary ] | Chronic atrophic gastritis is a well-known type of precancerous lesion. It is widely accepted that serum pepsinogen levels reflect the functional and morphologic status of the stomach mucosa. Serum pepsinogen was introduced for cancer screening to identify individuals with extensive atrophic gastritis. The study group for "Gastric Cancer Screening Systems, Using Serum Pepsinogens" organized by the National Cancer Fund of Japan from 1997-2000, advocated that individuals should be considered to have tested positive for extensive atrophic gastritis when their pepsinogen levels are PG I<70micro-g/l, I/II ratio<3.0. Number of 11,707 volunteers underwent endoscopic examinations to test for the presence of gastric cancer. The study showned that the positive predictive value of the serum pepsinogen test was 1.5%. Results of the serum pepsinogen test as a primary screening tool demonstrate that the cancer detection rate for screening with the serum tests is superior and more cost effective as compared to the conventional barium X-ray mass screening. Serum pepsinogen test screening is especially useful in detecting small asymptomatic cancers, which are relatively difficult to detect using barium X-rays. However, conventional screening is good for detecting symptomatic cancers. The cancers detected by the two screening methods are different in related to morphological and histrogical types, so the combination of the two methods has greatly improved screening efficiency and made them more cost effective. |
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