| Theme |
Pepsinogen -- Basic, Clinical Implications, and Epidemiology |
| Title |
Serological Screening for Stomach Cancer, Measuring Serum Pepsinogen -- Epidemiological Viewpoint |
| Author |
Yoshiyuki Watanabe |
Department of Social Medicine and Cultural Sciences, Research Institute for Neurological Diseases and Geriatrics, Kyoto Prefectural University of Medicine |
| [ Summary ] |
Recently, serological screening for stomach cancer, measuring serum pepsinogen I and II levels has been introduced in Japan. This new pepsinogen method is based on the observation that a considerable percent age of stomach cancers develop in gastric mucosa affected by severe and extensive atrophic gastritis. Serum pepsinogen levels serve as a sensitive marker of chronic atrophic gastritis. A positive screening result is usually determined from both the serum pepsinogen I level (<=70ng/ml) and the pepsinogen I/II ratio (<=3.0). According to several reports in Japan, the sensitivity and the specificity of this method with above standard cut-off levels were reported to be 6O to 96% and 55 to 84%, respectively. The use of the pepsinogen method is gradually being accepted throughout Japan because it is based on an objective test of serum pepsinogen levels, and has greater reliability compared to X-ray examinations. However, epidemiological evaluations of this method's efficacy have not been conducted yet. Therefore, a well-designed epidemio logical study of the pepsinogen method is necessary to demonstrate a reduction in stomach cancer mortality. |