Clinical Gastroenterology Vol.23 No.3(9)

Theme Gastric Cancer Screening -- Present Status and Uprising High-risk Strategy
Title Practical Method of Screening for Gastric Cancer Using Serum Pepsinogen
Publish Date 2008/03
Author Masaharu Yoshihara Health Service Center, Hiroshima Universit
Author Masanori Ito Department of Medicine and Molecular Science, Hiroshima University
Author Toru Hiyama Health Service Center, Hiroshima Universit
Author Shigeto Yoshida Department of Endoscopy, Hiroshima University Hospital
Author Shunsuke Takata Department of Medicine and Molecular Science, Hiroshima University
Author Shinji Tanaka Department of Endoscopy, Hiroshima University Hospital
[ Summary ] A practical method of gastric cancer screening employing the serum pepsinogen (PG-method) is reviewed Gastric cancer has been reported to be related to atrophic gastritis in which serum pepsinogen (PG) I levels and PG I / PG II ratios (I / II ratio) are reduced. In relation to PG methods, subjects in whom the PG I level is below 70 μg / liter and the PG I / II ratio is below 3.0 are considered to have atrophic gastritis, indicating a high risk for gastric cancer. There patients should receive further examinations through gastrointestinal endoscopy. Moreover, the addition of X-ray methods is more effective because of their high sensitivity in gastric cancer detection. Subjects with low PG levels should receive precise examinations regularly (once every 1 or 2 years). Special caution is required for subjects who have been treated for Helicobacter pylori eradication because of false negatives produced by the PG-method or morphological diagnosis.
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