| Theme | Evidence-based Guidelines Version 2 for Gastric Cancer Screening ; The Beginning of a New Era of Endoscopic Cancer Screening | |
|---|---|---|
| Title | High Risk of Gastric Cancer Based on Serum Pepsinogen Test | |
| Publish Date | 2016/02 | |
| Author | Izumi Inoue | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| Author | Jun Kato | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| Author | Takao Maekita | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| Author | Mikitaka Iguchi | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| Author | Hideyuki Tamai | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| Author | Masao Ichinose | Depertment of Gastroenterology, Faculty of Medicine, Wakayama Medical University |
| [ Summary ] | Subjects of extensive CAG (chronic atrophic gastritis) associated with high incidence of gastric cancer have been diagnosed based on PG (pepsinogen) test (positive criteria : PG I ≤ 70 ng/ml and PG I/II ≤ 3.0). Risk‒based assessment in gastric cancer screening by PG test enables the selection of high‒risk individuals for gastric cancer and efficient screening. However, a considerable proportion of gastric cancers were derived from PG negative subjects and major issue remains as for further stratification of PG negative group that is the detection of high‒risk subgroups for gastric cancer. Long‒term observational studies have revealed that an individual risk of gastric cancer can be assessed by the serum PG levels. Serum PG levels are considered reliable markers for CAG progression at high risk of intestinal‒type gastric cancer related to a stepwise reduction in the serum PG I level or PG I/II ratio and severity of active gastric inflammation leading to the diffuse‒type cancer correlated with high levels of PG II. Serum PG levels could be used as objective markers to differentiated individual risk for gastric cancer considering gastric carcinogenesis through two‒different pathway, and could be useful for the perspective screen‒and‒treat strategy in the prevention of gastric cancer. |
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