Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography
Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography
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DOI：
10.1111/j.1349-7006.2005.00098.x
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发表时间：
2005-10-01
期刊：
影响因子：
5.7
通讯作者：
Ichinose, M
中科院分区：
文献类型：
--
作者：
Ohata, H;Oka, M;Ichinose, M
为了在日本开发更有效的胃癌筛查方案，我们研究了一种结合血清胃蛋白酶原（PG）检测和钡数字放射照相（DR）的新筛查方案。在7年的时间里，共有17647名中年男性接受了PG检测和dr检测相结合的工作场所筛查。分析了该项目的有效性以及该项目的其他特征。检出胃癌49例（占早期胃癌病例的88%）。检出率为0.28%，阳性预测值为0.85%。PG检查检出率为63.3%，DR检查检出率为69.4%，两项检查均阳性的癌症病例占32.7%。这两种方法几乎同样有效，并且比使用荧光摄影的常规筛查有效得多。每种筛查方法检测到不同的胃癌亚组；PG检测对小肠型无症状早期小癌检测效率高，DR检测对形态凹陷或溃疡型弥漫性癌检测效率高。检测单个癌症的费用远低于常规筛查的费用。事实上，有可能进一步降低检测单个癌症的成本，使其与手术切除单个胃癌的成本相当。因此，将这两种筛查方法结合起来，很可能实现一个高效的胃癌筛查系统。这样的筛查项目对胃癌高危人群是有益的。
With the aim of developing more efficient gastric cancer screening programs for use in Japan, we studied a new screening program that combines serum pepsinogen (PG) testing and barium digital radiography (DR). A total of 17 647 middle-aged male subjects underwent workplace screening over a 7-year period using a combination of PG testing and DR. This program's effectiveness, as well as other characteristics of the program, was analyzed. Forty-nine cases of gastric cancer were detected (comprising 88% early cancer cases). The detection rate was 0.28%, and the positive predictive value was 0.85%. The PG test detected 63.3% of cases, DR detected 69.4% of cases, and both tests were positive in 32.7% of cancer cases. The two methods were almost equally effective, and were considerably more effective than conventional screening using photofluorography. Each screening method detected a distinct gastric cancer subgroup; the PG test efficiently detected asymptomatic small early cancer with intestinal type histology, while DR was efficient at detecting cancers with depressed or ulcerated morphology and diffuse type histology. The cost for the detection of a single cancer was much less than that for conventional screening. In fact, it is possible to further reduce the cost of detecting a single cancer to a cost comparable to that of surgically resecting a single gastric cancer. Thus, it is probable that a highly efficient gastric cancer screening system can be implemented by combining the two screening methods. Such a screening program would be beneficial in a population at high risk for gastric cancer.