Gastric cancer screening using the serum pepsinogen test method.
Gastric cancer screening using the serum pepsinogen test method.
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DOI：
10.1007/s10120-006-0397-0
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发表时间：
2006-01-01
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影响因子：
--
通讯作者：
Miki, Kazumasa
中科院分区：
文献类型：
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作者：
Miki, Kazumasa
回顾了全球以及日本使用血清胃蛋白酶原检测方法进行胃癌筛查的现状。我们对42项研究的敏感性和特异性结果进行了荟萃分析（27项基于人群的筛选研究：n = 296 553和15个选定组：n = 4 385）。合并胃蛋白酶原I水平≤ 70 ng/ml的敏感性和假阳性率（FPr）对;胃蛋白酶原I/II比值≤ 3，敏感性为77%/FPr 27%。阳性预测值为0.77%~ 1.25%，阴性预测值为99.08%~ 99.90%。因此，我们得出结论，胃蛋白酶原检测的定义应包括胃蛋白酶原I/II比值，因为基于人群的研究和在日本以外的高发地区使用胃蛋白酶原I血清水平和胃蛋白酶原I/II比值筛查胃癌的研究的选定组均获得了一致性。通过血清胃蛋白酶原水平检测为广泛萎缩性胃炎阳性的个体接受内窥镜检查以检测胃癌的存在。我们应该提高效率和成本效益的胃癌筛查系统，通过识别组，在低风险，以及那些在高风险，发展胃癌，使用血清幽门螺杆菌抗体滴度和胃蛋白酶原I和II的浓度的测定相结合。总之，胃蛋白酶原检测方法可作为高危受试者的筛查试验，而不是作为筛查癌症本身的工具。我希望这种胃蛋白酶原检测方法在不久的将来，在其他国家以及日本，成为胃癌预防的世界标准。
The current status of gastric cancer screening, worldwide, as well as in Japan, using the serum pepsinogen test method, was reviewed. We performed a metaanalysis of sensitivity and specificity results from 42 individual studies (27 population-based screening studies: n = 296 553 and 15 selected groups: n = 4 385). Pooled pairs of sensitivity and false-positive rates (FPr) for pepsinogen I level < or = 70 ng/ml; pepsinogen I/II ratio < or = 3, had a sensitivity of 77%/FPr27%. The positive predictive value varied between 0.77% and 1.25%, and the negative predictive value varied between 99.08% and 99.90%. Therefore, we concluded that the definition of the pepsinogen test should include the pepsinogen I/II ratio, as consistency was obtained for both the population-based studies and the selected groups for those studies that used pepsinogen I serum levels together with the pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Individuals testing positive for extensive atrophic gastritis by serum pepsinogen levels undergo endoscopic examination to test for the presence of gastric cancer. We should increase the efficacy and cost-effectiveness of the gastric cancer screening system, by the identification of groups, at low-risk, as well as those at high-risk, of developing gastric cancer, using a combination of assays of serum Helicobacter pylori antibody titers and the concentration of pepsinogen I and II. In conclusion, the pepsinogen test method can be used as a screening test for high-risk subjects, rather than as a tool for screening for cancer itself. I hope that this pepsinogen test method will become a world standard for gastric cancer prevention in the near future, in other countries, as well as in Japan.