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Screening markers for chronic atrophic gastritis in Chiapas, Mexico.

Abstract

Intestinal-type gastric adenocarcinomas usually are preceded by chronic atrophic gastritis. Studies of gastric cancer prevention often rely on identification of this condition. In a clinical trial, we sought to determine the best serological screening method for chronic atrophic gastritis and compared our findings to the published literature. Test characteristics of potential screening tests (antibodies to Helicobacter pyloni or CagA, elevated gastrin, low pepsinogen, increased age) alone or in combination were examined among consecutive subjects enrolled in a study of H. pylori and preneoplastic gastric lesions in Chiapas, Mexico; 70% had chronic atrophic gastritis. English-language articles concerning screening for chronic atrophic gastritis were also reviewed. Sensitivity for chronic atrophic gastritis was highest for antibodies to H. pylori (92%) or CagA, or gastrin levels >25 ng/l (both 83%). Specificity, however, was low for these tests (18, 41, and 22%, respectively). Pepsinogen levels were highly specific but insensitive markers of chronic atrophic gastritis (for pepsinogen I <25 microg/l, sensitivity was 6% and specificity was 100%; for pepsinogen I:pepsinogen II ratio <2.5, sensitivity was 14% and specificity was 96%). Combinations of markers did not improve test characteristics. Screening test characteristics from the literature varied widely and did not consistently identify a good screening strategy. In this study, CagA antibodies alone had the best combination of test characteristics for chronic atrophic gastritis screening. However, no screening test was both highly sensitive and highly specific for chronic atrophic gastritis.

Authors+Show Affiliations

Department of Health Research and Policy, Stanford University, California 94305, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11219766

Citation

Ley, C, et al. "Screening Markers for Chronic Atrophic Gastritis in Chiapas, Mexico." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 10, no. 2, 2001, pp. 107-12.
Ley C, Mohar A, Guarner J, et al. Screening markers for chronic atrophic gastritis in Chiapas, Mexico. Cancer Epidemiol Biomarkers Prev. 2001;10(2):107-12.
Ley, C., Mohar, A., Guarner, J., Herrera-Goepfert, R., Figueroa, L. S., Halperin, D., & Parsonnet, J. (2001). Screening markers for chronic atrophic gastritis in Chiapas, Mexico. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 10(2), pp. 107-12.
Ley C, et al. Screening Markers for Chronic Atrophic Gastritis in Chiapas, Mexico. Cancer Epidemiol Biomarkers Prev. 2001;10(2):107-12. PubMed PMID: 11219766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening markers for chronic atrophic gastritis in Chiapas, Mexico. AU - Ley,C, AU - Mohar,A, AU - Guarner,J, AU - Herrera-Goepfert,R, AU - Figueroa,L S, AU - Halperin,D, AU - Parsonnet,J, PY - 2001/2/24/pubmed PY - 2001/5/22/medline PY - 2001/2/24/entrez SP - 107 EP - 12 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 10 IS - 2 N2 - Intestinal-type gastric adenocarcinomas usually are preceded by chronic atrophic gastritis. Studies of gastric cancer prevention often rely on identification of this condition. In a clinical trial, we sought to determine the best serological screening method for chronic atrophic gastritis and compared our findings to the published literature. Test characteristics of potential screening tests (antibodies to Helicobacter pyloni or CagA, elevated gastrin, low pepsinogen, increased age) alone or in combination were examined among consecutive subjects enrolled in a study of H. pylori and preneoplastic gastric lesions in Chiapas, Mexico; 70% had chronic atrophic gastritis. English-language articles concerning screening for chronic atrophic gastritis were also reviewed. Sensitivity for chronic atrophic gastritis was highest for antibodies to H. pylori (92%) or CagA, or gastrin levels >25 ng/l (both 83%). Specificity, however, was low for these tests (18, 41, and 22%, respectively). Pepsinogen levels were highly specific but insensitive markers of chronic atrophic gastritis (for pepsinogen I <25 microg/l, sensitivity was 6% and specificity was 100%; for pepsinogen I:pepsinogen II ratio <2.5, sensitivity was 14% and specificity was 96%). Combinations of markers did not improve test characteristics. Screening test characteristics from the literature varied widely and did not consistently identify a good screening strategy. In this study, CagA antibodies alone had the best combination of test characteristics for chronic atrophic gastritis screening. However, no screening test was both highly sensitive and highly specific for chronic atrophic gastritis. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/11219766/Screening_markers_for_chronic_atrophic_gastritis_in_Chiapas_Mexico_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=11219766 DB - PRIME DP - Unbound Medicine ER -