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Serum pepsinogen levels, Helicobacter pylori CagA Status, and cytokine gene polymorphisms associated with gastric premalignant lesions in Costa Rica.
Cancer Epidemiol Biomarkers Prev 2007; 16(12):2631-6CE

Abstract

The detection of gastric premalignant lesions, atrophic gastritis, corpus atrophic gastritis, and intestinal metaplasia, using several potential markers was examined in Costa Rica. Depending on the lesion investigated, from a total of 223 dyspeptic patients, 58 (26.0%), 31 (13.9%), or 23 (10.3%) were histologically diagnosed with atrophic gastritis, corpus atrophic gastritis, or intestinal metaplasia, respectively. Sera were used for the measurement of pepsinogen (PG) and Helicobacter pylori CagA antibody (CagA-ab) levels by ELISA, and human genomic DNAs were used for the genotyping of interleukin (IL)-1beta (-511 and +3954), IL-10 (-1082 and -592), and IL-1RN intron 2 by PCR and RFLP. Multivariate analysis was done adjusting for sex, age, and H. pylori seropositivity. Low PG levels (L-PG; PG I < or = 70 microg/L + PG I/II < or = 3), very low PG levels (VL-PG; PG I < or = 30 microg/L + PG I/II < or = 2), and CagA-ab were individually associated with all premalignant lesions whereas IL-1beta +3954T-carrier and IL-1RN homozygous 2 allele were associated with intestinal metaplasia. VL-PG, for corpus atrophic gastritis detection, was the single marker with the highest combination of test characteristics, sensitivity (77.4%), specificity (80.7%), positive predictive value (39.3%), negative predictive value (95.7%), and seropositivity rate (27.4%), expected to improve after periodic measurements. Combined examinations of VL-PG and CagA-ab improved the specificity (92.7%) and positive predictive value (62.2%), with similar sensitivity (74.2%) and negative predictive value (95.7%). In conclusion, corpus atrophic gastritis detection with periodic measurements of serum PG, alone or in combination with CagA-ab status, to identify high gastric cancer risk, seems to be the method best suited for mass screening in Costa Rica.

Authors+Show Affiliations

Centro Digestivo Doctores Con-Mediplaza, Pavas, San José, Costa Rica. scon@gastrocolon.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18086767

Citation

Con, Sergio A., et al. "Serum Pepsinogen Levels, Helicobacter Pylori CagA Status, and Cytokine Gene Polymorphisms Associated With Gastric Premalignant Lesions in Costa Rica." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 16, no. 12, 2007, pp. 2631-6.
Con SA, Con-Wong R, Con-Chin GR, et al. Serum pepsinogen levels, Helicobacter pylori CagA Status, and cytokine gene polymorphisms associated with gastric premalignant lesions in Costa Rica. Cancer Epidemiol Biomarkers Prev. 2007;16(12):2631-6.
Con, S. A., Con-Wong, R., Con-Chin, G. R., Con-Chin, V. G., Takeuchi, H., Valerín, A. L., ... Sugiura, T. (2007). Serum pepsinogen levels, Helicobacter pylori CagA Status, and cytokine gene polymorphisms associated with gastric premalignant lesions in Costa Rica. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 16(12), pp. 2631-6.
Con SA, et al. Serum Pepsinogen Levels, Helicobacter Pylori CagA Status, and Cytokine Gene Polymorphisms Associated With Gastric Premalignant Lesions in Costa Rica. Cancer Epidemiol Biomarkers Prev. 2007;16(12):2631-6. PubMed PMID: 18086767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum pepsinogen levels, Helicobacter pylori CagA Status, and cytokine gene polymorphisms associated with gastric premalignant lesions in Costa Rica. AU - Con,Sergio A, AU - Con-Wong,Reinaldo, AU - Con-Chin,Gil R, AU - Con-Chin,Vicky G, AU - Takeuchi,Hiroaki, AU - Valerín,Ana L, AU - Echandi,Guillermo, AU - Mena,Fernando, AU - Brenes,Fernando, AU - Yasuda,Nobufumi, AU - Araki,Keijiro, AU - Sugiura,Tetsuro, PY - 2007/12/19/pubmed PY - 2008/3/5/medline PY - 2007/12/19/entrez SP - 2631 EP - 6 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 - 16 IS - 12 N2 - The detection of gastric premalignant lesions, atrophic gastritis, corpus atrophic gastritis, and intestinal metaplasia, using several potential markers was examined in Costa Rica. Depending on the lesion investigated, from a total of 223 dyspeptic patients, 58 (26.0%), 31 (13.9%), or 23 (10.3%) were histologically diagnosed with atrophic gastritis, corpus atrophic gastritis, or intestinal metaplasia, respectively. Sera were used for the measurement of pepsinogen (PG) and Helicobacter pylori CagA antibody (CagA-ab) levels by ELISA, and human genomic DNAs were used for the genotyping of interleukin (IL)-1beta (-511 and +3954), IL-10 (-1082 and -592), and IL-1RN intron 2 by PCR and RFLP. Multivariate analysis was done adjusting for sex, age, and H. pylori seropositivity. Low PG levels (L-PG; PG I < or = 70 microg/L + PG I/II < or = 3), very low PG levels (VL-PG; PG I < or = 30 microg/L + PG I/II < or = 2), and CagA-ab were individually associated with all premalignant lesions whereas IL-1beta +3954T-carrier and IL-1RN homozygous 2 allele were associated with intestinal metaplasia. VL-PG, for corpus atrophic gastritis detection, was the single marker with the highest combination of test characteristics, sensitivity (77.4%), specificity (80.7%), positive predictive value (39.3%), negative predictive value (95.7%), and seropositivity rate (27.4%), expected to improve after periodic measurements. Combined examinations of VL-PG and CagA-ab improved the specificity (92.7%) and positive predictive value (62.2%), with similar sensitivity (74.2%) and negative predictive value (95.7%). In conclusion, corpus atrophic gastritis detection with periodic measurements of serum PG, alone or in combination with CagA-ab status, to identify high gastric cancer risk, seems to be the method best suited for mass screening in Costa Rica. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/18086767/Serum_pepsinogen_levels_Helicobacter_pylori_CagA_Status_and_cytokine_gene_polymorphisms_associated_with_gastric_premalignant_lesions_in_Costa_Rica_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=18086767 DB - PRIME DP - Unbound Medicine ER -