Risk stratification for gastric cancer after Helicobacter pylori eradication: A population-based study on Matsu Islands.

Journal of Gastroenterology and Hepatology
Tsung-Hsien ChiangYi-Chia Lee

Abstract

The reliable method to stratify the gastric cancer risk after Helicobacter pylori eradication remains an elusive goal. Mass eradication of H. pylori began in 2004 in a high-risk population. After eradication, a screening program involving first-stage serological tests (pepsinogen-I, pepsinogen-II, H. pylori immunoglobin G, and gastrin-17) and second-stage endoscopic examination was launched in 2015-2018. Index lesions included gastric cancer or extensive premalignant lesions. We evaluated the performance of the serological tests to "rule in" and "rule out" the risk based on positive and negative likelihood ratios, respectively. The methylation levels of microRNA-124a-3 in the stomach were measured to indicate genetic damage. Among 6512 invited subjects, 3895 (59.6%) participated. Both gastrin-17 and pepsinogen tests were normal in 3560 (91.4%) subjects; 206 (5.3%) gastrin-17 and 129 (3.3%) pepsinogen tests were abnormal. Years after eradication, the severity of gastritis had fallen greatly, and extensive premalignant lesions or gastric cancer frequently occurred in newly non-atrophic-appearing mucosa. Pepsinogen testing could moderately predict atrophic gastritis (positive likelihood ratio: 4.11 [95% confidence interval: 2.92-5...Continue Reading

References

Apr 10, 2004·Cancer·Tony Hsiu-Hsi ChenUNKNOWN Taiwan Community-Based Integrated Screening Group
Jul 21, 2004·Digestive Diseases and Sciences·Yoshihisa UritaKazumasa Miki
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Jan 6, 2017·CA: a Cancer Journal for Clinicians·Rebecca L SiegelAhmedin Jemal
Jan 24, 2018·Proceedings of the National Academy of Sciences of the United States of America·Satoshi YamashitaToshikazu Ushijima
Jan 26, 2018·Journal of Clinical Gastroenterology·Tsung-Hsien ChiangMing-Wei Lin
Feb 11, 2018·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Masahiro MaedaToshikazu Ushijima

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Citations

Oct 3, 2020·Gut·Jyh-Ming LiouUNKNOWN Asian Pacific Alliance on Helicobacter and Microbiota (APAHAM)
Nov 6, 2020·Cancer Research·Sheetal Parida, Dipali Sharma
Jun 1, 2021·Gastrointestinal Endoscopy Clinics of North America·Robert J Huang, Joo Ha Hwang

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Atrophic Gastritis

Atrophic Gastritis is a process where gastric glandular cells are lost and replaced with firbous tissues, as a result of chronic inflammation. Learn more about Atrophic Gastritis here.