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REVIEW ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 10  |  Page : 1232-1239

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations: ABC Method for Gastric Cancer Screening


1 Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong 510515; Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China
2 Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080; Medical College, Shantou University, Shantou, Guangdong 515063, China
3 Reproductive Department, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China

Correspondence Address:
Dr. Xue-Qing Yao
Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan Second Road, Guangzhou, Guangdong 510080
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.231512

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Objective: Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice. Data Sources: The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords “Helicobacter pylori,” “Pepsinogens,” and “Stomach Neoplasms.” Study Selection: Original articles and reviews on the topics were selected. Results: Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval. Conclusions: The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

 

 Abstract in Chinese

联合血清幽门螺杆菌抗体和胃蛋白酶原浓度的胃癌筛查: 胃癌筛查的ABC方法

摘要

目的: 胃镜联合胃黏膜活检被认为是目前胃癌诊断的金标准,但作为侵入性检查,其临床应用受到了限制。一种新的非侵入性的大规模筛查,被称为“ABC方法”,结合了抗幽门螺杆菌抗体和血清胃蛋白酶原(PG),用于识别高危人群,以作进一步的胃镜检查,避免了每年对大多数人群进行不必要的侵入性检查,节省了每年人群胃癌筛查成本。然而,对于ABC方法的分组标准及每组的胃镜随访间隔均存在争议。在此综述中,我们总结了上述大家普遍关心的问题,为临床实践中的医疗从业者提供有用的参考。

数据来源:使用关键词“幽门螺杆菌”、“胃蛋白酶原”和“胃癌”,对PubMed数据库进行系统检索,检索时间截止在2017年11月22日。

资料选择:与本次研究主题相关的原创文章和综述均被纳入。

结果:当处于不同严重程度的幽门螺杆菌感染及萎缩性胃炎,抗幽门螺杆菌抗体和血清胃蛋白酶原浓度确实展示出显著变化,而这种显著的改变可应用于临床胃癌的风险分层.此外,抗幽门螺杆菌抗体滴度可用于胃癌的进一步风险分层,有助于确定更适宜的胃镜复查时间间隔。

结论:胃癌的早发现和早诊断得益于风险分层,但幽门螺杆菌抗体和血清胃蛋白酶原浓度的界值则需要进一步的完善。



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