Diagnostic value of gastric cancer risk assessment systems for patients with early gastric cancer / 中国实用内科杂志

ABSTRACT

OBJECTIVE: To evaluate the predictive value of various gastric cancer risk scoring systems based on the detection of pepsinogen and gastrin 17 for the risk of developing gastric cancer. METHODS: One hundred and forty-four patients were enrolled into the study from the First Affiliated Hospital of Anhui Medical University between April 2018 and October 2018.Among them, seventyfour patients were diagnosed with early gastric cancer while seventy patients didn't have gastric cancer(control group). The levels of serum pepsinogen I(PGI)/pepsinogen II(PGII), gastrin-17(G-17) and H.pylori antibody were measured. Patients were scored according to the Japanese ABC method, the modified ABC method, and the Chinese new gastric cancer risk scoring system. Compare the accuracy of the three methods for predicting the risk of developing gastric cancer. RESULTS: Compared with the control group, there was no significant difference in PG levels between the two groups, the serum G-17 levels were lower in gastric cancer patients than those in control group(P<0.05). According to the ABC method, the incidence rates of gastric cancer in the four groups of ABCD were 48.6%,59.4%, 0.0% and 100% respectively; the incidence rates of gastric cancer in the three groups of modified ABC method were 57.6%, 35.9% and 50% respectively. The cut-off value of new gastric cancer risk scoring system to diagnose gastric cancer was 11. The sensitivity,specificity, accuracy, positive predictive value and negative predictive value were 64.8%, 71.4%, 68.1%, 70.6 and 65.8% respectively. But in the low risk group, there were 26 cases(35.1%) of gastric cancer. Comparing the low-risk with the middle-high-risk population of gastric cancer, there were more females in the low risk group. CONCLUSION: The Japanese ABC method and the modified ABC method have value for limited screening gastric cancer and are not suitable for China's national conditions. The screening efficacy of the new gastric cancer scoring system for gastric cancer is significantly higher than the other two methods; however we should be vigilant when it is used in women with low risk.