Selgrad, Michael and Bornschein, Jan and Kandulski, Arne and Weigt, Jochen and Roessner, Albert and Wex, Thomas and Malfertheiner, Peter (2018) Combined Gastric and Colorectal Cancer ScreeningA New Strategy. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 19 (12): 3854. ISSN 1422-0067,
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Background: Our aim was to evaluate the feasibility of a serological assessment of gastric cancer risk in patients undergoing colonoscopy in countries with low-to-moderate incidence rates. Methods: Serum samples were prospectively collected from 453 patients (>50 years old) undergoing colonoscopies. Of these, 279 (61.6%) also underwent gastroscopy to correlate the results for serum pepsinogen I and II (sPG-I and sPG-II), sPG-I/II ratio, and anti-H. pylori antibodies with gastric histopathology findings (graded according to the updated Sydney classification and the Operative Link of Gastritis Assessment (OLGA) and the Operative Link for Gastric Intestinal Metaplasia assessment (OLGIM) systems). Results: H. pylori was found in 85 patients (30.5%). Chronic atrophic gastritis was diagnosed in 89 (31.9%) patients. High-risk OLGA (III-IV) stages were present in 24 patients, and high-risk OLGIM stages were present in 14 patients. There was an inverse correlation of sPG-I with the degree of atrophy and intestinal metaplasia (IM), as well as with the respective OLGA (r = -0.425; p < 0.001) and OLGIM (r = -0.303; p < 0.001) stages. A pathological sPG-I result was associated with a relative risk (RR) of 12.2 (95% confidence interval: 6.29-23.54; p < 0.001) for gastric preneoplastic changes. Conclusions: The assessment of serum pepsinogen allows the identification of patients at increased risk of gastric cancer. A prevention strategy of combining a screening colonoscopy with a serological screening for preneoplastic gastric changes should be considered in the general population.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HELICOBACTER-PYLORI ERADICATION; PRECANCEROUS CONDITIONS; ENDOSCOPIC RESECTION; PEPSINOGEN; THERAPY; ANTIBODIES; MANAGEMENT; MORTALITY; DIAGNOSIS; HISTOLOGY; gastric cancer; Helicobacter pylori; screening; pepsinogen; screening colonoscopy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2019 08:23 |
| Last Modified: | 04 Oct 2019 08:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13395 |
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