2023년 2월, Internal Journal of Molecular Science에 실린 내용입니다.
Gastric cancer (GC) 에 대한 조기 진단을 위한 방법으로 EGD는 위 음성률이 19%이며, invasive, time-consuming & uncomfortable 한 단점이 있습니다. 또한, 최근 GC의 임상적 역학을 살펴보면, Hp infection은 줄어들고 있지만 cardia GC의 유병률이 증가하고 있고, 젊은 성인에서의 GC 진단이 증가하고 있습니다. PG test의 경우 chronic atrophic gastritis (CAG) 진단을 위한 방법이지만, 평균 cutoff points가 PGI < 70 ng/mL 과 PGI/PGII < 3.0으로 wide하기 때문에 GC의 예측 지표로써는 만족스럽지 않습니다. 최근에는 GC와 CAG의 진단을 위해 PG test에 serum gastrin G17 (G17)과 anti-H. Pylori immunoglobulin (IgG)을 추가하는 것을 제안 하고 있습니다. 그리고, 60세 이상, 남성에서 GC에 대한 independent risk factors로 알려져 있습니다. 이러한 위험 인자들을 토대로, a model - herein called the DeRe–Steffan–Cannizzaro (DSC) test - 을 계발 하였고, 관련 항목은 <patient’s age and sex and their PG, anti-H. Pylori immunoglobulin (IgG), and serum gastrin G17 levels> 입니다.
Figure 1. Schematic of the study design and main results.
Table 1. Distribution of demographic and serological data in the discovery and validation cohorts according to sex and age categories.
Table 2. DSC GC risk classifications for participants in the validation cohorts
Table 3. Aggregation of participants according to histopathological diagnosis.
Figure 2. Distribution of DSC results taken from the validation 1 (A) and validation 2 (B) datasets according to the diagnostic categories. 
Table 4. Prediction value of DSC test for GC risk.
Table 5. Reproducibility of the DSC test.
Table 6. Comparison between the predictive values of the DSC test and pepsinogen tests for GC risk.
Abstract:
In this study, we aimed to assess the accuracy of the proposed novel, noninvasive serum DSC test in predicting the risk of gastric cancer before the use of upper endoscopy. To validate the DSC test, we enrolled two series of individuals living in Veneto and Friuli-Venezia Giulia, Italy (n = 53 and n = 113, respectively), who were referred for an endoscopy. The classification used for the DSC test to predict gastric cancer risk combines the coefficient of the patient’s age and sex and serum pepsinogen I and II, gastrin 17, and anti-Helicobacter pylori immunoglobulin G concentrations in two equations: Y1 and Y2. The coefficient of variables and the Y1 and Y2 cutoff points (>0.385 and >0.294, respectively) were extrapolated using regression analysis and an ROC curve analysis of two retrospective datasets (300 cases for the Y1 equation and 200 cases for the Y2 equation). The first dataset included individuals with autoimmune atrophic gastritis and first-degree relatives with gastric cancer; the second dataset included blood donors. Demographic data were collected; serum pepsinogen, gastrin G17, and anti-Helicobacter pylori IgG concentrations were assayed using an automatic Maglumi system. Gastroscopies were performed by gastroenterologists using an Olympus video endoscope with detailed photographic documentation during examinations. Biopsies were taken at five standardized mucosa sites and were assessed by a pathologist for diagnosis. The accuracy of the DSC test in predicting neoplastic gastric lesions was estimated to be 74.657% (65% CI; 67.333% to 81.079%). The DSC test was found to be a useful, noninvasive, and simple approach to predicting gastric cancer risk in a population with a medium risk of developing gastric cancer
2023년 2월, Internal Journal of Molecular Science에 실린 내용입니다.
Gastric cancer (GC) 에 대한 조기 진단을 위한 방법으로 EGD는 위 음성률이 19%이며, invasive, time-consuming & uncomfortable 한 단점이 있습니다. 또한, 최근 GC의 임상적 역학을 살펴보면, Hp infection은 줄어들고 있지만 cardia GC의 유병률이 증가하고 있고, 젊은 성인에서의 GC 진단이 증가하고 있습니다. PG test의 경우 chronic atrophic gastritis (CAG) 진단을 위한 방법이지만, 평균 cutoff points가 PGI < 70 ng/mL 과 PGI/PGII < 3.0으로 wide하기 때문에 GC의 예측 지표로써는 만족스럽지 않습니다. 최근에는 GC와 CAG의 진단을 위해 PG test에 serum gastrin G17 (G17)과 anti-H. Pylori immunoglobulin (IgG)을 추가하는 것을 제안 하고 있습니다. 그리고, 60세 이상, 남성에서 GC에 대한 independent risk factors로 알려져 있습니다. 이러한 위험 인자들을 토대로, a model - herein called the DeRe–Steffan–Cannizzaro (DSC) test - 을 계발 하였고, 관련 항목은 <patient’s age and sex and their PG, anti-H. Pylori immunoglobulin (IgG), and serum gastrin G17 levels> 입니다.
Figure 1. Schematic of the study design and main results.
Table 1. Distribution of demographic and serological data in the discovery and validation cohorts according to sex and age categories.
Table 2. DSC GC risk classifications for participants in the validation cohorts
Table 3. Aggregation of participants according to histopathological diagnosis.
Figure 2. Distribution of DSC results taken from the validation 1 (A) and validation 2 (B) datasets according to the diagnostic categories.
Table 4. Prediction value of DSC test for GC risk.
Table 6. Comparison between the predictive values of the DSC test and pepsinogen tests for GC risk.
Abstract:
In this study, we aimed to assess the accuracy of the proposed novel, noninvasive serum DSC test in predicting the risk of gastric cancer before the use of upper endoscopy. To validate the DSC test, we enrolled two series of individuals living in Veneto and Friuli-Venezia Giulia, Italy (n = 53 and n = 113, respectively), who were referred for an endoscopy. The classification used for the DSC test to predict gastric cancer risk combines the coefficient of the patient’s age and sex and serum pepsinogen I and II, gastrin 17, and anti-Helicobacter pylori immunoglobulin G concentrations in two equations: Y1 and Y2. The coefficient of variables and the Y1 and Y2 cutoff points (>0.385 and >0.294, respectively) were extrapolated using regression analysis and an ROC curve analysis of two retrospective datasets (300 cases for the Y1 equation and 200 cases for the Y2 equation). The first dataset included individuals with autoimmune atrophic gastritis and first-degree relatives with gastric cancer; the second dataset included blood donors. Demographic data were collected; serum pepsinogen, gastrin G17, and anti-Helicobacter pylori IgG concentrations were assayed using an automatic Maglumi system. Gastroscopies were performed by gastroenterologists using an Olympus video endoscope with detailed photographic documentation during examinations. Biopsies were taken at five standardized mucosa sites and were assessed by a pathologist for diagnosis. The accuracy of the DSC test in predicting neoplastic gastric lesions was estimated to be 74.657% (65% CI; 67.333% to 81.079%). The DSC test was found to be a useful, noninvasive, and simple approach to predicting gastric cancer risk in a population with a medium risk of developing gastric cancer