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Correlation between the ABC classification and radiological findings for assessing gastric cancer risk

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Abstract

Purpose

To investigate the correlation between ABC risk assessment and radiological findings of gastric mucosa and to propose an improved method for gastric cancer screening.

Materials and Methods

We evaluated 318 participants with Helicobacter pylori (Hp) antibody titers, serum pepsinogen (PG) and upper GI radiography and then classified them into three groups: A, double-negative; B, Hp-positive, PG-negative; C, PG-positive. Group A was subclassified as: A-1, Hp antibody titer <3.0 U/ml; A-2, Hp antibody titer ≥3.0 U/ml. Results for group A and non-A (B or C) participants and radiological findings of gastric mucosa (fold and area gastricae) were analyzed retrospectively.

Results

Radiological findings differed significantly between the 207 A-1 and 98 non-A group. Odds ratios were 17.72 for fold distribution, 10.63 for fold thickness, 6.10 for fold characteristics, and 10.62 for area gastricae. Presence of ≥2 risk factors offered 90.3 % sensitivity, 94.7 % specificity, and 93.3 % accuracy. Nine (69.2 %) of the 13 A-2 group participants and 11 (5.3 %) A-1 group participants had a risk for gastric cancer according to radiological findings.

Conclusion

A good correlation exists between ABC classifications and radiological findings for gastric cancer risk, but some discrepant cases exist. We recommend both methods as screening for gastric cancer.

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References

  1. International Agency for Research on Cancer Cancer Topics: Stomach http://www.iarc.fr/en/cancertopics/stomachtopics.php. Access date 28 Feb 2014.

  2. Oshima A, Hirata N, Ubukata T, Umeda K, Fujimoto I. Evaluation of a mass screening method for stomach cancer with a case-control study design. Int J Cancer. 1986;38:829–33.

    Article  CAS  PubMed  Google Scholar 

  3. Fukao A, Tsubono Y, Tsuji I, Hisamichi S, Sugahara N, Takano A. The evaluation of screeinig for gastric cancer in Miyagi prefecture, Japan: a population based case-control study. Int J Cancer. 1995;60:45–8.

    Article  CAS  PubMed  Google Scholar 

  4. Hamashima C, Shibuya D, Yamazaki H, Inoue K, Fukao A, Saito H, et al. The Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol. 2008;38:259–67.

    Article  PubMed  Google Scholar 

  5. Ohata H, Kitauchi S, Yoshimura N, Mugitani K, Iwane M, Nakamura H, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109:138–43.

    Article  CAS  PubMed  Google Scholar 

  6. Miki K. Gastric cancer screening by combined assay for serum anti-Helicobacter pylori IgG antibody and serum pepsinogen levels—“ABC method”. Proc Jpn Acad Ser B Phys Biol Sci. 2011;87:405–14.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Kudo T, Kakizaki S, Sohara N, Onozato Y, Okamura S, Inui Y, et al. Analysis of ABC (D) stratification for screening patients with gastric cancer. World J Gastroenterol. 2011;17:4793–8.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Nakajima S, Fukumoto K. Problems with Serum Helicobacter pylori Tests for the Evaluation of Gastric Cancer (in Japanese). Clin Gastroenterol. 2013;28:1137–43.

    Google Scholar 

  9. Nakajima S, Yamaoka M, Doi K, Nosuhara A, Nishimura M, Sato J, et al. Barium X-ray characteristics of the stomach with or without Helicobacter pylori infection (in Japanese). Stomach Intestine. 2006;41:1001–8.

    Google Scholar 

  10. Yasuda M, Aoki R, Torisu R, Sogabe M, Mima H, Kagoshima A, et al. Evaluation of X-ray findings for assessing the risk of stomach cancer using serum Helicobacter pylori antibody and the pepsinogen method (in Japanese). J Gastrointestinal Cancer Screen. 2010;48:344–54.

    Google Scholar 

  11. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–9.

    Article  CAS  PubMed  Google Scholar 

  12. Wang C, Yuan Y, Hunt RH. The association between Helicobacter pylori infection and early gastric cancer: a meta-analysis. Am J Gastroenterol. 2007;102:1789–98.

    Article  PubMed  Google Scholar 

  13. Mizuno S, Miki I, Ishida T, Yoshida M, Onoyama M, Azuma T, et al. Prescreening of a high-risk group for gastric cancer by serologically determined Helicobacter pylori infection and atrophic gastritis. Dig Dis Sci. 2010;55:3132–7.

    Article  PubMed  Google Scholar 

  14. Watabe H, Mitsushima T, Yamaji Y, Okamoto M, Wada R, Kokubo T, et al. Predicting the development of gastric cancer from combing Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Yoshida T, Kato J, Inoue I, Yoshimura N, Deguchi H, Mukobayashi C, et al. Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer. Int J Cancer. 2014;134:1445–57.

    Article  CAS  PubMed  Google Scholar 

  16. Sohn J, Levine MS, Furth EE, Laufer I, Rubesin SE, Herlinger H, et al. Helicobacter pylori gastritis: radiographic findings. Radiology. 1995;195:763–7.

    Article  CAS  PubMed  Google Scholar 

  17. Crocker JD, Bender JN. Antral nodularity, fold thickness, and narrowing. Signs on the upper gastrointestinal series that may indicate chronic active gastritis secondary to Helicobacter pylori. Invest Radiol. 1995;30:480–3.

    Article  CAS  PubMed  Google Scholar 

  18. Dheer S, Levine MS, Redfern RO, Metz DC, Rubesin SE, Laufer I. Radiographically diagnosed antral gastritis: finding in patient with and without Helicobacter pylori infection. Br J Radiol. 2002;75:805–11.

    Article  CAS  PubMed  Google Scholar 

  19. Okuda J, Uchiyama K, Ida K, Kuroda M. The possibility of infectious diagnosis of Helicobacter pylori using double-contrast radiology (in Japanese). Health Evaluation Promotion. 2002;29:894–8.

    Article  Google Scholar 

  20. Yamamichi N, Hirano C, Shimamoto T, Minatsuki C, Takahashi Y, Nakayama C, et al. Associated factors of atrophic gastritis diagnosed by double-contrast upper gastrointestinal barium X-ray radiography: a cross-sectional study analyzing 6901 healthy subjects in Japan. PloS One. 2014;9:111359. doi:10.1371/journal (Pone. 0111359. eCollection 2014).

    Article  Google Scholar 

  21. Goto H, Takahashi Y, Matsushita T. Study of the use of gastric radiography for diagnosing Helicobacter pylori infections during medical checkups in Japanese Red Cross Gifu Hospital (in Japanese). J Gastrointestinal Cancer Screen. 2012;50:429–39.

    Google Scholar 

  22. Itoh T, Kichikawa K, Hirai T, Fujii H, Nakagawa T, Akahane T, et al. Trial for introducing a new diagnostic criterion in gastric cancer screening (in Japanese). J Gastrointestinal Cancer Screen. 2011;49:493–502.

    Google Scholar 

  23. Saito Y, Tomiyama Y, Jyoko H, Okayasu K, Kuwabara J, Nishikido S, et al. Comparison of a barium X-ray examination and a combination test using a urine anti-Helicobacter pylori IgG antibody and serum pepsinogen levels (in Japanese). J Gastrointestinal Cancer Screen. 2014;52:46–60.

    Google Scholar 

  24. Miyamoto A, Nagahama R, Nakashima H. An evaluation of the degree of gastric mucosal atrophy by X-ray examination and the possibility of the application thereof to gastric cancer screening: a comparison with the pepsinogen assay (in Japanese). J Gastrointestinal Cancer Screen. 2009;47:55–62.

    Google Scholar 

  25. Mochizuki N, Kobayashi M, Nishiojo K, Kamaguchi M. Usefulness and issues in gastric cancer risk assessment during medical checkups using the ABC classification system (in Japanese). J Gastrointestinal Cancer Screen. 2014;52:545–55.

    Google Scholar 

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Acknowledgments

The authors thank Hajime Ohishi, MD, and the staff of Takanohara Central Hospital for their support.

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Authors and Affiliations

  1. Department of Radiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan

    Takahiro Itoh, Aki Marugami, Junko Takahama, Toshihiro Tanaka & Kimihiko Kichikawa

  2. Department of Endoscopy and Ultrasound, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan

    Miho Saito, Nagaaki Marugami & Toshiko Hirai

Authors
  1. Takahiro Itoh
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  2. Miho Saito
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  3. Nagaaki Marugami
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  4. Toshiko Hirai
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  6. Junko Takahama
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  7. Toshihiro Tanaka
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Corresponding author

Correspondence to Takahiro Itoh.

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Conflict of interest

The authors have no conflict of interest to disclose.

Ethical Statement

This study was approved without the need for individual informed consent by our institutional ethics committee and is in accordance with the 1964 Declaration of Helsinki and its later amendments.

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Itoh, T., Saito, M., Marugami, N. et al. Correlation between the ABC classification and radiological findings for assessing gastric cancer risk. Jpn J Radiol 33, 636–644 (2015). https://doi.org/10.1007/s11604-015-0469-3

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  • DOI: https://doi.org/10.1007/s11604-015-0469-3

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