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Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study

Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within t...

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Autores principales: Robles, Claudia, Rudzite, Dace, Polaka, Inese, Sjomina, Olga, Tzivian, Lilian, Kikuste, Ilze, Tolmanis, Ivars, Vanags, Aigars, Isajevs, Sergejs, Liepniece-Karele, Inta, Razuka-Ebela, Danute, Parshutin, Sergej, Murillo, Raul, Herrero, Rolando, Young Park, Jin, Leja, Marcis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325279/
https://www.ncbi.nlm.nih.gov/pubmed/35885649
http://dx.doi.org/10.3390/diagnostics12071746
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author Robles, Claudia
Rudzite, Dace
Polaka, Inese
Sjomina, Olga
Tzivian, Lilian
Kikuste, Ilze
Tolmanis, Ivars
Vanags, Aigars
Isajevs, Sergejs
Liepniece-Karele, Inta
Razuka-Ebela, Danute
Parshutin, Sergej
Murillo, Raul
Herrero, Rolando
Young Park, Jin
Leja, Marcis
author_facet Robles, Claudia
Rudzite, Dace
Polaka, Inese
Sjomina, Olga
Tzivian, Lilian
Kikuste, Ilze
Tolmanis, Ivars
Vanags, Aigars
Isajevs, Sergejs
Liepniece-Karele, Inta
Razuka-Ebela, Danute
Parshutin, Sergej
Murillo, Raul
Herrero, Rolando
Young Park, Jin
Leja, Marcis
author_sort Robles, Claudia
collection PubMed
description Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.
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spelling pubmed-93252792022-07-27 Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study Robles, Claudia Rudzite, Dace Polaka, Inese Sjomina, Olga Tzivian, Lilian Kikuste, Ilze Tolmanis, Ivars Vanags, Aigars Isajevs, Sergejs Liepniece-Karele, Inta Razuka-Ebela, Danute Parshutin, Sergej Murillo, Raul Herrero, Rolando Young Park, Jin Leja, Marcis Diagnostics (Basel) Article Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage. MDPI 2022-07-19 /pmc/articles/PMC9325279/ /pubmed/35885649 http://dx.doi.org/10.3390/diagnostics12071746 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Robles, Claudia
Rudzite, Dace
Polaka, Inese
Sjomina, Olga
Tzivian, Lilian
Kikuste, Ilze
Tolmanis, Ivars
Vanags, Aigars
Isajevs, Sergejs
Liepniece-Karele, Inta
Razuka-Ebela, Danute
Parshutin, Sergej
Murillo, Raul
Herrero, Rolando
Young Park, Jin
Leja, Marcis
Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title_full Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title_fullStr Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title_full_unstemmed Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title_short Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
title_sort assessment of serum pepsinogens with and without co-testing with gastrin-17 in gastric cancer risk assessment—results from the gistar pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325279/
https://www.ncbi.nlm.nih.gov/pubmed/35885649
http://dx.doi.org/10.3390/diagnostics12071746
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