Value of new modified ABCD method for screening in population with high risk factors of gasric cancer

Objective: To evaluate the diagnostic value of serum gastrin 17 (G-17) combined with pepsinogen (PG) for screening in population with high-risk factors of gasric cancer from Third Affiliated Hospital of Wenzhou Medical University.  Methods: Patients with complain of stomach discomfort from Department of Laboratory of Third Affiliated Hospital of Wenzhou Medical University between January 2016 and February 2017 were enrolled in this study. The enzyme-linked immunosorbent assay was used to detect the fasting serum G-17, PGⅠ and PGⅡ. The gastric endoscopy was conducted. The diagnosis of gastric cancer was confirmed by the results of endoscopic and pathological examinations to evaluate the diagnostic value of serum G-17 and PG. The cut-off value of serum G-17 and PG in the diagnosis of gastric cancer was calculated by receiver operating characteristic (ROC) curve. The incidence rate of gastric cancer was compared among patients who were divided into A, B, C and D groups by using modified ABCD method. Results: Three hundred and eighty-eight patients with gastric diseases were collected, including superficial gastritis (n = 132), atrophic gastritis (n = 168), gastric ulcer (n = 48) and gastric cancer (n = 40). The patients with superficial gastritis were taken as the control. The ratio of serum PGⅠ to PGⅡ (PGR) in patients with atrophic gastritis was lower than that in patients with superficial gastritis (P < 0.05). The serum levels of PGⅠ, PGⅡ and G-17 in patients with gastric ulcer were higher than those in patients with superficial gastritis (all P < 0.05), but the PGR value was lower (P < 0.05). The serum level of PGⅡ in patients with gastric antrum carcinoma was higher than that in patients with superficial gastritis (P < 0.05), but the PGR value was lower (P < 0.05). The serum levels of PGⅠ, PGⅡ and G-17 in patients with gastric cancer in cardia, fundus ventriculi, corpora ventriculi and angular were all higher than those in patients with superficial gastritis (all P < 0.05), but the PGR values were lower (all P < 0.05). The serum level of G-17 in patients with gastric antrum cancer was lower than that in patients with gastric cancer in other locations (P < 0.05). The serum level of PGⅠ in patients with gastric cancer of ulcerative type was higher than those in patients with gastric cancer of other types (all P < 0.05). The fitting areas under curve (AUC) of G-17, PG (PGⅠ, PGⅡ and PGR) and G-17 combined with PG to diagnose gastric cancer were 0.603, 0.630 and 0.673, respectively. The incidence rates of gastric cancer in A, B, C and D groups were 6.60%, 14.50%, 0.00% and 21.10%, respectively. In this study, the incidence rates of gastric cancer were 0.00%, 9.65%, 9.09% and 15.73%, respectively by the cut-off value determined through this fitting model. The incidence rate of gastric cancer in group D was significantly higher than that in group A according to the two cut-off values (both P < 0.05). Conclusion: Detection of serum G-17 combined with PG is valuable in screening for risk factors of gastric cancer. DOI:10.3781/j.issn.1000-7431.2017.33.455