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The new modified ABCD method for gastric neoplasm screening

 Chan Hyuk Park  ;  Eun Hye Kim  ;  Da Hyun Jung  ;  Hyunsoo Chung  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
 GASTRIC CANCER, Vol.19(1) : 128-135, 2016 
Journal Title
Issue Date
Adenoma/diagnosis ; Adenoma/etiology ; Adenoma/pathology ; Aged ; Antibodies, Bacterial/blood ; Endoscopy, Gastrointestinal ; Female ; Gastrins/blood ; Helicobacter Infections/complications ; Helicobacter Infections/diagnosis* ; Helicobacter pylori/immunology ; Humans ; Immunoglobulin G/blood ; Male ; Middle Aged ; Pepsinogen A/blood* ; Pepsinogen C/blood* ; Retrospective Studies ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/etiology ; Stomach Neoplasms/pathology
ABCD method ; Gastric adenoma ; Gastric cancer ; IgG anti-Helicobacter pylori antibody ; Pepsinogen
BACKGROUND: The ABCD screening method was developed for risk stratification of gastric cancer. It is unclear whether the ABCD method can predict the risk of gastric neoplasms, including gastric adenomas, as observed for gastric cancer. We aimed to devise a modified ABCD method for predicting gastric neoplasms. METHODS: We reviewed 562 patients who had undergone upper gastrointestinal tract endoscopy and whose serum IgG anti-Helicobacter pylori antibody, gastrin, and pepsinogen (PG) I and PG II data were available. Patients were classified into the following four groups: H. pylori antibody negative and normal PG level (group A), H. pylori antibody positive and normal PG level (group B), H. pylori antibody positive and low PG level (group C), and H. pylori antibody negative and low PG level (group D). RESULTS: The PG I/PG II ratio was lower in patients with gastric neoplasms than in patients without these lesions (gastric adenoma vs gastric cancer vs no neoplasm, 3.7 ± 2.0 vs 3.8 ± 1.8 vs 4.9 ± 2.1, P < 0.001). The optimal cutoff values of the PG I/PG II ratio for predicting gastric neoplasms were 3.1 for H. pylori antibody negative patients and 4.1 for H. pylori antibody positive patients. A higher group grade was associated with a significantly higher proportion of gastric neoplasms [odds ratio (95 % confidence interval), group A, reference; group B, 1.783 (1.007-3.156); group C, 3.807 (2.382-6.085); and group D, 5.862 (2.427-14.155)]. CONCLUSIONS: The modified ABCD method using two different cutoff values according to the H. pylori antibody status was useful for predicting the presence of gastric neoplasms. This method might be a supplementary screening tool for both gastric adenoma and gastric cancer. However, further studies will be required to provide a definitive conclusion.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Jung, Da Hyun(정다현)
Chung, Hyun Soo(정현수)
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