Affiliation:
1. Department of Epidemiology and Biostatistics, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Molecular Cancer Epidemiology of Tianjin Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Medical University Tianjin China
2. Tumor Etiology and Screening Department of Cancer Institute and General Surgery, Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, Key Laboratory of GI Cancer Etiology and Prevention in Liaoning Province The First Hospital of China Medical University Shenyang China
Abstract
AbstractBackgroundAlthough the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test‐negative individuals.MethodsA total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [−], PG [−]), Group B (Hp [+], PG [−]), Group C (Hp [+], PG [+]), and Group D (Hp [−], PG [+]). We used receiver‐operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China.ResultsIn the modified ABC method, we further classified Group B as low‐risk (Group B1) and high‐risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94–3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59–0.63) and improved risk reclassification (NRI = 0.11, p < .01). Similar results were observed in the validation dataset.ConclusionsThe modified ABC method can effectively identify high‐risk population for GC among Hp‐infected but sPG test‐negative participants in China.
Funder
National Basic Research Program of China
National Natural Science Foundation of China
Subject
Infectious Diseases,Gastroenterology,General Medicine
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献