AOKI Kazuo Oita Medical University, Department of Public Health and Hygiene, Research Associate, 医学部, 助手 (60201282)
MISUMI Junichi Oita Medical University, Department of Public Health and Hygiene, Professor, 医学部, 教授 (40109658)
|Budget Amount *help
¥2,700,000 (Direct Cost: ¥2,700,000)
Fiscal Year 1999: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1998: ¥2,200,000 (Direct Cost: ¥2,200,000)
One hundred and twenty three patients with suspected gastric cancer underwent gastrointestinal fiberscopic examination as well as biopsy examination and the diagnosis of gastric cancer was confirmed in all patients. Among these 123 cases, 64 had early and 59 had advanced gastric cancer. Fasting blood samples collected from these subjects after gastrointestinal fiberscopic examination were frozen and kept at -80C in our department, after serum separation by centrifugation, until measurement of serum pepsinogen as well as gastric levels and anti-body titers to Helicobcter pylori. Control subjects were selected as sex and age-matched pairs of the above gastric cases from over 4,000 residents of Oita prefecture (which has an average gastric cancer mortality rate) who tested negative for gastric lesions at regular health checkups, Data were compared between men and women and between subjects aged <60 and ≧60 and among the control group, according to the stage of gastric cancer.
we obtained t
he following results from this gastric cancer.
1. The ratios of PG I/II in gastric cancer cases decreased significantly in both men and women compared with control subjects. The serum gastrin values in case subjects also decreased significantly compared with control subjects.
2. Youden's indexes for gastric cancer cases were calculated according to sex, age and the stage of gastric cancer and the maximum Youden's index in each category was adopted as the cutoff level for gastric cancer screening using serum pepsinogens. The maximal Youden's index in all gastric cancer cases was 0.37, corresponding to a cutoff levels of PG<40(μg/l) and PG I/II <35. The sensitivity and specificity for gastric cancer cases of these cutoff levels were 0.50 and 0.87, respectively. Therefore, gastric cancer screening method using serum gastrin values combined with serum pepsinogen was suggested as more effective than using only serum pepsinogens.
3. The relationship between serum pepsinogens, the ratio of PG I/II as well as serum gastrin and smoking habit, alcohol consumption, present history of gastrointestinal diseases, past history of gastrointestinal diseases, sex together with age were analysis as explanatory variables by using multiple regression model. Only past history and age combined with past history were significant explanatory variables to PG I and PG II, respectively and furthermore, sex and age were significant explanatory variables to the ratio of PG I/II. On the other hand, four factors namely sex, age, present history, and past history were significant explanatory variables to gastrin.
4. Positivities to Helicobacter pylori increased with age in both men women, and total positivity to Helicobacter pylori in all control subjects was 66.9%. Less