Patients with negative anti-Helicobacter pylori antibody titer and high pepsinogen (PG) level (Group A) are regarded as having a low risk for gastric cancer.
However, gastric cancer cases are occasionally observed in this group.
Dr Masanori Ito and colleagues from Japan elucidated the clinical features of gastric neoplasm in Group A patients and reviewed advanced methods for mass screening.
A total of 271 gastric epithelial neoplasm patients were enrolled.
The research team classified them according to the Helicobacter pylori-pepsinogen system and determined the number of patients in each group.
After excluding trueHelicobacter pylori-negative cases from Group A, the team examined the differences between Group A and Group non-A.
Group A included 30 patients, and only 3 of these were true negative for Helicobacter pylori.
|Histologically, 89% had little inflammation|
The team observed that all patients in Group A exhibited endoscopic atrophy in the gastric corpus.
Serologically, these patients showed low gastrin, low pepsinogen II and high pepsinogen I/II ratio, indicative of post-eradication.
Histologically, 89% of these had little inflammation, and 96% were negative for Helicobacter pylori by immunohistochemistry.
The team observed no difference in the incidence of metachronous gastric tumors between Group A and Group non-A.
The discriminant function using gastrin and pepsinogens could distinguish these 27 patients from true Helicobacter pylori-negative controls with 85% sensitivity and 84% specificity.
Dr Ito's team concludes, "Group A included a certain number of patients with atrophic gastritis who were potentially at risk of gastric neoplasm development."
"Although evaluation of corpus atrophy is necessary for the identification of these patients, the discriminant function may be useful."