Professor Yuan Yuan and colleagues from China assessed a serological biopsy using five stomach-specific circulating biomarkers—pepsinogen I, pepsinogen II, PGI/II ratio, anti-Helicobacter pylori (H. pylori) antibody, and gastrin-17 (G-17)—for identifying high-risk individuals and predicting risk of developing gastric cancer.
Among 12,112 participants with prospective follow-up from an ongoing population-based screening program using both serology and gastroscopy in China, the researchers conducted a multi-phase study involving a cross-sectional analysis, a follow-up analysis, and an integrative risk prediction modeling analysis.
|The 5 biomarkers combined yielded a C statistic of 0.803|
|American Journal of Gastroenterology|
In the cross-sectional analysis, the team evaluated 5 biomarkers including especially pepsinogen II, the pepsinogen I/II ratio, and H. pylori sero-positivity, that were associated with the presence of precancerous gastric lesions or gastric cancer at enrollment.
In the follow-up analysis, low pepsinogen I levels and pepsinogen I/II ratios were associated with higher risk of developing gastric cancer, and both low, and high G-17 levels were associated with higher risk of developing gastric cancer, suggesting a J-shaped association.
The researchers found that the 5 biomarkers combined yielded a C statistic of 0.803, and improved prediction beyond traditional risk factors for identifying precancerous lesions at enrollment, and higher serological biopsy scores based on the five biomarkers at enrollment were associated with higher risk of developing gastric cancer during follow-up.
Professor Yuan's team, "A serological biopsy composed of the 5 stomach-specific circulating biomarkers could be used to identify high-risk individuals for further diagnostic gastroscopy, and to stratify individuals’ risk of developing gastric cancer, and thus to guide targeted screening and precision prevention."