Helicobacter pylori infection and gastric atrophy are both risk factors for gastric cancer.
Dr Watabe and colleagues from Japan elucidated the natural history of gastric cancer development according to H pylori infection and gastric atrophy status.
The researchers identified a total of 9293 participants in a mass health appraisal programme for inclusion in the present prospective cohort study of which 6983 revisited the follow up programme.
The research team reported that subjects were classified into 4 groups according to serological status at initial endoscopy.
The team indicated that Group A with 3324 patients had "normal" pepsinogen and were negative for H pylori antibody whilst 2134 in Group B had "normal" pepsinogen and were positive for H pylori antibody.
|The annual incidence of gastric cancer was 0.04% in Group A and 0.60% in Group D|
1082 patients in Group C had "atrophic" pepsinogen and were positive for H pylori antibody.
The team noted that 443 patients in Group D had "atrophic" pepsinogen and were negative for H pylori antibody.
The researchers determined the incidence of gastric cancer by annual endoscopic examination.
The mean duration of follow up was 5 years and the average number of endoscopic examinations was 5.
The researchers found that the annual incidence of gastric cancer was 0.04%, 0.06%, 0.35%, and 0.60% in Groups A, B, C, and D, respectively.
In addition, the team compared hazard ratios, which was 1 in Group A, 6 in Group B and 8 in Groups C, and D.
Using multivariate analysis, the researchers found that age, sex, and "group" significantly served as independent valuables.
Dr Watabe's team concluded, “The combination of serum pepsinogen and anti-H pylori antibody provides a good predictive marker for the development of gastric cancer.”