Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study
Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within t...
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MDPI AG
2022-07-01
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| Online Access: | https://www.mdpi.com/2075-4418/12/7/1746 |
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| author | Claudia Robles Dace Rudzite Inese Polaka Olga Sjomina Lilian Tzivian Ilze Kikuste Ivars Tolmanis Aigars Vanags Sergejs Isajevs Inta Liepniece-Karele Danute Razuka-Ebela Sergej Parshutin Raul Murillo Rolando Herrero Jin Young Park Marcis Leja |
| author_facet | Claudia Robles Dace Rudzite Inese Polaka Olga Sjomina Lilian Tzivian Ilze Kikuste Ivars Tolmanis Aigars Vanags Sergejs Isajevs Inta Liepniece-Karele Danute Razuka-Ebela Sergej Parshutin Raul Murillo Rolando Herrero Jin Young Park Marcis Leja |
| author_sort | Claudia Robles |
| collection | DOAJ |
| description | Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage. |
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| language | English |
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| publishDate | 2022-07-01 |
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| series | Diagnostics |
| spelling | doaj.art-9ed29ad1c8d34ff4a65a20e62dfe16be2023-12-03T14:55:27ZengMDPI AGDiagnostics2075-44182022-07-01127174610.3390/diagnostics12071746Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot StudyClaudia Robles0Dace Rudzite1Inese Polaka2Olga Sjomina3Lilian Tzivian4Ilze Kikuste5Ivars Tolmanis6Aigars Vanags7Sergejs Isajevs8Inta Liepniece-Karele9Danute Razuka-Ebela10Sergej Parshutin11Raul Murillo12Rolando Herrero13Jin Young Park14Marcis Leja15Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, FranceInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaDigestive Diseases Centre GASTRO, 1586 Riga, LatviaDigestive Diseases Centre GASTRO, 1586 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaEarly Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, FranceEarly Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, FranceEarly Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, FranceInstitute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, LatviaIntroduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.https://www.mdpi.com/2075-4418/12/7/1746serum pepsinogensgastrin-17gastric cancer preventionscreeningpublic health |
| spellingShingle | Claudia Robles Dace Rudzite Inese Polaka Olga Sjomina Lilian Tzivian Ilze Kikuste Ivars Tolmanis Aigars Vanags Sergejs Isajevs Inta Liepniece-Karele Danute Razuka-Ebela Sergej Parshutin Raul Murillo Rolando Herrero Jin Young Park Marcis Leja Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study Diagnostics serum pepsinogens gastrin-17 gastric cancer prevention screening public health |
| title | Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study |
| title_full | Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study |
| title_fullStr | Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study |
| title_full_unstemmed | Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study |
| title_short | Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study |
| title_sort | assessment of serum pepsinogens with and without co testing with gastrin 17 in gastric cancer risk assessment results from the gistar pilot study |
| topic | serum pepsinogens gastrin-17 gastric cancer prevention screening public health |
| url | https://www.mdpi.com/2075-4418/12/7/1746 |
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