Evaluation of a mass screening program for stomach cancer with a case-control study design. systematically searched from the inception dates to November 22, 2017, using the keywords antibody and serum PG concentration showed significant changes under the different status of infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric Rabbit polyclonal to PARP cancer in clinic. In addition, anti-antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval. Conclusions: The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for antibody and Ethylparaben serum PG concentration require further modification. Antibody, Pepsinogens, Risk Stratification, Stomach Neoplasms ABC(PG) ABC PubMed201711 22 . INTRODUCTION Gastric cancer is still the leading cause of cancer-related deaths all over the Ethylparaben world, especially in the countries of East Asia, such as Japan and China.[1,2,3] Correa[4] pointed out that the human gastric carcinogenesis is a slow progressive, multistep, and multifactorial pathology process. The multistep process is composed of chronic superficial gastritis, atrophy gastritis, intestinal metaplasia (IM), dysplasia, and adenocarcinoma.[5] Pathologically, gastric cancer is divided as intestinal type or diffuse type according to Lauren’s classification.[6] Similarly, multifactorial process involves infection and excessive ingestion of salt and nitrate.[7] Two significant risk factors of infection and atrophic gastritis are considered to contribute to the development and deterioration of gastric cancer.[8,9] What’s worse, the most patients with gastric cancer at early stage Ethylparaben (EGC) are insidious and asymptomatic.[10] Due to lack of standardized screening system, many patients were advanced to the late stage of gastric carcinoma even at the time the endoscopy was first performed in clinical setting. At that time, the prognosis becomes very poor and the 5-year survival rate after surgery is only 20C30% compared with 90% in patient with EGC.[11] Therefore, it is important to establish an efficient and better cost-effective screening method Ethylparaben for early detection of gastric cancer in regular mass survey.[12] Compare to any other country in the world, as a high risk nation of gastric cancer, Japan has established a relatively better screening system and shown the obvious achievements.[13,14] In Japan, a gastric cancer screening program, named photofluorography, was launched in 1960.[15] Together with other traditional screening methods including double-contrast barium X-rays or panendoscopy, it has been wildly adopted throughout the country.[16] However, these traditional methods leave much more to be desired. They require further efforts in aspects of detection rate and economic cost improvement.[17] Gastroscopy in combination with gastric mucosa biopsies is regarded as a gold standard model for diagnosis of gastric cancer.[18] However, it is hesitantly accepted by patients because it is an invasive procedure and may induce the discomfort. In addition, it is not suitable for large-scale survey as well due to the high cost consumption. On the contrary, it is advisable to Ethylparaben make the risk stratification for gastric cancer first by other noninvasive tests. In recent years, a number of noninvasive diagnosis tests are developed, such as reevaluation of conventional serum markers, new biomarkers, circulating tumor cell and cell-free nucleic acids, tumor-associated autoantibodies, and exhaled breath analysis.[19] A new mass screening named ABC method which incorporates the assay of antibody and serum pepsinogen (PG) has been implemented in Nishitokyo city from 2011 on the initiative of Nishitokyo Medical Association.[20] In comparison of the conventional mass screening, the ABC method not only increases the EGC detection rate but also reduces the screening cost.[21,22,23] INFECTION Discovered by Marshall and Warren in 1982, is regarded as a strong cancerogen and a trigger of gastric cancer cascade.[24] Approximately 70% of gastric cancers are related to infection which is called status. For example, Tsai and Yoon out of the gastric mucosa, the possibility of false-negative test results could significantly increase resulting in the different proportion of HPNGC. In other word, 70% of gastric cancer can be prevented potentially by removal of infection.[30] When infected by antibody titers are related to the immune response intensity of each host and the density of colonization.[32] The stronger immune response is, the higher antibody titers are. However, the controversy is raised whether immune suppression in advanced cancer impacts the titers of antibody.[33] The relationship between antibody titer and the density of colonization is clear.[32] The titer of antibody is significantly declined when the bacteria are successfully eradicated or spontaneously subsided.[34] Accordingly, antibody titer can be used to evaluate the density of colonization and the status of infection. Patients with antibody titer 10 U/ml (E-plate Eiken Hp antibody: enzyme immunoassay method) were categorized as the infection-positive group based on manufacturer’s recommended cutoff value, with.