Evaluation of the serum pepsinogen test in operative cases of gastric cancer

概要

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We reviewed the pros and cons of the serum pepsinogen test as a mass screening modality for gastric cancer. The serum pepsinogen test was performed preoperatively in 217 gastric cancer cases. The results were (+): 58.9%, (+-): 15.7%, (-): 25.4% of all cases. There were no significant differences among age, depth of invasion, lymph node metastasis, curative grade, histological type, tumor location and tumor size. In the asymptomatic group, 75.8% of cases were referred from mass screening. There was only one case (0.46%) of asymptomatic advanced gastric cancer. Three cases had been overlooked by mass screening using barium X-rays, but all of these cases were positive for the serum pepsinogen test. In conclusion, the serum pepsinogen test may provide a distinct index of the high risk group for gastric cancer, and it is useful for detection of cases overlooked by conventional mass screening. Also the serum pepsinogen test is considered to be an objective and minimally invasive examination, and thus it might contribute to improve the participation rate of mass screening for gastric cancer.