Intervals of Endoscopic Screening of the Stomach -Relationship between Type of Helicobacter pylori-Associated Chronic Gastritis and Gastric Cancer Development

概要

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To perform the endoscopic screening of the stomach efficiently, it is necessary to settle the intervals of the examination according to the risk of gastric cancer development. Therefore, we examined acceptable intervals of endoscopic screening by analyzing the relationship between type of Helicobacter pylori (Hp)-associated chronic gastritis and gastric cancer development (1), and we estimated the intervals by using values of serum pepsinogens (2). We examined 1,526 people who received gastric endoscopy annually for the study 1, and 498 people who received gastric endoscopy and serum pepsinogens test for the study 2. Gastric cancer was developed in 36 patients in the study 1. The rates of gastric cancer development was 1.43% year, 0.75%· year, 0.049%·year and 0%·year, in the patients with corpus-predominant gastritis, in the patients with pangastritis, in the patients with antrum-dominant gastritis and in the Hp-negative subjects, respectively. The Hpnegative subjects and the patients with antrum-predominant gastritis may be low-risk of gastric cancer development, and the patients with corpus-predominant gastritis and with pangastritis may be high-risk. One of each 5 year screening may be enough for the low-risk group. Values of serum pepsinogens can distinguish the low-risk group and the high-risk group.