P57

• Main Authors: A. Belkovets, S. Kurilovich, O. Reshetnikov, Y. Ragino, M. Voevoda
• Format: Article
• Language: English
• Published: Elsevier 2015-11-01
• Series: EJC Supplements
• Online Access: http://www.sciencedirect.com/science/article/pii/S1359634915000099

Gastric cancer (GC) remains one of the most important gastrointestinal cancers worldwide. The incidence and mortality rate from GC in Russia is higher in comparison with other European countries and USA. It should be noted that riskometry for the GC doesn’t exist. Parallel assessment of pepsinogen I (PG I), pepsinogen II (PG II), PG I/PG II ratio and gastrin-17 (G-17), as well as antibodies to Helicobacter pylori is an exact and validated set of stomach-specific biomarkers that reflect the extent and grade of gastric atrophy as a main premalignant condition for GC. Aim: To study the diagnostic and predicting value of biomarkers of atrophic gastritis (AG) in retro-prospective cohort case-control study in Siberian population. Object and methods: General population sample was surveyed in Novosibirsk in 2003–2005 (10.000 subjects aged 45–69 years). Each serum sample was deeply frozen and stored. In 2008 and 2012 this database was compared with the data of the Population Cancer Registry. As a result of cross-sectional analysis of two databases 60 novel cases of GC were identified until 2011. For each case of GC, an appropriate control case was selected at the ratio 1:2 matching the area of residence, sex and age. Finally, 156 serum samples (52 – GC group and 104 – control group) were available for the analysis using a panel of serum biomarkers “Gastropanel” (Biohit, Finland). Criteria for “Gastropanel” in the diagnosis of AG were used: PG I <30μg/l, PG II <3μg/l, the ratio PG I/PG II <3, the level of basal G-17<1 pmol/l, and the presence of antibodies to H. pylori. Results: Mean level of biomarkers did not differ between those with, and without GC, with the exception for PG I/PGII ratio, which was significantly lower in GC group. Indicators of gastric atrophy (OR; 95% CI) were associated with GC for PG I (2.9; 1.3–6.4), PG II (9.0; 1.8–44.3), and PG I/PG II (3.3; 1.5–7.3), but neither for G-17 (0.7, 0.4–1.6), nor for the presence of antibodies to H. pylori (0.4; 0.1–1.3). Multivariate regression analysis including sex, age of the patients, all biomarkers of “Gastropanel” confirmed PG I and PGI/PGII ratio as the most powerful indicators in the model. Atrophy Index (AI) was calculated as a sum of abnormal parameters of gastric atrophy (PG I, PG I/PG II ratio and G-17, see Table, ∗p < 0.019; ∗∗p < 0.006). AI 3 (all biomarkers below normal range) was more common in GC patients than in controls. Groups Severity of atrophy (Atrophy Index score) (%) 3 2 1 0 Gastric cancer 14.0∗∗ 20.0 10.0 56.0 Control 2.2 10.8 11.8 75.3∗ Conclusion: As a first step in the development of GC riskometry was found that noninvasive set of serological biomarkers is an informative and non-expensive tool for the early detection of GC in population-based retrospective cohort survey in Siberian population. Low levels of PGI and PGI/PGII ratio were proven as the most valuable prognostic factors. The low level of G-17 as a single index did not significantly predict the risk of GC.