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Meta-analysis on the validity of pepsinogen test for gastric carcinoma, clysplasia or chronic atrophic gastritis screening

Title
Meta-analysis on the validity of pepsinogen test for gastric carcinoma, clysplasia or chronic atrophic gastritis screening
Type
Another Publication in an International Scientific Journal
Year
2004
Authors
Yamaki, G
(Author)
Other
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Miki, K
(Author)
Other
The person does not belong to the institution. The person does not belong to the institution. The person does not belong to the institution. Without AUTHENTICUS Without ORCID
Matsukawa, M
(Author)
Other
The person does not belong to the institution. The person does not belong to the institution. The person does not belong to the institution. Without AUTHENTICUS Without ORCID
Kurihara, M
(Author)
Other
The person does not belong to the institution. The person does not belong to the institution. The person does not belong to the institution. Without AUTHENTICUS Without ORCID
Journal
Vol. 11
Pages: 141-147
ISSN: 0969-1413
Publisher: SAGE
Other information
Authenticus ID: P-000-D32
Abstract (EN): Aim: To assess the validity of the measurement of pepsinogen I and 11 as a screening test for gastric cancer and pre-malignant lesions, namely low-grade dysplasia, both in the general population and in selected groups of patients. Methods: A meta-analysis of sensitivity and specificity results from individual papers on the use of the pepsinogen test. An intrinsic cut-off effect was assumed and a random effect model was used for pooling. Results: Forty-two data sets were included: 27 (64%) population-based screening studies (n=296,553) and 15 (36%) sets of selected individuals (n=4385). Homogenous sensitivity and diagnostic odds ratio (DOR) estimates were found in studies using both pepsinogen I levels and pepsinogen I/II ratio calculations. Pooled pairs of sensitivity and false positive rates (FPr) for pepsinogen I less than or equal to 70; pepsinogen I/II ratio less than or equal to 3, pepsinogen I less than or equal to 50; pepsinogen I/II ratio less than or equal to 3, and pepsinogen I less than or equal to 30; pepsinogen I/II ratio less than or equal to2, were sensitivity 77%/FPr 27%, sensitivity 68%/FPr 31%, and sensitivity 52%/FPr 84%, respectively. Positive predictive values (PPV) varied between 0.77% and 1.25%, and negative predictive values (NPV) varied between 99.08% and 99.90%. In selected groups, pooling was only possible when considering pepsinogen I less than or equal to 70; pepsinogen I/II ratio less than or equal to 3: giving sensitivity 57%, specificity 80%, PPV 15% and NPV 83%. As for the diagnosis of dysplasia, studies considering pepsinogen I <50; pepsinogen I/II ratio <3 obtained sensitivity 65% and specificity ranging from 74%-85%, both with NPV >95%. Conclusion: Pepsinogen test definition should include pepsinogen I/II ratio as consistency was obtained, both in population based studies and in selected groups for those studies that used pepsinogen I serum levels together with pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Further studies of this test in the management of high-risk patients.. seem to be worthwhile.
Language: English
Type (Professor's evaluation): Scientific
No. of pages: 7
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