Value of Mass Screening of Serum Pepsinogen Test for Asian Population with High-risk Gastric Carcinoma: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 MADi-wa ¹ , NIUXiao-dong ¹ , TIANHong-liang ² , WANGWen-tao ¹ , LUXian-ming ¹ , SUHai-xia ¹ ,  JIANGLei ³

1. Second Clinical Medicine College Lanzhou University, Lanzhou 730000, China;
2. Department of Oncological Surgery, First Hospital, Lanzhou University, Lanzhou 730000, China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China;

Corresponding author：

JIANGLei, Email: goodjianglei@163.com

Keywords：

Pepsinogen; Gastric carcinoma; Screening; Systematic review; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20150031

Video：

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Objective To systematically review the value of mass screening of serum pepsinogen test for Asian population with high-risk gastric carcinoma. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data, VIP and CBM for diagnostic tests on serum pepsinogen test versus with pathological biopsy/X-ray examination (gold standard) between January 2004 and January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using Meta-DiSc software (version 1.4). Results A total of 15 studies involving 180 934 subjects were included. ROC curve showed "shoulder-arm shape" distribution. The results of Spearman correlation analysis suggested a significance of the threshold effect (P=0.001). The results of meta-analysis showed that, the area under curve (AUC) was 0.74. Conclusion Serum pepsinogen has good value in the screening of gastric carcinoma among Asian permanent residents. Due to limited quality of studies, the above conclusion should be verified by conducting more high quality studies.

Citation： MADi-wa, NIUXiao-dong, TIANHong-liang, WANGWen-tao, LUXian-ming, SUHai-xia, JIANGLei. Value of Mass Screening of Serum Pepsinogen Test for Asian Population with High-risk Gastric Carcinoma: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 176-180. doi: 10.7507/1672-2531.20150031 Copy

1.	Yanaoka K, Oka M, Mukoubayashi C, et al. Cancer high-risk subjects identified by serum pepsinogen tests:outcomes after 10-year follow-up in asymptomatic middle-aged males. Cancer Epide Bio & Prev, 2008, 17(4):838-845.
2.	胡靥, 房静远, 萧树东. 新世纪里胃癌的发病率能进一步降低吗? 胃肠病学, 2013, 18(1):2-5.
3.	郑朝旭, 郑荣寿, 陈万青. 中国2009年胃癌发病与死亡分析. 中国肿瘤, 2013, 22(5):327-332.
4.	Ohata H, Oka M, Yanaoka K, et al. Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography. Cancer, 2005, 96(10):713-720.
5.	于中麟, 冀明, 杨迅, 等. 血清胃蛋白酶原对胃癌普查的价值探讨. 中华消化内镜杂志, 2008, 25(10):512-515.
6.	刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定:用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4):296-306.
7.	张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学杂志, 2008, 8(2):97-100.
8.	吕艳丽, 李毅, 刘光顺, 等. 胃癌高发区血清胃蛋白酶原初筛加高危人群胃镜检查方案与直接胃镜筛查方案的效果比较. 中华肿瘤杂志, 2013, 35(5):394-397.
9.	张志镒, 吴正奇, 卢林芝, 等. 食管癌、胃癌均高发地区应用内镜对上消化道癌筛查的探讨. 中国肿瘤, 2012, 21(12):906-909.
10.	袁媛. 1997-2011年辽宁省庄河地区胃癌高危人群筛查效果评估. 中华肿瘤杂志, 2012, 34(7):538-542.
11.	徐巧莲, 万小勇, 杜燕, 等. 血清胃蛋白酶原检测在胃癌筛查中的价值. 胃肠病学, 2012, 17(10):614-617.
12.	魏树利, 常云波, 王建文. 胃蛋白酶原及其亚型含量测定在胃癌等胃部疾患中的诊断价值. 现代中西医结合杂志, 2012, 21(13):1414-1415.
13.	张志镒, 王贵齐, 吴正奇, 等. 血清胃蛋白酶原检测在胃癌及其癌前病变筛查中的价值. 世界华人消化杂志, 2011, 19(14):1511-1514.
14.	刘卫东, 赵永富, 王建玺, 等. 血清胃蛋白酶原及胃镜检查用于胃癌早诊筛查的探索性研究. 中华预防医学杂志, 2011, 45(8):752-753.
15.	相英花, 杨永耿, 熊元治, 等. 血清胃蛋白酶原筛查高原农牧区成年人胃癌前病变和胃癌标准的初步研究. 高原医学杂志, 2009, 19(2):19-23.
16.	Mizuno S, Kobayashi M, Tomita S, et al. Validation of the pepsinogen test method for gastric cancer screening using a followup study. Gastric Cancer, 2009, 12(3):158-163.
17.	Miki K, Fujishiro M, Kodashima S, et al. Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc, 2009, 21(2):78-81.
18.	Yanaoka K, Oka M, Mukoubayashi C, et al. Cancer high-risk subjects identified by serum pepsinogen tests:outcomes after 10-year follow-up in asymptomatic middle-aged males. Cancer Epide Bio & Prev, 2008, 17(4):838-845.
19.	Sun LP, Gong YH, Wang L, et al. Serum pepsinogen levels and their influencing factors:a population-based study in 6990 Chinese from North China. World J Gastroenterol, 2007, 13(48):6562-6567.
20.	张祥宏, 黄飚, 王俊灵, 等. 胃癌高发区居民血清胃蛋白酶原水平与胃黏膜病变的关系. 中华肿瘤杂志, 2006, 28(7):507-511.
21.	Ohata H, Oka M, Yanaoka K, et al. Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography. Cancer Sci, 2005, 96(10):713-720.
22.	王北宁, 杨剑, 徐东, 等. 胃蛋白酶原Ⅰ、Ⅱ的酶免疫分析. 标记免疫分析与临床, 2006, 13(3):162-164.
23.	Miki K, Ichinose M, Shimizu A, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn, 1987, 22(2):133-141.
24.	Dinis-Ribeiro M, Yamaki G, Miki K, et al. Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen, 2004, 11(3):141-147.

1. Yanaoka K, Oka M, Mukoubayashi C, et al. Cancer high-risk subjects identified by serum pepsinogen tests:outcomes after 10-year follow-up in asymptomatic middle-aged males. Cancer Epide Bio & Prev, 2008, 17(4):838-845.
2. 胡靥, 房静远, 萧树东. 新世纪里胃癌的发病率能进一步降低吗? 胃肠病学, 2013, 18(1):2-5.
3. 郑朝旭, 郑荣寿, 陈万青. 中国2009年胃癌发病与死亡分析. 中国肿瘤, 2013, 22(5):327-332.
4. Ohata H, Oka M, Yanaoka K, et al. Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography. Cancer, 2005, 96(10):713-720.
5. 于中麟, 冀明, 杨迅, 等. 血清胃蛋白酶原对胃癌普查的价值探讨. 中华消化内镜杂志, 2008, 25(10):512-515.
6. 刁骧, 艾昌林, 秦莉, 等译. QUADAS的制定:用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4):296-306.
7. 张天嵩, 钟文昭. Meta-DiSc软件在诊断试验Meta分析中的应用. 循证医学杂志, 2008, 8(2):97-100.
8. 吕艳丽, 李毅, 刘光顺, 等. 胃癌高发区血清胃蛋白酶原初筛加高危人群胃镜检查方案与直接胃镜筛查方案的效果比较. 中华肿瘤杂志, 2013, 35(5):394-397.
9. 张志镒, 吴正奇, 卢林芝, 等. 食管癌、胃癌均高发地区应用内镜对上消化道癌筛查的探讨. 中国肿瘤, 2012, 21(12):906-909.
10. 袁媛. 1997-2011年辽宁省庄河地区胃癌高危人群筛查效果评估. 中华肿瘤杂志, 2012, 34(7):538-542.
11. 徐巧莲, 万小勇, 杜燕, 等. 血清胃蛋白酶原检测在胃癌筛查中的价值. 胃肠病学, 2012, 17(10):614-617.
12. 魏树利, 常云波, 王建文. 胃蛋白酶原及其亚型含量测定在胃癌等胃部疾患中的诊断价值. 现代中西医结合杂志, 2012, 21(13):1414-1415.
13. 张志镒, 王贵齐, 吴正奇, 等. 血清胃蛋白酶原检测在胃癌及其癌前病变筛查中的价值. 世界华人消化杂志, 2011, 19(14):1511-1514.
14. 刘卫东, 赵永富, 王建玺, 等. 血清胃蛋白酶原及胃镜检查用于胃癌早诊筛查的探索性研究. 中华预防医学杂志, 2011, 45(8):752-753.
15. 相英花, 杨永耿, 熊元治, 等. 血清胃蛋白酶原筛查高原农牧区成年人胃癌前病变和胃癌标准的初步研究. 高原医学杂志, 2009, 19(2):19-23.
16. Mizuno S, Kobayashi M, Tomita S, et al. Validation of the pepsinogen test method for gastric cancer screening using a followup study. Gastric Cancer, 2009, 12(3):158-163.
17. Miki K, Fujishiro M, Kodashima S, et al. Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc, 2009, 21(2):78-81.
18. Yanaoka K, Oka M, Mukoubayashi C, et al. Cancer high-risk subjects identified by serum pepsinogen tests:outcomes after 10-year follow-up in asymptomatic middle-aged males. Cancer Epide Bio & Prev, 2008, 17(4):838-845.
19. Sun LP, Gong YH, Wang L, et al. Serum pepsinogen levels and their influencing factors:a population-based study in 6990 Chinese from North China. World J Gastroenterol, 2007, 13(48):6562-6567.
20. 张祥宏, 黄飚, 王俊灵, 等. 胃癌高发区居民血清胃蛋白酶原水平与胃黏膜病变的关系. 中华肿瘤杂志, 2006, 28(7):507-511.
21. Ohata H, Oka M, Yanaoka K, et al. Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography. Cancer Sci, 2005, 96(10):713-720.
22. 王北宁, 杨剑, 徐东, 等. 胃蛋白酶原Ⅰ、Ⅱ的酶免疫分析. 标记免疫分析与临床, 2006, 13(3):162-164.
23. Miki K, Ichinose M, Shimizu A, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn, 1987, 22(2):133-141.
24. Dinis-Ribeiro M, Yamaki G, Miki K, et al. Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen, 2004, 11(3):141-147.

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Value of Mass Screening of Serum Pepsinogen Test for Asian Population with High-risk Gastric Carcinoma: A Meta-analysis

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