Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test‐negative individuals

Background Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially amo...

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Veröffentlicht in:Helicobacter (Cambridge, Mass.) Mass.), 2023-06, Vol.28 (3), p.e12966-n/a
Hauptverfasser: Sheng, Chao, Sun, Liping, Lyu, Zhangyan, Li, Limin, Zhang, Yuhao, Zhang, Yu, Zhang, Yacong, Dai, Hongji, Huang, Yubei, Song, Fengju, Yuan, Yuan, Chen, Kexin
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container_title Helicobacter (Cambridge, Mass.)
container_volume 28
creator Sheng, Chao
Sun, Liping
Lyu, Zhangyan
Li, Limin
Zhang, Yuhao
Zhang, Yu
Zhang, Yacong
Dai, Hongji
Huang, Yubei
Song, Fengju
Yuan, Yuan
Chen, Kexin
description Background Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test‐negative individuals. Methods A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [−], PG [−]), Group B (Hp [+], PG [−]), Group C (Hp [+], PG [+]), and Group D (Hp [−], PG [+]). We used receiver‐operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. Results In the modified ABC method, we further classified Group B as low‐risk (Group B1) and high‐risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94–3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59–0.63) and improved risk reclassification (NRI = 0.11, p 
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We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test‐negative individuals. Methods A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [−], PG [−]), Group B (Hp [+], PG [−]), Group C (Hp [+], PG [+]), and Group D (Hp [−], PG [+]). We used receiver‐operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. Results In the modified ABC method, we further classified Group B as low‐risk (Group B1) and high‐risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94–3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59–0.63) and improved risk reclassification (NRI = 0.11, p &lt; .01). Similar results were observed in the validation dataset. Conclusions The modified ABC method can effectively identify high‐risk population for GC among Hp‐infected but sPG test‐negative participants in China.</description><identifier>ISSN: 1083-4389</identifier><identifier>EISSN: 1523-5378</identifier><identifier>DOI: 10.1111/hel.12966</identifier><identifier>PMID: 36941759</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>ABC method ; cancer screening ; Gastric cancer ; Helicobacter Infections - diagnosis ; Helicobacter pylori ; Heterogeneity ; Histology ; Humans ; Pepsinogen A ; pepsinogens ; Reclassification ; Risk ; Risk Factors ; Risk groups ; ROC Curve ; Screening ; Stomach Neoplasms - diagnosis ; Subgroups</subject><ispartof>Helicobacter (Cambridge, Mass.), 2023-06, Vol.28 (3), p.e12966-n/a</ispartof><rights>2023 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2023 John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-ce03a080bb200b206732dc1a3000d905335297e5b55c8aae82442e887e5a9a1d3</citedby><cites>FETCH-LOGICAL-c3536-ce03a080bb200b206732dc1a3000d905335297e5b55c8aae82442e887e5a9a1d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhel.12966$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhel.12966$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36941759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sheng, Chao</creatorcontrib><creatorcontrib>Sun, Liping</creatorcontrib><creatorcontrib>Lyu, Zhangyan</creatorcontrib><creatorcontrib>Li, Limin</creatorcontrib><creatorcontrib>Zhang, Yuhao</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Zhang, Yacong</creatorcontrib><creatorcontrib>Dai, Hongji</creatorcontrib><creatorcontrib>Huang, Yubei</creatorcontrib><creatorcontrib>Song, Fengju</creatorcontrib><creatorcontrib>Yuan, Yuan</creatorcontrib><creatorcontrib>Chen, Kexin</creatorcontrib><title>Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test‐negative individuals</title><title>Helicobacter (Cambridge, Mass.)</title><addtitle>Helicobacter</addtitle><description>Background Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test‐negative individuals. Methods A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [−], PG [−]), Group B (Hp [+], PG [−]), Group C (Hp [+], PG [+]), and Group D (Hp [−], PG [+]). We used receiver‐operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. Results In the modified ABC method, we further classified Group B as low‐risk (Group B1) and high‐risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94–3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59–0.63) and improved risk reclassification (NRI = 0.11, p &lt; .01). Similar results were observed in the validation dataset. Conclusions The modified ABC method can effectively identify high‐risk population for GC among Hp‐infected but sPG test‐negative participants in China.</description><subject>ABC method</subject><subject>cancer screening</subject><subject>Gastric cancer</subject><subject>Helicobacter Infections - diagnosis</subject><subject>Helicobacter pylori</subject><subject>Heterogeneity</subject><subject>Histology</subject><subject>Humans</subject><subject>Pepsinogen A</subject><subject>pepsinogens</subject><subject>Reclassification</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>ROC Curve</subject><subject>Screening</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Subgroups</subject><issn>1083-4389</issn><issn>1523-5378</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1O3DAUha2qVaHTLngBZKkbugjjnzixlzAMTKWRumnXlhPfDEZJnNrJwOx4BJ6RJ8EwwKJSLVn32vp0dO49CB1RckrTmV9De0qZKooP6JAKxjPBS_kx9UTyLOdSHaAvMd4QQgTP1Wd0wAuV01KoQ3R3AVto_dBBP2LfYIM7b13jwOKz8wXuYLz2FpvO9xu8gtbVvjL1CAEPu9YHh13fQHpbXE0jjhCmDg8wRNf7DfR4hDg-3j_0sDGj20Kirds6O5k2fkWfmlTg22udoT-Xy9-LVbb-dfVzcbbOai54kdVAuCGSVBUjJN2i5MzW1PA0jFVpHi6YKkFUQtTSGJAszxlImb6MMtTyGTrZ6w7B_52SH925WEPbmh78FDUrpWI8J5wm9Ps_6I2fQp_caSaJ4lQWxTP1Y0_VwccYoNFDcJ0JO02Jfo5Dpzj0SxyJPX5VnKoO7Dv5tv8EzPfArWth938lvVqu95JPeMWVJw</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Sheng, Chao</creator><creator>Sun, Liping</creator><creator>Lyu, Zhangyan</creator><creator>Li, Limin</creator><creator>Zhang, Yuhao</creator><creator>Zhang, Yu</creator><creator>Zhang, Yacong</creator><creator>Dai, Hongji</creator><creator>Huang, Yubei</creator><creator>Song, Fengju</creator><creator>Yuan, Yuan</creator><creator>Chen, Kexin</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>202306</creationdate><title>Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test‐negative individuals</title><author>Sheng, Chao ; Sun, Liping ; Lyu, Zhangyan ; Li, Limin ; Zhang, Yuhao ; Zhang, Yu ; Zhang, Yacong ; Dai, Hongji ; Huang, Yubei ; Song, Fengju ; Yuan, Yuan ; Chen, Kexin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-ce03a080bb200b206732dc1a3000d905335297e5b55c8aae82442e887e5a9a1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>ABC method</topic><topic>cancer screening</topic><topic>Gastric cancer</topic><topic>Helicobacter Infections - diagnosis</topic><topic>Helicobacter pylori</topic><topic>Heterogeneity</topic><topic>Histology</topic><topic>Humans</topic><topic>Pepsinogen A</topic><topic>pepsinogens</topic><topic>Reclassification</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>ROC Curve</topic><topic>Screening</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Subgroups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sheng, Chao</creatorcontrib><creatorcontrib>Sun, Liping</creatorcontrib><creatorcontrib>Lyu, Zhangyan</creatorcontrib><creatorcontrib>Li, Limin</creatorcontrib><creatorcontrib>Zhang, Yuhao</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Zhang, Yacong</creatorcontrib><creatorcontrib>Dai, Hongji</creatorcontrib><creatorcontrib>Huang, Yubei</creatorcontrib><creatorcontrib>Song, Fengju</creatorcontrib><creatorcontrib>Yuan, Yuan</creatorcontrib><creatorcontrib>Chen, Kexin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Helicobacter (Cambridge, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sheng, Chao</au><au>Sun, Liping</au><au>Lyu, Zhangyan</au><au>Li, Limin</au><au>Zhang, Yuhao</au><au>Zhang, Yu</au><au>Zhang, Yacong</au><au>Dai, Hongji</au><au>Huang, Yubei</au><au>Song, Fengju</au><au>Yuan, Yuan</au><au>Chen, Kexin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test‐negative individuals</atitle><jtitle>Helicobacter (Cambridge, Mass.)</jtitle><addtitle>Helicobacter</addtitle><date>2023-06</date><risdate>2023</risdate><volume>28</volume><issue>3</issue><spage>e12966</spage><epage>n/a</epage><pages>e12966-n/a</pages><issn>1083-4389</issn><eissn>1523-5378</eissn><abstract>Background Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test‐negative individuals. Methods A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [−], PG [−]), Group B (Hp [+], PG [−]), Group C (Hp [+], PG [+]), and Group D (Hp [−], PG [+]). We used receiver‐operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. Results In the modified ABC method, we further classified Group B as low‐risk (Group B1) and high‐risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94–3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59–0.63) and improved risk reclassification (NRI = 0.11, p &lt; .01). Similar results were observed in the validation dataset. Conclusions The modified ABC method can effectively identify high‐risk population for GC among Hp‐infected but sPG test‐negative participants in China.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36941759</pmid><doi>10.1111/hel.12966</doi><tpages>11</tpages></addata></record>
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subjects ABC method
cancer screening
Gastric cancer
Helicobacter Infections - diagnosis
Helicobacter pylori
Heterogeneity
Histology
Humans
Pepsinogen A
pepsinogens
Reclassification
Risk
Risk Factors
Risk groups
ROC Curve
Screening
Stomach Neoplasms - diagnosis
Subgroups
title Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test‐negative individuals
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