Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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The Role of Serum Pepsinogen in Detection of Gastric Cancer

위암 검출에서 혈중 Pepsinogen검사의 의의

  • Ryu, Hyong-Kyun (Department of Surgery, Pohang St. Mary's Hospital) ;
  • Park, Jeon-Woo (Department of Surgery, School of Medicine, Daegu Catholic University) ;
  • Lee, Keon-Ho (Department of Family Medicine, School of Medicine, Daegu Catholic University) ;
  • Jeon, Chang-Ho (Department of Laboratory Medicine, School of Medicine, Daegu Catholic University) ;
  • Lee, Ho-Joon (Department of Radiation Oncology, School of Medicine, Daegu Catholic University) ;
  • Chae, Hyun-Dong (Department of Surgery, School of Medicine, Daegu Catholic University)
  • 류형균 (포항성모병원 외과) ;
  • 박전우 (대구가톨릭대학교 의과대학 외과학교실) ;
  • 이건호 (대구가톨릭대학교 의과대학 가정의학교실) ;
  • 전창호 (대구가톨릭대학교 의과대학 진단검사의학교실) ;
  • 이호준 (대구가톨릭대학교 의과대학 방사선종양학교실) ;
  • 채현동 (대구가톨릭대학교 의과대학 외과학교실)
  • Received : 2009.09.07
  • Accepted : 2009.10.21
  • Published : 2009.12.30
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Abstract

Purpose: This study was done to determine the usefulness of serum pepsinogen (PG) levels as a screening method for gastric cancer, and to assess the relationships between serum PG and clinicopathologic factors of gastric adenocarcinoma. Materials and Methods: Serum PG concentrations were measured in 94 subjects who were classified into (a) a control group (50 subjects) without abnormal endoscopic finding on a health checkup, or (b) a gastric cancer group (44 subjects) who had surgery at Daegu Catholic University Hospital between Nov. 2008 and May 2009. Receiver operator characteristic curves were utilized to select the most suitable test. Using different cutoff points, sensitivity and specificity were calculated. We compared preoperative serum PG levels with several clinicopathologic findings for patients with gastric adenocarcinoma. Results: The Serum PG I：II ratio was the most useful as a screening test. The sensitivity and specificity of PG screening for gastric cancer were, respectively, 81.8% and 82%. The cut off point correlated with the type of intestinal cancer (Lauren classification; P=0.003), tumor stage (P=0.001), and gastric adenocarcinoma with peritumoral chronic atrophic gastritis (P=0.036). Conclusion: Serum PG levels were found to be a potentially useful screening test and to correlate with clinicopathologic factors in gastric cancer patients. But, in order to use serum PG found in a health checkup for gastric cancer as a clinical application a large scale study is recommended.

목적: 정상인과 위암 환자의 혈중 Pepsinogen (PG)농도를 비교 분석하여 선별검사로서 이용가능성 및 위암의 임상 조직학적 요소와의 상관 관계를 알아보고자 하였다. 대상 및 방법: 2008년 11월부터 2009년 5월까지 대구가톨릭대학병원에서 내시경상 특이소견이 없는 정상인과 위선암 환자의 수술 전 혈중 PG농도를 측정하였다. 위암진단의 선별검사로서의 이용가능성을 알아 보기 위해 receiver operator characteristics (ROC) curves를 이용하여 가장 유용한 검사법을 선별하였고, 위암 조직과의 상관관계를 알아보기 위해 특정 기준치에 따라 임상 조직학적 요소를 비교 분석하였다. 결과:선별검사로서 혈중 PG I/II 비율이 가장 유용하였고, 기준치에 따른 민감도, 특이도는 81.8%, 82%로 나타났다. 임상 조직학적 요소 중 Lauren분류에 따른 종양의 아형(P=0.003), TNM 병기의 T 병기(P=0.001), 및 종양주위의 만성 위축성 위염(P=0.036)을 동반한 위선암이 특정기준치(cut off point)값에 의미 있는 관련을 보였다. 결론: 본 연구는 정상 대조군의 수가 적어 선별검사로서 혈중 PG측정의 유용성을 논하기에는 부족하나, 위암의 선별검사로서 이용 가능성 및 임상 조직학적 요소와 의미 있는 관련을 보여 차후 추가연구가 필요할 것으로 생각한다.

Keywords

References

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