Serological Tests for Detection of Gastric Precancerous Lesions and Gastric Cancer

Aim: to present current information on serological screening approaches for precancerous gastric diseases and early gastric cancer.

Key points. Gastric cancer is one of the most common malignant tumors. Advanced stage of the tumor at the time of diagnosis determines an unfavorable prognosis in a significant proportion of patients. A real strategy for reducing both the incidence of gastric cancer and mortality rate is the introduction of cost-effective screening methods for atrophic gastritis associated with Helicobacter pylori (H. pylori) as a precancerous condition of the stomach. As an alternative to endoscopic examination of the stomach, approaches based on the evaluation of serological markers associated with H. pylori infection and reflecting the state of the gastric mucosa are currently proposed for laboratory screening: serum levels of antibodies to H. pylori, pepsinogen I, pepsinogen II and gastrin 17. Tests combining these markers, GastroPanel®, ABC and New ABC methods, as well as some of their modifications, are currently being widely studied as a tool for atrophic gastritis or gastric cancer risk group selection for further endoscopic examination.

Conclusion. An ensemble of serological markers, pepsinogen I, pepsinogen II, gastrin 17, and antibodies to H. pylori, allows for identifying atrophic gastritis with relatively high reliability, and considering additional factors, a high-risk group for the presence of gastric cancer. To achieve optimal medical and economic efficiency, it is necessary to improve the criteria for interpreting test results and including subjects in screening programs.

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