Performance evaluation of four prediction models for risk stratification in gastric cancer screening among a high-risk population in China

Hu, Yue; Bao, Haibiao; Jin, Haifeng; Jin, Zhao; Xu, Yi; Huang, Xuan; Liu, Shan; Lü, Bin

doi:10.1007/s10120-021-01204-6

Cited by 13 publications

(15 citation statements)

References 17 publications

(40 reference statements)

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“…6 risk factors were identified and included based on statistical analysis in this study: patient gender, lesion size, location, border line, number, and erosion. A national multicenter study 13 , 14 showed that gender was an independent risk factor for high-risk gastric cancer, with OR 2.52 (1.92 to 3.30), P < .001, which was consistent with our results. However, our results indicated that there was no significant correlation between gastric LGIN progression and age.…”

Section: Discussionsupporting

confidence: 92%

Establishment and Validation of a Pathologic Upgrade Prediction Nomogram Model for Gastric Low-Grade Intraepithelial Neoplasia Patients After the Eradication ofHelicobacter pylori

Ruan

Zhu

et al. 2022

Cancer Control

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Background As yet, there is no unified method of treatment for the evaluation and management of gastric low-grade intraepithelial neoplasia (LGIN) worldwide. Methods Patients with gastric LGIN who had been treated with Helicobacter pylori eradication were gathered retrospectively. Based on several relevant characteristics described and analyzed by LASSO regression analysis and multivariable logistic regression, a prediction nomogram model was established. C-index, the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA) were adopted to evaluate the accuracy and reliability of the model. Results A total of 309 patients with LGIN were randomly divided into the training groups and the validation groups. LASSO regression analysis and multivariable logistic regression identified that 6 variables including gender, size, location, borderline, number, and erosion were independent risk factors. The nomogram model displayed good discrimination with a C-index of .765 (95% confidence interval: .702-.828). The accuracy and reliability of the model were also verified by an AUC of .764 in the training group and .757 in the validation group. Meanwhile, the calibration curve and the DCA suggested that the predictive nomogram had promising accuracy and clinical utility. Conclusions A predictive nomogram model was constructed and proved to be clinically applicable to identify high-risk groups with possible pathologic upgrade in patients with gastric LGIN. Since it is regarded that strengthening follow-up or endoscopic treatment of high-risk patients may contribute to improving the detection rate or reducing the incidence of gastric cancer, the predictive nomogram model provides a reliable basis for the treatment of LGIN.

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Section: Discussionsupporting

confidence: 92%

Establishment and Validation of a Pathologic Upgrade Prediction Nomogram Model for Gastric Low-Grade Intraepithelial Neoplasia Patients After the Eradication ofHelicobacter pylori

Ruan

Zhu

et al. 2022

Cancer Control

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“…This nationwide study successfully developed and validated prediction rule identifying individuals at a higher risk in a Chinese high-risk population, which needed to receive further gastroscopy. Compared to ABC method ( Miki, 2011 ), five markers-based method ( Tu et al., 2017 ), the prediction model of seven variables ( Cai et al., 2019 ) showed higher Area Under the Curve and Youden index values, which was further confirmed by a retrospective analysis of data from the Provincial Gastric Cancer Screening Program with 97, 541 individuals included ( Hu et al., 2021 ). A future large population-based screening project should be launched to test and validate its efficacy of novel GC risk prediction rule.…”

Section: The Stratification Of Risk For Gc In the Chinese Gc Risk Pop...mentioning

confidence: 72%

The management of Helicobacter pylori infection and prevention and control of gastric cancer in China

Zhu

Lü

2022

Front. Cell. Infect. Microbiol.

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Helicobacter pylori (H. pylori) infection, a type-1 carcinogen, was closely associated with gastric cancer (GC). Successfully eradicating H. pylori infection could reduce the incidence of GC. China was a country with high incidence of GC and high prevalence of H. pylori infection. Nearly half of worldwide GC new cases and deaths attributed to H. pylori infection occurred in China. H. pylori prevalence varied over time with the improvement of socioeconomic status and sanitary conditions. The knowledge of antibiotic resistance rate in time was important to guide the clinical choice of antibiotics use in the regimens. With the publication of five Chinese consensus reports on the management of H. pylori infection and the effort of public preach of H. pylori-related knowledge, the standardization of H. pylori diagnosis and treatment by clinicians was improved. Bismuth-containing quadruple therapy was widely applied in clinical practice of H. pylori eradication because of high efficacy and safety. High-dose Proton Pump Inhibitor-amoxicillin dual therapy or vonoprazan-amoxicillin dual therapy showed comparable efficacy and lower side effects than bismuth-containing quadruple therapy, which were the alternative choice. The diagnosis rate of early GC was low and distinguishing Chinese GC risk population for the further endoscopy screening was important. Efforts have been done to establish prediction models to stratify GC risk in the Chinese GC risk population. We reviewed the current situation of the management of H. pylori infection and prevention and control of GC in China here.

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“…However, several population‐based studies have shown significant country‐specific differences in the proportions of ABCD groups according to the ABC method between Japan and China 11–19 . Compared with Japan, a larger proportion of individuals were classified as Group B (Hp [+] and PG [−]) in China.…”

Section: Introductionmentioning

confidence: 99%

“…10 However, several population-based studies have shown significant country-specific differences in the proportions of ABCD groups according to the ABC method between Japan and China. [11][12][13][14][15][16][17][18][19] Compared with Japan, a larger proportion of individuals were classified as Group B (Hp [+] and PG [−]) in China. Therefore, screening gastroscopy cannot be offered to all participants in Group B due to the high costs in China.…”

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confidence: 99%

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

et al. 2023

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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 < .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.

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Performance evaluation of four prediction models for risk stratification in gastric cancer screening among a high-risk population in China

Cited by 13 publications

References 17 publications

Establishment and Validation of a Pathologic Upgrade Prediction Nomogram Model for Gastric Low-Grade Intraepithelial Neoplasia Patients After the Eradication ofHelicobacter pylori

Establishment and Validation of a Pathologic Upgrade Prediction Nomogram Model for Gastric Low-Grade Intraepithelial Neoplasia Patients After the Eradication ofHelicobacter pylori

The management of Helicobacter pylori infection and prevention and control of gastric cancer in China

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

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