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Comparison of serum trefoil factor 3 with the pepsinogen test for the screening of diffuse-type gastric cancer

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Abstract

Emerging data show that serum trefoil factor 3 (TFF3) alone and combined with the serum pepsinogen (PG) test can increase the diagnostic yield of gastric cancer. We aimed to evaluate the diagnostic value of serum TFF3 for the screening of gastric cancer in Korean patients, especially for the screening of the diffuse type of gastric cancer, and compared TFF3 to the serum PG test. We enrolled 25 healthy controls and 79 subjects with gastric cancer who underwent endoscopic resection or surgery from June 2006 to June 2015. Data about age, sex, histological type according to the Lauren classification, stage of gastric cancer, and status of H. pylori were collected. Serum levels of PG I and PG II were measured by the latex-enhanced turbidimetric immunoassay, and serum TFF3 levels were measured by enzyme-linked immunosorbent assay. The optimal cutoff value of serum TFF3 was ≥8.9 ng/mL to diagnose gastric cancer, with 73.4 % sensitivity and 92.0 % specificity, which were higher than those of the serum PG I/II ratio, with 69.6 % sensitivity and 68.0 % specificity. The optimal sensitivity and specificity of serum TFF3 for the diagnosis of diffuse-type gastric cancer were 68.0 and 92.0 %, respectively, which were lower than those for the diagnosis of intestinal-type gastric cancer (75.6 and 100 %, respectively). Serum TFF3 is a more stable and useful marker than the serum PG test for the screening of gastric cancer in Korean patients. Serum TFF3 showed good diagnostic power in detecting both intestinal- and diffuse-type gastric cancer although it showed decreased power in diffuse type.

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Acknowledgments

The authors thank the Institute for Cancer Research, Keimyung University Dongsan Medical Center, for advising and helping experimental process. The biospecimens for this study were provided by the Keimyung Human Bio-Resource Bank (KHBB), a member of the National Biobank of Korea, which is supported by the Ministry of Health and Welfare.

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Authors and Affiliations

  1. Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea

    Ju Yup Lee, Kyung Sik Park, Kwang Bum Cho, Yoo Jin Lee & Yoon Suk Lee

  2. Institute for Cancer Research, Keimyung University Dongsan Medical Center, Daegu, South Korea

    Hyun-Gyo Lee & Won-Ki Baek

  3. Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea

    Seung-Wan Ryu

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  1. Ju Yup Lee
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Correspondence to Kyung Sik Park.

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Lee, J.Y., Park, K.S., Lee, HG. et al. Comparison of serum trefoil factor 3 with the pepsinogen test for the screening of diffuse-type gastric cancer. Clin Exp Med 17, 403–410 (2017). https://doi.org/10.1007/s10238-016-0426-1

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  • DOI: https://doi.org/10.1007/s10238-016-0426-1

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