{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:44:56Z","timestamp":1790185496894,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19ck0106267"],"award-info":[{"award-number":["JP19ck0106267"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["107\u2010T11"],"award-info":[{"award-number":["107\u2010T11"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>\n                      The reliable method to stratify the gastric cancer risk after\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      eradication remains an elusive goal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Mass eradication of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H.\u00a0pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      began in 2004 in a high\u2010risk population. After eradication, a screening program involving first\u2010stage serological tests (pepsinogen\u2010I, pepsinogen\u2010II,\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H.\u00a0pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      immunoglobin G, and gastrin\u201017) and second\u2010stage endoscopic examination was launched in 2015\u20132018. Index lesions included gastric cancer or extensive premalignant lesions. We evaluated the performance of the serological tests to \u201crule in\u201d and \u201crule out\u201d the risk based on positive and negative likelihood ratios, respectively. The methylation levels of\n                      <jats:italic>microRNA\u2010124a\u20103<\/jats:italic>\n                      in the stomach were measured to indicate genetic damage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 6512 invited subjects, 3895 (59.6%) participated. Both gastrin\u201017 and pepsinogen tests were normal in 3560 (91.4%) subjects; 206 (5.3%) gastrin\u201017 and 129 (3.3%) pepsinogen tests were abnormal. Years after eradication, the severity of gastritis had fallen greatly, and extensive premalignant lesions or gastric cancer frequently occurred in newly non\u2010atrophic\u2010appearing mucosa. Pepsinogen testing could moderately predict atrophic gastritis (positive likelihood ratio: 4.11 [95% confidence interval: 2.92\u20135.77]; negative likelihood ratio: 0.14 [0.10\u20130.19]). Gastrin\u201017 was not useful (0.66 and 1.20, respectively). However, pepsinogen testing poorly predicted the index lesions (2.04 [1.21\u20133.42] and 0.57 [0.34\u20130.95]). DNA methylation levels in the post\u2010eradication mucosa were more discriminative for predicting index lesions (3.89 [2.32\u20136.54] and 0.25 [0.15\u20130.42]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After eradication, pepsinogen false\u2010negative results become more frequent because histology is improved but genetic damage may persist. Direct testing for genetic damage offers better discrimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.15187","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T22:19:51Z","timestamp":1594851591000},"page":"671-679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Risk stratification for gastric cancer after\n                    <i>Helicobacter pylori<\/i>\n                    eradication: A population\u2010based study on Matsu Islands"],"prefix":"10.1111","volume":"36","author":[{"given":"Tsung\u2010Hsien","family":"Chiang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Integrated Diagnostics and Therapeutics National Taiwan University Hospital  Taipei Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Maeda","sequence":"additional","affiliation":[{"name":"Division of Epigenomics National Cancer Center Research Institute  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harumi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Epigenomics National Cancer Center Research Institute  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Chuan","family":"Chan","sequence":"additional","affiliation":[{"name":"Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health National Taiwan University  Taipei Taiwan"},{"name":"Institute of Environmental and Occupational Health Sciences, College of Public Health National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam Li\u2010Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Oral Hygiene, College of Oral Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry Yueh\u2010Hsia","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Health Care Management and Healthy Aging Research Center Chang Gung University  Taoyuan Taiwan"},{"name":"Division of Hepatogastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Nien","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Hsuan","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Fu","family":"Shieh","sequence":"additional","affiliation":[{"name":"Health Bureau of Lienchiang County, Nangan Township, Lienchiang County  Matsu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Lienchiang County Government, Nangan Township, Lienchiang County  Matsu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2786-8056","authenticated-orcid":false,"given":"Han\u2010Mo","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University  Taipei 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