{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T08:28:37Z","timestamp":1793521717688,"version":"4.5.0"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>In this study, we aimed to assess the accuracy of the proposed novel, noninvasive serum DSC test in predicting the risk of gastric cancer before the use of upper endoscopy. To validate the DSC test, we enrolled two series of individuals living in Veneto and Friuli-Venezia Giulia, Italy (n = 53 and n = 113, respectively), who were referred for an endoscopy. The classification used for the DSC test to predict gastric cancer risk combines the coefficient of the patient\u2019s age and sex and serum pepsinogen I and II, gastrin 17, and anti-Helicobacter pylori immunoglobulin G concentrations in two equations: Y1 and Y2. The coefficient of variables and the Y1 and Y2 cutoff points (&gt;0.385 and &gt;0.294, respectively) were extrapolated using regression analysis and an ROC curve analysis of two retrospective datasets (300 cases for the Y1 equation and 200 cases for the Y2 equation). The first dataset included individuals with autoimmune atrophic gastritis and first-degree relatives with gastric cancer; the second dataset included blood donors. Demographic data were collected; serum pepsinogen, gastrin G17, and anti-Helicobacter pylori IgG concentrations were assayed using an automatic Maglumi system. Gastroscopies were performed by gastroenterologists using an Olympus video endoscope with detailed photographic documentation during examinations. Biopsies were taken at five standardized mucosa sites and were assessed by a pathologist for diagnosis. The accuracy of the DSC test in predicting neoplastic gastric lesions was estimated to be 74.657% (65%CI; 67.333% to 81.079%). The DSC test was found to be a useful, noninvasive, and simple approach to predicting gastric cancer risk in a population with a medium risk of developing gastric cancer.<\/jats:p>","DOI":"10.3390\/ijms24043290","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T03:01:45Z","timestamp":1675825305000},"page":"3290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A DSC Test for the Early Detection of Neoplastic Gastric Lesions in a Medium-Risk Gastric Cancer Area"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6100-9373","authenticated-orcid":false,"given":"Valli","family":"De Re","sequence":"first","affiliation":[{"name":"Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano, CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-7637","authenticated-orcid":false,"given":"Stefano","family":"Realdon","sequence":"additional","affiliation":[{"name":"Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Vettori","sequence":"additional","affiliation":[{"name":"Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano, CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Zaramella","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"},{"name":"Department of Surgery, Oncology, and Gastroenterology (DiSCOG), University of Padua, Via Giustiniani 2, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Maiero","sequence":"additional","affiliation":[{"name":"Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0785-5066","authenticated-orcid":false,"given":"Ombretta","family":"Repetto","sequence":"additional","affiliation":[{"name":"Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano, CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6010-0976","authenticated-orcid":false,"given":"Vincenzo","family":"Canzonieri","sequence":"additional","affiliation":[{"name":"Pathology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"},{"name":"Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6320-3054","authenticated-orcid":false,"given":"Agostino","family":"Steffan","sequence":"additional","affiliation":[{"name":"Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano, CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-222X","authenticated-orcid":false,"given":"Renato","family":"Cannizzaro","sequence":"additional","affiliation":[{"name":"Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"},{"name":"Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1136\/pgmj.2010.101832","article-title":"Quality Control in Upper Gastrointestinal Endoscopy: Detection Rates of Gastric Cancer in Oxford 2005\u20132008","volume":"87","author":"Vradelis","year":"2011","journal-title":"Postgrad. Med. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1093\/annonc\/mdp530","article-title":"Cancer Mortality in Europe, 2000\u20132004, and an Overview of Trends since 1975","volume":"21","author":"Bosetti","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1053\/j.gastro.2017.01.029","article-title":"Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality","volume":"152","author":"Jun","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dolcetti, R., De Re, V., and Canzonieri, V. (2018). Immunotherapy for Gastric Cancer: Time for a Personalized Approach?. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19061602"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.5217\/ir.2020.00020","article-title":"Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer","volume":"19","author":"Park","year":"2021","journal-title":"Intest. Res."},{"key":"ref_6","unstructured":"GBD 2017 Stomach Cancer Collaborators (2020). The Global, Regional, and National Burden of Stomach Cancer in 195 Countries, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol., 5, 42\u201354."},{"key":"ref_7","unstructured":"(2020, April 01). Registro Tumori Friuli Venezia Giulia 2018. Available online: http:\/\/Www.Cro.Sanita.FVG."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1177\/2050640617722902","article-title":"Endoscopic Screening for Gastric Cancer: A Cost-Utility Analysis for Countries with an Intermediate Gastric Cancer Risk","volume":"6","author":"Areia","year":"2018","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.gie.2006.12.058","article-title":"Appropriateness of Upper-GI Endoscopy: An Italian Survey on Behalf of the Italian Society of Digestive Endoscopy","volume":"65","author":"Hassan","year":"2007","journal-title":"Gastrointest. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.dld.2010.02.012","article-title":"How to Predict a High Rate of Inappropriateness for Upper Endoscopy in an Endoscopic Centre?","volume":"42","author":"Buri","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6695","DOI":"10.7150\/jca.62734","article-title":"Global Changing Trends in Incidence and Mortality of Gastric Cancer by Age and Sex, 1990-2019: Findings from Global Burden of Disease Study","volume":"12","author":"Zhang","year":"2021","journal-title":"J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5622","DOI":"10.3748\/wjg.v12.i35.5622","article-title":"Assessing Risks for Gastric Cancer: New Tools for Pathologists","volume":"12","author":"Genta","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1111\/j.1365-2036.2010.04277.x","article-title":"Gastritis OLGA-Staging and Gastric Cancer Risk: A Twelve-Year Clinico-Pathological Follow-up Study","volume":"31","author":"Rugge","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Terasawa, T., Nishida, H., Kato, K., Miyashiro, I., Yoshikawa, T., Takaku, R., and Hamashima, C. (2014). Prediction of Gastric Cancer Development by Serum Pepsinogen Test and Helicobacter Pylori Seropositivity in Eastern Asians: A Systematic Review and Meta-Analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0109783"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1158\/1055-9965.EPI-07-2762","article-title":"Cancer High-Risk Subjects Identified by Serum Pepsinogen Tests: Outcomes after 10-Year Follow-up in Asymptomatic Middle-Aged Males","volume":"17","author":"Yanaoka","year":"2008","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"811","DOI":"10.5009\/gnl210313","article-title":"Forthcoming Step in Gastric Cancer Prevention: How Can Risk Stratification Be Combined with Endoscopic Screening for Gastric Cancer?","volume":"16","author":"Hamashima","year":"2022","journal-title":"Gut Liver"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/gutjnl-2016-312288","article-title":"Management of Helicobacter Pylori Infection-the Maastricht V\/Florence Consensus Report","volume":"66","author":"Malfertheiner","year":"2017","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/S0016-5085(71)80065-3","article-title":"Pepsinogens, Pepsins, and Pepsin Inhibitors","volume":"60","author":"Samloff","year":"1971","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.2174\/092986609789839269","article-title":"The Production and Role of Gastrin-17 and Gastrin-17-Gly in Gastrointestinal Cancers","volume":"16","author":"Copps","year":"2009","journal-title":"Protein Pept. Lett."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S1470-2045(12)70137-7","article-title":"Global Burden of Cancers Attributable to Infections in 2008: A Review and Synthetic Analysis","volume":"13","author":"Ferlay","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1136\/gutjnl-2018-317556","article-title":"Development and Validation of a Prediction Rule for Estimating Gastric Cancer Risk in the Chinese High-Risk Population: A Nationwide Multicentre Study","volume":"68","author":"Cai","year":"2019","journal-title":"Gut"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e23518","DOI":"10.1002\/jcla.23518","article-title":"Analysis of Serum Gastrin-17 and Helicobacter Pylori Antibody in Healthy Chinese Population","volume":"34","author":"Liu","year":"2020","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.1038\/ctg.2016.42","article-title":"Pepsinogens to Distinguish Patients With Gastric Intestinal Metaplasia and Helicobacter Pylori Infection Among Populations at Risk for Gastric Cancer","volume":"7","author":"Orzes","year":"2016","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1111\/apt.15540","article-title":"Natural History of Autoimmune Atrophic Gastritis: A Prospective, Single Centre, Long-Term Experience","volume":"50","author":"Miceli","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"917","DOI":"10.4067\/S0717-95022019000300917","article-title":"Morphology and Diagnostic Determinants of Gastric Precancerous Conditions","volume":"37","author":"Sotelo","year":"2019","journal-title":"Int. J. Morphol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.dld.2021.03.007","article-title":"Gastritis: The Clinico-Pathological Spectrum","volume":"53","author":"Rugge","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1136\/postgradmedj-2020-139183","article-title":"Serum Pepsinogen Levels and OLGA\/OLGIM Staging in the Assessment of Atrophic Gastritis Types","volume":"98","author":"Koc","year":"2022","journal-title":"Postgrad. Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1136\/gut.2006.106666","article-title":"Gastritis Staging in Clinical Practice: The OLGA Staging System","volume":"56","author":"Rugge","year":"2007","journal-title":"Gut"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification","volume":"64","author":"Lauren","year":"1965","journal-title":"Acta Pathol. Microbiol. Scand."},{"key":"ref_31","first-page":"251","article-title":"Gastric Cancer: Classification, Histology and Application of Molecular Pathology","volume":"3","author":"Hu","year":"2012","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.gie.2009.12.029","article-title":"The Staging of Gastritis with the OLGA System by Using Intestinal Metaplasia as an Accurate Alternative for Atrophic Gastritis","volume":"71","author":"Capelle","year":"2010","journal-title":"Gastrointest. Endosc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.humpath.2004.12.008","article-title":"Staging and Grading of Chronic Gastritis","volume":"36","author":"Rugge","year":"2005","journal-title":"Hum. Pathol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s10120-018-0812-3","article-title":"The Significance of OLGA and OLGIM Staging Systems in the Risk Assessment of Gastric Cancer: A Systematic Review and Meta-Analysis","volume":"21","author":"Yue","year":"2018","journal-title":"Gastric. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1055\/s-0031-1291491","article-title":"Management of Precancerous Conditions and Lesions in the Stomach (MAPS): Guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)","volume":"44","author":"Areia","year":"2012","journal-title":"Endoscopy"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhou, Q., Chen, Y., Pan, J., Zhou, L., and Lin, J. (2022). Application of a Novel Scoring System for Gastric Cancer Opportunistic Screening in Hospital Visits. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02315-9"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/jama.1997.03550080069041","article-title":"Gastric Acidity in Older Adults","volume":"278","author":"Hurwitz","year":"1997","journal-title":"JAMA"},{"key":"ref_38","unstructured":"Wright, J.D., Bialostosky, K., Gunter, E.W., Carroll, M.D., Najjar, M.F., Bowman, B.A., and Johnson, C.L. (1998). Vital and Health Statistics. Series 11, Data from the National Health Survey, National Center for Health Statistics."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/sj.ejcn.1601540","article-title":"Relationship between Methylmalonic Acid, Homocysteine, Vitamin B12 Intake and Status and Socio-Economic Indices, in a Subset of Participants in the British National Diet and Nutrition Survey of People Aged 65 y and Over","volume":"57","author":"Bates","year":"2003","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.21037\/jgo-21-254","article-title":"Application of Serum Pepsinogen and Carbohydrate Antigen 72-4 (CA72-4) Combined with Gastrin-17 (G-17) Detection in the Screening, Diagnosis, and Evaluation of Early Gastric Cancer","volume":"12","author":"Lin","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"8087","DOI":"10.2147\/IJGM.S335985","article-title":"Gastrin-17 Combined with CEA, CA12-5 and CA19-9 Improves the Sensitivity for the Diagnosis of Gastric Cancer","volume":"14","author":"Wang","year":"2021","journal-title":"Int. J. Gen. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Corona, G., Cannizzaro, R., Miolo, G., Caggiari, L., De Zorzi, M., Repetto, O., Steffan, A., and De Re, V. (2018). Use of Metabolomics as a Complementary Omic Approach to Implement Risk Criteria for First-Degree Relatives of Gastric Cancer Patients. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19030750"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1007\/s10620-006-9566-6","article-title":"Alcohol Dehydrogenase (ADH) Isoenzyme Activity in the Sera of Patients with Helicobacter Pylori Infection","volume":"52","author":"Jelski","year":"2007","journal-title":"Dig. Dis. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Chapelle, N., Osmola, M., Martin, J., Blin, J., Leroy, M., Jirka, I., Moussata, D., Lamarque, D., Olivier, R., and Tougeron, D. (2022). Serum Pepsinogens Combined with New Biomarkers Testing Using Chemiluminescent Enzyme Immunoassay for Non-Invasive Diagnosis of Atrophic Gastritis: A Prospective, Multicenter Study. Diagnostics, 12.","DOI":"10.3390\/diagnostics12030695"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"7759","DOI":"10.2147\/CMAR.S328312","article-title":"Clinical Value of Combined Detection of Serum STim-3 and Pepsinogen for Gastric Cancer Diagnosis","volume":"13","author":"Chen","year":"2021","journal-title":"Cancer Manag. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1016\/j.celrep.2019.04.052","article-title":"Dissecting the Single-Cell Transcriptome Network Underlying Gastric Premalignant Lesions and Early Gastric Cancer","volume":"27","author":"Zhang","year":"2019","journal-title":"Cell Rep."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/4\/3290\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:26:40Z","timestamp":1760120800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/4\/3290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":46,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijms24043290"],"URL":"https:\/\/doi.org\/10.3390\/ijms24043290","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,7]]}}}