A total of 228 patients were included in the study from 2019 to 2022. The mean age among the GC group was higher (55 years) when compared to the precancerous conditions/lesions (45 years) and the control group (52 years). The prevalence of GC and precancerous conditions/lesions was higher among the male gender. GC patients were malnourished (BMI < 18.5) compared to the other two groups (p < 0.001). The usage of alcohol and tobacco was higher among all the three groups. The prevalence of positive family history was higher among the GC group (17.1%), with a p-value of < 0.05 compared to the control group. Neither of the groups had any association with comorbidities. Among the GC group of patients, the intestinal sub-type of malignancy was predominant (59.2%), followed by the diffuse type (39.5%). The majority of the tumours were moderately differentiated (28.9%), while an equal proportion was both well (17.1%) and poorly differentiated (17.1%). More than half of them, about 50 to 60%, had a non-metastatic disease; however, they had positive nodal involvement and hence a higher stage of disease (stage III/IV). About 39.4% of the patients were of Stage IV, followed by Stage III (31.6%). Stage I and II comprised 10.5% and 18.4% of the patients, respectively. And 45 out of the 76 patients (59.2%) were of the intestinal type, according to Lauren’s classification. Precancerous conditions comprised chronic gastritis ( 46%), chronic H. pylori gastritis (17.1%) and H. pylori positive cases (13.2%). Precancerous lesions comprised gastric adenomatous polyps (9.2%), intestinal metaplasia (7.9%) and atrophic gastritis (6.6%) (Table 1).
Table 2 compares the three-dimensional panel of markers among the three groups. Among the stomach-specific markers, PGI and, correspondingly, PGI/II ratio was lower in the GC group when compared to the precancerous conditions/lesions group (p = 0.01). G-17 and TFF3 were higher in the GC group (p = 0.04 and p = 0.01 respectively). Among the biomarkers considered in the GC-related environmental factors group, H. pylori IgG and Bab A were elevated among the precancerous conditions/lesions group compared to the control group but had no association in the GC group. The cancer-associated biomarkers OPN, CA 19 − 9 and CA125 were elevated in the GC group compared to other groups.
Table 1: Description of precancerous conditions/lesions group (N=76)
Precancerous conditions/lesions*
|
N
|
Percentage (%)
|
Chronic Gastritis
|
35
|
46
|
Chronic H. pylori active gastritis
|
13
|
17.1
|
H. pylori positive cases
|
10
|
13.2
|
Gastric adenomatous polyps
|
7
|
9.2
|
Intestinal metaplasia
|
6
|
7.9
|
Atrophic gastritis
|
5
|
6.6
|
Precancerous conditions included chronic gastritis, Chronic H. pylori active gastritis & H. pylori positive cases, whereas precancerous lesions included Gastric adenomatous polyps, Intestinal metaplasia and Atrophic gastritis
Table 2
Comparison of three-dimensional biomarkers among three groups (N = 228)
Variable
|
Gastric Cancer
Median (Q1, Q3)
|
Precancerous
Median (Q1, Q3)
|
Controls
Median (Q1, Q3)
|
P value
(overall)
|
p1*
|
p2*
|
p3*
|
Stomach specific markers
|
Pepsinogen I (ng/ml)
|
56.0 (25.0, 73.5)
|
74.3 (54.0, 157.4)
|
85.9 (71.8, 152.1)
|
0.001
|
0.001
|
0.001
|
0.018
|
Pepsinogen II (ng/ml)
|
23.6 (18.2, 25.0)
|
23.0 (16.7, 24.9)
|
20.1 (16.4, 24.3)
|
0.69
|
0.441
|
0.014
|
0.232
|
Pepsinogen I/II ratio
|
2.25 (1.15, 4.08)
|
4.54 (2.84, 7.24)
|
4.87 (3.50, 7.26)
|
0.001
|
0.001
|
0.001
|
0.191
|
Gastrin- 17 (pg/ml)
|
132.8 (71.0, 389.7)
|
107.5 (57.0, 170.5)
|
81.4 (53.8 123.1)
|
0.004
|
0.114
|
0.003
|
0.173
|
Trefoil factor 3 (ng/ml)
|
6.6 (3.70, 11.10)
|
3.5 (2.48, 6.36)
|
3.5 (1.65, 7.32)
|
0.001
|
0.001
|
0.001
|
0.733
|
Gastric cancer related environmental factors
|
H. pylori IgG (U/ml)
|
39.0 (14.6, 69.9)
|
46.2 (20.1, 89.4)
|
19.4 (6.2, 48.8)
|
0.001
|
1.00
|
0.013
|
0.001
|
Blood group antigen-binding adhesin A(ng/L)
|
5.3 (2.62, 8.00)
|
6.3 (2.69, 9.02)
|
4.2 (2.20, 7.30)
|
0.243
|
0.463
|
0.284
|
0.109
|
Cancer-associated biomarkers
|
Osteopontin (ng/ml)
|
27.1 (18.5, 33.7)
|
14.2 (9.7, 18.7)
|
11.8 (9.1, 17.7)
|
0.001
|
0.001
|
0.001
|
0.139
|
CA19-9 - Carbohydrate antigen 19 − 9 (U/ml)
|
49.9 (16.7, 187.5)
|
14.7 (4.7, 33)
|
11.7 (3.9, 25.2)
|
0.001
|
0.001
|
0.001
|
0.605
|
CA125 - Carbohydrate antigen 125 (U/ml)
|
10.5 (5.6, 34.6)
|
4.1 (2.8, 7.4)
|
3.77 (2.3, 6.6)
|
0.001
|
0.001
|
0.001
|
0.148
|
Q1, Q3: Quartile 1, Quartile 3. p1 – comparison between gastric cancer group and precancerous conditions/lesions group, p2 - comparison between gastric cancer group and control group, p3 - comparison between precancerous conditions/lesions group and control group, *Kruskal Wallis one-way ANOVA (k-samples) test, P value < 0.2 is considered statistically significant and indicated in bold. |
Analysing the clinicopathological features (p < 0.2 taken as significant) with three-dimensional biomarkers, PGII was associated with nodal involvement (p = 0.01) and the stage of malignancy (p = 0.01). PGI/II ratio was associated with nodal involvement (p = 0.15) and G-17 with the depth of infiltration (p = 0.11) and nodal involvement (p = 0.15). TFF3 was associated with differentiation of tumour (p = 0.19). Bab A was associated with differentiation of tumour (0.14) and OPN with a depth of infiltration and nodal involvement (p-value < 0.2). CA 19 − 9 was associated with nodal involvement and stage of malignancy (p-value < 0.2). CA125 was associated with differentiation of tumour, nodal involvement and stage of malignancy (p-value < 0.2).
Table 3 depicts the multivariable regression analysis of factors associated with GC and precancerous lesions/conditions after adjusting for covariates significant in univariate analysis. PGI, G-17, H. pylori IgG, OPN and CA125 were associated with GC compared to the control group. A similar analysis done for GC, when compared to the precancerous conditions/lesions, showed that PGI/II ratio, G-17, TFF3, OPN, CA 19 − 9, and CA125 were associated with the GC group. When precancerous conditions/lesions were compared with controls, H. pylori IgG and PGI/II ratio were associated after adjusting for covariates.
Table 3
Multivariable regression analysis of factors associated with gastric cancer and precancerous conditions/lesions group
Variables
|
Categories
|
CPR (CI)
|
APR (CI)
|
P Value
|
Gastric cancer vs Controls a
|
Pepsinogen I
|
Less than 73.78
|
3.05 (2.00, 4.66)
|
1.15 (1.04, 1.28)
|
0.006
|
Pepsinogen II
|
Greater than 22.40
|
1.76 (1.25, 2.47)
|
1.09 (0.99, 1.20)
|
0.075
|
Pepsinogen I/II ratio
|
Less than 3.79
|
2.26 (1.55, 3.31)
|
1.00 (0.89, 1.11)
|
0.975
|
Gastrin 17
|
Greater than 102.4
|
1.71 (1.21, 2.41)
|
1.10 (1.01, 1.21)
|
0.027
|
Trefoil factor 3
|
Greater than 3.59
|
2.30 (1.45, 3.64)
|
1.08 (0.97, 1.19)
|
0.136
|
H. pylori IgG
|
Greater than 32.9
|
1.70 (1.22, 2.39)
|
1.16 (1.05, 1.29)
|
0.002
|
Osteopontin (OPN)
|
Greater than 14.58
|
4.53 (2.60, 7.88)
|
1.12 (1.01, 1.24)
|
0.024
|
CA19-9 - Carbohydrate antigen 19 − 9
|
Greater than 31.5
|
2.57 (1.81, 3.65)
|
1.09 (0.98, 1.20)
|
0.080
|
CA125 - Carbohydrate antigen 125
|
Greater than 6.11
|
2.77 (1.83, 4.17)
|
1.13 (1.03, 1.24)
|
0.008
|
Gastric cancer vs precancerous conditions/lesions b
|
Pepsinogen I
|
Less than 73.78
|
1.87 (1.24, 2.84)
|
1.07 (0.95, 1.21)
|
0.229
|
Pepsinogen I/II ratio
|
Less than 3.93
|
2.24 (1.49, 3.37)
|
1.13 (1.01, 1.27)
|
0.026
|
Gastrin 17
|
Greater than 112.4
|
1.27 (0.91, 1.76)
|
1.12 (1.01, 1.25)
|
0.021
|
Trefoil factor 3
|
Greater than 4.89
|
1.73 (1.21, 2.45)
|
1.11 (1.00, 1.23)
|
0.046
|
Osteopontin (OPN)
|
Greater than 21.2
|
3.50 (2.38, 5.16)
|
1.24 (1.09, 1.41)
|
0.001
|
CA 19.9- Carbohydrate antigen 19.9
|
Greater than 31.5
|
2.25 (1.58, 3.19)
|
1.25 (1.12, 1.38)
|
0.001
|
CA 125 - Carbohydrate antigen 125
|
Greater than 7.48
|
2.45 (1.71, 3.50)
|
1.13 (1.01, 1.27)
|
0.033
|
Precancerous conditions/lesions vs controls c
|
Pepsinogen I
|
Less than 73.78
|
1.6 (1.22, 2.26)
|
0.92 (0.79, 1.08)
|
0.342
|
Pepsinogen I/II ratio
|
Less than 3.9
|
1.05 (0.76, 1.45)
|
1.22 (1.05, 1.42)
|
0.010
|
Gastrin 17
|
Greater than 103.7
|
1.37 (1.00, 1.88)
|
1.04 (0.90, 1.20)
|
0.580
|
H. pylori IgG
|
Greater than 19.7
|
1.93 (1.27, 2.92)
|
1.20 (1.03, 1.40)
|
0.015
|
Blood group antigen-binding adhesin A (Bab A)
|
Greater than 3.88
|
1.24 (0.89, 1.73)
|
1.11 (0.96, 1.27)
|
0.131
|
Osteopontin (OPN)
|
Greater than 13.14
|
1.70 (1.22, 2.37)
|
1.11 (0.95, 1.29)
|
0.156
|
CA 125 - Carbohydrate antigen 125
|
Greater than 3.00
|
1.27 (0.88, 1.83)
|
0.95 (0.83, 1.10)
|
0.560
|
a Covariates adjusted for family history of GC, smoking, alcohol consumption, BMI, education, fruits, fish, mutton, chicken, dry fish, epigastric pain, vomiting, weight loss, early satiety, melena, NLR (Neutrophils to Lymphocytes ratio); PLR (Platelets to Lymphocytes ratio); MLR (Monocytes to Lymphocytes ratio) |
b Covariates adjusted for age, gender, family history of GC, smoking, alcohol consumption, BMI, education, fish, mutton, dry fish, epigastric pain, vomiting, weight loss, early satiety, melena, NLR; PLR; MLR |
c Covariates adjusted for age, gender, education, smoking, alcohol consumption, BMI, both alcohol and tobacco, family history of GC, fish, mutton, chicken, dry fish, melena |
P value < 0.05 is considered statistically significant and indicated in bold. |
ROC analysis of the three-dimensional biomarkers done for the three groups showed marked heterogeneity (Table 4). Among the GC vs the control group, the AUC ranged from 0.550 to 0.812. Among the stomach-specific markers, TFF3 showed the highest sensitivity (80.3%), while among the GC-related environmental factors, H. pylori IgG had the highest sensitivity (67.1%). Additionally, among the cancer-associated markers, CA125 displayed the highest level of sensitivity (75%). A similar analysis was done for the GC group compared to precancerous conditions/lesions group. The cut-off values that were used to predict GC compared to controls were applied to predict GC vs. precancerous conditions/lesions except for H. pylori IgG and Bab A. Among the stomach-specific biomarkers, the AUC ranged from 0.536 to 0.729. TFF3 showed highest sensitivity (80.3%) and specificity (51.3%). Among the GC-related environmental factors, H. pylori IgG had the highest sensitivity (71.1%) but a relatively lower specificity (42.1%) compared to Bab A (52.6%). For cancer-associated markers, the AUC values ranged from 0.738 to 0.805. The sensitivity of these markers varied from 65.8–75%, while the specificity ranged from 65.8–84.2%.
Table 4
Cut-off values of three-dimensional biomarkers for predicting gastric cancer and precancerous conditions/lesions group
Parameter
|
Cut-off
|
AUC
|
95% CI
|
Se
|
Sp
|
PPV
|
NPV
|
LR+
|
LR-
|
CC%
|
Gastric cancer vs Controls
|
Stomach-specific markers
|
Pepsinogen I
|
≤ 73.78
|
0.812
|
0.745–0.879
|
76.3
|
73.7
|
83.6
|
84.9
|
4.31
|
0.49
|
74.3
|
Pepsinogen II
|
≥ 22.40
|
0.615
|
0.524–0.707
|
63.2
|
64.5
|
74.8
|
74.3
|
2.52
|
0.80
|
63.8
|
Pepsinogen I/II ratio
|
≤ 3.9
|
0.794
|
0.723–0.865
|
75.0
|
63.2
|
78.1
|
79.2
|
3.02
|
0.66
|
68.4
|
Gastrin- 17
|
≥ 102.4
|
0.653
|
0.564–0.742
|
63.2
|
63.2
|
73.9
|
73.9
|
2.41
|
0.82
|
63.1
|
Trefoil factor 3
|
≥ 3.59
|
0.731
|
0.652–0.809
|
80.3
|
52.6
|
72.5
|
83.9
|
2.20
|
0.62
|
66.4
|
GC related environmental factors
|
H. pylori IgG
|
≥ 32.9
|
0.639
|
0.551–0.727
|
67.1
|
64.5
|
74.4
|
73.5
|
2.47
|
0.82
|
63.1
|
Bab A
|
≥ 3.02
|
0.550
|
0.459–0.642
|
61.8
|
40.8
|
63.4
|
68.7
|
1.45
|
1.23
|
53.9
|
Cancer-associated markers
|
Osteopontin
|
≥ 21.2
|
0.793
|
0.714–0.871
|
72.4
|
86.8
|
75.5
|
83.3
|
5.48
|
0.31
|
78.9
|
CA 19 − 9
|
≥ 31.5
|
0.794
|
0.725–0.863
|
65.8
|
80.3
|
86.5
|
79.5
|
5.39
|
0.59
|
73.0
|
CA125
|
≥ 6.11
|
0.780
|
0.705–0.855
|
75.0
|
71.1
|
81.7
|
83.5
|
3.77
|
0.53
|
73.0
|
Gastric cancer vs precancerous conditions/lesions
|
Stomach-specific markers
|
Pepsinogen I
|
≤ 73.78
|
0.697
|
0.615–0.779
|
73.7
|
54.0
|
60.4
|
67.8
|
1.60
|
0.48
|
63.1
|
Pepsinogen II
|
≥ 22.40
|
0.536
|
0.444–0.629
|
63.2
|
47.4
|
65.2
|
68.6
|
1.58
|
1.13
|
55.2
|
Pepsinogen I/II ratio
|
≤ 3.9
|
0.729
|
0.649–0.809
|
75
|
60.5
|
75.4
|
81.4
|
2.58
|
0.63
|
67.7
|
Gastrin- 17
|
≥ 102.4
|
0.599
|
0.509–0.690
|
61.8
|
50
|
55.1
|
58.9
|
1.23
|
0.76
|
55.9
|
Trefoil factor 3
|
≥ 3.59
|
0.718
|
0.637–0.798
|
80.3
|
51.3
|
62.2
|
72.2
|
1.64
|
0.38
|
65.7
|
GC related environmental factors
|
H. pylori IgG
|
≤ 59.5
|
0.548
|
0.456–0.640
|
71.1
|
42.1
|
65.2
|
72.4
|
1.56
|
1.07
|
56.5
|
Bab A
|
≤ 6.19
|
0.534
|
0.442–0.627
|
55.3
|
52.6
|
65.2
|
65.7
|
1.59
|
1.18
|
53.9
|
Cancer-associated markers
|
Osteopontin
|
≥ 21.2
|
0.805
|
0.731–0.879
|
71.1
|
84.2
|
63.7
|
78.0
|
4.50
|
0.34
|
68.4
|
CA 19 − 9
|
≥ 31.5
|
0.777
|
0.705–0.850
|
65.8
|
75
|
71.4
|
68.2
|
2.63
|
0.34
|
69.7
|
CA125
|
≥ 6.11
|
0.738
|
0.655–0.820
|
75
|
65.8
|
68.6
|
72.4
|
2.19
|
0.37
|
70.3
|
Precancerous conditions/lesions vs Controls
|
Stomach-specific markers
|
Pepsinogen I
|
≤ 73.78
|
0.61
|
0.519–0.703
|
75.0
|
50.0
|
78.6
|
69.9
|
3.14
|
0.86
|
62.5
|
Pepsinogen II
|
≥ 22.4
|
0.55
|
0.462–0.649
|
53.0
|
67.0
|
61.5
|
58.6
|
1.60
|
0.70
|
59.8
|
Pepsinogen I/II ratio
|
≤ 3.9
|
0.56
|
0.469–0.654
|
60.0
|
41.0
|
64.8
|
61.7
|
1.59
|
1.24
|
51.3
|
Gastrin-17
|
≥ 102.4
|
0.56
|
0.472–0.656
|
51.2
|
64.5
|
71
|
67.6
|
2.10
|
1.00
|
57.8
|
Trefoil factor 3
|
≥ 2.69
|
0.51
|
0.422–0.609
|
67.0
|
45.0
|
54.8
|
57.6
|
1.21
|
0.73
|
55.9
|
GC related environmental factors
|
H. pylori IgG
|
≥ 19.78
|
0.67
|
0.586–0.757
|
76.3
|
51.3
|
70.9
|
80.1
|
2.04
|
0.73
|
63.8
|
Bab A
|
≥ 3.88
|
0.57
|
0.483–0.667
|
61.8
|
48.7
|
65.4
|
68.3
|
1.60
|
1.13
|
55.2
|
Cancer-associated markers
|
Osteopontin
|
≥ 13.14
|
0.57
|
0.476–0.663
|
60.5
|
65.8
|
74.9
|
73.1
|
2.54
|
0.83
|
63.1
|
CA 19 − 9
|
≥ 11.99
|
0.52
|
0.431–0.617
|
57.0
|
53.0
|
54.4
|
54.7
|
1.21
|
0.81
|
54.6
|
CA125
|
≥ 3.00
|
0.56
|
0.477–0.659
|
71.1
|
40.0
|
64
|
71.3
|
1.48
|
1.15
|
55.2
|
AUC area under curve, 95% CI: 95% Confidence Interval, Se sensitivity, Sp specificity, PPV positive predictive value, NPV negative predictive value, LR likelihood ratio, CC correctly classified. Bab A - Blood group antigen-binding adhesin A; CA 19 − 9 - Carbohydrate antigen 19 − 9; CA125- Carbohydrate antigen 125 |
Similarly, when precancerous conditions/lesions were compared with the control group, the stomach-specific biomarkers displayed AUC values ranging from 0.51 to 0.61. These biomarkers individually exhibited sensitivities ranging from 51.2–75% and specificities from 41–67%. Among the GC-related environmental factors, H. pylori IgG exhibited the highest sensitivity of 76.3% with a specificity of 51.3%. Among the cancer-associated markers, CA125 demonstrated the highest sensitivity of 71.1%, and OPN showed the highest specificity of 65.8%. These are depicted in the ROC curves (Figs. 1A, 1B and 1C).
Table 5 shows the combination of different panels of markers among the groups. The three-dimensional panel exhibited a high diagnostic ability among the three groups, demonstrating the highest AUC, sensitivity, and specificity. When comparing GC to the control group, the combination of the three-dimensional panel achieved the highest sensitivity of 94.7% and specificity of 81.6%. When GC was compared to the precancerous conditions/lesions group, only stomach-specific and cancer-associated panels were eligible for the combinations. This combined panel exhibited the highest sensitivity of 93.4% and specificity of 92.1%. When the precancerous conditions/lesions group was compared to controls, the combination of the three-dimensional panel showed the highest AUC of 0.749 with a sensitivity of 77.1% and specificity of 65.8%.
Table 5
Combination of different panels of markers among the groups
Parameter
|
AUC
|
Se
|
Sp
|
PPV
|
NPV
|
LR+
|
LR-
|
CC%
|
Gastric cancer compared to the control group
|
All stomach-specific markers and GC related environmental factors panel
|
0.841
|
86.8
|
69.7
|
74.2
|
84.1
|
2.86
|
0.189
|
78.3
|
All stomach-specific markers and cancer-associated panel
|
0.936
|
89.5
|
86.8
|
87.2
|
89.2
|
6.78
|
0.12
|
88.2
|
All cancer-associated markers and GC related environmental factors panel
|
0.917
|
82.9
|
93.4
|
92.6
|
84.5
|
12.5
|
0.18
|
88.2
|
All three dimensions panel
|
0.938
|
94.7
|
81.6
|
83.7
|
93.9
|
5.14
|
0.06
|
88.2
|
Gastric cancer compared to precancerous conditions/lesions group
|
All stomach-specific markers and cancer-associated panel
|
0.951
|
93.4
|
92.1
|
92.2
|
93.3
|
13.15
|
0.07
|
92.8
|
Precancerous conditions/lesions compared to the control group
|
All stomach-specific markers and GC related environmental factors panel
|
0.727
|
75
|
60.5
|
65.5
|
70.8
|
1.89
|
0.41
|
67.8
|
All stomach-specific markers and cancer-associated panel
|
0.679
|
77.1
|
64.5
|
65.4
|
66.2
|
2.17
|
0.35
|
65.8
|
All cancer-associated markers and GC related environmental factors panel
|
0.694
|
42.1
|
90.8
|
82.1
|
61.1
|
4.57
|
0.63
|
66.4
|
All three dimensions panel
|
0.749
|
77.1
|
65.8
|
67.5
|
69.4
|
2.07
|
0.43
|
68.4
|
AUC area under curve, 95% CI: 95% Confidence Interval, Se sensitivity, Sp specificity, PPV positive predictive value, |
NPV negative predictive value, LR likelihood ratio, CC correctly classified. |
Table 6 shows the comparison of three-dimensional panel of markers based on the highest sensitivity among different groups. When GC was compared to controls, the combination of TFF3, H. pylori, and CA125 had the highest sensitivity (98.7%) among the markers studied in each dimension. Similarly, when the GC group was compared to the precancerous conditions/lesions group, a combination of TFF3 and CA125 had the highest sensitivity (90.8%). Whereas, with precancerous conditions/lesions compared to controls, the combination of PGI, H. pylori and CA125 had the highest sensitivity (100%) and low specificity (5.26%) among the markers studied in each dimension.
Table 6
Comparison of three-dimensional panel of markers based on the highest sensitivity among different groups
Panel
|
Biomarkers
|
AUC
|
Se
|
Sp
|
PPV
|
NPV
|
LR+
|
LR-
|
Gastric cancer compared to control group
|
Single dimension
|
TFF3
|
0.731
|
80.3
|
52.6
|
72.5
|
83.9
|
1.69
|
0.37
|
H. pylori
|
0.639
|
61.8
|
64.5
|
74.4
|
73.5
|
1.74
|
0.57
|
CA125
|
0.78
|
75
|
71.1
|
81.7
|
835
|
2.59
|
0.35
|
Two-dimensions
|
TFF3 + H. pylori
|
0.67
|
97.4
|
36.8
|
60.7
|
93.3
|
1.54
|
0.07
|
TFF3 + CA125
|
0.65
|
98.7
|
32.9
|
59.5
|
96.2
|
1.47
|
0.03
|
H. pylori + CA125
|
0.67
|
84.2
|
51.3
|
63.4
|
76.5
|
1.72
|
0.30
|
Three-dimensions
|
TFF3 + H. pylori + CA125
|
0.61
|
98.7
|
25
|
56.8
|
95
|
1.31
|
0.05
|
Gastric cancer compared to precancerous conditions/lesions group
|
Single dimension
|
TFF3
|
0.71
|
80.3
|
51.3
|
62.2
|
72.2
|
1.64
|
0.38
|
CA125
|
0.73
|
75
|
65.8
|
68.6
|
72.4
|
2.19
|
0.37
|
Two-dimensions
|
TFF3 + CA125
|
0.63
|
90.8
|
36.8
|
59
|
80
|
1.43
|
0.25
|
Precancerous conditions/lesions compared to control group
|
Single dimension
|
PGI
|
0.61
|
76.3
|
50
|
78.6
|
69.9
|
1.52
|
0.47
|
H. pylori
|
0.67
|
75.0
|
51.3
|
70.9
|
80.1
|
1.54
|
0.48
|
CA125
|
0.56
|
71.1
|
40.0
|
64
|
71.3
|
1.18
|
0.72
|
Two-dimensions
|
PGI + H. pylori
|
0.559
|
98.7
|
13.2
|
53.2
|
90.9
|
1.13
|
0.09
|
PGI + CA125
|
0.546
|
94.7
|
14.5
|
52.6
|
73.3
|
1.10
|
0.36
|
H. pylori + CA125
|
0.546
|
92.1
|
17.1
|
52.6
|
68.4
|
1.11
|
0.44
|
Three-dimensions
|
PGI + H. pylori + CA125
|
0.526
|
100
|
5.26
|
51.4
|
100
|
1.05
|
0
|
AUC area under curve, Se sensitivity, Sp specificity, PPV positive predictive value, NPV negative predictive value, LR likelihood ratio PGI: Pepsinogen I, TFF3: Trefoil factor 3, CA125: Carbohydrate Antigen 125