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Li Y, Wu D, Xu A, Xu M, Fu B, Xiong W. Exploring the effect of NK-cell related molecules on the prognosis and tumor microenvironment of gastric cancer patients: Evidence from large sample populations. Heliyon 2024; 10:e33759. [PMID: 39071629 PMCID: PMC11276922 DOI: 10.1016/j.heliyon.2024.e33759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/17/2024] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Background Natural killer (NK) cells play a significant role in anti-tumor immunity, and their involvement has been documented in various cancers. However, a deeper understanding of the mechanisms by which NK cells influence gastric cancer progression remains necessary. Methods We utilized the Cancer Genome Atlas (TCGA) database to acquire transcriptional profiles, clinical information, and mutation data for gastric cancer patients. R software and associated packages were employed for all analyses of this publicly available data. Results We used multiple algorithms to evaluate the tumor microenvironment in gastric cancer samples. We performed differential expression analysis to pinpoint genes related to NK cells. Utilizing this data, we developed a prognostic model featuring three crucial NK cell-related genes: MAB21L2, ARPP21, and MUCL1. This model showed strong predictive performance in the training and validation groups. Consistently, patients identified as high-risk according to our model had worse overall survival rates. To further elucidate the biological differences between high-risk and low-risk patients, we performed enrichment analyses focusing on biological pathways and immune-related factors. Additionally, we observed a correlation between higher risk scores and non-responsiveness to treatment. Interestingly, high-risk patients were found to be potentially more sensitive to axitinib. We selected MUCL1 for further investigation due to its potential role in the model. While MUCL1 mRNA levels were elevated in both gastric cancer and paired normal tissues, protein expression analysis using the Human Protein Atlas database revealed a decrease in MUCL1 protein levels within tumor tissues. Conclusions Our findings contribute to a more comprehensive understanding of the role of NK cells in gastric cancer and highlight MUCL1 as a promising therapeutic target.
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Affiliation(s)
- Yuqin Li
- Department of Gastroenterology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong New District, Shanghai, 201399, China
| | - Dejun Wu
- Department of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
- Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
| | - Anjun Xu
- Department of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
- Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
| | - Ming Xu
- Department of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
- Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Shanghai, 201399, China
| | - Baiqing Fu
- Department of Gastroenterology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong New District, Shanghai, 201399, China
| | - Wujun Xiong
- Department of Gastroenterology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong New District, Shanghai, 201399, China
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Zhou S, Chen Z, Jiao Y, Cheng Z, Gao Y, Wang T, Xin L, Wan R, Wang L. Development of esophagogastroduodenoscopy in China: results from the national census in 2013 and 2020. Front Oncol 2024; 14:1366706. [PMID: 38912062 PMCID: PMC11190165 DOI: 10.3389/fonc.2024.1366706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Background Given the significant burden of upper digestive diseases, there has been a substantial increase in the utilization of esophagogastroduodenoscopy (EGD) in China from 2012 to 2019. The objective of this study is to investigate the development, practice, and factors influencing the widespread use of EGD during this period. Methods Two national censuses were conducted among all hospitals in mainland China that perform gastrointestinal endoscopy. These censuses aimed to extract information on the infrastructure, volume, and quality of EGD. The analysis of potential factors influencing EGD practice was based on real-world data from open access sources. Results From 2012 to 2019, the number of hospitals performing EGD in mainland China increased from 1,518 to 2,265 (1.49-fold) in tertiary hospitals and from 3,633 to 4,097 (1.12-fold) in secondary hospitals, respectively. The national utilization rate of EGD also increased from 1,643.53 to 2,018.06 per 100,000 inhabitants, indicating a 1.23-fold increase. Regions with more endoscopists per 100,000 inhabitants (OR 9.61, P<0.001), more tertiary hospitals performing EGD per million inhabitants (OR 2.43, P<0.001), higher incidence of esophageal and gastric cancer (OR 2.09, P=0 016), and higher number of hospitals performing EGD per million inhabitants (OR 1.77, P=0.01) tended to provided more numerous and qualitied EGD. And hospital grading, regional GDP, incidence of esophageal and gastric cancer and the volume of EGD were observed as the significantly relevant factors of malignant dictation rate (MDR) (P<0.05), but not the number and educational background of endoscopists. Conclusion Over the past seven years, China has made significant progress in EGD. However, challenges persist in terms of quality and inequality.
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Affiliation(s)
- Siwei Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zheran Chen
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Yunfei Jiao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zhiyuan Cheng
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ye Gao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Tianjiao Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Rong Wan
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luowei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
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Park E, Nishimura M, Simoes P. Endoscopic advances in the management of gastric cancer and premalignant gastric conditions. World J Gastrointest Endosc 2023; 15:114-121. [PMID: 37034969 PMCID: PMC10080555 DOI: 10.4253/wjge.v15.i3.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/17/2022] [Accepted: 02/10/2023] [Indexed: 03/16/2023] Open
Abstract
Gastric cancer is the fifth most common cancer and in 2018, it was the third most common cause of cancer-related deaths worldwide. Endoscopic advances continue to be made for the diagnosis and management of both early gastric cancer and premalignant gastric conditions. In this review, we discuss the epidemiology and risk factors of gastric cancer and emphasize the differences in early vs late-stage gastric cancer outcomes. We then discuss endoscopic advances in the diagnosis of early gastric cancer and premalignant gastric lesions. This includes the implementation of different imaging modalities such as narrow-band imaging, chromoendoscopy, confocal laser endomicroscopy, and other experimental techniques. We also discuss the use of endoscopic ultrasound in the diagnosis and staging of early gastric cancer. We then discuss the endoscopic advances made in the treatment of these conditions, including endoscopic mucosal resection, endoscopic submucosal dissection, and hybrid techniques such as laparoscopic endoscopic cooperative surgery. Finally, we comment on the current suggested recommendations for surveillance of both gastric cancer and its premalignant conditions.
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Affiliation(s)
- Erica Park
- Division of Gastroenterology and Hepatology, Mount Sinai Morningside and West, New York, NY 10025, United States
| | - Makoto Nishimura
- Gastroenterology, Hepatology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Priya Simoes
- Division of Gastroenterology and Hepatology, Mount Sinai Morningside and West, New York, NY 10025, United States
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Yu JI. Role of Adjuvant Radiotherapy in Gastric Cancer. J Gastric Cancer 2023; 23:194-206. [PMID: 36750999 PMCID: PMC9911621 DOI: 10.5230/jgc.2023.23.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022] Open
Abstract
Although continuous improvement in the treatment outcome of localized gastric cancer has been achieved through early screening, diagnosis, and treatment and the active application of surgery and adjuvant chemotherapy, the necessity of adjuvant radiotherapy (RT) remains controversial. In this review, based on the results of two recently published randomized phase III studies (Adjuvant Chemoradiation Therapy In Stomach Cancer 2 and ChemoRadiotherapy after Induction chemoTherapy of Cancer in the Stomach) and a meta-analysis of six randomized trials including these two studies, the role of adjuvant RT in gastric cancer was evaluated and discussed, especially in patients who underwent curative gastrectomy with D2 lymphadenectomy. This article also reported the possible indications for adjuvant RT in the current clinical situation and in future research to enable patient-specific treatments according to the risk of recurrence.
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Affiliation(s)
- Jeong Il Yu
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Vedantam S, Katona BW, Sussman DA, Kumar S. Outcomes of upper endoscopy screening in Lynch syndrome: a meta-analysis. Gastrointest Endosc 2023; 97:2-10.e1. [PMID: 36084717 DOI: 10.1016/j.gie.2022.08.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Lynch syndrome (LS) predisposes affected individuals to a high lifetime risk of malignancies, including colorectal, endometrial, gastric, and duodenal cancers. The role of upper GI (UGI) cancer screening in LS has been uncertain, but recent studies have evaluated its utility. METHODS Databases were queried through December 2021 to identify studies that examined upper endoscopy screening in LS using EGD. Mantel-Haenszel pooled odds ratios and 95% confidence intervals (CIs) for outcomes were constructed using a random-effects model to identify pooled odds of endoscopic findings in persons with LS. Event rates for detection of gastric and duodenal cancers, high-risk lesions, and clinically actionable findings were calculated. Statistical heterogeneity was assessed using the I2 statistic. RESULTS Nine studies were identified with 2356 LS patients undergoing approximately 7838 EGDs. In total, 47 LS-associated UGI cancers (18 gastric and 29 duodenal cancers), 237 high-risk lesions, and 335 clinically actionable findings were identified. The pooled event rate for detection of any UGI cancer, high-risk lesions, and clinically actionable findings during screening were .9% (95% CI, .3-2.1; I2 = 89%), 4.2% (95% CI, 1.6-10.9; I2 = 98%), and 6.2% (95% CI, 2.2-16.5; I2 = 99%), respectively. There was no difference between LS-associated gene and gastric or duodenal cancer detection. CONCLUSIONS In LS, there is evidence that endoscopic screening detects UGI cancers, precancerous lesions, and other clinically actionable findings that favor its use as a part of cancer risk management in LS.
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Affiliation(s)
- Shyam Vedantam
- Department of Medicine, University of Miami, Miami, Florida, USA
| | - Bryson W Katona
- Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Daniel A Sussman
- Division of Digestive Health and Liver Diseases, Department of Medicine, Miller School of Medicine at the University of Miami, Miami, Florida, USA
| | - Shria Kumar
- Division of Digestive Health and Liver Diseases, Department of Medicine, Miller School of Medicine at the University of Miami, Miami, Florida, USA; Sylvester Comprehensive Cancer Center, Miller School of Medicine at the University of Miami, Miami, Florida, USA.
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Analysis of Phellinus Igniarius Effects on Gastric Cancer Cells by Atomic Force Microscopy. Micron 2022; 164:103376. [DOI: 10.1016/j.micron.2022.103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/02/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
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Shin C, Han JY, Kim SI, Park SH, Yang HK, Lee HJ, Kong SH, Suh YS, Kim HJ, Choi YP, Jeon B. In vivo and autopsy validation of alpha-synuclein seeding activity using RT-QuIC assay in the gastrointestinal tract of patients with Parkinson's disease. Parkinsonism Relat Disord 2022; 103:23-28. [PMID: 36029607 DOI: 10.1016/j.parkreldis.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/11/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE In the present study, real-time quaking-induced conversion (RT-QuIC) assay was used to evaluate pathologic alpha-synuclein (AS) seeding activity in formalin-fixed paraffin-embedded (FFPE) tissue from the gastrointestinal (GI) tract of Parkinson's disease (PD) patients. METHODS This study was conducted in two parts: Part I. a preliminary autopsy study that included four autopsy-confirmed patients with synucleinopathy (2 PD, 1 dementia with Lewy bodies [DLB], and 1 multiple system atrophy [MSA]) and two normal autopsy controls. Frozen and FFPE tissues of the brain were obtained. Part II. a clinical case-control study that included 20 clinically diagnosed PD patients and matched controls. Surgically resected FFPE tissues from the upper and lower GI tracts were used. The RT-QuIC assay was performed to evaluate pathologic seed amplification using frozen or FFPE tissues. The presence or absence of AS aggregation was confirmed by conventional phosphorylated AS (pAS) immunohistochemistry (IHC). RESULTS In Part I, RT-QuIC assay showed pathologic AS amplification in frozen and FFPE brain tissues of PD and DLB patients, and FFPE stomach tissue of PD patients but not in the MSA patient and controls. In Part II, pathologic seeding activity was found in 10% (2/20) of the stomach tissues of clinical PD patients but in none of the matched controls. IHC showed pAS-positive staining in 55% of patients (11/20) and 15% of controls (3/20). CONCLUSION The present study results showed that the RT-QuIC assay using FFPE tissue of the GI tract was inadequate as a biomarker in PD.
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Affiliation(s)
- Chaewon Shin
- Department of Neurology, Chungnam National University Sejong Hospital, Chungnam National University, 20, Bodeum 7-ro, Sejong-si, Republic of Korea; Department of Neurology, Chungnam National University College of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Jung-Youn Han
- Laboratory Animal Center, Division of Research Strategy, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Seong-Ik Kim
- Department of Pathology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Han-Kwang Yang
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Seong-Ho Kong
- Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Yun-Suhk Suh
- Department of Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Han-Joon Kim
- Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Young Pyo Choi
- Laboratory Animal Center, Division of Research Strategy, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Beomseok Jeon
- Department of Neurology, MRC and Movement Disorder Center, Seoul National University Hospital, Parkinson Study Group, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
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Zhang C, Xiong Z, Chen S, Ding A, Cao Y, Liu B, Liu X. Automated Disease Detection in Gastroscopy Videos Using Convolutional Neural Networks. Front Med (Lausanne) 2022; 9:846024. [PMID: 35492307 PMCID: PMC9041416 DOI: 10.3389/fmed.2022.846024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
A large percentage of the world's population is affected by gastric diseases ranging from erosion and ulcer to serious ailments such as gastric cancer, which is mainly caused by Helicobacter pylori(H.pylori) infection. While most erosions and ulcers are benign, severe cases of gastric diseases can still develop into cancer. Thus, early screening and treatment of all gastric diseases are of great importance. Upper gastroscopy is one such common screening procedure that visualizes the patient's upper digestive system by inserting a camera attached to a rubber tube down the patient's digestive tracts, but since the procedure requires manual inspection of the video feed, it is prone to human errors. To improve the sensitivity and specificity of gastroscopies, we applied deep learning methods to develop an automated gastric disease detection system that detects frames of the video feed showing signs of gastric diseases. To this end, we collected data from images in anonymous patient case reports and gastroscopy videos to train and evaluate a convolutional neural network (CNN), and we used sliding window to improve the stability of our model's video performance. Our CNN model achieved 84.92% sensitivity, 88.26% specificity, and 85.2% F1-score on the test set, as well as 97% true positive rate and 16.2% false positive rate on a separate video test set.
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Affiliation(s)
- Chenxi Zhang
- Department of Computer Science, University of Massachusetts Lowell, Lowell, MA, United States
| | - Zinan Xiong
- Department of Computer Science, University of Massachusetts Lowell, Lowell, MA, United States
| | - Shuijiao Chen
- Department of Gastroenterology, Xiangya Hospital of Central South University and Hunan International Computer Aided Diagnosis and Treatment for Digestive Disease, Changsha, China
| | - Alex Ding
- Department of Computer Science, Brown University, Providence, RI, United States
| | - Yu Cao
- Department of Computer Science, University of Massachusetts Lowell, Lowell, MA, United States
| | - Benyuan Liu
- Department of Computer Science, University of Massachusetts Lowell, Lowell, MA, United States
| | - Xiaowei Liu
- Department of Gastroenterology, Xiangya Hospital of Central South University and Hunan International Computer Aided Diagnosis and Treatment for Digestive Disease, Changsha, China
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