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Wang CY, Fan XJ, Wang FL, Ge YY, Cai Z, Wang W, Zhou XP, Du J, Dai DW. Clinical value of oral contrast-enhanced ultrasonography in diagnosis of gastric tumors. World J Gastrointest Oncol 2024; 16:110-117. [PMID: 38292839 PMCID: PMC10824109 DOI: 10.4251/wjgo.v16.i1.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The incidence of gastric cancer remains high, and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide. Oral contrast-enhanced ultrasonography is a simple, non-invasive, and painless method for the diagnosis of gastric tumors. AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors. METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination. RESULTS Among 42 patients with gastric tumors enrolled in the study, the diagnostic accordance rate was 95.2% for oral contrast-enhanced ultrasonography (n = 40) and 90.5% for electronic gastroscopy (n = 38) compared with postoperative pathological examination. The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy, and there was no significant difference between them (P = 0.397). For the TNM staging of gastric tumors, the accuracy rate of oral contrast-enhanced ultrasonography was 81.9% for the overall T staging and 50%, 77.8%, 100%, and 100% for T1, T2, T3, and T4 staging, respectively. The sensitivity and specificity were both 100% for stages T3 and T4. The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%, 80%, 100%, and 100% for stages N0, N1-N3, M0, and M1, respectively. CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy, and it could be used as the preferred method for the early screening of gastric tumors.
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Affiliation(s)
- Chuan-Yu Wang
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
| | - Xiao-Jing Fan
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
| | - Fei-Liang Wang
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
| | - Yue-Yue Ge
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
| | - Zhao Cai
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
| | - Wei Wang
- Department of Gastroscopy, Beijing Hospital, Beijing 100005, China
| | - Xin-Ping Zhou
- Department of General Surgery, Beijing Hospital, Beijing 100005, China
| | - Jun Du
- Department of Pathology, Beijing Hospital, Beijing 100005, China
| | - De-Wei Dai
- Department of Ultrasound Medicine, Beijing Hospital, Beijing 100005, China
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Peng Z, Wang R, Wu N, Gao H, Gao H, Li D. Assessment of the risk factors of duodenogastric reflux in relation to different dietary habits in a Chinese population of the Zhangjiakou area. Food Nutr Res 2023; 67:9385. [PMID: 37920676 PMCID: PMC10619390 DOI: 10.29219/fnr.v67.9385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/21/2023] [Accepted: 06/26/2023] [Indexed: 11/04/2023] Open
Abstract
Objective To explore the risk factors of duodenogastric reflux (DGR) in relation to different dietary habits. Methods A total of 106 patients with symptoms of DGR who underwent electronic gastroscopy from June 2019 to June 2020 were selected and divided into the DGR group (n = 33) and the non-DGR group (n = 73) according to the diagnosis of bile reflux. Questionnaires were used to collect the basic information and dietary habits of the patients, including age, gender, body mass index, place of residence, comorbidities, dietary composition, salt intake, smoking and drinking consumption. The total bile acid (TBA) and cholesterol (CHO) of the gastric juice were measured using a fully automated biochemical analyser, with an enzyme-linked immunosorbent assay used for the serum cholecystokinin, gastrin and gastrin levels. Univariate analysis and multivariate logistic regression analysis were used to predict the attendant DGR risk factors. Results There was no significant difference in age or gender between the DGR and the non-DGR groups (P > 0.05). The proportion of patients living in the Bashang region was significantly higher in the DGR group (78.79%) than in the non-DGR group (38.36%) (P < 0.05). The levels of TBA and CHO in the gastric juice and the cholecystokinin and gastrin levels in the serum of the DGR group were higher than those in the non-DGR group, while the serum motilin levels were significantly lower in the DGR group than in the non-DGR group (P < 0.05). The univariate analysis indicated that the proportion of patients with daily consumption of dairy products and fried foods, a high salt intake and smoking and drinking consumption were significantly higher in the DGR than in the non-DGR group (P < 0.05). Conclusion The daily consumption of dairy products and a preference for fried food are independent risk factors for the occurrence of DGR (odds ratio ≥ 1, P < 0.05).
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Affiliation(s)
- Zhao Peng
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Rui Wang
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Na Wu
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Huiru Gao
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Huibin Gao
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Duo Li
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
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Sun M, Ma T, Yuan H. Association between history of cholecystectomy and risk of gastric cancer: a meta-analysis of epidemiological studies. BMJ Open 2023; 13:e057138. [PMID: 37640459 PMCID: PMC10462960 DOI: 10.1136/bmjopen-2021-057138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/22/2023] [Indexed: 08/31/2023] Open
Abstract
PURPOSE Evidence from previous studies on the association between cholecystectomy and risk of gastric cancer are still inconsistent. We aimed at conducting a meta-analysis of epidemiological studies to evaluate this association. METHODS Researchers searched three databases (PubMed, Embase and Web of Science) through January 2021 for eligible studies. Relative risks (RRs) and 95% CIs in each included studies were pooled by random-effects models. Patients and the public were not involved in our study. RESULTS Eight studies were identified. Four studies reported significantly positive association between history of cholecystectomy and risk of gastric cancer, and the remaining studies reported null association. The pooled RR of these eight studies showed that a history of cholecystectomy was associated with a 11% higher risk of gastric cancer (pooled RR=1.11, 95% CI: 1.03 to 1.20). Moderate heterogeneity across the studies was detected (p=0.117, I2=37.8%). The pooled RRs were 1.12 (95% CI: 1.01 to 1.24) for five cohort studies and 0.95 (95% CI: 0.66 to 1.38) for three case-control studies. Compared with the risk in Europe and the USA, the pooled RR was higher for two studies conducted in Asia. Six studies were assessed as high-quality studies with the pooled RR of 1.12 (95% CI: 1.02 to 1.23). The pooled results were robust by sensitivity analyses, and no indication of publication bias was detected. CONCLUSION This meta-analysis suggests that a history of cholecystectomy may be associated with an increased risk of gastric cancer.
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Affiliation(s)
- Mei Sun
- Department of Gastroenterology, Dalian Municipal Central Hospital, Dalian, Liaoning, China
| | - Tianyi Ma
- Department of Gastroenterology, Dalian Municipal Central Hospital, Dalian, Liaoning, China
| | - Huawei Yuan
- Department of Gastroenterology, Dalian Municipal Central Hospital, Dalian, Liaoning, China
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Lee SM, Park MS, Park SY, Choi YD, Chung JO, Kim DH, Jung YD, Kim HS. Primary bile acid activates Egr‑1 expression through the MAPK signaling pathway in gastric cancer. Mol Med Rep 2022; 25:129. [PMID: 35169855 PMCID: PMC8867467 DOI: 10.3892/mmr.2022.12646] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/20/2022] [Indexed: 11/09/2022] Open
Abstract
Bile acids have been linked to pathomechanism and prognosis in various types of cancers. The present study aimed to investigate the effect of bile acids on the molecular change in gastric epithelial cancer cells and to evaluate gastric bile acid concentration in patients with early gastric cancer (EGC). Human gastric cancer cells (AGS and NCI-N87 cell lines) were treated with several bile acid types to determine their effect on molecular changes in the cells. Gastric levels of individual bile acids were measured (primary unconjugated or conjugated bile acids and secondary bile acids) in 39 participants (20 controls and 19 patients with EGC). Exposing gastric epithelial cancer cells to primary bile acids in vitro upregulated the expression of early growth response factor 1 (Egr-1) and the oncogenes including c-Jun, c-Myc and Snail, whereas a p42/44 MAPK inhibitor exposure reduced their expression. There was a significant difference in age and presence of atrophic gastritis with intestinal metaplasia in background mucosa between controls and patients with EGC. There were significant differences in the levels of unconjugated or conjugated primary bile acids between controls and EGC patients except lithocholic acid. After adjustment of age and presence of atrophic gastritis with intestinal metaplasia, the levels of cholic acid [adjusted odds ratio (aOR) 4.3; 95% confidence interval (CI): 1.2-16.2; P=0.029] and glycochenodeoxycholic acid [aOR 9.9; 95% CI: 1.3-75.3; P=0.027] were significantly higher in patients with EGC compared with controls. In conclusion, bile acids upregulate Egr-1 in gastric cancer cells via the MAPK signaling pathway, and higher gastric levels of primary bile acids are associated with EGC. Therefore, exposure of gastric cells to primary bile acids may play a role in gastric carcinogenesis.
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Affiliation(s)
- Su-Mi Lee
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Moon Sik Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Seon-Young Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Jin Ook Chung
- Division of Endocrinology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Dong Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Young Do Jung
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Hyun Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
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Long-Term Evaluation of Biliary Reflux on Esogastric Mucosae after One-Anastomosis Gastric Bypass and Esojejunostomy in Rats. Obes Surg 2021; 30:2598-2605. [PMID: 32130650 DOI: 10.1007/s11695-020-04521-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND One-anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) remains controversial because it may cause chronic biliary reflux (BR). The risk of developing esogastric cancer due to BR after OAGB/MGB is based on the results of experimental rat studies using esojejunostomy (EJ). The aim of this study was to analyze the potential long-term consequences of BR on the esogastric mucosae in OAGB/MGB-operated rats and to compare these results to those from the use of EJ. METHODS Wistar rats received OAGB/MGB (n = 16), EJ (n = 16), and sham (n = 8) operations. Mortality and weight changes were evaluated throughout the experiment. BR was measured using magnetic resonance imaging (MRI). Rats received follow-ups for 30 weeks. A double-blinded histological analysis was performed in the esogastric segments. RESULTS BR was diagnosed in OAGB/MGB and EJ rats using the MRI technique; no BR occurred in the sham group. After a 30-week follow-up, no incidences of dysplasia or cancer were observed in the three groups. Additionally, esophageal intestinal metaplasia and mucosal ulcerations were observed in 41.7% and 50% of EJ rats, respectively, and no incidences of these conditions were observed in OAGB/MGB and sham rats. The incidence of esophagitis was significantly higher and more severe in the EJ group compared to those in the OAGB/MGB and sham groups (EJ = 100%, OAGB/MGB = 16.7%, sham = 8.3%; p < 0.001). CONCLUSIONS After a 30-week follow-up period, OAGB/MGB rats did not develop any precancerous or cancerous lesions when more than 40% of EJ rats had intestinal metaplasia.
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Li D, Zhang J, Yao WZ, Zhang DL, Feng CC, He Q, Lv HH, Cao YP, Wang J, Qi Y, Wu SR, Wang N, Zhao J, Shi YQ. The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study. J Dig Dis 2020; 21:222-229. [PMID: 32187838 PMCID: PMC7317534 DOI: 10.1111/1751-2980.12858] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the relationship between gastric cancer (GC) and precancerous lesions and bile reflux. METHODS Medical records of 30 465 participants who underwent gastroscopy between January and December 2018 in our center were reviewed. Their age, sex, time of endoscopy, endoscopic/histologic diagnosis and grade of bile reflux were recorded. The participants were further divided into the chronic gastritis group (n = 27 807), a precancerous lesion group (n = 1943) and a GC group (n = 715). The χ2 tests and hierarchical analyses were performed. RESULTS Patients aged 18-27 years had a higher bile reflux rate than those aged 28-37 and 68-75 years (P < 0.001), while it did not differ between patients aged <50 years and those over 50 years (P = 0.639). It was lower in men than in women (P < 0.001). The bile reflux rate did not differ in terms of months, seasons and half of the year (all P > 0.05), but differed between morning and afternoon when they underwent the endoscopy (P = 0.000). There was an interrelationship between the severity of gastric mucosal disease and bile reflux grade (r = 0.171). After excluding the effects of sex, age and time of endoscopy on bile reflux, bile reflux rate in chronic gastritis and precancerous lesions was lower than in gastric cancer (P < 0.01). CONCLUSIONS Bile reflux may be a risk factor for gastric cancer and precancerous lesions. A high grade of bile reflux may be associated with the progression of gastric mucosal diseases.
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Affiliation(s)
- Dan Li
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Jian Zhang
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive DiseasesAir Force Military Medical UniversityXi'anShaanxi ProvinceChina
| | - Wen Zhu Yao
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Dong Lin Zhang
- Division of General MedicineThe First Affiliated Hospital of Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | | | - Qi He
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Huan Huan Lv
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Ya Ping Cao
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Jie Wang
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Ying Qi
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina
| | - Si Ran Wu
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive DiseasesAir Force Military Medical UniversityXi'anShaanxi ProvinceChina
| | - Na Wang
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive DiseasesAir Force Military Medical UniversityXi'anShaanxi ProvinceChina
| | - Jing Zhao
- Division of GastroenterologySecond Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxi ProvinceChina
| | - Yong Quan Shi
- Xi'an Medical UniversityXi'anShaanxi ProvinceChina,State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive DiseasesAir Force Military Medical UniversityXi'anShaanxi ProvinceChina
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Lee W, Um J, Hwang B, Lee YC, Chung BC, Hong J. Assessing the progression of gastric cancer via profiling of histamine, histidine, and bile acids in gastric juice using LC-MS/MS. J Steroid Biochem Mol Biol 2020; 197:105539. [PMID: 31730800 DOI: 10.1016/j.jsbmb.2019.105539] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/18/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
Bile acid (BA) imbalance may be directly associated with gastric cancer and indirectly influence stomach carcinogenesis via overexpression of histidine decarboxylase (HDC), which converts histidine (His) into histamine (HIST). Moreover, the progression of gastric cancer, could change the gut microbiome, including bacteria spp. that produce secondary BAs. Gastric juice has various metabolites that could indicate gastric cancer-related stomach conditions. Therefore, profiling of HIST, His, and BAs in gastric juice is crucial for understanding the etiological mechanisms of gastric cancer. We used a profiling method to simultaneously determine targeted metabolites in gastric juice using liquid chromatography-tandem mass spectrometry (LC-MS/MS). We successfully analyzed 70 human gastric juice samples from patients with chronic superficial gastritis (CSG, n = 20), intestinal metaplasia (IM, n = 12), and gastric cancer (n = 38). Furthermore, we investigated the relevance between BA metabolism and gastric cancer. There were statistical differences in the metabolism of cholic acid (CA) into deoxycholic acid (DCA) based on the progression of CSG into IM and gastric cancer. Hence, the progression of gastric cancer might be related to the alterations in gut microbiome composition. We provide insight into the etiological mechanisms of the progression of gastric cancer and biomarkers to diagnose and treat gastric cancer.
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Affiliation(s)
- Wonwoong Lee
- College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jinhee Um
- College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Boram Hwang
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Bong Chul Chung
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Jongki Hong
- College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.
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