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Mansuri I, Goldsmith JD, Liu E, Bonilla S. Gastric Intestinal Metaplasia in Children: Natural History and Clinicopathological Correlation. J Pediatr Gastroenterol Nutr 2023; 77:332-338. [PMID: 37319118 DOI: 10.1097/mpg.0000000000003862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Gastric intestinal metaplasia (GIM) is defined as the replacement of the normal gastric epithelium by intestinal-type epithelium. GIM is considered a preneoplastic lesion for gastric adenocarcinoma in adults and is found in 25% of Helicobacter pylori ( H pylori ) exposed adults. However, the significance of GIM in pediatric gastric biopsies is still unknown. METHODS We conducted a retrospective study of children with GIM on gastric biopsies at Boston Children's Hospital between January 2013 and July 2019. Demographic, clinical, endoscopic, and histologic data were collected and compared to age and sex-matched cohort without GIM. Gastric biopsies were reviewed by the study pathologist. GIM was classified as complete/incomplete based on Paneth cell presence or absence and limited/extensive based on its distribution in the antrum or both antrum and corpus. RESULTS Of 38 patients with GIM, 18 were male (47%), mean age of detection was 12.5 ± 5.05 years (range, 1-18 years). The most common histologic was chronic gastritis (47%). Complete GIM was present in 50% (19/38) and limited GIM was present in 92% (22/24). H pylori was positive in 2 patients. Two patients had persistent GIM on repeat esophagogastroduodenoscopy (2/12). No dysplasia or carcinoma was identified. Proton-pump inhibitor use and chronic gastritis were more common in GIM patients compared to control ( P = 0.02). CONCLUSION Most children with GIM had low-risk histologic subtype (complete/limited) for gastric cancer; GIM was rarely associated with H pylori gastritis in our cohort. Larger multicenter studies are needed to better understand outcomes and risk factors in children with GIM.
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Affiliation(s)
- Ishrat Mansuri
- From the Division of Gastroenterology, Boston Children's Hospital, Boston, MA
| | | | - Enju Liu
- the Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA
| | - Silvana Bonilla
- From the Division of Gastroenterology, Boston Children's Hospital, Boston, MA
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2
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Yu M, Ma J, Song XX, Shao QQ, Yu XC, Khan MN, Qi YB, Hu RB, Wei PR, Xiao W, Jia BL, Cheng YB, Kong LF, Chen CL, Ding SZ. Gastric mucosal precancerous lesions in Helicobacter pylori-infected pediatric patients in central China: A single-center, retrospective investigation. World J Gastroenterol 2022; 28:3682-3694. [PMID: 36161049 PMCID: PMC9372804 DOI: 10.3748/wjg.v28.i28.3682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/02/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infects about 50% of the world population and is the major cause of chronic gastritis, peptic ulcers, and gastric cancer. Chronic H. pylori infection induces gastric mucosal precancerous lesions mostly in adulthood, and it is debatable whether these pathological conditions can occur in childhood and adolescents as well. Since this is a critical issue to determine if intervention should be offered for this population group, we investigated the gastric mucosal precancerous lesions in pediatric patients in an area in central China with a high prevalence of H. pylori and gastric cancer.
AIM To investigate the relationship of H. pylori infection and gastric mucosal precancerous lesions in children and adolescents in central China.
METHODS We screened 4258 ward-admitted children and adolescent patients with upper gastrointestinal symptoms, and finally enrolled 1015 pediatric patients with H. pylori infection and endoscopic and histological data. H. pylori infection status was determined by rapid urease test and histopathological examination. Both clinical and pathological data were collected and analyzed retrospectively. Occurrence of gastric mucosal precancerous lesions, inflammatory activity and degree of inflammatory cell infiltration between H. pylori-positive and -negative groups were compared.
RESULTS Among the 1015 eligible children and adolescents, the overall H. pylori infection rate was 84.14% (854/1015). The infection rate increased with age. The incidence of gastric mucosal precancerous lesions in H. pylori-infected children was 4.33% (37/854), which included atrophic gastritis (17 cases), intestinal metaplasia (11 cases) and dysplasia (9 cases). In H. pylori-negative patients, only 1 atrophic gastritis case [0.62%, (1/161)] was found (P < 0.05). Active inflammation in H. pylori-infected patients was significantly higher than that in non-infected patients, and the H. pylori-infected group showed more severe lymphocyte and neutrophil granulocyte infiltration (P < 0.001). In addition, endoscopy revealed that the most common findings in H. pylori-positive patients were antral nodularity, but in H. pylori-negative patients only superficial gastritis was observed.
CONCLUSION In children and adolescents, gastric mucosal precancerous lesions occurred in 4.33% of H. pylori-infected patients in central China. These cases included atrophic gastritis, intestinal metaplasia, and dysplasia. The data revealed an obvious critical issue requiring future investigation and intervention for this population group.
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Affiliation(s)
- Miao Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Jing Ma
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xiao-Xia Song
- Department of Pathology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Muhammad Noman Khan
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ya-Bin Qi
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ruo-Bing Hu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Pei-Ru Wei
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wei Xiao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Bai-Ling Jia
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yan-Bo Cheng
- Department of Pediatrics, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ling-Fei Kong
- Department of Pathology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Chuan-Liang Chen
- Department of Medical Imaging, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
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3
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Hsieh H, Yang HB, Sheu BS, Yang YJ. Atrophic gastritis in Helicobacter pylori-infected children. Helicobacter 2022; 27:e12885. [PMID: 35306717 DOI: 10.1111/hel.12885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Helicobacter pylori infection is the leading cause of peptic ulcer and chronic gastritis and may initiate gastric carcinogenesis following the Correa cascade. Another lineage of metaplasia, spasmolytic peptide-expressing metaplasia (SPEM) has recently been found to be an alternative precursor to gastric cancer. To date, few reports have investigated gastric precancerous lesions among children with H. pylori infection. This study aimed to evaluate the histopathological pattern of H. pylori atrophic gastritis in children and the extent of precancerous lesions. MATERIALS AND METHODS This study enrolled pediatric patients with H. pylori infection from 1998 to 2019. During esophagogastroduodenoscopy examinations, biopsy fragments were collected from the gastric antrum and corpus for rapid urease test, culture, and histology evaluation. The presence and degree of chronic inflammation, activity of gastritis, H. pylori density, atrophy, and intestinal metaplasia (IM) were assessed according to the modified Updated Sydney System. Trefoil factor 2 (TFF2) immunohistochemistry was also performed to assess SPEM in the gastric tissues collected from each case using rabbit anti-human TFF2 antibodies. RESULTS A total of 92 children with H. pylori infection and adequate gastric mucosa biopsies were enrolled. Esophagogastroduodenoscopy showed that 39 (42.4%) had duodenal ulcers, 11 (12.0%) had gastric ulcers, 41 (44.6%) had gastritis, and 1 (1.1%) had negative findings. Mild-to-moderate IM was identified in 4 patients (4.3%). SPEM was found in 8 patients (8.7%) with a significantly higher incidence among female patients (15.8% vs. 8.7%, p = .031). Gastric glandular atrophy presented in 28 patients (30.4%), and high-grade atrophy was more common in female patients (3.2% vs. 1.9%, p = .031). CONCLUSIONS The prevalence rates of atrophic gastritis in the children with H. pylori infection were 30.4% for gastric glandular atrophy, 4.3% for IM and 8.7% for SPEM. SPEM and high-grade atrophy were more common in female patients.
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Affiliation(s)
- Hsuan Hsieh
- Departments of Pediatrics, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Bai Yang
- Departments of Pathology, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Department of Pathology, Ton-Yen General Hospital, Zhubei, Taiwan
| | - Bor-Shyang Sheu
- Departments of Internal Medicine, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Institutes of Clinical Medicine, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Jong Yang
- Departments of Pediatrics, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Institutes of Clinical Medicine, Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
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Virkkula A, Kivela L, Hiltunen P, Sotka A, Huhtala H, Kurppa K, Repo M. Prevalence and Clinical Significance of Helicobacter Pylori-negative Chronic Gastritis in Children. J Pediatr Gastroenterol Nutr 2022; 74:949-955. [PMID: 35258500 DOI: 10.1097/mpg.0000000000003440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The clinical significance of Helicobacter pylori-negative chronic gastritis (HPNCG) in children is unclear. We examined this issue in patients who had undergone esophagogastroduodenoscopy with systematic gastric sampling. METHODS Data of 1178 consecutive children who underwent diagnostic esophagogastroduodenoscopy were collected. Baseline characteristics and long-term outcomes were compared between children with active and inactive HPNCG and those with normal gastric histology. Follow-up data were available for up to 13 years. RESULTS Altogether 24 (2.0%) children had active and 235 (19.9%) inactive HPNCG, 27 (2.3%) were Hpylori-positive, 46 (3.9%) had other gastric pathology, and 846 (71.8%) normal histology. Diarrhea (31.3% vs 25.1%, P = 0.033), poor growth (23.6% vs 14.7%, P < 0.001), bloody stools (13.9% vs 7.2%, P < 0.001), anemia (46.5% vs 23.4%, P < 0.001), hypersedimentation (39.7% vs 21.4%, P < 0.001), hypoalbuminemia (40.4% vs 16.2%, P < 0.001), and elevated fecal calprotectin (62.4% vs 31.5%, P < 0.001) were more common and heartburn (13.9% vs 22.9%, P = 0.002) less common in the HPNCG group than in the controls. Both active (OR 3.64,95% CI 1.35-9.82) andinactive (2.98, 2.18-4.08) HPNCG predicted a diagnosis in the initial investigations. Crohn disease (41.7%) was the most common diagnosis in active HPNCG and celiac disease (37.4%) in inactive HPNCG. During follow-up, 7 (9.9%) of the 71 initially nondiagnosed HPNCG children received a diagnosis. CONCLUSIONS HPNCG is a frequent finding in children undergoing EGD, the active form being associated especially with Crohn disease and the inactive with celiac disease. The long-term prognosis of patients with HPNCG who do not receive an initial diagnosis is good.
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Affiliation(s)
- Anni Virkkula
- Tampere Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Laura Kivela
- Tampere Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere university, Tampere
- University of Helsinki and Helsinki University Hospital, Children's Hospital, and Paediatric Research Center, Helsinki
| | - Pauliina Hiltunen
- Tampere Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere
| | - Antti Sotka
- Department of Pediatrics, South Karelia Central Hospital, Lappeen-ranta
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere
| | - Kalle Kurppa
- Tampere Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere university, Tampere
- University Consortium of Seinajoki and Seinajoki Central Hospital, Seinajoki, Finland
| | - Marleena Repo
- Tampere Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere university, Tampere
- Department of Pediatrics, Central Finland Central Hospital, Jyvaskyla, Finland
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5
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Kalach N, Misak Z, Bontems P, Kori M, Homan M, Cabral J, Casswall T, Chong S, Cilleruelo ML, Faraci S, Megraud F, Papadopoulou A, Pehlivanoglu E, Raymond J, Rea F, Maria R, Roma E, Tavares M, Ugras M, Urbonas V, Urruzuno P, Gosset P, Creusy C, Delebarre M, Verdun S. Systematic Review and Meta-analysis of Histological Gastric Biopsy Aspects According to the Updated Sydney System in Children. J Pediatr Gastroenterol Nutr 2022; 74:13-19. [PMID: 34338237 DOI: 10.1097/mpg.0000000000003259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES A descriptive and comparative study of gastric histological aspects according to the updated Sydney classification (USC), obtained from Helicobacter pylori-positive versus H pylori-negative children referred for upper gastrointestinal endoscopy. METHODS The Prisma method was used to perform a systematic review and meta-analysis. Selection criteria were based on following key words USC, H pylori, children, endoscopy, or biopsy. Publication biases were assessed according to the Newcastle-Ottawa Scale, and a meta-regression analysis was done. The study was registered on the PROSPERO platform. RESULTS Between 1994 and 2017, 1238 references were found; 97 studies were retained for the systematic review with a total number of 25,867 children; 75 studies were selected for the meta-analysis concerning 5990 H pylori-infected and 17,782 uninfected children.H pylori-positive versus H pylori-negative children, according to the USC, showed significantly higher relative risk for gastric antral and corpus chronic inflammation, presence of neutrophils, and of lymphoid follicles, and gastric mucosa atrophy, whereas, intestinal metaplasia showed a significantly higher RR only in antral biopsies. The meta-regression analysis showed that H pylori-positive versus H pylori-negative children had significantly higher risk only for corpus activity according to age, recurrent abdominal pain, and geographical area of low H pylori prevalence. CONCLUSIONS H pylori infection in children was associated with higher relative risk for gastric antral and corpus chronic inflammation, presence of neutrophils, lymphoid follicles, and rare gastric mucosa atrophy, whereas, rare intestinal metaplasia was only significantly higher in the antral area.
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Affiliation(s)
- Nicolas Kalach
- Pediatric Clinic, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille, Lille, France
| | - Zrinjka Misak
- Department of Pediatrics, Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia
| | - Patrick Bontems
- Department of Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Belgium
| | - Michal Kori
- Kaplan Medical Center, Pediatric Gastroenterology Unit, Rehovot, Israel
| | - Matjaz Homan
- Department of Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - José Cabral
- Hospital of Dona Estefania, CHLC, Pediatric Gastroenterology Unit, Lisbon, Portugal
| | - Thomas Casswall
- Karolinska University Hospital, Department of Pediatrics, Stockholm, Sweden
| | - Sonny Chong
- Queen Mary's Hospital for children Epsom & St Helier NHS Trust Carshalton, Surrey, United Kingdom
| | - Maria Luz Cilleruelo
- Hospital Universitario Puerta de Hierro-Majadahonda, Pediatric Gastroenterology Unit, Madrid, Spain
| | - Simona Faraci
- Bambino Gesù Children's Hospital, Digestive Endoscopy and Surgery Unit, Rome, Italy
| | - Francis Megraud
- INSERM U1053, University of Bordeaux, & National Reference Centre for Campylobacter and Helicobacter, Hospital Pellegrin, Bordeaux, France
| | - Alexandra Papadopoulou
- Division of Gastroenterology & Hepatology, First Department of Pediatrics, University of Athens, Agia Sofia Children's Hospital, Athens, Greece
| | - Ender Pehlivanoglu
- Department of Child Health & Nutrition, Istanbul Kent University, Istanbul, Turkey
| | - Josette Raymond
- Microbiology Department, Cochin Hospital, Assistances Publiques des Hôpitaux de Paris (AP-HP), University René Descartes Paris V, Paris, France
| | - Francesca Rea
- Bambino Gesù Children's Hospital, Digestive Endoscopy and Surgery Unit, Rome, Italy
| | - Rogalidou Maria
- Division of Gastroenterology & Hepatology, First Department of Pediatrics, University of Athens, Agia Sofia Children's Hospital, Athens, Greece
| | | | - Marta Tavares
- Unidade de Gastrenterologia Pediátrica do Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Meltem Ugras
- Yeditepe University Medical Faculty, Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Ataşehir, Istanbul, Turkey
| | - Vaidotas Urbonas
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - Pedro Urruzuno
- Hospital Universitario Doce de Octubre, Servicio de Pediatria, Madrid, Spain
| | - Pierre Gosset
- Pathology Department, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille
| | - Colette Creusy
- Pathology Department, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille
| | - Mathilde Delebarre
- Pediatric Clinic, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille, Lille, France
| | - Stephane Verdun
- Department of Medical Research, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Lille Catholic Hospital, Lille, France
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6
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Duan F, Song C, Shi J, Wang P, Ye H, Dai L, Zhang J, Wang K. Identification and epidemiological evaluation of gastric cancer risk factors: based on a field synopsis and meta-analysis in Chinese population. Aging (Albany NY) 2021; 13:21451-21469. [PMID: 34491229 PMCID: PMC8457565 DOI: 10.18632/aging.203484] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022]
Abstract
To summarize and assess the credibility and strength of non-genetic factors and genetic variation on gastric cancer risk, we performed a field synopsis and meta-analysis to identify the risk of gastric cancer in Chinese population. Cumulative evidence was graded according to the Venice criteria, and attributable risk percentage (ARP) and population attributable risk percentage (PARP) were used to evaluate the epidemiological effect. A total of 956 studies included non-genetic (404 studies) and genetic factors (552 studies) were quantified, and data on 1161 single nucleotide polymorphisms (SNPs) were available. We identified 14 non-genetic factors were significantly associated with gastric cancer risk. For the analysis of time trends, H. pylori infection rate in gastric cancer and population showed a downward trend. Meanwhile 22 variants were identified significantly associated with gastric cancer: 3 (PLCE1 rs2274223, PSCA rs2976392, MUC1 rs4072037) were high and 19 SNPs were intermediate level of summary evidence, respectively. For non-genetic factors, the top three for ARP were 54.75% (pickled food), 65.87% (stomach disease), and 49.75% (smoked and frying). For PARP were 34.22% (pickled food), 34.24% (edible hot food) and 23.66%(H. pylori infection). On the basis of ARP and PARP associated with SNPs of gastric cancer, the top three for ARP were 53.91% (NAT2, rs1799929),53.05% (NAT2 phenotype), and 42.85% (IL-10, rs1800896). For PARP (Chinese Han in Beijing) were 36.96% (VDR, rs731236), 25.58% (TGFBR2, rs3773651) and 20.56% (MUC1, rs4072037). Our study identified non-genetic risk factors and high-quality biomarkers of gastric cancer susceptibility and their contribution to gastric cancer.
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Affiliation(s)
- Fujiao Duan
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China.,Medical Research Office, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Chunhua Song
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Jiachen Shi
- Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University,Zhengzhou, Henan Province, China
| | - Peng Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Hua Ye
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Liping Dai
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Jianying Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
| | - Kaijuan Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.,Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou, Henan Province, China
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7
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Suyapoh W, Tangkawattana S, Suttiprapa S, Punyapornwithaya V, Tangkawattana P, Sripa B. Synergistic effects of cagA+ Helicobacter pylori co-infected with Opisthorchis viverrini on hepatobiliary pathology in hamsters. Acta Trop 2021; 213:105740. [PMID: 33159904 DOI: 10.1016/j.actatropica.2020.105740] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Human liver fluke infection caused by Opisthorchis viverrini is associated with several biliary diseases including cholangiocarcinoma (CCA). Recently, it was discovered that the liver fluke is a reservoir of Helicobacter pylori, particularly the cagA-positive strain (cytotoxin-associated gene A) in its gut. Given that two carcinogenic pathogens are associated with CCA development, however, the role of cagA-positive H. pylori in opisthorchiasis has not been clarified. The present study was therefore aimed to investigate histopathological changes of the biliary system in hamsters co-infected with O. viverrini and cagA-positive H. pylori or O. viverrini and cagA-negative H. pylori, with controls of O. viverrini, cagA-positive H. pylori, or cagA-negative H. pylori alone, over time. Major histopathological changes were systematically investigated. All pathological features were quantified/semi-quantified and compared among the experimental groups. The results showed that O. viverrini infection groups (O. viverrini, cagA-positive H. pylori and cagA-negative H. pylori) showed a high degree of eosinophil and mononuclear cell infiltration, lymphoid aggregation and granuloma. Specifically, O. viverrini co-infected with cagA-positive H. pylori presented significantly higher inflammatory scores than O. viverrini and O. viverrini with cagA-positive H. pylori. Proliferation and adaptive lesions such as hyperplasia, goblet cell metaplasia and dysplasia were detected only in O. viverrini infection groups. Dysplasia, the precancerous lesion of CCA, was observed in the first-order bile ducts, especially where the inflammation existed and was found earlier and more severely in O. viverrini with cagA-positive H. pylori than other groups. Similarly, the BrdU (bromodeoxyuridine) proliferation index was significantly higher in O. viverrini co-infected with cagA-positive H. pylori than O. viverrini and O. viverrini with cagA-negative H. pylori groups. Periductal fibrosis was a prominent histopathologic feature in chronic infection in O. viverrini infection groups. Multiple logistic regression showed that O. viverrini co-infected with cagA-positive H. pylori and the duration of infection were the most important factors associated with periductal fibrosis (OR 3.02, 95% CI 1.02-9.29, p = 0.04 and OR 3.82, 95% CI 2.61-5.97, p<0.001). This study demonstrates that the liver fluke co-infected with cagA-positive H. pylori induces severe biliary pathology that may predispose to cholangiocarcinogenesis.
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8
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Saafan T, El Ansari W, Bashah M. Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens? Obes Surg 2020; 29:2166-2173. [PMID: 30989568 DOI: 10.1007/s11695-019-03801-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or pre-malignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes. METHOD Retrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens. RESULTS Females comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies. CONCLUSION When confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates.
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Affiliation(s)
- Tamer Saafan
- Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. .,College of Medicine, Qatar University, Doha, Qatar. .,School of Health and Education, University of Skövde, Skövde, Sweden.
| | - Moataz Bashah
- Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine, Doha, Qatar
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9
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Şenocak Taşçı E, Akbaş T. The Relationship between the Sydney Classification and the First-Line Treatment Efficacy in Helicobacter-Associated Gastritis. Med Princ Pract 2020; 29:551-557. [PMID: 32344409 PMCID: PMC7768124 DOI: 10.1159/000508248] [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: 11/06/2019] [Accepted: 04/27/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Helicobacter pyloriis responsible for a wide spectrum of diseases. Due to ease of use and access, the standard triple therapy is being used as first-line eradication in many areas. Intestinal metaplasia (IM) is a precancerous lesion that requires eradication therapy. Our aim is to investigate the effect of IM on the standard triple therapy success in H. pylori-positive patients. SUBJECTS AND METHODS The patients who were referred to Düzce University Hospital and Avrasya Hospital Gastroenterohepatology clinic between January 2014 and December 2016 and diagnosed with H. pylori-positive gastritis and underwent first-line eradication were evaluated retrospectively. Biopsy specimens were evaluated according to the updated Sydney system. All patients diagnosed with H. pylori started treatment with pantoprazole 40 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 14 days. RESULTS The mean age of 181 patients included in the study was 55.5 ± 7.8. The success rate of H. pylori eradication was found to be low in severe chronic inflammation (p = 0.001). The success rate was found to be high among patients with no neutrophil activity (p = 0.009). As the intensity of IM increased, density of H. pylori was found to be decreased (p = 0.019). There was no correlation between glandular atrophy, IM, and H. pylori eradication success rate (p = 0.390 and p = 0.812). CONCLUSION The severity of chronic inflammation is the most effective Sydney criteria for success of eradication, while the presence on IM does not have any effect.
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Affiliation(s)
- Elif Şenocak Taşçı
- Department of Internal Medicine, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey,
| | - Türkay Akbaş
- Department of Internal Medicine and Critical Care Unit, Düzce University School of Medicine, Düzce, Turkey
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10
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Öner Rİ, Özdaş S. Histopathological Findings in Morbid Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: Does H. pylori Infection Effective on Pathological Changes? Obes Surg 2019; 28:3136-3141. [PMID: 29663251 DOI: 10.1007/s11695-018-3250-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AıM: To determine the prevalence of histopathological findings requiring clinical follow-up in morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG) and evaluate the relationship between these findings and Helicobacter pylori as well as to add more data to the published literature in this regard. MATERıAL AND METHODS: Overall, 161 morbidly obese patients with body mass index (BMI) > 40 kg/m2 who underwent LSG between May 1, 2014 and May 31, 2017 were retrospectively included in the study. The findings of the histopathological evaluation of the resected gastric material and the relationship between these findings and histopathologically detected H. pylori infection were investigated. RESULTS The study included 114 women (70.8%) and 47 men (29.2%). The mean age of the patients was 36.82 ± 10.41 years, and the mean BMI was 46.05 ± 3.76 kg/m2. H. pylori infection was detected in 103 (64%), chronic gastritis in 156, chronic active gastritis in 47, intestinal metaplasia in eight, and atrophy in seven patients. The rate of H. pylori-associated chronic gastritis was 64%, that of chronic active gastritis was 24.2%, that of lymphoid aggregation was 62.2%, and that of intestinal metaplasia and atrophy was 3.1%. There was a significant relationship between H. pylori infection and chronic gastritis, chronic active gastritis, and lymphoid aggregation; however, no significant relationship was found between intestinal metaplasia and atrophy. CONCLUSıON: Clinicians should be aware of the histopathological findings requiring clinical follow-up for LSG-treated patients. Given the complications of H. pylori infection such as lymphoma and malignancy, periodic follow-up of patients and eradication therapy may be a suitable approach for treating intestinal metaplasia and atrophic changes.
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Affiliation(s)
- Ramazan İlyas Öner
- Department of Internal Medicine, Faculty of Medicine, Adiyaman University, Yunus Emre Mah, Şifa Cad, 024000, Adiyaman, Turkey.
| | - Sabri Özdaş
- Department of General Surgery, Faculty of Medicine, Adiyaman University, Adıyaman, Turkey
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11
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Zendehdel A, Roham M. Biological evidence of the relationship between
Helicobacter pylori
and associated extragastric diseases. J Cell Biochem 2019; 120:12128-12140. [DOI: 10.1002/jcb.28681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/07/2019] [Accepted: 02/14/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Abolfazl Zendehdel
- Department of Geriatric Medicine, Ziaeian Hospital Tehran University of Medical Sciences Tehran Iran
| | - Maryam Roham
- Antimicrobial‐Resistant Research Center Iran University of Medical Sciences Tehran Iran
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12
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Šterbenc A, Poljak M, Zidar N, Luzar B, Homan M. Prevalence of the Helicobacter pylori homA and homB genes and their correlation with histological parameters in children. Microb Pathog 2018; 125:26-32. [PMID: 30195645 DOI: 10.1016/j.micpath.2018.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 12/16/2022]
Abstract
The significance of Helicobacter pylori (H. pylori) virulence genes such as cagA and vacA has been extensively studied in children; however, data regarding the significance of homA and homB genes are scarce. The aim of our study was to evaluate the prevalence and clinical relevance of these genes in Slovenian children. All children diagnosed with H. pylori infection between 1993 and 2013 were included in the study (n = 343). DNA was extracted from biopsy specimens previously used for the rapid urease test. Five histological parameters were evaluated and the presence of the vacA, cagA, iceA, babA2, and homA and homB genes was determined by PCR amplification. The homA and homB genes were detected in 174/285 (61.1%) and 116/285 (40.7%) strains, respectively. The presence of the homA gene was significantly associated with the absence of the homB gene (P < 0.001); however, no associations were found between the presence of either the homA or homB genes and any of the other investigated virulence genes. Similarly, there were no correlations between the presence of the homA and homB genes and any of the histological parameters. In contrast, genotype profiles vacA s1m1/cagA+/babA2+/homB+, vacA s1m2/cagA+/babA2+/homA+, vacA s1m1/cagA+/babA2+/homA+, vacA s1m1/cagA+/babA2-/homA+, vacA s1m2/cagA-/babA2-/homA+, and vacA s2m2/cagA-/babA2-/homB+ were associated with a higher degree of gastric mucosal damage. Thus, although the homA and homB genes did not represent important individual virulence markers in this population, they may act synergistically with other H. pylori virulence genes, causing severe gastritis in children.
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Affiliation(s)
- Anja Šterbenc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Boštjan Luzar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Matjaž Homan
- Department of Gastroenterology, Hepatology, and Nutrition, University Children's Hospital, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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13
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Kaplan M, Ates I, Yuksel M, Arikan MF, Aydog G, Turhan N, Gökbulut V, Kayacetin E. The role of the PLR-NLR combination in the prediction of the presence of Helicobacter pylori and its associated complications. Saudi J Gastroenterol 2018; 24:294-300. [PMID: 29873316 PMCID: PMC6152001 DOI: 10.4103/sjg.sjg_29_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIM The aim of this study was to investigate the role of the platelet-to-lymphocyte ratio (PLR)-neutrophil-to-lymphocyte ratio (NLR) combination, in the prediction of the presence of Helicobacter pylori (HP) and its associated complications in the gastrointestinal system. PATIENTS AND METHODS In all, 1289 patients who underwent esophagogastroduodenoscopy and biopsy for HP were included in the study. RESULTS The ratio of patients with moderate and severe chronic gastritis was higher in HP (+) group than HP (-) group. The ratio of patients with levels 1-3 atrophy and intestinal metaplasia was higher in HP (+) group. Compared with HP (-) group, HP (+) had higher PLR and NLR levels. The ratio of HP (+) patients was higher in high-risk group compared with low- and medium-risk groups. HP invasion stage, the intestinal metaplasia level, and the ratio of patients with atrophy level "3" were higher in high-risk group compared with low- and medium-risk groups. Regression analysis showed that the PLR-NLR combination was an independent risk factor for both HP presence and moderate and severe chronic gastritis. CONCLUSION We found the PLR-NLR combination to be a good predictor of HP presence and gastrointestinal complications associated with HP.
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Affiliation(s)
- Mustafa Kaplan
- Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey,Address for correspondence: Dr. Mustafa Kaplan, Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, 06100 Sihhiye, Ankara, Turkey. E-mail:
| | - Ihsan Ates
- Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Mahmut Yuksel
- Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mehmet F. Arikan
- Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Gulden Aydog
- Department of Pathology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Nesrin Turhan
- Department of Pathology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Volkan Gökbulut
- Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ertugrul Kayacetin
- Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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14
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Zabala Torrres B, Lucero Y, Lagomarcino AJ, Orellana-Manzano A, George S, Torres JP, O'Ryan M. Review: Prevalence and dynamics of Helicobacter pylori infection during childhood. Helicobacter 2017. [PMID: 28643393 DOI: 10.1111/hel.12399] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Long-term persistent Helicobacter pylori infection has been associated with ulceropeptic disease and gastric cancer. Although H. pylori is predominantly acquired early in life, a clear understanding of infection dynamics during childhood has been obfuscated by the diversity of populations evaluated, study designs, and methods used. AIM Update understanding of true prevalence of H. pylori infection during childhood, based on a critical analysis of the literature published in the past 5 years. METHODS Comprehensive review and meta-analysis of original studies published from 2011 to 2016. RESULTS A MEDLINE® /PubMed® search on May 1, 2016, using the terms pylori and children, and subsequent exclusion, based on abstract review using predefined criteria, resulted in 261 citations. An Embase® search with the same criteria added an additional 8 citations. In healthy children, meta-analysis estimated an overall seroprevalence rate of 33% (95% CI: 27%-38%). Seven healthy cohort studies using noninvasive direct detection methods showed infection prevalence estimates ranging from 20% to 50% in children ≤5 and 38% to 79% in children >5 years. The probability of infection persistence after a first positive sample ranged from 49% to 95%. Model estimates of cross-sectional direct detection studies in asymptomatic children indicated a prevalence of 37% (95% CI: 30%-44%). Seroprevalence, but not direct detection rates increased with age; both decreased with increasing income. The model estimate based on cross-sectional studies in symptomatic children was 39% (95% CI: 35%-43%). CONCLUSIONS The prevalence of H. pylori infection varied widely in the studies included here; nevertheless, model estimates by detection type were similar, suggesting that overall, one-third of children worldwide are or have been infected. The few cohort and longitudinal studies available show variability, but most studies, show infection rates over 30%. Rather surprisingly, overall infection prevalence in symptomatic children was only slightly higher, around 40%. Studies including only one positive stool sample should be interpreted with caution as spontaneous clearance can occur.
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Affiliation(s)
- Beatriz Zabala Torrres
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile.,Universidad de Aysén, Campus Rio Simpson, Coyhaique, Chile
| | - Yalda Lucero
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Anne J Lagomarcino
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Andrea Orellana-Manzano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida (FCV), Campus Gustavo Galindo Km. 30.5 Vía Perímetral, P. O. Box 09-01-5863, Guayaquil, Ecuador
| | - Sergio George
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Juan P Torres
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Miguel O'Ryan
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
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15
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Broide E, Richter V, Mendlovic S, Shalem T, Eindor-Abarbanel A, Moss SF, Shirin H. Lymphoid follicles in children with Helicobacter pylori-negative gastritis. Clin Exp Gastroenterol 2017; 10:195-201. [PMID: 28860835 PMCID: PMC5560569 DOI: 10.2147/ceg.s133421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The prevalence of Helicobacter pylori gastritis has been declining, whereas H. pylori-negative gastritis has become more common. We evaluated chronic gastritis in children with regard to H. pylori status and celiac disease (CD). Patients and methods Demographic, clinical, endoscopic, and histologic features of children who underwent elective esophagogastroduodenoscopy were reviewed retrospectively. Gastric biopsies from the antrum and corpus of the stomach were graded using the Updated Sydney System. H. pylori presence was defined by hematoxylin and eosin, Giemsa, or immunohistochemical staining and urease testing. Results A total of 184 children (61.9% female) met the study criteria with a mean age of 10 years. A total of 122 (66.3%) patients had chronic gastritis; 74 (60.7%) were H. pylori-negative. Children with H. pylori-negative gastritis were younger (p=0.003), were less likely to present with abdominal pain (p=0.02), and were mostly of non-Arabic origin (p=0.011). Nodular gastritis was found to be less prevalent in H. pylori-negative gastritis (6.8%) compared with H. pylori-positive gastritis (35.4%, p<0.001). The grade of mononuclear infiltrates and neutrophil density was more severe in the H. pylori-positive group (p<0.001). Pan-gastritis and lymphoid follicles were associated most commonly with H. pylori. Although less typical, lymphoid follicles were demonstrated in 51.3% of H. pylori-negative patients. The presence or absence of CD was not associated with histologic findings in H. pylori-negative gastritis. Conclusion Our findings suggest that lymphoid follicles are a feature of H. pylori-negative gastritis in children independent of their CD status.
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Affiliation(s)
- Efrat Broide
- Pediatric Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler School of Medicine, Tel Aviv University
| | - Vered Richter
- Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Sonia Mendlovic
- Pathology Institute, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Tzippora Shalem
- Pediatric Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Department of Pediatrics, Assaf Harofeh Medical Center, Tzrifin, Israel
| | | | - Steven F Moss
- Division of Gastroenterology, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA
| | - Haim Shirin
- Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler School of Medicine, Tel Aviv University
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16
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Safaan T, Bashah M, El Ansari W, Karam M. Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens: Prevalence, Risk Factors, and Value of Routine Histopathologic Examination. Obes Surg 2017; 27:1741-1749. [PMID: 28063114 PMCID: PMC5489580 DOI: 10.1007/s11695-016-2525-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is a common surgical therapeutic option for obese patients, with debate about the value of routine histopathologic examination of LSG specimens. We assessed the following: prevalence of different histopathologic changes in LSG specimens, risk factors associated with premalignant and with frequent histopathologic changes, and whether routine histopathologic examination is warranted for LSG patients with nonsignificant clinical history. METHODS Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (February 2011-July 2014, n = 1555), was conducted. Risk factors (age, BMI, gender, and Helicobacter pylori) were assessed in relation to specific abnormal histopathologic changes. RESULTS Mean age and BMI of our sample were 35.5 years and 46.8, respectively. Females comprised 69.7% of the sample. Normal histopathologic specimens comprised 52% of the sample. The most common histopathologic changes were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), and lymphoid aggregates (2.2%). We observed rare histopathology in 3.3% of the sample [e.g., intestinal metaplasia and gastrointestinal stromal tumor (GIST)]. Older age was associated with GIST and intestinal metaplasia (P = 0.001 for both). Females were associated with chronic active gastritis (P = 0.003). H. pylori infection was associated with follicular gastritis, lymphoid aggregates, GIST, intestinal metaplasia, and chronic active gastritis (P < 0.001 for each). CONCLUSION Older age, H. pylori, and female gender are risk factors for several abnormal histopathologic changes. Histopathologic examination of LSG specimens might harbor significant findings; however, routine histopathologic examination of all LSG specimens, particularly in the absence of suggestive clinical symptoms, is questionable. The association between female gender and chronic active gastritis; and the association between H. pylori infection and GIST are both novel findings that have not been previously reported in the published literature.
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Affiliation(s)
- Tamer Safaan
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
| | - Moataz Bashah
- Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
- College of Medicine, Doha, State of Qatar
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - Mohsen Karam
- Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
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SHI JUN, WEI PINKANG. Interleukin-8 does not influence proliferation of the SGC7901 gastric cancer cell line. Oncol Lett 2014; 8:2475-2480. [PMID: 25364410 PMCID: PMC4214491 DOI: 10.3892/ol.2014.2531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 08/15/2014] [Indexed: 12/28/2022] Open
Abstract
Interleukin-8 (IL-8), an important inflammatory factor, is induced by Helicobacter pylori infection and is clearly associated with gastric cancer. IL-8 levels have been revealed to correlate significantly with the adhesion, migration and invasion of gastric cancer cells. However, whether IL-8 influences cell proliferation in gastric cancer remains unclear. In the present study, the effect of IL-8 on the proliferation of the SGC7901 human gastric cancer cell line was investigated. SGC7901 cells were exposed to various concentrations of IL-8 (0, 0.2, 0.5, 0.8 and 1 ng/ml) for one to seven days. Cell proliferation was detected by Cell Counting Kit-8 assay. In addition, proliferating cell nuclear antigen (PCNA) protein and mRNA levels were measured by immunofluorescence, western blotting and quantitative polymerase chain reaction. Following exposure of SGC7901 cells to the various concentrations of IL-8, no significant changes in terms of cell proliferation were identified. However, IL-8 was shown to regulate PCNA protein and mRNA expression levels; at a concentration of 0.8 ng/ml, IL-8 significantly elevated the PCNA protein and mRNA expression levels, whereas IL-8 significantly inhibited these levels at other concentrations, compared with no treatment. In conclusion, IL-8 does not affect the proliferation of SGC7901 cells. However, IL-8 dosage was associated with PCNA protein and mRNA expression levels.
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Affiliation(s)
- JUN SHI
- Department of Traditional Chinese Medicine, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P.R. China
| | - PIN-KANG WEI
- Department of Traditional Chinese Medicine, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P.R. China
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