1
|
Rugge M, Genta RM. Gastric cancer prevention: Merging future hopes, with present clinical practice. J Surg Oncol 2022; 126:838-839. [PMID: 35855522 DOI: 10.1002/jso.26997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Massimo Rugge
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy.,Veneto Tumor Registry (RTV), Veneto Regional Authority, Padova, Italy.,Department of Medicine, Michael E. De Bakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA
| | - Robert M Genta
- Department of Medicine, Michael E. De Bakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA.,Department of Pathology, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
2
|
Pizzi M, Sbaraglia M, Bellan A, Santoro L, Dal Santo L, De Bartolo D, Carraro E, Zoletto S, Visentin A, Marino D, Trentin L, Dei Tos AP. Incidental lymphomas in surgical pathology: diagnostic clues and clinical-pathological correlations. Virchows Arch 2021; 480:459-465. [PMID: 33830333 DOI: 10.1007/s00428-021-03096-4] [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: 02/24/2021] [Revised: 03/21/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
Incidental lymphomas (ILs) are rare and challenging lesions with poorly characterized clinical-epidemiological and histological features. The present study addressed the open issues concerning these tumors, by assessing the clinical-pathological features of 28 consecutive ILs, diagnosed over a 10-year period at a tertiary center for surgical pathology. ILs were more frequently documented in elderly males (mean age at surgery 70.8 years; M/F ratio 3.3), with sharp prevalence of gastrointestinal and urinary tract involvement (22/28 [78.6%] cases). Low-grade B-cell lymphomas outnumbered all other entities, and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was the most common subtype (18/28 [64.3%] cases). Compared to other ILs, CLL/SLL occurred at older age and was the sole lymphoid neoplasm affecting the urinary tract. In conclusion, ILs are rare lesions, mostly affecting the gastrointestinal and urinary tract of elderly males. The diagnosis of IL is based on a high degree of suspicion and on careful morphological/phenotypic characterization.
Collapse
Affiliation(s)
- Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy.
| | - Marta Sbaraglia
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Alberto Bellan
- Department of Pathology, ULSS6, Camposampiero Hospital, Camposampiero - Padua, Italy
| | - Luisa Santoro
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Luca Dal Santo
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Debora De Bartolo
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Elisa Carraro
- Oncohematology Unit, Department of Children and Women's Health, University of Padua, Padua, Italy
| | - Simone Zoletto
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Andrea Visentin
- Hematology & Clinical Immunology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Dario Marino
- Medical Oncology 1, Veneto Institute of Oncology IOV IRCCS, Padua, Italy
| | - Livio Trentin
- Hematology & Clinical Immunology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| |
Collapse
|
3
|
Moradzadeh R, Anoushirvani AA. Trend of Gastric Cancer Incidence in an Area Located in the Center of Iran: 2009-2014. J Gastrointest Cancer 2020; 51:159-164. [PMID: 30911981 DOI: 10.1007/s12029-019-00227-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE There are remarkable differences between the incidence and mortality of gastric cancer in different places of the world. This study, for the first time, estimated the information around the incidence rates and trends of gastric cancer in the central area of Iran, Arak metropolitan. METHODS In this study, all cases with gastric cancer in Arak from 2009 to 2014 were included. Direct standardized method was applied to estimate age-standardized incidence rates (ASIRs) by a STATA package, with efficient interval estimation that might be preferable in the case of rare diseases, including cancer data. The obtained standard errors were used to calculate annual percent changes (APCs) by the Joinpoint analysis. RESULTS Annual ASIRs of gastric cancer were 23.92 (95% CI 21.62, 26.37) and 9.60 (95% CI 8.20, 11.18) for male and female, respectively. In male, APC of ASIRs was - 5.00% (95% CI - 9.32, - 0.47). In contrast, among female, it was - 2.69% (95% CI - 31.56, 38.34) that was statistically insignificant. CONCLUSIONS The ASIRs have significantly decreased trends in males, but not in females. The preventive strategies should be a focus on the declining of the risk factors and the quick early diagnosis of gastric cancer.
Collapse
Affiliation(s)
- Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran.
| | | |
Collapse
|
4
|
Analysis of Risk Factors of Gastric Low-Grade Intraepithelial Neoplasia in Asymptomatic Subjects Undergoing Physical Examination. Gastroenterol Res Pract 2020; 2020:7907195. [PMID: 32256566 PMCID: PMC7072095 DOI: 10.1155/2020/7907195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/01/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
Abstract
Secondary prevention is an important strategy in gastric cancer. Low-grade intraepithelial neoplasia (LGIN) is the last stage of precancerous lesion, and its timely diagnosis can greatly improve the detection rate of early gastric cancer. We performed a prospective study to analyze the risk factors of gastric LGIN in asymptomatic subjects undergoing physical examination. A total of 3437 subjects were included in this study, and 2259 asymptomatic subjects were investigated from March 2015 to April 2018. Risk factors were evaluated, and the endoscopic features of LGIN and prognosis were described. The overall incidence of LGIN was 19.73% (678/3437), while the incidence of LGIN in the asymptomatic and symptomatic groups was 19.65% (444/2259) and 19.86% (234/1178), respectively (P = 0.884). The rate of Helicobacter pylori infection in this physical examination population was 39.13% (35.8% asymptomatic group, 45.5% symptomatic group; P ≤ 0.001). Risk factors including age, H. pylori infection, history of antibiotic misuse, and spicy and high-fat diet (all P < 0.05) were further verified by multivariate analysis as independent risk factors. History of antibiotic misuse and H. pylori infection showed significant associations with LGIN (odds ratio (OR) = 6.767, 95% confidence interval (CI) 3.873-11.825 and OR = 3.803, 95% CI 3.009-4.808, respectively). The most common endoscopic classification of LGIN was erosive gastritis (50.78%), and the major endoscopic appearance was Paris IIa (flat with slight elevation located mostly in the antrum). During the mean follow-up period of 15.02 months, 49.4% of LGIN regressed, 0.61% of LGIN progressed, and 50% of LGIN remained unchanged. History of antibiotic misuse and H. pylori infection were predominant risk factors of LGIN in asymptomatic subjects, and those individuals should consider early screening for gastric cancer.
Collapse
|
5
|
Jiang ZX, Nong B, Liang LX, Yan YD, Zhang G. Differential diagnosis of Helicobacter pylori-associated gastritis with the linked-color imaging score. Dig Liver Dis 2019; 51:1665-1670. [PMID: 31420229 DOI: 10.1016/j.dld.2019.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 06/23/2019] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection in gastric mucosa is the main risk factor for gastric cancer. The purpose of this study was to assess the value of the linked-color imaging (LCI) score for the identification of H. pylori-associated gastritis. METHODS A total of 358 patients were enrolled in the study. H. pylori was positive in 127 cases and negative in 231 cases. Redness of fundus glands, granular erosion, purple mucus (+) and mucus lake turbidity were investigated by the LCI mode of endoscopy. Logistic regression was used to screen the observation indexes and their relative partial regression coefficients, which were helpful for the differential diagnosis of H. pylori infection. Then, each observation index was scored according to the partial regression coefficient. RESULTS Using a total scores of 3.5 as the cut-off value, the sensitivity and specificity were 83.8% and 99.5%, respectively, for the differential diagnosis of H. pylori gastritis. The area under the curve was 95.3%. CONCLUSIONS The LCI score showed high sensitivity and specificity for the differential diagnosis of H. pylori-associated gastritis and is an effective method for identifying H. pylori infection in gastric mucosa.
Collapse
Affiliation(s)
- Zhang-Xiu Jiang
- Department of Digestion, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Bing Nong
- Department of Digestion, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China.
| | - Lie-Xin Liang
- Department of Digestion, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Yu-Dong Yan
- Department of Digestion, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Guo Zhang
- Department of Digestion, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| |
Collapse
|
6
|
Miraglia C, Moccia F, Russo M, Scida S, Franceschi M, Crafa P, Franzoni L, Nouvenne A, Meschi T, Leandro G, De' Angelis GL, Di Mario F. Non-invasive method for the assessment of gastric acid secretion. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:53-57. [PMID: 30561418 PMCID: PMC6502207 DOI: 10.23750/abm.v89i8-s.7986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 12/12/2022]
Abstract
Methods for the measure of gastric acid secretion include invasive and non-invasive tests. The gold-standard to measure the acid output is the collection of gastric after in basal condition (Basal Acid Output, B.A.O.) and after an i.m. injection of pentagastrin (Maximal Acid Output, M.A.O.). However, direct measurement of gastric acid production is out of order in clinical practice, but many GI symptoms are claimed to be related with acid disorders and empirically cured. Hypochlorhydria is associated with precancerous conditions such as chronic atrophic gastritis (CAG). Acid measurement with non-invasive methods (pepsinogens) is supported by international guidelines.
Collapse
Affiliation(s)
- Chiara Miraglia
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Elghali MA, Gouader A, Bouriga R, Mahjoub M, Jarrar MS, Ziadi S, Mokni M, Hamila F, Ltaeif R. Gastric Adenocarcinomas in Central Tunisia: Evolution Specificities through Two Decades and Relation with Helicobacter pylori. Oncology 2018; 95:121-128. [PMID: 29694966 DOI: 10.1159/000488488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 03/15/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In developed countries, authors have reported variations over time in the seat and histological type of gastric adenocarcinomas, which were explained by Helicobacter pylori infection (HPI) incidence changes. In North-African countries and the Arabic world, epidemiological changes in gastric adenocarcinomas are still unknown. Our study aims to explore and to describe those changes in central Tunisia. MATERIALS AND METHODS This is a retrospective observational and descriptive study including 876 cases based on the National Central Tunisian Register of Cancers over a period of 21 years. Two groups were formed and compared (group A: 337 patients from 1995 to 2005; group B: 539 patients from 2006 to 2015). RESULTS HPI decreased from 32.6% in group A to 11.2% in group B (p < 0.05). Signet ring cell carcinomas increased in 2 decades from 14% in group A to 36% in group B (p < 0.05). Proximal cancers were 16.61% in group A and increased to 19.66% in group B (p = 0.3). Total gastrectomy rate was 10.4% in group A versus 23.2% in group B (p < 0.05). CONCLUSION This study has shown a significant increase of signet ring cell carcinomas with a simultaneous decrease in HPI in the last decade in central Tunisia.
Collapse
Affiliation(s)
| | - Amine Gouader
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rym Bouriga
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Epidemiology and Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Salah Jarrar
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Sonia Ziadi
- Department of Pathology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Moncef Mokni
- Department of Pathology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Fahmi Hamila
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rached Ltaeif
- Department of Digestive Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| |
Collapse
|
8
|
Li CY, Liang GY, Yao WZ, Sui J, Shen X, Zhang YQ, Ma SM, Ye YC, Zhang ZY, Zhang WH, Yin LH, Pu YP. Identification and functional characterization of long non-coding RNAs in human gastric cancer. Oncol Lett 2018; 15:8805-8815. [PMID: 29805620 DOI: 10.3892/ol.2018.8369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/17/2017] [Indexed: 02/06/2023] Open
Abstract
Abnormal regulation of long non-coding RNAs (lncRNAs) appears to be a primary feature of numerous types of human cancer. However, the association between the dysregulation of lncRNAs and functional alterations in gastric cancer (GC) remains unclear. In previous studies, we applied microarray and bioinformatics analyses to screen for key lncRNAs from the tumor tissues and matched adjacent non-tumor tissues of 10 patients with GC. There were seven key lncRNAs demonstrated to be significantly different between carcinoma tissues and adjacent non-tumor tissues. In the present study, the expression of these seven selected lncRNAs were validated in 82 patients with GC to further investigate the association between lncRNAs and GC clinical characterization. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) results demonstrated that RP5-919F19, MCPH1 antisense RNA 1 (CTD-2541M15) and urothelial carcinoma-associated 1 (UCA1) exhibited consistent upregulation in cancer compared with adjacent non-tumor tissues, whereas AP000459, LOC101928316, tumor suppressor candidate 8 (LINC01071) and maternally expressed 3 (MEG3) showed consistent downregulation. The results from the microarray and RT-qPCR experiments achieved 100% agreement. A correlation analysis indicated that RP5-919F19, LOC101928316 and MEG3 were significantly associated with tumor differentiation degree, RP5-919F19, UCA1 and MEG3 were significantly associated with lymph node metastasis, and RP5-919F19, CTD-2541M15 and UCA1 were significantly associated with tumor-node-metastasis stage (P<0.05). In addition, it was identified that the differential expression of LINC01071 and LOC101928316 significantly correlated with the age and gender of the GC patients, respectively (P<0.05). The results suggest that the lncRNAs RP5-919F19, LOC101928316, CTD-2541M15, UCA1 and MEG3 are closely associated with the invasion and metastasis of GC, which reveals these indicators as potential specificity biomarkers for the diagnosis, prognosis and classification of GC. Thus, these lncRNAs merit further study as novel candidate biomarkers for the clinical diagnosis of GC and as potential targets for therapy.
Collapse
Affiliation(s)
- Cheng-Yun Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Ge-Yu Liang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Wen-Zhuo Yao
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Jing Sui
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Xian Shen
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Yan-Qiu Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Shu-Mei Ma
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Yan-Cheng Ye
- Department of Cancer Epidemiology, Wuwei Cancer Registry, Gansu Wuwei Tumor Hospital, Wuwei, Gansu 733000, P.R. China
| | - Zhi-Yi Zhang
- Department of Cancer Epidemiology, Wuwei Cancer Registry, Gansu Wuwei Tumor Hospital, Wuwei, Gansu 733000, P.R. China
| | - Wen-Hua Zhang
- Department of Cancer Epidemiology, Wuwei Cancer Registry, Gansu Wuwei Tumor Hospital, Wuwei, Gansu 733000, P.R. China
| | - Li-Hong Yin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Yue-Pu Pu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| |
Collapse
|
9
|
Chen XY, Wang W, Li H. Clinical efficacy and safety of Shenling Baizhu powder as an adjunctive treatment for atrophic gastritis with Helicobacter pylori infection. Shijie Huaren Xiaohua Zazhi 2018; 26:488-493. [DOI: 10.11569/wcjd.v26.i8.488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the clinical efficacy and safety of Shenling Baizhu powder as an adjunctive treatment for atrophic gastritis with Helicobacter pylori (H. pylori) infection.
METHODS Sixty atrophic gastritis patients with H. pylori infection were selected from January 2016 to October 2016 at the Third Affiliated Hospital of Zhejiang Chinese Medicine University and randomly divided into either an experimental group (n = 30) or a control group (n = 30). The control group was treated with quadruple therapy to eradicate H. pylori, while the experimental group was treated with quadruple therapy plus Shenling Baizhu powder. The patients in both groups were treated for 8 wk. The total effective rates of the two groups were calculated. The scores of main symptoms (including abdominal distension, dry mouth, anorexia, fatigue, and indigestion), endoscopic scores (including mucosa, mucous erosion, bile reflux, mucous folds, and blood vessels), H. pylori eradication rate, and complications (headache, diarrhea, constipation, rash, nausea, and vomiting) were compared between the two groups.
RESULTS The total effective rate was significantly higher in the experimental group than in the control group (93.33% vs 73.33%, χ2 = 4.3221, P = 0.0377). Before treatment, there was no significant difference in abdominal distension, dry mouth, anorexia, fatigue, or indigestion scores between the two groups (P > 0.05); after treatment, these scores were significantly decreased in both groups (P < 0.05), and the decrease was more significant in the experimental group. The eradication rate of H. pylori was significantly higher in the experimental group than in the control group (96.67% vs 80.00%, χ2 = 4.0421, P = 0.0444).
CONCLUSION Shenling Baizhu power is effective in the treatment of atrophic gastritis with H. pylori, and it can significantly reduce the clinical symptoms and improve the clinical changes of mucosal blood flow with good safety.
Collapse
|
10
|
Shen CL, Wang Z. Shenqi Yiwei decoction for treatment of atrophic gastritis of spleen-stomach deficiency cold type: Clinical efficacy and influence on TXB 2 and 6-keto-PGF1α. Shijie Huaren Xiaohua Zazhi 2018; 26:236-242. [DOI: 10.11569/wcjd.v26.i4.236] [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] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the clinical efficacy of Shenqi Yiwei decoction in the treatment of atrophic gastritis of spleen-stomach deficiency cold type and investigate its influence on TXB2 and 6-keto-PGF1α.
METHODS Eighty-six patients with atrophic gastritis of spleen-stomach deficiency cold type were selected from January 2016 to October 2017 at the Third Affiliated Hospital of Zhejiang Chinese Medicine University, and the patients were randomly divided into either an experimental group (n = 43) or a control group (n = 43). The control group was treated with omeprazole, while the experimental group was treated with Shenqi Yiwei decoction. The patients in both groups were treated for 8 wk. The effective rates of the two groups were compared. Main symptom scores (including abdominal distension, dry mouth, anorexia, fatigue, and indigestion), endoscopic scores (including mucosal appearance, mucosal erosion, bile reflux, mucous folds, and blood vessels), TXB2 and 6-keto-PGF1α, and complications were also compared between the two groups.
RESULTS The total effective rate was significantly higher in the experimental group than in the control group (95.35% vs 81.40%, χ2 = 4.0741, P = 0.0436). Before treatment, abdominal distension, dry mouth, anorexia, fatigue, and indigestion scores were not statistically significant between the two groups (P > 0.05); after treatment, these scored significantly decreased in both groups (P < 0.05), and the decrease was more significant in the experimental group. Before treatment, scores of mucosal appearance, mucosal erosion, bile reflux, mucous folds, and blood vessels were not statistically significant between the two groups (P > 0.05); after treatment, these scores were significantly improved in both groups (P < 0.05), and the improvement was more significant in the experimental group (P < 0.05). Before treatment, TXB2 and 6-keto-PGF1α differed significantly between the two groups (P > 0.05); after treatment, TXB2 decreased significantly and 6-keto-PGF1α increased significantly in both groups (P < 0.05), and the changes were more significant in the experimental group (P < 0.05). Adverse reactions such as constipation and vomiting did not occur in either group.
CONCLUSION Shenqi Yiwei decoction has a good therapeutic effect in atrophic gastritis of spleen-stomach deficiency cold type, and it can significantly reduce clinical symptoms and improve endoscopic changes possibly by regulating TXB2 and 6-keto-PGF1α.
Collapse
|
11
|
Abstract
The esophagus and stomach are host to their own population of bacteria, which differs in health and disease. Helicobacter pylori uniquely colonizes only gastric mucosa, but an increasing number of bacteria is now isolated from the gastric juice and gastric mucosa, including Lactobacillus. The presence of H pylori alters populations of other gastric bacteria with a marked reduction in diversity. Alterations in intragastric acidity may be the cause or the consequence of changes in the microbial populations of the stomach. Esophageal inflammation is associated with an altered microbiota in gastroesophageal reflux disease, Barrett's esophagus, eosinophilic esophagitis, and cancer.
Collapse
|
12
|
Na HK, Cho CJ, Bae SE, Lee JH, Park YS, Ahn JY, Kim DH, Choi KD, Song HJ, Lee GH, Jang SJ, Jung HY. Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. PLoS One 2017; 12:e0169456. [PMID: 28072871 PMCID: PMC5225017 DOI: 10.1371/journal.pone.0169456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/16/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases. METHODS Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems. RESULTS Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III-IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively). CONCLUSIONS Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC.
Collapse
Affiliation(s)
- Hee Kyong Na
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Charles J. Cho
- Department of Biomedical Science, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Suh Eun Bae
- Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jeong Hoon Lee
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Young Soo Park
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ji Yong Ahn
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Do Hoon Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Kee Don Choi
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ho June Song
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
- * E-mail:
| | - Gin Hyug Lee
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Se Jin Jang
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hwoon-Yong Jung
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| |
Collapse
|
13
|
Hunt RH, Camilleri M, Crowe SE, El-Omar EM, Fox JG, Kuipers EJ, Malfertheiner P, McColl KEL, Pritchard DM, Rugge M, Sonnenberg A, Sugano K, Tack J. The stomach in health and disease. Gut 2015; 64:1650-68. [PMID: 26342014 PMCID: PMC4835810 DOI: 10.1136/gutjnl-2014-307595] [Citation(s) in RCA: 215] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 07/14/2015] [Indexed: 12/12/2022]
Abstract
The stomach is traditionally regarded as a hollow muscular sac that initiates the second phase of digestion. Yet this simple view ignores the fact that it is the most sophisticated endocrine organ with unique physiology, biochemistry, immunology and microbiology. All ingested materials, including our nutrition, have to negotiate this organ first, and as such, the stomach is arguably the most important segment within the GI tract. The unique biological function of gastric acid secretion not only initiates the digestive process but also acts as a first line of defence against food-borne microbes. Normal gastric physiology and morphology may be disrupted by Helicobacter pylori infection, the most common chronic bacterial infection in the world and the aetiological agent for most peptic ulcers and gastric cancer. In this state-of-the-art review, the most relevant new aspects of the stomach in health and disease are addressed. Topics include gastric physiology and the role of gastric dysmotility in dyspepsia and gastroparesis; the stomach in appetite control and obesity; there is an update on the immunology of the stomach and the emerging field of the gastric microbiome. H. pylori-induced gastritis and its associated diseases including peptic ulcers and gastric cancer are addressed together with advances in diagnosis. The conclusions provide a future approach to gastric diseases underpinned by the concept that a healthy stomach is the gateway to a healthy and balanced host. This philosophy should reinforce any public health efforts designed to eradicate major gastric diseases, including stomach cancer.
Collapse
Affiliation(s)
- R H Hunt
- Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University Health Science Centre, Hamilton, Ontario, Canada
| | - M Camilleri
- Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - S E Crowe
- Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - E M El-Omar
- Division of Applied Medicine, Aberdeen University, Institute of Medical Sciences, Foresterhill, Aberdeen, UK
| | - J G Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - E J Kuipers
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - P Malfertheiner
- Klinik für Gastroenterologie, Hepatologie und Infektiologi Universitätsklinikum Magdeburg A.ö.R.Leipziger Str. 44, Magdeburg, Germany
| | - K E L McColl
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - D M Pritchard
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - M Rugge
- Department of Medicine DIMED, Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - A Sonnenberg
- Department of Gastroenterology, Oregon Health Science University, Portland, Oregon, USA
| | - K Sugano
- Department of Internal Medicine, Jichi Medical School, Shimotsuke, Japan
| | - J Tack
- Translational Research in GastroIntestinal Disorders, Leuven, Belgium
| |
Collapse
|
14
|
Khanna P, Chua PJ, Bay BH, Baeg GH. The JAK/STAT signaling cascade in gastric carcinoma (Review). Int J Oncol 2015; 47:1617-26. [PMID: 26398764 DOI: 10.3892/ijo.2015.3160] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/03/2015] [Indexed: 11/06/2022] Open
Abstract
Gastric carcinoma remains one of the most prevalent forms of cancer worldwide, despite the decline in incidence rates, increased awareness of the disease and advancement in treatment strategies. Helicobacter pylori infection, dietary factors, lifestyle influences and various genetic aberrations have been shown to contribute to the development and progression of gastric cancer. Recent studies on the genomic landscape of gastric adenocarcinoma have identified several key signaling molecules, including epidermal growth factor receptor family (ErbB) members, vascular endothelial growth factor receptor family (VEGFR) members and PI3K/Akt/mTOR pathway components, that have been implicated in the molecular pathogenesis of gastric cancers. However, clinical trials with compounds that target these molecules have failed to show a significant improvement in overall survival rates when supplemented with conventional therapies. Therefore, it is essential to identify effective prognostic and/or diagnostic biomarkers and develop molecular targeted therapies. The JAK/STAT cascade is a principal signal transduction pathway in cytokine and growth factor signaling, regulating various cellular processes such as cell proliferation, differentiation, migration and survival. Numerous in vivo and in vitro studies have shown that dysregulated JAK/STAT signaling is a driving force in the pathogenesis of various solid cancers as well as hematopoietic malignancies. Hence, a large number of preclinical and clinical studies of drugs targeting this pathway are currently underway. Notably, aberrant JAK/STAT signaling has also been implicated in gastric cancers. In this review, we focus on the ongoing research on the JAK/STAT cascade in gastric carcinoma and discuss the therapeutic potential of targeting JAK/STAT signaling for the treatment of gastric cancer.
Collapse
Affiliation(s)
- Puja Khanna
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117 597, Republic of Singapore
| | - Pei Jou Chua
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117 597, Republic of Singapore
| | - Boon Huat Bay
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117 597, Republic of Singapore
| | - Gyeong Hun Baeg
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117 597, Republic of Singapore
| |
Collapse
|
15
|
Rugge M. Gastric Cancer Risk in Patients with Helicobacter pylori Infection and Following Its Eradication. Gastroenterol Clin North Am 2015; 44:609-24. [PMID: 26314671 DOI: 10.1016/j.gtc.2015.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
As Helicobacter pylori is a first-class carcinogen, eradication of the infection would be expected to be a beneficial measure for the (primary) prevention of gastric cancer. Given the natural history of gastric cancer, it is plausible that eradication before gastric atrophy sets in offers the best chance for cancer risk reduction. The beneficial effects of eradication may, nevertheless, still be achievable in more advanced disease. The reversibility of inflammatory lesions has been supported by undeniable evidence; the regression of mucosal atrophy/metaplasia has also been confirmed by several recent histologic studies.
Collapse
Affiliation(s)
- Massimo Rugge
- Surgical Pathology & Cytopathology Unit, Department of Medicine - DIMED, University of Padova, Via Aristide Gabelli, 61, Padova 35121, Italy.
| |
Collapse
|
16
|
|
17
|
Rugge M, Capelle LG, Fassan M. Individual risk stratification of gastric cancer: evolving concepts and their impact on clinical practice. Best Pract Res Clin Gastroenterol 2014; 28:1043-53. [PMID: 25439070 DOI: 10.1016/j.bpg.2014.09.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/02/2014] [Accepted: 09/15/2014] [Indexed: 01/31/2023]
Abstract
Gastric cancer (GC) is the third leading cause of cancer-related death worldwide and it mostly develops in long-standing inflammatory conditions, and Helicobacter pylori-gastritis, in particular. Despite the increasing understanding of both the phenotypic alterations and the molecular mechanisms occurring during GC multi-step carcinogenesis, no reliable biomarker is available to be reliably implemented into GC secondary prevention strategies. Multidisciplinary diagnostic approaches integrating endoscopy, serology, histology and molecular profiling currently appears as the most appropriate approach for patients' stratification into different GC risk classes.
Collapse
Affiliation(s)
- Massimo Rugge
- Department of Medicine, DIMED, Surgical Pathology and Cytopathology Unit, University of Padua, 35100 Padua, Italy.
| | - Lisette G Capelle
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands
| | - Matteo Fassan
- Department of Medicine, DIMED, Surgical Pathology and Cytopathology Unit, University of Padua, 35100 Padua, Italy
| |
Collapse
|
18
|
Jiang H, Zhou Y, Liao Q, Ouyang H. Helicobacter pylori infection promotes the invasion and metastasis of gastric cancer through increasing the expression of matrix metalloproteinase-1 and matrix metalloproteinase-10. Exp Ther Med 2014; 8:769-774. [PMID: 25120597 PMCID: PMC4113550 DOI: 10.3892/etm.2014.1822] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 05/09/2014] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to investigate the effect and mechanism of Helicobacter pylori infection in the invasion and metastasis of gastric cancer. Specimens from 80 patients with gastric cancer (of which 20 patients had metastatic gastric cancer) and 40 patients with chronic gastritis were included in this study. H. pylori infection was determined by ELISA and the expression of matrix metalloproteinase-1 (MMP-1) and MMP-10 was observed using immunohistochemistry. The correlation between H. pylori infection and the clinical pathological features of gastric cancer was analyzed by SPSS 13.0 software. The protein expression levels of MMP-1 and MMP-10 in MGC-803 cells infected with H. pylori were analyzed using western blotting. H. pylori infection was found in 62 of the 80 patients with gastric cancer and in 13 of the 40 patients with chronic gastritis. In addition, H. pylori infection was correlated with the staging and lymph node metastasis, but not with the gender, age and histological types of patients. H. pylori infection was also significantly correlated with the expression of MMP-1 and MMP-10 (r=0.8718, P<0.05 and r=0.5477, P<0.05, respectively). The expression of MMP-1 and MMP-10 was significantly upregulated following induction by H. pylori infection (P<0.05), with significant effects occurring following infection for 12 and 6 h, respectively. H. pylori infection may promote the invasion and metastasis of gastric cancer by increasing the expression of MMP-1 and MMP-10.
Collapse
Affiliation(s)
- Hao Jiang
- Gastric Cancer Research Center of Hunan, Department of Oncology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yujuan Zhou
- Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P.R. China
| | - Qianjin Liao
- Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P.R. China
| | - Hongjuan Ouyang
- Gastric Cancer Research Center of Hunan, Department of Oncology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| |
Collapse
|