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Dinis-Ribeiro M, Areia M, de Vries AC, Marcos-Pinto R, Monteiro-Soares M, O'Connor A, Pereira C, Pimentel-Nunes P, Correia R, Ensari A, Dumonceau JM, Machado JC, Macedo G, Malfertheiner P, Matysiak-Budnik T, Megraud F, Miki K, O'Morain C, Peek RM, Ponchon T, Ristimaki A, Rembacken B, Carneiro F, Kuipers EJ. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy 2012; 44:74-94. [PMID: 22198778 PMCID: PMC3367502 DOI: 10.1055/s-0031-1291491] [Citation(s) in RCA: 451] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods.
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Affiliation(s)
- M. Dinis-Ribeiro
- Department of Gastroenterology, Portuguese Oncology Institute of Porto, Portugal, Centre for Research in Health Technologies and Information Systems (CINTESIS), Medical Faculty, Porto, Portugal
| | - M. Areia
- Department of Gastroenterology, Portuguese Oncology Institute of Coimbra, Portugal, Centre for Research in Health Technologies and Information Systems (CINTESIS), Medical Faculty, Porto, Portugal
| | - A. C. de Vries
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
| | - R. Marcos-Pinto
- Department of Gastroenterology, Centro Hospitalar do Porto, Portugal, Institute of Biomedical Sciences, University of Porto (ICBAS/UP), Porto, Portugal
| | - M. Monteiro-Soares
- Centre for Research in Health Technologies and Information Systems (CINTESIS), Medical Faculty, Porto, Portugal
| | - A. O'Connor
- AMNCH/TCD, Adelaide and Meath Hospital/Trinity College, Gastroenterology Department, Dublin, Ireland
| | - C. Pereira
- Molecular Oncology Research Group, Portuguese Oncology Institute of Porto, Portugal
| | - P. Pimentel-Nunes
- Department of Gastroenterology, Portuguese Oncology Institute of Porto, Portugal
| | - R. Correia
- Centre for Research in Health Technologies and Information Systems (CINTESIS), Medical Faculty, Porto, Portugal
| | - A. Ensari
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - J. M. Dumonceau
- Département de Gastroénterologie et d'Hépatopancréatologie, H.U.G. Hôpital Cantonal, Geneve, Switzerland
| | - J. C. Machado
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
| | - G. Macedo
- Department of Gastroenterology, Centro Hospitalar S. João/Medical Faculty, Porto, Portugal
| | - P. Malfertheiner
- Klinik der Gasroenterologie, Hepatologie und Infektologie, Otto von Guericke Universität Magdeburg, Magdeburg, Germany
| | - T. Matysiak-Budnik
- Service d'Hépato-Gastroentérologie, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - F. Megraud
- Inserm U853 & Université Bordeaux, Laboratoire de Bacteriologie, Bordeaux, France
| | - K. Miki
- Japan Research Foundation of Prediction, Diagnosis and Therapy for Gastric Cancer (JRF PDT GC), Tokyo, Japan
| | - C. O'Morain
- AMNCH/TCD, Adelaide and Meath Hospital/Trinity College, Gastroenterology Department, Dublin, Ireland
| | - R. M. Peek
- Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, USA
| | - T. Ponchon
- Hôpital Edouard Herriot, Department of Digestive Diseases, Lyon, France
| | - A. Ristimaki
- Department of Pathology, HUSLAB and Haartman Institute, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland., Genome-Scale Biology, Research Program Unit, University of Helsinki, Helsinki, Finland
| | - B. Rembacken
- Centre for Digestive Diseases, The General Infirmary at Leeds, Leeds, United Kingdom
| | - F. Carneiro
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal, Department of Pathology, Medical Faculty/Centro Hospitalar S. João, Porto, Portugal
| | - E. J. Kuipers
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
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Sgroi DC, Finkelstein DM, Shepherd L, Ingle JN, Rimm DL, Sasano H, Porter P, Pins M, Paik S, Ristimaki A, Pritchard KI, Tu D, Goss PE. Abstract P3-10-26: Quantitative Protein and Gene Expression Biomarkers of Tamoxifen and Letrozole Recurrence in the NCIC CTG MA.17 Cohort. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The MA.17 study showed that extended adjuvant endocrine therapy with letrozole (LET) after completing 5 years of tamoxifen (TAM) markedly reduced the risk of recurrence in women with ER+ early stage breast cancer and improved overall survival in women presenting with node +ve disease. The HOXB 13:IL17BR gene expression ratio (signature) has been shown to predict outcome in breast cancer patients treated with adjuvant tamoxifen monotherapy and provides additional information beyond that from known positive (ER and PR) and negative (Her-1 and Her-2) predictors of responsiveness to tamoxifen in node-ve women. We report a case control evaluation of the Breast Cancer Index (BCI; bioTheranostics, Inc.), which combines the HOXB13 and IL17BR twogene and the molecular grade index (MGI) gene expression signatures, with respect to distinguishing which patients are at risk of late recurrences and who would respond to extended endocrine therapy with LET. The prognostic and predictive utility of quantitative immunofluorescence of ER, PR, Her-2, tumor aromatase, COX-2, GATA3 and Nat1 in the TAM-PLACEBO and the TAM-LET cohorts will also be evaluated and compared to results derived by standard immunohistochemistry. Methods: FFPE tumor blocks were collected from patients who experienced a breast cancer recurrence up to unblinding of MA.17. Controls were matched 2:1 for age, tumor size, lymph node status, and prior chemotherapy, and were all disease free for longer than cases. All cases were reviewed for standard histopathology by two independent pathologists. RNA was extracted, amplified, converted to cDNA and subjected to RT-PCR with primers and probes to HOXB13, IL17BR, BUB1A, CENPA, NEK2, RACGAP1 and RRM2. ER, PR HER1, HER2, COX2, Aromatase, GATA3 and NAT1 will be analyzed by routine IHC techniques and by immunoflourescent Automated Quantitative Analysis (AQuA).
Results: 105 cases and 210 matched controls are available for evaluation. All sections are under review and tissue microarrays have been performed on all cases and controls. Detailed results on the BCI and ER, PR, Her-2 will be available at the SABCS.
Discussion: MA.17 has shown that extended adjuvant endocrine therapy after tamoxifen is effective at preventing disease recurrence given for an additional 5 years. Numerous clinical trials are exploring whether extending AIs will show this benefit, and there is an increasing need to improve the therapeutic index by distinguishing those at risk from those who are not. It is also important to determine which patients will benefit from the therapy and which will recur without benefit. The latter patients could be triaged to clinical trials of novel therapies to overcome endocrine resistance. This study will help to define these issues and pave the way for more effective selection of specific patients for adjuvant endocrine strategies.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-26.
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Affiliation(s)
- DC Sgroi
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - DM Finkelstein
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Shepherd
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - JN Ingle
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - DL Rimm
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - H Sasano
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P Porter
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Pins
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S Paik
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - A Ristimaki
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - KI Pritchard
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - D Tu
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - PE Goss
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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