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Robles C, Rudzite D, Polaka I, Sjomina O, Tzivian L, Kikuste I, Tolmanis I, Vanags A, Isajevs S, Liepniece-Karele I, Razuka-Ebela D, Parshutin S, Murillo R, Herrero R, Young Park J, Leja M. Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment-Results from the GISTAR Pilot Study. Diagnostics (Basel) 2022; 12:1746. [PMID: 35885649 PMCID: PMC9325279 DOI: 10.3390/diagnostics12071746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction−−Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods−−Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results−−Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4−31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33−45% while specificity decreased (range: 61.1−62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions−−Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.
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Affiliation(s)
- Claudia Robles
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Cancer Epidemiology Research Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Olga Sjomina
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Lilian Tzivian
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Ivars Tolmanis
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Aigars Vanags
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Academic Histology Laboratory, 1073 Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Academic Histology Laboratory, 1073 Riga, Latvia
| | - Danute Razuka-Ebela
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Sergej Parshutin
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Raul Murillo
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá 11001, Colombia
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Agencia Costarricense de Investigaciones Biomedicas, Fundacion INCIENSA, San Jose 2250, Costa Rica
| | - Jin Young Park
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
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Skrebinska S, Megraud F, Daugule I, Santare D, Isajevs S, Liepniece-Karele I, Bogdanova I, Rudzite D, Vangravs R, Kikuste I, Vanags A, Tolmanis I, Savcenko S, Alix C, Herrero R, Park JY, Leja M. Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection? Diagnostics (Basel) 2022; 12:133. [PMID: 35054298 PMCID: PMC8774513 DOI: 10.3390/diagnostics12010133] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Discrepancies between histology and serology results for Helicobacter pylori detection could be caused by a variety of factors, including a biopsy sampling error, expertise of the pathologist, natural loss of infection due to advanced atrophy, or a false-positive serology in the case of a previous infection, since antibodies may be present in blood following recovery from the infection. AIMS To identify true H. pylori-positive individuals in discrepant cases by serology and histology using real time polymerase chain reaction (RT-PCR) as a gold standard. METHODS Study subjects with discrepant histology and serology results were selected from the GISTAR pilot study data base in Latvia. Subjects having received previous H. pylori eradication therapy or reporting use of proton pump inhibitors, antibacterial medications, or bismuth containing drugs one month prior to upper endoscopy were excluded. We compared the discrepant cases to the corresponding results of RT-PCR performed on gastric biopsies. RESULTS In total, 97 individuals with discrepant results were identified: 81 subjects were serology-positive/histology-negative, while 16 were serology-negative/histology-positive. Among the serology-positive/histology-negative cases, 64/81 (79.0%) were false-positives by serology and, for the majority, inflammation was absent in all biopsies, while, in the serology-negative/histology-positive group, only 6.2% were proven false-positives by histology. CONCLUSIONS Among this high H. pylori prevalent, middle-aged population, the majority of discrepant cases between serology and histology were due to false positive-serology, rather than false-negative histology. This confirms the available evidence that the choice of treatment should not be based solely on the serological results, but also after excluding previous, self-reported eradication therapy.
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Affiliation(s)
- Sabine Skrebinska
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
| | - Francis Megraud
- French National Reference Centre for Campylobacters and Helicobacters, Bacteriology Laboratory, Bordeaux University Hospital, 33076 Bordeaux, France; (F.M.); (C.A.)
- Campus of Carreire, INSERM U1053 BaRITOn, University of Bordeaux, 33000 Bordeaux, France
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Inga Bogdanova
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Reinis Vangravs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Aigars Vanags
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Ivars Tolmanis
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Selga Savcenko
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Chloé Alix
- French National Reference Centre for Campylobacters and Helicobacters, Bacteriology Laboratory, Bordeaux University Hospital, 33076 Bordeaux, France; (F.M.); (C.A.)
- Campus of Carreire, INSERM U1053 BaRITOn, University of Bordeaux, 33000 Bordeaux, France
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomedicas, Fundación INCIENSA, San Jose 2250, Costa Rica;
- International Agency for Research on Cancer, Early Detection, Prevention and Infections Branch, 69372 Lyon, France;
| | - Jin Young Park
- International Agency for Research on Cancer, Early Detection, Prevention and Infections Branch, 69372 Lyon, France;
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
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Mezmale L, Polaka I, Rudzite D, Vangravs R, Kikuste I, Parshutin S, Daugule I, Tazhedinov A, Belikhina T, Igissinov N, Park JY, Herrero R, Leja M. Prevalence and Potential Risk Factors of Helicobacter pylori Infection among Asymptomatic Individuals in Kazakhstan. Asian Pac J Cancer Prev 2021; 22:597-602. [PMID: 33639679 PMCID: PMC8190350 DOI: 10.31557/apjcp.2021.22.2.597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is associated with several risk factors such as demographic, socioeconomic status and personal habits, which vary in different populations. This is the most up-to-date data on H. pylori prevalence and potential risk factors for H. pylori infection among asymptomatic middle-aged individuals in Kazakhstan. METHODS Apparently healthy individuals aged 40 to 64, who took part in the health control in the outpatient clinic, were invited to participate in the study; answered a questionnaire, donated a blood sample. The antibodies to H. pylori were analysed by latex agglutination method. The baseline characteristics of study subjects with or without H. pylori infection were compared using the Chi-square test. Odds ratio (OR) and 95% confidence intervals (CI) for the association between H. pylori infection and potential risk factors were estimated using multivariable logistic regression models. RESULTS Altogether 166 subjects (59% male; the median age - 51 years old) were included; 104 (62.7%) were H. pylori positive. There were no statistically significant differences between H. pylori positive and H. pylori negative groups in respect to the gender, anthropometric measurements, socioeconomic factors and personal habits. The multiple variable analysis showed that age (OR, 1.99; 95% CI, 1.03 - 3.86; P=0.04) and increased salt intake (OR, 2.21; 95% CI, 1.12 - 4.35; P=0.02) were associated with H. pylori infection. CONCLUSIONS More than half of the study subjects were infected with H. pylori in Kazakhstan. The prevalence of H. pylori infection was independently associated with older age and regular high salt consumption.
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Affiliation(s)
- Linda Mezmale
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Riga East University Hospital, Riga, Latvia.
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Reinis Vangravs
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Digestive Disease Centre GASTRO, Riga, Latvia.
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | | | | | - Nurbek Igissinov
- Astana Medical University, Nur-Sultan, Kazakhstan.
- Central Asian Cancer Institute, Nur-Sultan, Kazakhstan.
- Eurasian Institute For Cancer Research, Bishkek, Kyrgyzstan.
| | - Jin Young Park
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
| | - Rolando Herrero
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
- Agencia Costarricense de Investigaciones Biomédicas, San José, Costa Rica.
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Riga East University Hospital, Riga, Latvia.
- Digestive Disease Centre GASTRO, Riga, Latvia.
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Leiherer A, Ślefarska D, Leja M, Heinzle C, Mündlein A, Kikuste I, Mezmale L, Drexel H, Mayhew CA, Mochalski P. The Volatilomic Footprints of Human HGC-27 and CLS-145 Gastric Cancer Cell Lines. Front Mol Biosci 2021; 7:607904. [PMID: 33585559 PMCID: PMC7874186 DOI: 10.3389/fmolb.2020.607904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022] Open
Abstract
The presence of certain volatile biomarkers in the breath of patients with gastric cancer has been reported by several studies; however, the origin of these compounds remains controversial. In vitro studies, involving gastric cancer cells may address this problem and aid in revealing the biochemical pathways underlying the production and metabolism of gastric cancer volatile indicators. Gas chromatography with mass spectrometric detection, coupled with headspace needle trap extraction as the pre-concentration technique, has been applied to map the volatilomic footprints of human HGC-27 and CLS-145 gastric cancer cell lines and normal Human Stomach Epithelial Cells (HSEC). In total, 27 volatile compounds are found to be associated with metabolism occurring in HGC-27, CLS-145, and HSEC. Amongst these, the headspace concentrations of 12 volatiles were found to be reduced compared to those above just the cultivating medium, namely there was an observed uptake of eight aldehydes (2-methylpropanal, 2-methyl-2-propenal, 2-methylbutanal, 3-methylbutanal, hexanal, heptanal, nonanal, and benzaldehyde), three heterocyclic compounds (2-methyl-furan, 2-ethyl-furan, and 2-pentyl-furan), and one sulfur-containing compound (dimethyl disulphide). For the other 15 volatiles, the headspace concentrations above the healthy and cancerous cells were found to be higher than those found above the cultivating medium, namely the cells were found to release three esters (ethyl acetate, ethyl propanoate, and ethyl 2-methylbutyrate), seven ketones (2-pentanone, 2-heptanone, 2-nonanone, 2-undecanone, 2-tridecanone, 2-pentadecanone, and 2-heptadecanone), three alcohols (2-methyl-1-butanol, 3-methyl-1-butanol, and 2-ethyl-1-hexanol), one aromatic compound (toluene), and one sulfur containing compound [2-methyl-5-(methylthio) furan]. In comparison to HSEC, HGC-27 cancer cell lines were found to have significantly altered metabolism, manifested by an increased production of methyl ketones containing an odd number of carbons. Amongst these species, three volatiles were found exclusively to be produced by this cell line, namely 2-undecanone, 2-tridecanone, and 2-heptadecanone. Another interesting feature of the HGC-27 footprint is the lowered level of alcohols and esters. The CLS-145 cells exhibited less pronounced changes in their volatilomic pattern compared to HSEC. Their footprint was characterized by the upregulated production of esters and 2-ethyl-hexanol and downregulated production of other alcohols. We have therefore demonstrated that it is possible to differentiate between cancerous and healthy gastric cells using biochemical volatile signatures.
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Affiliation(s)
- Andreas Leiherer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Medical Central Laboratories, Feldkirch, Austria
| | - Daria Ślefarska
- Institute for Breath Research, University of Innsbruck, Dornbirn, Austria
- Institute of Chemistry, Jan Kochanowski University, Kielce, Poland
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- Faculty of Medicine, University of Latvia, Riga, Latvia
- Riga East University Hospital, Riga, Latvia
| | - Christine Heinzle
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
| | - Axel Mündlein
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- Faculty of Medicine, University of Latvia, Riga, Latvia
- Riga East University Hospital, Riga, Latvia
| | - Linda Mezmale
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- Faculty of Medicine, University of Latvia, Riga, Latvia
- Riga East University Hospital, Riga, Latvia
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Drexel University College of Medicine, Philadelphia, PA, United States
| | - Chris A. Mayhew
- Institute for Breath Research, University of Innsbruck, Dornbirn, Austria
- Molecular Physics Group, School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
| | - Paweł Mochalski
- Institute for Breath Research, University of Innsbruck, Dornbirn, Austria
- Institute of Chemistry, Jan Kochanowski University, Kielce, Poland
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Dekante A, Daugule I, Pavlovics S, Kikuste I, Polaka I, Tzivian L, Kojalo I, Putnins V, Tolmanis I, Rumba-Rozenfelde I, Boka S, Vanags A, Leja M. Low Prevalence of Celiac Disease among Patients with Functional Gastrointestinal Disorders in Latvia. J Gastrointestin Liver Dis 2020; 29:33-39. [PMID: 32176757 DOI: 10.15403/jgld-233] [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] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 01/22/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Studies suggest that the prevalence of celiac disease (CD) is increased in individuals with functional gastrointestinal disorders (FGIDs), in particular, irritable bowel syndrome (IBS); however, the evidence is conflicting. We aimed to analyze the prevalence of CD in patients with FGIDs in Latvia. METHODS This retrospective study included patients with FGIDs, referred for a gastroenterologist consultation in a secondary gastroenterology practice unit. Patients were divided into three groups - patients only with IBS (IBS group), patients only with functional dyspepsia (FD) (FD group), patients with mixed symptoms IBS and FD (Mixed group). Patient levels of tissue transglutaminase IgA (tTG-IgA) and/or antiendomysial IgA group antibodies (EMA-IgA) were evaluated. Four duodenal biopsies were obtained and reported according to Marsh classification. Patients diagnosed or being referred for confirmation of CD were excluded from the study. RESULTS Overall, 1,833 FGIDs patients were enrolled. Celiac serology was available for 1,570 patients, duodenal histology for 582 patients, both histology and serology for 319 patients. In total, celiac seropositivity was present in 1.78% (28/1570) (3.18% in IBS group, 0.90% in FD group and 1.11% of cases in the mixed group). Fifteen patients had histopathological changes (2.58%; 15/582). Three IBS patients (2.36%) were both serology and biopsy positive. None of the FD patients had CD. CONCLUSION Prevalence of biopsy-proven CD in patients from Latvia with FGIDs was low. Routine screening for CD could be considered only among patients with IBS.
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Affiliation(s)
- Alise Dekante
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | - Ilva Daugule
- Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | | | - Ilze Kikuste
- Faculty of Medicine, University of Latvia, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Lilian Tzivian
- Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Ilona Kojalo
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | | | | | | | - Sarmite Boka
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | - Aigars Vanags
- Digestive Diseases Centre GASTRO, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
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Mezmale L, Isajevs S, Bogdanova I, Polaka I, Krigere A, Rudzite D, Rudule A, Kikuste I, Parshutin S, Tazhedinov A, Mushinskiy D, Sametayev D, Belikhina T, Igissinov N, Park JY, Herrero R, Leja M. Prevalence of Atrophic Gastritis in Kazakhstan and the Accuracy of Pepsinogen Tests to Detect Gastric Mucosal Atrophy. Asian Pac J Cancer Prev 2019; 20:3825-3829. [PMID: 31870128 PMCID: PMC7173362 DOI: 10.31557/apjcp.2019.20.12.3825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/08/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Atrophic gastritis is considered precursor condition for gastric cancer. There is so far limited evidence on the performance of pepsinogens for atrophy detection in Central Asia. The aim of our study was to detect the prevalence of atrophic gastritis in the asymptomatic adult population in Kazakhstan as well as address the accuracy of pepsinogen testing in atrophy detection. METHODS Healthy individuals aged 40-64 were included. Upper endoscopy and pepsinogens (PG) evaluation were performed. PG were analysed in plasma by latex agglutination. Cut off values were used to define decreased PG values (PGR ≤ 3 and PG I ≤ 70 ng/mL); severely decreased PG values (PGR ≤ 2 and PG I ≤ 30 ng/mL). Biopsies were analyzed and obtained according to the updated Sydney System. PG test sensitivity, specificity and overall accuracy were assessed using the histological diagnosis as the "gold standard". RESULTS Altogether 157 individuals - female 40,1% and male 59,9% were included. Histologically, moderate to severe corpus atrophy, was present only in 1,3% cases. From all study subjects, 26,8% had decreased plasma PG values with cut-off values PGR ≤ 3 and PG I ≤ 70 ng/mL. The sensitivity of the PG test with this cut-off values was 50,0%, specificity 73,5%, overall accuracy 73,2% for detection of moderate to severe atrophy in the corpus. The sensitivity of PG test with cut-off values PGR ≤ 2 and PG I ≤30 ng/mL was 50,0%, specificity 90,9% and overall accuracy 90,4%. CONCLUSIONS The prevalence of gastric mucosal atrophy was low in the Kazakh population. Serological PG test screening nevertheless can play an important role in the diagnosis of gastric precancerous lesions. However, the diagnostic accuracy of the PG test is mainly dependent on the cut-off values for positive results.
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Affiliation(s)
- Linda Mezmale
- Institute of Clinical and Preventive Medicine,
- Faculty of Medicine, University of Latvia,
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine,
- Academic Histology Laboratory,
| | - Inga Bogdanova
- Institute of Clinical and Preventive Medicine,
- Academic Histology Laboratory,
| | | | | | | | - Aiga Rudule
- Institute of Clinical and Preventive Medicine,
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine,
- Faculty of Medicine, University of Latvia,
- Digestive Disease Centre GASTRO, Riga, Latvia,
| | | | | | | | | | | | - Nurbek Igissinov
- Astana Medical University,
- Central Asian Cancer Institute, Nur-Sultan, Kazakhstan,
- International High School of Medicine,
- Eurasian Institute For Cancer Research, Bishkek, Kyrgyzstan,
| | - Jin Young Park
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
| | - Rolando Herrero
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine,
- Faculty of Medicine, University of Latvia,
- Digestive Disease Centre GASTRO, Riga, Latvia,
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Broza YY, Khatib S, Gharra A, Krilaviciute A, Amal H, Polaka I, Parshutin S, Kikuste I, Gasenko E, Skapars R, Brenner H, Leja M, Haick H. Screening for gastric cancer using exhaled breath samples. Br J Surg 2019; 106:1122-1125. [PMID: 31259390 DOI: 10.1002/bjs.11294] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/27/2019] [Accepted: 06/04/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim was to derive a breath-based classifier for gastric cancer using a nanomaterial-based sensor array, and to validate it in a large screening population. METHODS A new training algorithm for the diagnosis of gastric cancer was derived from previous breath samples from patients with gastric cancer and healthy controls in a clinical setting, and validated in a blinded manner in a screening population. RESULTS The training algorithm was derived using breath samples from 99 patients with gastric cancer and 342 healthy controls, and validated in a population of 726 people. The calculated training set algorithm had 82 per cent sensitivity, 78 per cent specificity and 79 per cent accuracy. The algorithm correctly classified all three patients with gastric cancer and 570 of the 723 cancer-free controls in the screening population, yielding 100 per cent sensitivity, 79 per cent specificity and 79 per cent accuracy. Further analyses of lifestyle and confounding factors were not associated with the classifier. CONCLUSION This first validation of a nanomaterial sensor array-based algorithm for gastric cancer detection from breath samples in a large screening population supports the potential of this technology for the early detection of gastric cancer.
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Affiliation(s)
- Y Y Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa, Israel
| | - S Khatib
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa, Israel
| | - A Gharra
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa, Israel
| | - A Krilaviciute
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Centre, Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Centre and National Centre for Tumour Diseases, Heidelberg, Germany
| | - H Amal
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa, Israel
| | - I Polaka
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia
| | - S Parshutin
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia
| | - I Kikuste
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Digestive Diseases Centre GASTRO, Riga, Latvia
| | - E Gasenko
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia
| | - R Skapars
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia
| | - H Brenner
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Centre, Heidelberg, Germany.,German Cancer Consortium, German Cancer Research Centre, Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Centre and National Centre for Tumour Diseases, Heidelberg, Germany
| | - M Leja
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia.,Department of Research, Digestive Diseases Centre GASTRO, Riga, Latvia
| | - H Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa, Israel
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8
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Sjomina O, Pavlova J, Daugule I, Janovic P, Kikuste I, Vanags A, Tolmanis I, Rudzite D, Polaka I, Kojalo I, Liepniece-Karele I, Isajevs S, Santare D, Pirags V, Pahomova J, Dzerve V, Tzivian L, Erglis A, Leja M. Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: a population-based study. J Gastrointestin Liver Dis 2019; 27:11-17. [PMID: 29557410 DOI: 10.15403/jgld.2014.1121.271.pep] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AIMS The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings. METHODS Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system). RESULTS Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV - 10.5% and 0.0%, OLGIM stages III-IV - 3.5% and 0%, and low-grade dysplasia - 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05). CONCLUSIONS All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed. However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.
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Affiliation(s)
- Olga Sjomina
- Institute of Clinical and Preventive Medicine, University of Latvia;Faculty of Medicine, University of Latvia, Riga, Latvia. or sjomina.
| | - Jelizaveta Pavlova
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Pavel Janovic
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia; Department of Research, Riga East University Hospital, Riga, Latvia
| | - Aigars Vanags
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Ivars Tolmanis
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Ilona Kojalo
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia;Academic Histology Laboratory, Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia;Academic Histology Laboratory, Riga, Latvia
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine, University of Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Valdis Pirags
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Jelena Pahomova
- Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Vilnis Dzerve
- Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Lilian Tzivian
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Andrejs Erglis
- Institute of Clinical and Preventive Medicine, University of Latvia; Institute of Information Technology, Riga Technical University; P. Stradins Clinical Hospital, Riga, Latvia
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia; Digestive Diseases Centre Gastro, Riga, Latvia
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Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, Garrido M, Kikuste I, Megraud F, Matysiak-Budnik T, Annibale B, Dumonceau JM, Barros R, Fléjou JF, Carneiro F, van Hooft JE, Kuipers EJ, Dinis-Ribeiro M. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 2019; 51:365-388. [PMID: 30841008 DOI: 10.1055/a-0859-1883] [Citation(s) in RCA: 473] [Impact Index Per Article: 94.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Patients with chronic atrophic gastritis or intestinal metaplasia (IM) are at risk for gastric adenocarcinoma. This underscores the importance of diagnosis and risk stratification for these patients. High definition endoscopy with chromoendoscopy (CE) is better than high definition white-light endoscopy alone for this purpose. Virtual CE can guide biopsies for staging atrophic and metaplastic changes and can target neoplastic lesions. Biopsies should be taken from at least two topographic sites (antrum and corpus) and labelled in two separate vials. For patients with mild to moderate atrophy restricted to the antrum there is no evidence to recommend surveillance. In patients with IM at a single location but with a family history of gastric cancer, incomplete IM, or persistent Helicobacter pylori gastritis, endoscopic surveillance with CE and guided biopsies may be considered in 3 years. Patients with advanced stages of atrophic gastritis should be followed up with a high quality endoscopy every 3 years. In patients with dysplasia, in the absence of an endoscopically defined lesion, immediate high quality endoscopic reassessment with CE is recommended. Patients with an endoscopically visible lesion harboring low or high grade dysplasia or carcinoma should undergo staging and treatment. H. pylori eradication heals nonatrophic chronic gastritis, may lead to regression of atrophic gastritis, and reduces the risk of gastric cancer in patients with these conditions, and it is recommended. H. pylori eradication is also recommended for patients with neoplasia after endoscopic therapy. In intermediate to high risk regions, identification and surveillance of patients with precancerous gastric conditions is cost-effective.
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Affiliation(s)
- Pedro Pimentel-Nunes
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
- Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
- Surgery and Physiology Department, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Diogo Libânio
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
- Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
| | - Ricardo Marcos-Pinto
- Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
- Department of Gastroenterology, Porto University Hospital Centre, Institute of Biomedical Sciences, University of Porto (ICBAS/UP), Portugal
| | - Miguel Areia
- Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
- Gastroenterology Department, Portuguese Oncology Institute of Coimbra, Portugal
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Digestive Diseases Center, GASTRO, Riga, Latvia
| | - Gianluca Esposito
- Department of Medicine, Surgery and Translational Medicine University Hospital Sant'Andrea, University Sapienza Roma, Rome, Italy
| | - Monica Garrido
- Department of Gastroenterology, Porto University Hospital Centre, Institute of Biomedical Sciences, University of Porto (ICBAS/UP), Portugal
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia, Digestive Diseases Center, GASTRO, Riga, Latvia
| | - Francis Megraud
- INSERM U1053, Université de Bordeaux and CHU Pellegrin, Laboratoire de Bacteriologie, Bordeaux, France
| | - Tamara Matysiak-Budnik
- IMAD, Hepato-Gastroenterology and Digestive Oncology, CHU de Nantes, University of Nantes, France
| | - Bruno Annibale
- Department of Medicine, Surgery and Translational Medicine University Hospital Sant'Andrea, University Sapienza Roma, Rome, Italy
| | | | - Rita Barros
- Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
| | - Jean-François Fléjou
- Service d'Anatomie Pathologique, Hôpital Saint-Antoine, AP-HP, Faculté de Médecine Sorbonne Université, Paris, France
| | - Fátima Carneiro
- Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
- Pathology Department, Centro Hospitalar de São João and Faculty of Medicine, Porto, Portugal
| | - Jeanin E van Hooft
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Ernst J Kuipers
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mario Dinis-Ribeiro
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
- Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
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10
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Skrebinska S, Daugule I, Santare D, Isajevs S, Liepniece-Karele I, Rudzite D, Kikuste I, Vanags A, Tolmanis I, Atstupens J, Park JY, Herrero R, Leja M. Accuracy of two plasma antibody tests and faecal antigen test for non-invasive detection of H. pylori in middle-aged Caucasian general population sample. Scand J Gastroenterol 2018; 53:777-783. [PMID: 29889002 DOI: 10.1080/00365521.2018.1476909] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 05/06/2018] [Accepted: 05/07/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of the study was to assess the accuracy of two plasma Helicobacter pylori (H. pylori) antibody test-systems and a stool antigen test (SAT) system in a general population sample in Latvia. MATERIALS AND METHODS Blood and faecal samples were analysed in healthy individuals (40-64 years), referred for upper gastrointestinal endoscopy according to pilot study protocol within a population-based study investigating gastric cancer prevention strategies (GISTAR pilot study). Antibodies to H. pylori were assessed in plasma by latex-agglutination test and enzyme-linked immunosorbent assay (ELISA). H. pylori antigen in faecal samples was detected by a monoclonal enzyme immunoassay-based SAT. Histological assessment of H. pylori based on a modified Giemsa staining method was used as the gold standard. Individuals having received H. pylori eradication within one year prior to enrolment were excluded. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy were calculated. Receiver-operating characteristic curves were designed to estimate the optimal diagnostic cut-off value of tests. RESULTS The analysis included 779 participants for latex-agglutination test, 1002 for ELISA and 672 individual samples for SAT. The sensitivity, specificity, PPV, NPV and overall accuracy were as follows: latex-agglutination test (86;81;87;80;84%), ELISA (97;72;83;94;86%) and SAT (87;81;87;81;85%), respectively. The optimal diagnostic cut-off value for ELISA test was ≥50.26 g/L. CONCLUSIONS Although the performance of the three tests was comparable to each other, the three test systems showed suboptimal accuracy, with important implications for public health programs based on 'test-and-treat' strategy.
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Affiliation(s)
- Sabine Skrebinska
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- b Faculty of Continuing Education , Riga Stradins University , Riga , Latvia
| | - Ilva Daugule
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- c Faculty of Medicine , University of Latvia , Riga , Latvia
| | - Daiga Santare
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- c Faculty of Medicine , University of Latvia , Riga , Latvia
- d Department of Research , Riga East University Hospital , Riga , Latvia
| | - Sergejs Isajevs
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- c Faculty of Medicine , University of Latvia , Riga , Latvia
- e Academic Histology Laboratory , Riga , Latvia
| | - Inta Liepniece-Karele
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- e Academic Histology Laboratory , Riga , Latvia
| | - Dace Rudzite
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- d Department of Research , Riga East University Hospital , Riga , Latvia
| | - Ilze Kikuste
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- c Faculty of Medicine , University of Latvia , Riga , Latvia
- f Digestive Diseases Centre, "GASTRO" , Riga , Latvia
| | - Aigars Vanags
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- f Digestive Diseases Centre, "GASTRO" , Riga , Latvia
| | | | - Juris Atstupens
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
| | - Jin Young Park
- g Prevention and Implementation Group , International Agency for Research on Cancer , Lyon , France
| | - Rolando Herrero
- g Prevention and Implementation Group , International Agency for Research on Cancer , Lyon , France
| | - Marcis Leja
- a Institute of Clinical and Preventive Medicine, University of Latvia , Riga , Latvia
- c Faculty of Medicine , University of Latvia , Riga , Latvia
- d Department of Research , Riga East University Hospital , Riga , Latvia
- f Digestive Diseases Centre, "GASTRO" , Riga , Latvia
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11
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Leja M, Park JY, Murillo R, Liepniece-Karele I, Isajevs S, Kikuste I, Rudzite D, Krike P, Parshutin S, Polaka I, Kirsners A, Santare D, Folkmanis V, Daugule I, Plummer M, Herrero R. Multicentric randomised study of Helicobacter pylori eradication and pepsinogen testing for prevention of gastric cancer mortality: the GISTAR study. BMJ Open 2017; 7:e016999. [PMID: 28801429 PMCID: PMC5724070 DOI: 10.1136/bmjopen-2017-016999] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/14/2017] [Accepted: 06/21/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Population-based eradication of Helicobacter pylori has been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whether H pylori eradication combined with pepsinogen testing reduces mortality from gastric cancer among 40-64-year-old individuals. The secondary objectives include evaluation of H pylori eradication effectiveness in gastric cancer prevention in patients with precancerous lesions and evaluation of the potential adverse events, including effects on microbiome. METHODS AND ANALYSIS Individuals are recruited from general population (50% men) in areas with high gastric cancer risk in Europe and undergo detailed lifestyle and medical history questionnaire before being randomly allocated to intervention or control groups. The intervention group undergoes H pylori testing and is offered eradication therapy if positive; in addition, pepsinogen levels are detected in plasma and those with decreased levels are referred for upper endoscopy. All participants are offered faecal occult blood testing as an incentive for study participation. Effectiveness of eradication and the spectrum of adverse events are evaluated in study subpopulations. A 35% difference in gastric cancer mortality between the groups is expected to be detectable at 90% power after 15 years if 30 000 individuals are recruited. Biological materials are biobanked for the main and ancillary studies. The study procedure and assumptions will be tested during the pilot phase. ETHICS AND DISSEMINATION The study was approved by the respective ethics committees. An independent Data Safety and Monitoring Board has been established. The findings will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER NCT02047994.
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Affiliation(s)
- Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Jin Young Park
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Academic Histology Laboratory, Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Academic Histology Laboratory, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Petra Krike
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Arnis Kirsners
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Valdis Folkmanis
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Martyn Plummer
- Infection and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Rolando Herrero
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
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12
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Meistere I, Werner S, Zayakin P, Siliņa K, Rulle U, Pismennaja A, Šantare D, Kikuste I, Isajevs S, Leja M, Kupčinskas L, Kupčinskas J, Jonaitis L, Wu CY, Brenner H, Linē A, Kalniņa Z. The Prevalence of Cancer-Associated Autoantibodies in Patients with Gastric Cancer and Progressive Grades of Premalignant Lesions. Cancer Epidemiol Biomarkers Prev 2017; 26:1564-1574. [PMID: 28768706 DOI: 10.1158/1055-9965.epi-17-0238] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/17/2017] [Accepted: 07/21/2017] [Indexed: 01/14/2023] Open
Abstract
Background: Serum autoantibodies against tumor-associated antigens (TAAs) are detectable in early-stage gastric cancer patients; however, the time point during cancerogenesis when they appear in circulation is still obscure.Methods: In this study, we developed a recombinant antigen microarray and analyzed the prevalence of autoantibodies against 102 TAAs in 829 gastric cancer patients and 929 healthy controls from Caucasian and Asian populations, as well as 100 patients with chronic atrophic gastritis and 775 individuals staged according to different grades of intestinal metaplasia.Results: Six antigens, including CTAG1B/CTAG2, DDX53, IGF2BP2, TP53, and MAGEA3, were predominantly reacting with sera from gastric cancer patients when compared with healthy controls, and the seroreactivity was associated with intestinal-type gastric cancer, but not with patients' Helicobacter pylori status, grade, age, gender, or stage of gastric cancer. We detected gastric cancer-associated seroreactivity in 13% of patients with advanced/severe intestinal metaplasia, which was increased in comparison with mild/moderate intestinal metaplasia (5.3%) and was comparable with that seen in early-stage gastric cancer patients (12%). Moreover, by testing serum samples taken 1 to 9 years before the clinical diagnosis of 18 incident gastric cancer cases, we detected autoantibody responses against several TAAs-SOX2, MYC, BIRC5, IGF2BP1, and MUC1.Conclusions: Our results suggest that humoral immune response against TAAs is generated already during premalignant stages.Impact: Based on the obtained results, cancer-associated autoantibodies might make a valuable contribution to the stratification of high-risk patients with premalignant lesions in the stomach through enhancing the positive predictive power of existing risk models. Cancer Epidemiol Biomarkers Prev; 26(10); 1564-74. ©2017 AACR.
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Affiliation(s)
- Irēna Meistere
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Simone Werner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pawel Zayakin
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Karīna Siliņa
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Undīne Rulle
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Angelina Pismennaja
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Daiga Šantare
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Riga East University Hospital, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Riga East University Hospital, Riga, Latvia
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.,Riga East University Hospital, Riga, Latvia.,Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Limas Kupčinskas
- Institute for Digestive Research and Department of Gastroenterology Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Juozas Kupčinskas
- Institute for Digestive Research and Department of Gastroenterology Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laimas Jonaitis
- Institute for Digestive Research and Department of Gastroenterology Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Chun-Ying Wu
- Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Aija Linē
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Zane Kalniņa
- Cancer Biomarker and Immunotherapy Group, Latvian Biomedical Research and Study Centre, Riga, Latvia.
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13
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Leja M, Camargo MC, Polaka I, Isajevs S, Liepniece-Karele I, Janciauskas D, Rudzite D, Kikuste I, Vanags A, Kojalo I, Folkmanis V, Kirsners A, Tolmanis I, Rabkin CS. Detection of gastric atrophy by circulating pepsinogens: A comparison of three assays. Helicobacter 2017; 22:10.1111/hel.12393. [PMID: 28557128 PMCID: PMC5847288 DOI: 10.1111/hel.12393] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Circulating levels of pepsinogens have been used in high gastric cancer-risk Asian and European populations to triage endoscopic evaluation for more severe pathology. There are different analytic methods with uncertain correlations. We therefore compared diagnostic performance of three commonly used pepsinogen assays to detect histologically confirmed gastric atrophy. METHODS We tested plasma samples from adult patients with (n=50) and without (n=755) moderate or severe gastric corpus atrophy, as determined histologically by consensus of three expert pathologists. A single laboratory measured pepsinogens I (PgI) and II (PgII) using commercially available assays: two ELISA assays produced by Biohit (Finland) and Vector Best (Russia), and a latex agglutination assay from Eiken (Japan). Quantitative correlations were assessed by Spearman statistics. Receiver operating characteristic (ROC) curves vs histological diagnosis were calculated using both the manufacturers' and optimized cutoffs. RESULTS Pepsinogen levels were highly correlated among the assays (pairwise Rhos: PgI≥0.84, PgII≥0.87; all P-values<.01). Based on manufacturers' cutoffs, sensitivities, specificities and areas under the ROC curve for detecting moderate to severe histological corpus atrophy by PgI/PgII were 44%/91%/0.70, 56%/84%/0.76, and 52%/90%/0.77 for Biohit, Vector Best and Eiken, respectively. Cutoffs optimized by ROC or data mining analyses did not substantially improve test performance. CONCLUSIONS Commercial assays for pepsinogen have good relative agreement but are imperfect tests for clinical diagnosis of gastric atrophy. IMPACT Pepsinogen testing alone does not provide sufficient information for gastric cancer risk stratification. Future investigations should focus on other potential markers, in combination with pepsinogens.
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Affiliation(s)
- Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia,Digestive Diseases Centre GASTRO, Riga, Latvia
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, United States
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Faculty of Computer Sciences and Information Technology, Riga Technical University, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia,Academic Histology laboratory, Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia,Academic Histology laboratory, Riga, Latvia
| | | | - Dace Rudzite
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Digestive Diseases Centre GASTRO, Riga, Latvia
| | | | - Ilona Kojalo
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia
| | - Valdis Folkmanis
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Arnis Kirsners
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia,Department of Research, Riga East University Hospital, Riga, Latvia,Faculty of Computer Sciences and Information Technology, Riga Technical University, Latvia
| | | | - Charles S. Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, United States
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14
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Nakhleh M, Amal H, Jeries R, Broza YY, Aboud M, Gharra A, Ivgi H, Khatib S, Badarneh S, Har-Shai L, Glass-Marmor L, Lejbkowicz I, Miller A, Badarny S, Winer R, Finberg J, Cohen-Kaminsky S, Perros F, Montani D, Girerd B, Garcia G, Simonneau G, Nakhoul F, Baram S, Salim R, Hakim M, Gruber M, Ronen O, Marshak T, Doweck I, Nativ O, Bahouth Z, Shi DY, Zhang W, Hua QL, Pan YY, Tao L, Liu H, Karban A, Koifman E, Rainis T, Skapars R, Sivins A, Ancans G, Liepniece-Karele I, Kikuste I, Lasina I, Tolmanis I, Johnson D, Millstone SZ, Fulton J, Wells JW, Wilf LH, Humbert M, Leja M, Peled N, Haick H. Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules. ACS Nano 2017; 11:112-125. [PMID: 28000444 PMCID: PMC5269643 DOI: 10.1021/acsnano.6b04930] [Citation(s) in RCA: 256] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 12/02/2016] [Indexed: 05/17/2023]
Abstract
We report on an artificially intelligent nanoarray based on molecularly modified gold nanoparticles and a random network of single-walled carbon nanotubes for noninvasive diagnosis and classification of a number of diseases from exhaled breath. The performance of this artificially intelligent nanoarray was clinically assessed on breath samples collected from 1404 subjects having one of 17 different disease conditions included in the study or having no evidence of any disease (healthy controls). Blind experiments showed that 86% accuracy could be achieved with the artificially intelligent nanoarray, allowing both detection and discrimination between the different disease conditions examined. Analysis of the artificially intelligent nanoarray also showed that each disease has its own unique breathprint, and that the presence of one disease would not screen out others. Cluster analysis showed a reasonable classification power of diseases from the same categories. The effect of confounding clinical and environmental factors on the performance of the nanoarray did not significantly alter the obtained results. The diagnosis and classification power of the nanoarray was also validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry. This analysis found that 13 exhaled chemical species, called volatile organic compounds, are associated with certain diseases, and the composition of this assembly of volatile organic compounds differs from one disease to another. Overall, these findings could contribute to one of the most important criteria for successful health intervention in the modern era, viz. easy-to-use, inexpensive (affordable), and miniaturized tools that could also be used for personalized screening, diagnosis, and follow-up of a number of diseases, which can clearly be extended by further development.
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Affiliation(s)
- Morad
K. Nakhleh
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Haitham Amal
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Raneen Jeries
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Yoav Y. Broza
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Manal Aboud
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Alaa Gharra
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Hodaya Ivgi
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Salam Khatib
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Shifaa Badarneh
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Lior Har-Shai
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Lea Glass-Marmor
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Izabella Lejbkowicz
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Ariel Miller
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Samih Badarny
- Movement
Disorders Clinic, Department of Neurology, Carmel Medical Center,
and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - Raz Winer
- Movement
Disorders Clinic, Department of Neurology, Carmel Medical Center,
and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - John Finberg
- Department of Molecular Pharmacology, Rappaport
Family Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Sylvia Cohen-Kaminsky
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Frédéric Perros
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - David Montani
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Barbara Girerd
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Gilles Garcia
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Gérald Simonneau
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Farid Nakhoul
- Department of
Nephrology and Hypertension Baruch Padeh
Medical Center, Poriya 15208, Israel
| | - Shira Baram
- Department of Obstetrics
and Gynecology, Emek Medical Center, Afula 18101, and Rappaport Family
Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Raed Salim
- Department of Obstetrics
and Gynecology, Emek Medical Center, Afula 18101, and Rappaport Family
Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Marwan Hakim
- Department
of Obstetrics and Gynecology, Nazareth Hospital EMMS, Nazareth, and
Faculty of Medicine in the Galilee, Bar
Ilan University, Ramat
Gan, Israel
| | - Maayan Gruber
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ohad Ronen
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Tal Marshak
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ilana Doweck
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ofer Nativ
- Department of Urology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Zaher Bahouth
- Department of Urology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Da-you Shi
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Wei Zhang
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Qing-ling Hua
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Yue-yin Pan
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Li Tao
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Hu Liu
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Amir Karban
- Internal Medicine C and Gastroenterology Departments,
Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 3525408, Israel
| | - Eduard Koifman
- Internal Medicine C and Gastroenterology Departments,
Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 3525408, Israel
| | - Tova Rainis
- Department of Gastroenterology, Bnai Zion
Hospital and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - Roberts Skapars
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Armands Sivins
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Guntis Ancans
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Inta Liepniece-Karele
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Ilze Kikuste
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Ieva Lasina
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Ivars Tolmanis
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Douglas Johnson
- Department of Radiation
Oncology, Baptist Cancer Institute (BCI), 1235 San Marco Boulevard, Suite100, Jacksonville, Florida 32207, United States
| | - Stuart Z. Millstone
- Pulmonary
and Critical Care Associates, Orange Park, Florida 32073, United States
| | - Jennifer Fulton
- Pulmonary Diseases, Baptist Medical Center, Jacksonville, Florida 32217, United States
| | - John W. Wells
- Pulmonary
and Critical Care Associates, Orange Park, Florida 32073, United States
| | - Larry H. Wilf
- Oncologic Imaging Division, Florida Radiation Oncology Group, Jacksonville, Florida 32217, United States
| | - Marc Humbert
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Nir Peled
- Thoracic
Cancer Unit, Davidoff Cancer Center, RMC, Kaplan Street, Petach Tiqwa 49100, Israel
| | - Hossam Haick
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
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15
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Amal H, Leja M, Funka K, Skapars R, Sivins A, Ancans G, Liepniece-Karele I, Kikuste I, Lasina I, Haick H. Detection of precancerous gastric lesions and gastric cancer through exhaled breath. Gut 2016; 65:400-7. [PMID: 25869737 DOI: 10.1136/gutjnl-2014-308536] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 02/07/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Timely detection of gastric cancer (GC) and the related precancerous lesions could provide a tool for decreasing both cancer mortality and incidence. DESIGN 968 breath samples were collected from 484 patients (including 99 with GC) for two different analyses. The first sample was analysed by gas chromatography linked to mass spectrometry (GCMS) while applying t test with multiple corrections (p value<0.017); the second by cross-reactive nanoarrays combined with pattern recognition. For the latter, 70% of the samples were randomly selected and used in the training set while the remaining 30% constituted the validation set. The operative link on gastric intestinal metaplasia (OLGIM) assessment staging system was used to stratify the presence/absence and risk level of precancerous lesions. Patients with OLGIM stages III-IV were considered to be at high risk. RESULTS According to the GCMS results, patients with cancer as well as those at high risk had distinctive breath-print compositions. Eight significant volatile organic compounds (p value<0.017) were detected in exhaled breath in the different comparisons. The nanoarray analysis made it possible to discriminate between the patients with GC and the control group (OLGIM 0-IV) with 73% sensitivity, 98% specificity and 92% accuracy. The classification sensitivity, specificity, and accuracy between the subgroups was as follows: GC versus OLGIM 0-II-97%, 84% and 87%; GC versus OLGIM III-IV-93%, 80% and 90%; but OLGIM I-II versus OLGIM III-IV and dysplasia combined-83%, 60% and 61%, respectively. CONCLUSIONS Nanoarray analysis could provide the missing non-invasive screening tool for GC and related precancerous lesions as well as for surveillance of the latter. TRIAL REGISTRATION NUMBER Clinical Trials.gov number, NCT01420588 (3/11/2013).
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Affiliation(s)
- Haitham Amal
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Konrads Funka
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Roberts Skapars
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia
| | - Armands Sivins
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia
| | - Guntis Ancans
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia
| | - Inta Liepniece-Karele
- Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia Academic Histology laboratory, Riga, Latvia
| | - Ilze Kikuste
- Faculty of Medicine, University of Latvia, Riga, Latvia Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Ieva Lasina
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
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Kalniņa Z, Meistere I, Kikuste I, Tolmanis I, Zayakin P, Linē A. Emerging blood-based biomarkers for detection of gastric cancer. World J Gastroenterol 2015; 21:11636-11653. [PMID: 26556992 PMCID: PMC4631966 DOI: 10.3748/wjg.v21.i41.11636] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/08/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
Early detection and efficient monitoring of tumor dynamics are prerequisites for reducing disease burden and mortality, and for improving the management of patients with gastric cancer (GC). Blood-based biomarker assays for the detection of early-stage GC could be of great relevance both for population-wide or risk group-based screening programs, while circulating biomarkers that reflect the genetic make-up and dynamics of the tumor would allow monitoring of treatment efficacy, predict recurrences and assess the genetic heterogeneity of the tumor. Recent research to identify blood-based biomarkers of GC has resulted in the identification of a wide variety of cancer-associated molecules, including various proteins, autoantibodies against tumor associated antigens, cell-free DNA fragments, mRNAs and various non-coding RNAs, circulating tumor cells and cancer-derived extracellular vesicles. Each type of these biomarkers provides different information on the disease status, has different advantages and disadvantages, and distinct clinical usefulness. In the current review, we summarize the recent developments in blood-based GC biomarker discovery, discuss the origin of various types of biomarkers and their clinical usefulness and the technological challenges in the development of biomarker assays for clinical use.
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Amal H, Leja M, Funka K, Lasina I, Skapars R, Sivins A, Ancans G, Kikuste I, Vanags A, Tolmanis I, Kirsners A, Kupcinskas L, Haick H. Breath testing as potential colorectal cancer screening tool. Int J Cancer 2015. [PMID: 26212114 DOI: 10.1002/ijc.29701] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. All patients, including the controls, had undergone colonoscopy. The samples were analysed with two different techniques. The first technique relied on gas chromatography coupled with mass spectrometry (GC-MS) for identification and quantification of volatile organic compounds (VOCs). The T-test was used to identify significant VOCs (p values < 0.017). The second technique relied on sensor analysis with a pattern recognition method for building a breath pattern to identify different groups. Blind analysis or leave-one-out cross validation was conducted for validation. The GC-MS analysis revealed four significant VOCs that identified the tested groups; these were acetone and ethyl acetate (higher in CRC), ethanol and 4-methyl octane (lower in CRC). The sensor-analysis distinguished CRC from the control group with 85% sensitivity, 94% specificity and 91% accuracy. The performance of the sensors in identifying the advanced adenoma group from the non-advanced adenomas was 88% sensitivity, 100% specificity, and 94% accuracy. The performance of the sensors in identifying the advanced adenoma group was distinguished from the control group was 100% sensitivity, 88% specificity, and 94% accuracy. For summary, volatile marker testing by using sensor analysis is a promising noninvasive approach for CRC screening.
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Affiliation(s)
- Haitham Amal
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia.,Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Konrads Funka
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia.,Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Ieva Lasina
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Roberts Skapars
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia
| | - Armands Sivins
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia
| | - Guntis Ancans
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Research, Riga East University Hospital, Riga, Latvia
| | - Ilze Kikuste
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Digestive Diseases Centre GASTRO, Riga, Latvia
| | | | | | | | | | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
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Leja M, Shums Z, Nikitina-Zake L, Gavars M, Kikuste I, Milo J, Daugule I, Pahomova J, Pirags V, Dzerve V, Klovins J, Erglis A, Norman GL. Prevalence estimation of celiac disease in the general adult population of Latvia using serology and HLA genotyping. United European Gastroenterol J 2015; 3:190-9. [PMID: 25922680 DOI: 10.1177/2050640615569379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 01/01/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Prevalence estimates for celiac disease (CD) depend on the method used. The role of deamidated gliadin peptide (DGP) and genetic testing in epidemiological studies and diagnostic settings of celiac disease (CD) has still to be established. OBJECTIVES The objective of this article is to assess the prevalence of CD in Latvia by combining serological tests with DQ2.5/DQ8 testing. METHODS A total of 1444 adults from a randomly selected cross-sectional general population sample were tested by ELISA for tTG IgA, DGP IgA and IgG antibodies (QUANTA Lite®, Inova Diagnostics Inc). Samples with tTG IgA ≥20U were tested for EMA IgA by indirect immunofluorescence assay, and all specimens with tTG IgA ≥15U were tested by QUANTA-Flash® chemiluminescent assays (CIA) (Inova Diagnostics Inc) for tTG IgA, DGP IgA and IgG. DQ2.5/8 was detected in individuals with any positive ELISA test and a subgroup of controls. RESULTS Forty-three individuals (2.98%; 95% CI: 2.10-3.86%) tested positive by at least one ELISA test; 41.86% of the serology-positive individuals (any test above the cutoff) were DQ positive. Six individuals (0.42%; 95% CI: 0.09-0.75%) were triple ELISA positive, and DQ2.5 or DQ8 was positive in all; 0.35% (95% CI: 0.05-0.65%) were tTG IgA and EMA positive. Two tTG IgA-negative cases were both DGP IgG and IgA positive, both being DQ positive; including them in the "serology-positive" group would increase the prevalence to 0.49% (95% CI: 0.13-0.85%). CIA tests revealed 2 tTG IgA-positive and EMA-negative cases with a positive genotype. DQ2.5 or DQ8 genotype was positive in 28.6% of the serology-negative population. CONCLUSIONS Estimates of the prevalence of CD in Latvia based on the serogenetic testing approach range from 0.35% to 0.49% depending on the criteria used. There is a rationale for combining serological tests and DQ2.5/8 genotyping.
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Affiliation(s)
- Marcis Leja
- University of Latvia, Faculty of Medicine, Riga East University Hospital, Riga, Latvia
| | | | | | | | | | - Jay Milo
- Inova Diagnostics Inc, San Diego, CA, USA
| | | | | | - Valdis Pirags
- University of Latvia, Faculty of Medicine, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Vilnis Dzerve
- Institute of Cardiology, University of Latvia, Riga, Latvia
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Andrejs Erglis
- Institute of Cardiology, University of Latvia, Riga, Latvia
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Serrano M, Kikuste I, Dinis-Ribeiro M. Advanced endoscopic imaging for gastric cancer assessment: new insights with new optics? Best Pract Res Clin Gastroenterol 2014; 28:1079-91. [PMID: 25439073 DOI: 10.1016/j.bpg.2014.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 09/22/2014] [Accepted: 10/01/2014] [Indexed: 01/31/2023]
Abstract
The most immediate strategy for improving survival of gastric cancer patients is secondary prevention through diagnosis of early gastric cancer either through screening or follow-up of individuals at high risk. Endoscopy examination is therefore of paramount importance and two general steps are to be known in assessing gastric mucosa - detection and characterization. Over the past decade, the advent of advanced endoscopic imaging technology led to diverse descriptions of these modalities reporting them to be useful in this setting. In this review, we aim at summarizing the current evidence on the use of advance imaging in individuals at high-risk (i.e., advance stages of gastric atrophy/intestinal metaplasia) and in those harbouring neoplastic lesions, and address its potential usefulness providing the readers a framework to use in daily practice. Further research is also suggested.
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Affiliation(s)
- M Serrano
- Gastroenterology Department, Portuguese Oncology Institute, Rua Professor Lima Basto, 1099-023 Lisbon, Portugal.
| | - I Kikuste
- Faculty of Medicine, University of Latvia, Riga, Latvia; Digestive Diseases Centre GASTRO, 6 Linezera Street, LV1006 Riga, Latvia.
| | - M Dinis-Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Porto Faculty of Medicine, Porto, Portugal; Gastroenterology Department, Portuguese Oncology Institute, Rua Dr. Bernardino de Almeida, 4200-072 Porto, Portugal.
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Pasechnikov V, Chukov S, Fedorov E, Kikuste I, Leja M. Gastric cancer: prevention, screening and early diagnosis. World J Gastroenterol 2014; 20:13842-62. [PMID: 25320521 PMCID: PMC4194567 DOI: 10.3748/wjg.v20.i38.13842] [Citation(s) in RCA: 260] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/28/2014] [Accepted: 06/26/2014] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.
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Isajevs S, Liepniece-Karele I, Janciauskas D, Moisejevs G, Putnins V, Funka K, Kikuste I, Vanags A, Tolmanis I, Leja M. Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems. Virchows Arch 2014; 464:403-7. [PMID: 24477629 DOI: 10.1007/s00428-014-1544-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/01/2014] [Accepted: 01/14/2014] [Indexed: 12/11/2022]
Abstract
Atrophic gastritis remains a difficult histopathological diagnosis with low interobserver agreement. The aim of our study was to compare gastritis staging and interobserver agreement between general and expert gastrointestinal (GI) pathologists using Operative Link for Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia (OLGIM). We enrolled 835 patients undergoing upper endoscopy in the study. Two general and two expert gastrointestinal pathologists graded biopsy specimens according to the Sydney classification, and the stage of gastritis was assessed by OLGA and OLGIM system. Using OLGA, 280 (33.4 %) patients had gastritis (stage I-IV), whereas with OLGIM this was 167 (19.9 %). OLGA stage III- IV gastritis was observed in 25 patients, whereas by OLGIM stage III-IV was found in 23 patients. Interobserver agreement between expert GI pathologists for atrophy in the antrum, incisura angularis, and corpus was moderate (kappa = 0.53, 0.57 and 0.41, respectively, p < 0.0001), but almost perfect for intestinal metaplasia (kappa = 0.82, 0.80 and 0.81, respectively, p < 0.0001). However, interobserver agreement between general pathologists was poor for atrophy, but moderate for intestinal metaplasia. OLGIM staging provided the highest interobserver agreement, but a substantial proportion of potentially high-risk individuals would be missed if only OLGIM staging is applied. Therefore, we recommend to use a combination of OLGA and OLGIM for staging of chronic gastritis.
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Affiliation(s)
- Sergejs Isajevs
- Faculty of Medicine, University of Latvia, 1a Sarlotes str, Riga, 1001, Latvia,
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22
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Kikuste I, Marques-Pereira R, Monteiro-Soares M, Pimentel-Nunes P, Areia M, Leja M, Dinis-Ribeiro M. Systematic review of the diagnosis of gastric premalignant conditions and neoplasia with high-resolution endoscopic technologies. Scand J Gastroenterol 2013; 48:1108-17. [PMID: 24047392 DOI: 10.3109/00365521.2013.825315] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [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: 02/04/2023]
Abstract
AIM. The aim of the article is to systematically review the current evidence on the diagnostic use of narrow band imaging (NBI), flexible spectral imaging color enhancement (FICE) and endoscopic image enhancement technology i-scan endoscopies for gastric precancerous and cancerous lesions. MATERIALS AND METHODS. Original manuscripts were searched in PubMed until October 2012. Pertinent data were collected and pooled diagnostic accuracy measures were estimated when possible. RESULTs. In total, 38 studies were evaluated. Thirty-one studies were included for NBI and 7 studies for FICE assessment in this systematic review. No article was found meeting inclusion criteria for i-scan endoscopy. The most defined and evaluated outcomes were cancer-related (n = 26). Quality Assessment of Diagnostic Accuracy Studies score varied from 9 to 12 (out of 14). Only few studies assessed the interobserver reliability. On a patient level analysis, NBI's pooled sensitivity, specificity and diagnostic odds ratio were 0.67 (95% CI: 0.61-0.73), 0.81 (95% CI: 0.76-0.85) and 22.71 (95% CI: 12.53-41.1), respectively for diagnosing normal mucosa; 0.86 (95% CI: 0.82-0.90), 0.77 (95% CI: 0.73-0.80) and 17.01 (95% CI: 1.4-207.2) for intestinal metaplasia and 0.90 (95% CI: 0.84-0.94), 0.83 (95% CI: 0.80-0.86) and 47.61 (95% CI: 4.61-491.34) for dysplasia. Owing to the insufficient data and different definitions, we could not aggregate the results for FICE. CONCLUSION. Gastric pattern descriptions have been proposed for NBI and FICE studies by gathering all descriptions in one single description. The classification systems varied between studies, a single description of gastric mucosal features with HR--scopes or at least per technology--will have to be agreed on.
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Affiliation(s)
- Ilze Kikuste
- CINTESIS, Porto Faculty of Medicine , Porto , Portugal
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