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Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice 预览
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作者 Duc Trong Quach Toru Hiyama Takuji Gotoda 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3546-3562,共17页
Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for ga... Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for gastric cancer(GC) development. There are several approaches to identifying these subjects,including noninvasive methods, esophagogastroduodenoscopy and histology.The main approach in Western countries is histology-based while that in Eastern countries with a high prevalence of GC is endoscopy-based. Regarding asymptomatic individuals, the key issues in selecting applicable approaches are the ability to reduce GC mortality and the cost-effectiveness of the approach. At present, population-based screening programs have only been applied in a few Asian countries with a high risk of GC. Pre-endoscopic risk assessment based on demographic and clinical features, such as ethnicity, age, gender, smoking and Helicobacter pylori status, is helpful for identifying subjects with high pre-test probability for a possibly cost-effective approach, especially in intermediate-and low-risk countries. Regarding symptomatic patients with indications for esophagogastroduodenoscopy, the importance of opportunistic screening should be emphasized. The combination of endoscopic and histological approaches should always be considered as endoscopy provides a real-time assessment of the patient’s risk level. In addition, imaging enhanced endoscopy(IEE) has been shown to facilitate targeted biopsies resulting in better correlation between endoscopic and histological findings. Currently, the use of IEE is recommended for endoscopic examinations, and the Operative Link for Gastric Intestinal Metaplasia or Operative Link on Gastritis Assessment grading systems are recommended for histological examinations whenever available. However,resource limitations are an important barrier in many regions worldwide. Thus,for an approach to be applicable in real-life practice, it should be not only evidence-based but also resource-sensitive. In 展开更多
关键词 GASTRIC cancer PRECANCEROUS GASTRIC lesions Dysplasia GASTRIC ATROPHY Chronic ATROPHIC gastritis Intestinal METAPLASIA SURVEILLANCE Screening Costeffective
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Personalized medicine in functional gastrointestinal disorders:Understanding pathogenesis to increase diagnostic and treatment efficacy 预览
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作者 Xiao Jing Wang Michael Camilleri 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1185-1196,共12页
There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in p... There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in patients presenting with functional upper gastrointestinal symptoms(UGI Sx). Among patients with UGI Sx, approximately equal proportions(25%) of patients have delayed gastric emptying(GE), reduced gastric accommodation(GA), both impaired GE and GA,or neither, presumably due to increased gastric or duodenal sensitivity.Treatments targeted to the underlying pathophysiology utilize prokinetics,gastric relaxants, or central neuromodulators. Similarly, specific mechanisms in patients presenting with functional lower gastrointestinal symptoms, especially with diarrhea or constipation, are recognized, including at least 30% of patients with functional constipation pelvic floor dyssynergia and 5% has colonic inertia(with neural or interstitial cells of Cajal loss in myenteric plexus);25% of patients with diarrhea-predominant irritable bowel syndrome(IBSD) has evidence of bile acid diarrhea;and, depending on ethnicity, a varying proportion of patients has disaccharidase deficiency, and less often sucrose-isomaltase deficiency. Among patients with predominant pain or bloating, the role of fermentable oligosaccharides, disaccharides, monosaccharides and polyols should be considered. Personalization is applied through pharmacogenomics related to drug pharmacokinetics, specifically the role of CYP2 D6, 2 C19 and 3 A4 in the use of drugs for treatment of patients with FGIDs. Single mutations or multiple genetic variants are relatively rare, with limited impact to date on the understanding or treatment of FGIDs. The role of mucosal gene expression in FGIDs, particularly in IBS-D, is the subject of ongoing research. In summary, the time for personalization of FGIDs, based on deep phenotyping, is here;pharmacogenomics is relevant in the use of central neuromodulators. There is still unclear impact of the role of genet 展开更多
关键词 Gastrointestinal symptoms GASTRIC EMPTYING GASTRIC accommodation DIARRHEA Constipation Irritable bowel syndrome Bile acid DIARRHEA Phenotypes PHARMACOGENOMICS PROKINETICS NEUROMODULATORS
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The role of endoscopy in the management of hereditary diffuse gastric cancer syndrome 预览
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作者 Shria Kumar Jessica M Long +1 位作者 Gregory G Ginsberg Bryson W Katona 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第23期2878-2886,共9页
Hereditary diffuse gastric cancer(HDGC) syndrome is an inherited cancer risk syndrome associated with path-ogenic germline CDH1 variants. Given the high risk for developing diffuse gastric cancer, CDH1 carriers are re... Hereditary diffuse gastric cancer(HDGC) syndrome is an inherited cancer risk syndrome associated with path-ogenic germline CDH1 variants. Given the high risk for developing diffuse gastric cancer, CDH1 carriers are recommended to undergo prophylactic total gastrectomy for cancer risk reduction. Current guidelines recommend upper endoscopy in CDH1 carriers prior to surgery and then annually for individuals deferring prophylactic total gastrectomy.Management of individuals from HDGC families without CDH1 pathogenic variants remains less clear, and management of families with CDH1 pathogenic variants in the absence of a family history of gastric cancer is particularly problematic at present. Despite adherence to surveillance protocols, endoscopic detection of cancer foci in HDGC is suboptimal and imperfect for facilitating decision-making. Alternative endoscopic modalities, such as chromoendoscopy,endoscopic ultrasound, and other non-white light methods have been utilized,but are of limited utility to further improve cancer detection and risk stratification in HDGC. Herein, we review what is known and what remains unclear about endoscopic surveillance for HDGC, among individuals with and without germline CDH1 pathogenic variants. Ultimately, the use of endoscopy in the management of HDGC remains a challenging arena, but one in which further research to improve surveillance is crucial. 展开更多
关键词 CDH1 gene HEREDITARY DIFFUSE GASTRIC CANCER GASTRIC CANCER Endoscopic screening ENDOSCOPY
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Prognostic and pathological impact of tumor budding in gastric cancer:A systematic review and meta-analysis 预览
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作者 Yi-Xian Guo Zi-Zhen Zhang +1 位作者 Gang Zhao En-Hao Zhao 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第10期898-908,共11页
BACKGROUND Tumor budding,is a promising prognostic hallmark in many cancers,and can help us better assess the degree of malignancy in gastric cancer(GC)and in colorectal cancer.In the past few years,several articles o... BACKGROUND Tumor budding,is a promising prognostic hallmark in many cancers,and can help us better assess the degree of malignancy in gastric cancer(GC)and in colorectal cancer.In the past few years,several articles on the relationship between tumor budding and GC have been published,but different results have been observed.As the relationship between tumor budding and GC remains controversial,we integrated the data from 7 eligible studies to conduct a systematic review and meta-analysis.AIM To systematically evaluate the prognostic and pathological impact of tumor budding in GC.METHODS Literature searches were conducted in the PubMed,Cochrane Library,EMBASE and Web of Science databases,and 7 cohort studies involving 2178 patients met our criteria and included in the analysis.The patients were divided into those with high-grade tumor budding and those with low-grade tumor budding,and the cut-off values for tumor budding varied across the included studies.The hazard ratios(HRs)with 95%confidence intervals(CIs)were calculated to estimate the impact of tumor budding on overall survival(OS)in GC patients.The odds ratios(ORs)with 95%CIs were used to determine the correlation between tumor budding and pathological parameters(tumor stage,tumor differentiation,lymphovascular invasion,lymph node metastasis)of GC.RESULTS Seven studies involving 2178 patients were included in the meta-analysis.The combined ORs suggested that high-grade tumor budding was significantly associated with tumor stage(OR=6.63,95%CI:4.01-10.98,P<0.01),tumor differentiation(OR=3.74,95%CI:2.68-5.22,P<0.01),lymphovascular invasion(OR=7.85,95%CI:5.04-12.21,P<0.01),and lymph node metastasis(OR=5.75,95%CI:3.20-10.32,P<0.01).Moreover,high-grade tumor budding predicted a poor 5-year OS(HR=1.79,95%CI:1.53-2.05,P<0.01)in patients with GC and an adverse 5-year OS(HR=1.93,95%CI:1.45-2.42,P<0.01)in patients with intestinal-type GC.CONCLUSION High-grade tumor budding suggested a poor prognosis in patients with GC or intestinal-type GC. 展开更多
关键词 Tumor BUDDING GASTRIC CANCER Intestinal-type GASTRIC CANCER Epithelialmesenchymal transition
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Gastric submucosa-invasive carcinoma associated with Epstein-Barr virus and endoscopic submucosal dissection:A case report 预览
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作者 Yu Kobayashi Takehito Kunogi +12 位作者 Hiroki Tanabe Yuki Murakami Takuya Iwama Takahiro Sasaki Keitaro Takahashi Katsuyoshi Ando Yoshiki Nomura Nobuhiro Ueno Shin Kashima Kentaro Moriichi Hidehiro Takei Mikihiro Fujiya Toshikatsu Okumura 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第10期925-932,共8页
BACKGROUND Epstein-Barr virus(EBV)-associated carcinoma is a gastric cancer subtype with a morphology characterized by gastric carcinoma with lymphoid stroma(GCLS).Clinicopathological studies have indicated a better p... BACKGROUND Epstein-Barr virus(EBV)-associated carcinoma is a gastric cancer subtype with a morphology characterized by gastric carcinoma with lymphoid stroma(GCLS).Clinicopathological studies have indicated a better prognosis for GCLS than for common gastric carcinomas.Some previous cases of early gastric cancer associated with EBV had been diagnosed by endoscopic resection.CASE SUMMARY We present two GCLS cases subjected to endoscopic submucosal dissection(ESD)for a definitive diagnosis.A protruded gastric lesion was identified by routine endoscopic examination,but forceps biopsy showed no atypical cells before ESD.The resected specimen showed a poorly differentiated adenocarcinoma with lymphoid cells involving the mucosa and submucosa.The final diagnosis was submucosa-invasive poorly differentiated gastric adenocarcinoma.Accordingly,additional gastrectomy was recommended to obtain a complete cure.One patient underwent additional distal gastrectomy with lymph node dissection,but the other was refused because of cardiovascular complications.Both patients remained in remission for more than half a year.EBV positivity was determined by EBV-encoded RNA in situ hybridization.We also conducted a literature review of cases of early gastric cancer associated with EBV that had been diagnosed by ESD.CONCLUSION Submucosa-invasive GCLS could be dissected using ESD,and EBV positivity should be subsequently assessed to determine whether or not any additional curative surgery is required.Further prospective investigations on the prevalence of lymph node metastasis in EBV-associated carcinoma should be performed to expand the indications for endoscopic resection. 展开更多
关键词 HERPESVIRUS 4 Human Stomach neoplasms GASTRIC CARCINOMA with LYMPHOID stroma EPSTEIN-BARR virus-associated GASTRIC CARCINOMA Case report
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Gastro-duodenal disease in Africa:Literature review and clinical data from Accra,Ghana 预览
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作者 Timothy N Archampong Richard H Asmah +6 位作者 Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3344-3358,共15页
Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GD... Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the world.Following the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of Africa.Recognised risk factors for gastric cancer(GCA)include Helicobater pylori(H.pylori),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are H.pylori,non-steroidal antiinflammatory drug(NSAID)-use,smoking and alcohol consumption.Of these,H.pylori is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal GCA.Here,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,Mozambique.As there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic individuals.In Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical patterns.Furthermore,there are differences in PUD within-country despite universally endemic H.pylori infection.PUD is not uncommon in Africa.Most of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western countries.An additional intriguing observation is a recent,ongoing decline in PUD in some African countries where H.pylori infection is still high.One possible reason for the high,sustained prevalence of PUD may be the significant use of NSAIDs in local or over-the-counter preparations.The prevalence of AG and IM,were similar or modestly higher ove 展开更多
关键词 GASTRODUODENAL PEPTIC ULCER GASTRIC cancer AFRICA Pre-malignant Atrophy Intestinal metaplasia DUODENAL ULCER GASTRIC ULCER
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Issues and controversies in esophageal inlet patch 预览
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作者 Adriana Ciocalteu Petrica Popa +1 位作者 Mircea Ionescu Dan Ionut Gheonea 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4061-4073,共13页
The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a r... The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a region in which their prevalence is likely underestimated.Various studies have reported correlations between these esophageal marks with different issues such as Barrett’s esophagus,but these findings remain controversial.Conflicting reports complicate the process of interpreting the clinical features of esophageal inlet patches and underestimate their importance.Unfortunately,the limited clinical data and statistical analyses make reaching any conclusions difficult.It is hypothesized that inlet patches are correlated with various esophageal and extraesophageal symptoms,diagnoses and the personalized therapeutic management of patients with inlet patches as well as the differential diagnosis for premalignant lesions or early cancers.Due to its potential underdiagnosis,there are no consensus guidelines for the management and follow up of inlet patches.This review focuses on questions that were raised from published literature on esophageal inlet patches in adults. 展开更多
关键词 INLET PATCH Ectopic GASTRIC MUCOSA Heterotopic GASTRIC MUCOSA ESOPHAGEAL cancer Narrow band imaging Optical chromoendoscopy Cervical ESOPHAGUS Functional dyspepsia Barrett’s ESOPHAGUS Helicobacter pylori
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Gastric per-oral endoscopic myotomy: Current status and future directions 预览
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作者 Alexander Podboy Joo Ha Hwang +5 位作者 Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal George Triadafilopoulos John O Clarke 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第21期2581-2590,共10页
Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by t... Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field. 展开更多
关键词 Gastroparesis GASTRIC per-oral ENDOSCOPIC MYOTOMY Per-oral ENDOSCOPIC PYLOROMYOTOMY MYOTOMY ENDOSCOPIC MYOTOMY Peroral ENDOSCOPIC MYOTOMY GASTRIC emptying
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Effect of moxibustion on survival status and nutritional metabolic factor in tumor-bearing rats with gastric cancer
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作者 彭卓隽 谭静 +3 位作者 陈欲攀 赵欢 石峻林 林亚平 《世界针灸杂志:英文版》 CSCD 2019年第3期210-215,共6页
Objective:To observe the effect of moxibustion on the survival status and nutritional metabolic factors of tumor-bearing rats with gastric cancer and explore the inhibitory effect of moxibustion on the tumorbearing ra... Objective:To observe the effect of moxibustion on the survival status and nutritional metabolic factors of tumor-bearing rats with gastric cancer and explore the inhibitory effect of moxibustion on the tumorbearing rats.Methods:A total of 40 SD rats were randomly divided into a blank group,a sham-operated group,a model group and a moxibustion group,10 rats in each group.Gastric cancer models were established in the model group and the moxibustion group.The rats of all the groups underwent the same constraining procedure for 20 min every day.Additionally,moxibustion was applied at acupoints for 20 min in the rats of the moxibustion group.There were two groups of acupoints.One group included"Zusanli(足三里ST 36)""Zhongwan(中脘CV12)"and"Guanyuan(关元CV4)".The other group included bilateral"Pishu(脾俞BL 20)"and"Weishu(胃俞BL 21)".Moxibustion was applied for 20 min every day at the acupoints of the two groups alternatively and lasted for 14 days.The survival status of rats was observed and the score of survival status and body weight of rats were recorded every day.At the end of intervention,the orbital blood was collected and the rats were sacrificed for sample collection.The viscera-free body weight was recorded.Using biochemical analyzer,the blood glucose(GLU),albumin(ALB),total protein(TP)and triglyceride(TG)in serum were detected.Results:(1)Regarding the score of the survival status,after modeling,the scores in the model group and the moxibustion group were all higher than those of the sham-operation group(both P<0.05).After intervention,the score in the moxibustion group was lower than that of the model group(P<0.05).(2)After modeling,the body weight in the moxibustion group and the model group was lower than those of the blank group,indicating a statistical significance(both P<0.05).The body weight in the moxibustion group was higher than that of the model group after intervention,indicating the statistical significance(P<0.05).(3)Regarding the viscera-free body weight,it was lower in the model group 展开更多
关键词 MOXIBUSTION Tumor-bearing rats with gastric cancer SURVIVAL STATUS Blood glucose(GLU) Albumin(ALB) Total protein(TP) Triglyceride(TG) Viscera-free weight
Potential role of new technological innovations in nonvariceal hemorrhage 预览
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作者 David Friedel 《世界胃肠内镜杂志:英文版(电子版)》 2019年第8期443-447,共5页
The present armamentarium of endoscopic hemostatic therapy for non-variceal upper gastrointestinal hemorrhage includes injection,electrocautery and clips.There are newer endoscopic options such as hemostatic sprays,en... The present armamentarium of endoscopic hemostatic therapy for non-variceal upper gastrointestinal hemorrhage includes injection,electrocautery and clips.There are newer endoscopic options such as hemostatic sprays,endoscopic suturing and modifications of current options including coagulation forceps and over-the-scope clips.Peptic hemorrhage is the most prevalent type of nonvariceal upper gastrointestinal hemorrhage and traditional endoscopic interventions have demonstrated significant hemostasis success.However,the hemostatic success rate is less for other entities such as Dieulafoy’s lesions and bleeding from malignant lesions.Novel innovations such as endoscopic submucosal dissection and peroral endoscopic myotomy has spawned a need for dependable hemostasis.Gastric antral vascular ectasias are associated with chronic gastrointestinal bleeding and usually treated by standard argon plasma coagulation (APC),but newer modalities such as radiofrequency ablation,banding,cryotherapy and hybrid APC have been utilized as well.We will opine on whether the newer hemostatic modalities have generated success when traditional modalities fail and should any of these modalities be routinely available in the endoscopic toolbox. 展开更多
关键词 NON-VARICEAL upper gastrointestinal HEMORRHAGE ENDOSCOPIC HEMOSTASIS Gastric antral vascular ectasias Over-the-scope CLIPS ENDOSCOPIC SUTURING
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MicroRNA-596 acts as a tumor suppressor in gastric cancer and is upregulated by promotor demethylation 预览
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作者 Zhen Zhang Dong-Qiu Dai 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1224-1237,共14页
BACKGROUND In the present study, we investigated a suppressive role of microRNA-596(miR-596) in gastric cancer(GC). Moreover, the downregulation of miR-596 in GC cell lines was associated with an increase of miR-596 p... BACKGROUND In the present study, we investigated a suppressive role of microRNA-596(miR-596) in gastric cancer(GC). Moreover, the downregulation of miR-596 in GC cell lines was associated with an increase of miR-596 promoter methylation. We also established that miR-596 controls the expression of peroxiredoxin 1(PRDX1),which has never been reported before, suggesting that this interaction could play an important role in GC progression.AIM To study the potential role and possible regulatory mechanism of miR-596 in GC.METHODS The expression levels of miR-596 and PRDX1 in gastric cancer tissues and cell lines were detected by quantitative real-time PCR(qRT-PCR). Western blot and luciferase reporter assay were used to detect the effect of miR-596 on PRDX1 expression. Then, the proliferation, metastasis, and invasion of GC cell lines transfected with miR-596 mimics were analyzed, respectively, by Cell Counting Kit-8 proliferation assay, wound healing assay, and transwell invasion assay.Meanwhile, the methylation status of the promoter CpG islands of miR-596 in GC cell lines was detected by methylation-specific PCR(MSP).RESULTS Expression of miR-596 was decreased and PRDX1 was upregulated in GC tissues and cell lines. Overexpression of miR-596 decreased the expression of PRDX1 and luciferase reporter assays detected the direct binding of miR-596 to the 3’-untranslated region(UTR) of PRDX1 transcripts. Furthermore, we found that overexpression of miR-596 remarkably suppressed cell proliferation, migration,and invasion in GC cells. We further analyzed miR-596 promoter methylation by MSP and qRT-PCR, and found the downregulation of miR-596 was associated with promoter methylation status in GC cell lines. Moreover, DNA demethylation and reactivation of miR-596 after treatment with 5-Aza-2’-deoxycytidine inhibited the proliferative ability of GC cells.CONCLUSION MiR-596 has a tumor suppressive role in GC and is downregulated partly due to promoter hypermethylation. Furthermore, PRDX1 is one of the putative target genes 展开更多
关键词 Gastric cancer MicroRNA-596 METHYLATION PEROXIREDOXIN 1
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PD-1/PD-L1 antagonists in gastric cancer: Current studies and perspectives 预览
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作者 Jian Li Xiao-Hong Zhang +1 位作者 Song-Hua Bei Li Feng 《世界荟萃分析杂志》 2019年第3期101-109,共9页
Immune checkpoints release suppressive signals for T cells, which enable the tumors to escape from immune destruction and provide a new concept that uses the capabilities of the immune system as a therapeutic target f... Immune checkpoints release suppressive signals for T cells, which enable the tumors to escape from immune destruction and provide a new concept that uses the capabilities of the immune system as a therapeutic target for tumors. At present, programmed death receptor 1 (PD-1)/programmed death ligand-1 (PDL1) has become the most promising therapeutic target. PD-1/PD-L1 blockades exhibit long-lasting antitumor efficacy and safety in patients with various cancers, such as melanoma and non-small-cell lung cancer. Moreover, PD-L1 is highly expressed in the peripheral blood and tumor specimens of patients with cancer, and the expression of PD-L1 is positively correlated with various pathological features and may serve as a predictor of poor prognosis or a diagnostic tool. Clinical trials have verified that PD-1/PD-L1 blockade therapy benefits patients with advanced gastric cancer or gastroesophageal junction cancer. Furthermore, there are many molecules involved in the regulation of PD- 1/PD-L1 expression, and the modification of these molecules via drugs and combinations with PD-1/PD-L1 inhibitors may further improve the efficacy of immunotherapy for gastric cancer. In this review, the efficacy, safety, and possible combination treatment options of PD-1/PD-L1 in gastric cancer are reviewed in experimental and clinical settings. 展开更多
关键词 IMMUNOTHERAPY PD-1/PD-L1 INHIBITORS Programmed death-ligand 1 Gastric cancer
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Multiple gastric adenocarcinoma of fundic gland type: A case report 预览
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作者 Ou Chen Ze-Yong Shao +1 位作者 Xiong Qiu Guang-Ping Zhang 《世界临床病例杂志》 2019年第18期2871-2878,共8页
BACKGROUND In recent years, there have been reports of a new histological type of gastric cancer, termed gastric adenocarcinoma of the fundic gland (GA-FG). This disease entity presents differentiation towards the fun... BACKGROUND In recent years, there have been reports of a new histological type of gastric cancer, termed gastric adenocarcinoma of the fundic gland (GA-FG). This disease entity presents differentiation towards the fundic gland, especially chief cellpredominant differentiation (GA-FG-CCP). GA-FG-CCP easily invades into the submucosa but rarely shows metastasis. The reports mostly describe primarily single lesions. Herein, we report a case with multiple lesions, and summarize the clinicopathologic characteristics of multiple cases. CASE SUMMARY A 55-year-old woman underwent upper gastrointestinal endoscopy screening. Two whitish lesions on the anterior wall of the gastric corpus and the gastric fundus were detected. The patient had previously received Helicobacter pylori eradication therapy. The mucosa was characterized as grade C-2 atrophic gastritis. We diagnosed the patient with multiple GA-FG (GA-FG-CCP) by hematoxylin and eosin (HE) staining and immunohistochemical staining of the endoscopic biopsy. Upon performing endoscopic submucosal dissection (ESD), one lesion was not found, but the scar from the biopsy was visible;the mucularis mucosa of the biopsy and ESD-resected specimen were intact. The two lesions showed no lymphatic nor venous invasion. The resection performed appeared to be relatively curative. CONCLUSION Cases of multiple GA-FG-CCP are very rare in clinical practice. Most of its clinicopathologic characteristics are similar to those of a single lesion. Our case provides diagnostic and therapeutic information about GA-FG-CCP with multiple lesions. 展开更多
关键词 Gastric ADENOCARCINOMA of the fundic GLAND MULTIPLE lesions Pepsinogen-I Endoscopic SUBMUCOSAL DISSECTION Case report
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Utility of linked color imaging for endoscopic diagnosis of early gastric cancer 预览
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作者 Toshihisa Fujiyoshi Ryoji Miyahara +11 位作者 Kohei Funasaka Kazuhiro Furukawa Tsunaki Sawada Keiko Maeda Takeshi Yamamura Takuya Ishikawa Eizaburo Ohno Masanao Nakamura Hiroki Kawashima Masato Nakaguro Masahiro Nakatochi Yoshiki Hirooka 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1248-1257,共10页
BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and... BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological findings.METHODS Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l’Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological analyses.RESULTS LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis. 展开更多
关键词 Linked COLOR imaging Early GASTRIC cancer Endoscopic SUBMUCOSAL DISSECTION VESSEL density COLOR difference
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胃炎性纤维性息肉的临床和内镜特点分析 预览
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作者 张馨梅 关月 +2 位作者 吴寒 张予蜀 张振玉 《胃肠病学和肝病学杂志》 CAS 2019年第7期779-781,共3页
目的探讨胃炎性纤维性息肉(inflammatory fibroid polyp,IFP)的临床和内镜特点。方法对27例病理确诊为胃IFP患者的临床表现、内镜、超声内镜特征,治疗及预后情况进行回顾性分析。结果27例胃IFP患者年龄(60.5±9.9)岁(27~77岁),女性... 目的探讨胃炎性纤维性息肉(inflammatory fibroid polyp,IFP)的临床和内镜特点。方法对27例病理确诊为胃IFP患者的临床表现、内镜、超声内镜特征,治疗及预后情况进行回顾性分析。结果27例胃IFP患者年龄(60.5±9.9)岁(27~77岁),女性多于男性。临床症状可见腹痛、腹胀、黑便或无明显症状。胃窦部、单发病灶为主(96.3%),偶见多发。病灶形态多样,以山田Ⅱ型为多见(60.7%),部分病灶表面糜烂或溃疡形成(25.9%)。病灶直径(1.2±0.5)cm(0.6~2.5cm)。超声内镜见起源于黏膜肌层,或起源于黏膜下层、向黏膜肌层延伸的低回声团块。所有患者经内镜下切除病灶,随访未见复发。结论胃IFP缺乏特异性症状,病灶形态多样,内镜下切除预后好,超声内镜表现有助于鉴别诊断,指导治疗。 展开更多
关键词 炎性纤维性息肉 内镜 超声内镜 治疗
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Artificial intelligence for endoscopy 预览
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作者 Hiroyuki Imaeda Yoshikazu Tsuzuki +3 位作者 Kazuya Miyaguchi Keigo Ashitani Hideki Ohgo Hidetomo Nakamoto 《世界荟萃分析杂志》 2019年第7期343-345,共3页
In recent times,there has been progressive development in artificial intelligence(AI)following the introduction of deep learning in the medical field including gastroenterology and endoscopy.Most of the reported studi... In recent times,there has been progressive development in artificial intelligence(AI)following the introduction of deep learning in the medical field including gastroenterology and endoscopy.Most of the reported studies were based on retrospective data.Several prospective studies of real-time diagnosis of moving images using the AI system are expected to match the real clinical situation and to aid the endoscopists in the detection and diagnosis of neoplasms without missing any lesion.AI can read a large number of endoscopic images in a few minutes and make a diagnosis;therefore,it is expected to cover the lack of support for the screening esophagogastroduodenoscopy in the health check-up and a large number of capsule images,thereby freeing the endoscopists from this burden.AI can help make the diagnosis during the endoscopic procedure and thereby prevent an unnecessary biopsy for patients taking antithrombotic drugs.AI can also be useful for education and training in endoscopy.Trainees can learn to perform endoscopy and the detection and diagnosis of lesions by the support of AI.In the near future,real-time endoscopic diagnosis using AI is expected to lessen the burden of endoscopists,to enhance the quality level of endoscopists,to overcome the miss of lesions and to make optimal diagnosis. 展开更多
关键词 Artificial INTELLIGENCE ENDOSCOPY GASTRIC CANCER COLONIC NEOPLASM
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Up-regulated Wnt1-inducible signaling pathway protein 1 correlates with poor prognosis and drug resistance by reducing DNA repair in gastric cancer 预览
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作者 Li-Hua Zhang Yan Wang +5 位作者 Qian-Qian Fan Yan-Kui Liu Long-Hai Li Xiao-Wei Qi Yong Mao Dong Hua 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第38期5814-5825,共12页
BACKGROUND Wnt1-inducible signaling pathway protein 1(WISP1)is upregulated in several types of human cancer,and has been implicated in cancer progression.However,its clinical implications in gastric cancer(GC)remain u... BACKGROUND Wnt1-inducible signaling pathway protein 1(WISP1)is upregulated in several types of human cancer,and has been implicated in cancer progression.However,its clinical implications in gastric cancer(GC)remain unclear.AIM To explore the expression pattern and clinical significance of WISP1 in GC.METHODS Public data portals,including Oncomine,The Cancer Genome Atlas database,Coexpedia,and Kaplan-Meier plotter,were analyzed for the expression and clinical significance of WISP1 mRNA levels in GC.One hundred and fifty patients who underwent surgery for GC between February 2010 and October 2012 at the Affiliated Hospital of Jiangnan University were selected for validation study.WISP1 levels were measured at both the mRNA and protein levels by RTqPCR,Western blot analysis,and immunohistochemistry(IHC).In addition,the in situ expression of WISP1 in the GC tissues was determined by IHC,and the patients were accordingly classified into high-and low-expression groups.The correlation of WISP1 expression status with patient prognosis was then determined by univariate and multivariate Cox regression analyses.WISP1 was knocked down by RNA interference.The 50%inhibitory concentration of oxaliplatin was detected by CellTiter-Blue assay.RESULTS WISP1 levels at both the mRNA and protein levels were remarkably upregulated in GC tissues compared to normal tissues.Moreover,IHC revealed that WISP1 expression was associated with T stage and chemotherapy outcome,but not with lymph node metastasis,age,gender,histological grade,or histological type.GC patients with high WISP1 expression showed a poor overall survival.Multivariate survival analysis indicated that WISP1 was an important prognostic factor for GC patients.Mechanistically,knock-down of WISP1 expression enhanced sensitivity to oxaliplatin by reducing DNA repair and enhancing DNA damage.CONCLUSION Significantly upregulated WISP1 expression is associated with cancer progression,chemotherapy outcome,and prognosis in GC.Mechanistically,knock-down of WISP1 expression enhances 展开更多
关键词 Wnt1-inducible signaling pathway PROTEIN 1 Biomarker BIOINFORMATICS analysis Chemotherapy outcome Gastric cancer
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Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer 预览
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作者 Wen-Quan Liang Ke-Cheng Zhang +9 位作者 Jian-Xin Cui Hong-Qing Xi Ai-Zhen Cai Ji-Yang Li Yu-Hua Liu Jie Liu Wang Zhang Peng-Peng Wang Bo Wei Lin Chen 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第38期5838-5849,共12页
BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction ... BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of PPOI.We hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer patients.AIM To investigate the risk factors for PPOI and establish a nomogram for clinical risk estimation.METHODS Between June 2016 and March 2017,the data of 162 patients with gastrectomy were obtained from a prospective and observational registry database.Clinical data of patients who fulfilled the criteria were obtained.Univariate and multivariable logistic regression models were performed to detect the relationship between variables and PPOI.A nomogram for PPOI was developed and verified by bootstrap resampling.The calibration curve was employed to detect the concentricity between the model probability curve and ideal curve.The clinical usefulness of our model was evaluated using the net benefit curve.RESULTS This study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent gastrectomy.The incidence of PPOI was 19.75%in patients with gastrectomy.Age older than 60 years,open surgery,advanced stage(III–IV),and postoperative use of opioid analgesic were independent risk factors for PPOI.We developed a simple and easy-to-use prediction nomogram of PPOI after gastrectomy.This nomogram had an excellent diagnostic performance[area under the curve(AUC)=0.836,sensitivity=84.4%,and specificity=75.4%].This nomogram was further validated by bootstrapping for 500 repetitions.The AUC of the bootstrap model was 0.832(95%CI:0.741–0.924).This model showed a good fitting and calibration and positive net benefits in decision curve analysis.CONCLUSION We have developed a prediction nomogram of PPOI for gastric cancer.This novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients 展开更多
关键词 PROLONGED POSTOPERATIVE ILEUS Gastric cancer COMPLICATION NOMOGRAM Bootstrap
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NIMA related kinase 2 promotes gastric cancer cell proliferation via ERK/MAPK signaling 预览
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作者 Wei-Dong Fan Tao Chen Peng-Jun Liu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第23期2898-2910,共13页
BACKGROUND NIMA related kinase 2(NEK2) is closely related to mitosis, and it is currently considered to be over-expressed frequently in many poorly prognostic cancers.However, the effect of the up-regulated NEK2 on ce... BACKGROUND NIMA related kinase 2(NEK2) is closely related to mitosis, and it is currently considered to be over-expressed frequently in many poorly prognostic cancers.However, the effect of the up-regulated NEK2 on cellular signaling in tumors,such as gastric cancer(GC), is con-fusing.AIM To determine the role of the up-regulation of NEK2 in GC.METHODS To investigate the pathological significance of NEK2 in GC, the expression pattern of NEK2 in GC was investigated based on the 'Oncomain' database and compared between 30 pairs of cancer samples and adjacent tissues. The coexpression of NEK2 and ERK in GC was analyzed using The Cancer Genome Atlas(TCGA) database and confirmed in clinical samples by quantitative realtime PCR(qRT-PCR), and the survival curve was also plotted. Western blot or qRT-PCR was used to analyze the effect of NEK2 on the phosphorylation levels of ERK and c-JUN in two GC cell lines(BGC823 and SGC7901) with NEK2 overexpression, and the expression of the downstream effector cyclin D1.Furthermore, CCK8, EdU incorporation assay, and flow cytometry were used to detect the proliferative ability of BGC823 and SGC7901 cells with stably silenced ERK.RESULTS NEK2 was significantly up-regulated in human GC tissues. ERK was significantly associated with NEK2 expression in human clinical specimens, and combined overexpression of NEK2 and ERK potentially forecasted a poor prognosis andsurvival in GC patients. NEK2 knockdown in GC cells inhibited ERK and c-JUN phosphory-lation and reduced the transcription of cyclin D1. More interestingly,NEK2 can rescue the inhibition of cellular viability, proliferation, and cell cycle progression due to ERK knockdown.CONCLUSION Our results indicate that NEK2 plays a carcinogenic role in the malignant proliferation of GC cells via the ERK/MAPK signaling, which may be important for treatment and improving patient survival. 展开更多
关键词 NIMA RELATED KINASE 2 ERK/MAPK SIGNALING Cyclin D1 Cell proliferation Gastric cancer
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Effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis
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作者 Xing-Long Wang 《海南医科大学学报(英文版)》 2019年第10期28-31,共4页
Objective: To study the effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis. Methods: SD rats were selected and given intragastric administration of Jianpi Yiqi solution and nor... Objective: To study the effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis. Methods: SD rats were selected and given intragastric administration of Jianpi Yiqi solution and normal saline respectively to collect aorta blood and prepare the Jianpi Yiqi Prescription serum and blank serum;gastric cancer SGC-7901 cells were cultured and divided into 10% drug serum group, 10% blank serum group and 10% fetal bovine serum group, and the cell proliferation activity, apoptosis index as well as proliferation gene, apoptosis gene and angiogenesis gene expression were measured after 24 h of treatment. Results: Cell proliferation activity as well as EZH2, UHRF1, CyclinA, CyclinB1, CDK1, c-IAP1, XIAP, VEGF, VEGFR2, HIF-1α and COX2 mRNA expression in cells of 10% drug serum group was significantly lower than those of 10% blank serum group and 10% fetal bovine serum group while apoptosis index as well as Caspase-3 and PDCD5 mRNA expression in cells was significantly higher than those of 10% blank serum group and 10% fetal bovine serum group. Conclusion: Jianpi Yiqi Prescription serum can inhibit the gastric cancer cell growth and angiogenesis. 展开更多
关键词 GASTRIC cancer Jianpi Yiqi PRESCRIPTION PROLIFERATION Apoptosis ANGIOGENESIS
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