|
1
|
Zhao W, Li T, Wang P, Zhang R, Gao F, Ma Z, Zhen S, Liu F, Chu Y. Development and validation of a relatively accurate gastric cancer high-risk group screening scoring system in urban residents. Clin Transl Oncol 2025; 27:2269-2280. [PMID: 39377973 DOI: 10.1007/s12094-024-03748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 09/25/2024] [Indexed: 11/29/2024]
Abstract
PURPOSE Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy. METHODS The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems. RESULTS In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency. CONCLUSIONS Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.
Collapse
Affiliation(s)
- Weipeng Zhao
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
- Department of Gastroenterology, Heze Municipal Hospital, Heze, China
| | - Tian Li
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Ping Wang
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Rui Zhang
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Fan Gao
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | | | | | - Feng Liu
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Yanliu Chu
- Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China.
| |
Collapse
|
|
2
|
Xue J, Lyu G, Li S. The diagnostic value of two-dimensional ultrasound Su-RADS combined with shear wave elastography for benign and malignant lesions of the gastric wall. BMC Med Imaging 2024; 24:352. [PMID: 39731044 DOI: 10.1186/s12880-024-01530-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 12/16/2024] [Indexed: 12/29/2024] Open
Abstract
OBJECTIVE This study explored the value of stomach ultrasound reporting and data system (Su-RADS) and two-dimensional shear wave elastography (2D-SWE) in the diagnosis of benign and malignant lesions of the gastric wall, evaluating the feasibility of combining the two methods for the diagnosis of gastric wall lesions. METHODS 113 patients with gastric wall lesions were examined after oral gastric ultrasound contrast agent, and the grades of the gastric wall lesions were classified according to Su-RADS. Moreover, 2D-SWE was performed to measure the E value of the lesions. ROC curves were constructed to evaluate the diagnostic efficacy of Su-RADS, 2D-SWE and their combination for gastric wall lesions. RESULTS The cutoff values for Emean and Emax were 8.01 kPa and 11.08 kPa, respectively. The sensitivity and specificity of 2D-SWE were 70.59%, 93.67% and 85.69%, 88.61%, respectively. The diagnostic sensitivity and specificity of Su-RADS were 91.18% and 82.28%, respectively. The AUC of combination of two methods was 0.951, which was greater than that of Su-RADS (0.940) or 2D-SWE alone (0.853, 0.903), and the sensitivity and specificity were 82.35% and 94.94%. The sensitivity and specificity of the combination of the two methods for the diagnosis of malignant gastric lesions were 82.35% and 94.94%, respectively. The AUC was 0.951, and the Youden index was 0.8064. The DeLong test was used to determine the AUC between the combination of two methods and 2D-SWE was P < 0.05. CONCLUSION Compared with Su-RADS or 2D-SWE alone, the combination of the two methods is more effective at diagnosing of gastric wall.And improved the specificity in the diagnosis of gastric wall lesions.
Collapse
Affiliation(s)
- Jingjing Xue
- Department of Ultrasound, The Fujian Medical University Union Hospital, Fuzhou, China
| | - Guorong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
- Quanzhou Medical College, Quanzhou, China.
- Department of Clinical Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
| | - Shaohui Li
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
| |
Collapse
|
|
3
|
Shi H, Ma J, Wang J, Luo J, Ji M, Xu T, Shen Y, Zhou C. Association of COL4A2 indel polymorphism with the development of stomach adenocarcinoma in Chinese populations. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2024:1-12. [PMID: 39340310 DOI: 10.1080/15257770.2024.2409888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 05/09/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024]
Abstract
OBJECTIVE The objective of the study was to assess the potential association between the indel polymorphism (rs34802628) located within the intron of the collagen type ⅳ alpha 2 gene (COL4A2) and the susceptibility to stomach adenocarcinoma (STAD) within a Chinese population. METHODS Peripheral venous blood samples were collected from a total of 497 STAD patients and 804 healthy control individuals to extract genomic DNA. The genotyping of the COL4A2 rs34802628 polymorphism was carried out using a polymerase chain reaction assay. Additionally, statistical analyses were conducted on the expression levels of COL4A2 mRNA using the GEPIA database. Meanwhile, the expression of COL4A2 mRNA was also validated by Real-time PCR using STAD tissue samples. Then, based on an analysis of patient tumor RNA seq data available from the Cancer Genome Atlas (TCGA), we assessed the prognostic value of mRNA expression of the COL4A2 gene in STAD patients using K-M plotter. RESULTS The study presented compelling evidence supporting an association between the rs34802628 polymorphism in the COL4A2 gene and susceptibility to STAD. Logistic regression analysis revealed that both the heterozygote and homozygote 4-bp del/del genotypes were significantly associated with a decreased risk of STAD, even after controlling for other variables (adjusted odds ratio [OR] = 0.663, 95% confidence interval [CI] 0.519-0.848, p = 0.037; OR = 0.422, 95% CI 0.290-0.614, p = 0.000005, respectively). Importantly, individuals carrying the 4-bp deletion allele demonstrated a notably lower risk of developing the disease (OR = 0.696, 95% CI 0.591-0.820, p = 0.000014). Furthermore, Genotype-phenotype correlation studies in human STAD tissue samples demonstrated that the higher mRNA expression levels of COL4A2 were associated with the ins allele of rs34802628. Bioinformatics analysis revealed that higher expression of the COL4A2 gene was significant with development and poor prognosis of STAD. CONCLUSION The results of our study provide strong evidence indicating a potential involvement of genetic variants in the COL4A2 gene in the development of STAD. Nonetheless, to validate and consolidate these findings, additional investigations incorporating larger sample sizes and functional experiments are necessary.
Collapse
Affiliation(s)
- Huihai Shi
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jialin Ma
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jing Wang
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jiale Luo
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Mengyue Ji
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Ting Xu
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yingxiao Shen
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Chunxiao Zhou
- Department of Gastroenterology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| |
Collapse
|
|
4
|
Kotelevets SM, Chekh SA, Chukov SZ. Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention. World J Gastrointest Endosc 2024; 16:462-471. [PMID: 39155993 PMCID: PMC11325870 DOI: 10.4253/wjge.v16.i8.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/30/2024] [Accepted: 07/25/2024] [Indexed: 08/01/2024] Open
Abstract
BACKGROUND New markers are needed to improve the effectiveness of serological screening for atrophic gastritis. AIM To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity. METHODS Of the 169 patients with atrophic gastritis, selected by the visual endoscopic Kimura-Takemoto method, 165 showed histological mucosal atrophy using the updated Kimura-Takemoto method. All 169 patients were examined for postprandial levels of gastrin-17 (G17) and pepsinogen-1 (PG1) using GastroPanel® (Biohit Plc, Helsinki, Finland). RESULTS We used the histological standard of five biopsies of the gastric mucosa, in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy. We also compared the morpho-functional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1, as the markers of atrophic gastritis. The sensitivity of postprandial G17 was 62.2% for serological levels of G17 (range: 0-4 pmol/L) and 100% for serological G17 (range: 0-10 pmol/L) for the detection of monofocal severe atrophic gastritis. No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus. In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis, there is a pronounced positive long-term dynamics of the serological marker of atrophy - postprandial G17, after five months of rennet replacement therapy. CONCLUSION Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity. Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system. Therefore, postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.
Collapse
Affiliation(s)
- Sergey M Kotelevets
- Department of Therapy, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
| | - Sergey A Chekh
- Department of Mathematics, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
| | - Sergey Z Chukov
- Department of Pathological Anatomy, Stavropol State Medical University, Stavropol 355017, Russia
| |
Collapse
|
|
5
|
Chu LY, Wu FC, Guo HP, Xie JJ, Qu QQ, Li XH, Xu YW, Peng YH, Qiu B. Combined detection of serum EFNA1 and MMP13 as diagnostic biomarker for gastric cancer. Sci Rep 2024; 14:15957. [PMID: 38987376 PMCID: PMC11237037 DOI: 10.1038/s41598-024-65839-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024] Open
Abstract
We previously identified that serum EFNA1 and MMP13 were potential biomarker for early detection of esophageal squamous cell carcinoma. In this study, our aim is to explore the diagnostic value of serum EFNA1 and MMP13 for gastric cancer. We used enzyme-linked immunosorbent assay (ELISA) to detect the expression levels of serum EFNA1 and MMP13 in 210 GCs and 223 normal controls. The diagnostic value of EFNA1 and MMP13 was evaluated in an independent cohorts of GC patients and normal controls (n = 238 and 195, respectively). Receiver operating characteristics were used to calculate diagnostic accuracy. In training and validation cohorts, serum EFNA1 and MMP13 levels in the GC groups were significantly higher than those in the normal controls (P < 0.001). The area under the curve (AUC) of the combined detection of serum EFNA1 and MMP13 for GC was improved (0.794), compared with single biomarker used. Similar results were observed in the validation cohort. Importantly, the combined measurement of serum EFNA1 and MMP13 to detect early-stage GC also had acceptable diagnostic accuracy in training and validation cohort. Combined detection of serum EFNA1 and MMP13 could help identify early-stage GC, suggesting that it may be a promising tool for the early detection of GC.
Collapse
Affiliation(s)
- Ling-Yu Chu
- Department of Pathology, Medical College of Jiaying University, No. 146 Huangtang Road, Meizhou, China
- Department of Clinical Laboratory Medicine, Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, China
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Fang-Cai Wu
- Department of Head and Neck Surgery, Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hai-Peng Guo
- Department of Radiation Oncology, Esophageal Cancer Prevention and Control Research Center, The Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Jian-Jun Xie
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, China
| | - Qi-Qi Qu
- Department of Clinical Laboratory Medicine, Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, China
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Xin-Hao Li
- Department of Clinical Laboratory Medicine, Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, China
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, China.
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, Esophageal Cancer Prevention and Control Research Center, the Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, China.
- Guangdong Esophageal Cancer Institute, The Cancer Hospital of Shantou University Medical College, Shantou, China.
| | - Bo Qiu
- Department of Pathology, Medical College of Jiaying University, No. 146 Huangtang Road, Meizhou, China.
| |
Collapse
|
|
6
|
Fu Y, Jiang J, Wu Y, Cao D, Jia Z, Zhang Y, Li D, Cui Y, Zhang Y, Cao X. Genome-wide 5-hydroxymethylcytosines in circulating cell-free DNA as noninvasive diagnostic markers for gastric cancer. Gastric Cancer 2024; 27:735-746. [PMID: 38584223 DOI: 10.1007/s10120-024-01493-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND 5-Hydroxymethylcytosine-enriched gene profiles and regions show tissue-specific and tumor specific. There is a potential value to explore cell-free DNA 5-hydroxymethylcytosine feature biomarkers for early gastric cancer detection. METHODS A matched case‒control study design with 50 gastric cancer patients and 50 controls was performed to sequence the different 5-hydroxymethylcytosine modification features of cell free DNA. Significantly differential 5-hydroxymethylcytosine modification genes were identified to construct a gastric cancer diagnostic model. Data set from GEO was used as an external testing set to test the robustness of the diagnostic model. RESULTS Accounting for more than 90% of 5-hydroxymethylcytosine peaks were distributed in the gene body in both the gastric cancer and control groups. The diagnostic model was developed based on five different 5-hydroxymethylcytosine modification genes, FBXL7, PDE3A, TPO, SNTG2 and STXBP5. The model could effectively distinguish gastric cancer patients from controls in the training (AUC = 0.95, sensitivity = 88.6%, specificity = 94.3%), validation (AUC = 0.87, sensitivity = 73.3%, specificity = 93.3%) and testing (AUC = 0.90, sensitivity = 81.9%, specificity = 90.2%) sets. The risk scores of the controls from the model were significantly lower than those of gastric cancer patients in both our own data (P < 0.001) and GEO external testing data (P < 0.001), and no significant difference between different TNM stage patients (P = 0.09 and 0.66). Furthermore, there was no significant difference between the healthy control and benign gastric disease patients in the testing set from GEO (P = 0.10). CONCLUSIONS The characteristics of 5-hydroxymethylcytosine in cell free DNA are specific to gastric cancer patients, and the diagnostic model constructed by five genes' 5-hydroxymethylcytosine features could effectively identify gastric cancer patients.
Collapse
Affiliation(s)
- Yingli Fu
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Jing Jiang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yanhua Wu
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Donghui Cao
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Zhifang Jia
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Dongming Li
- Department of Hospital Infection Management, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yingnan Cui
- Department of Hospital Infection Management, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yuzheng Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
- Department of Hospital Infection Management, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xueyuan Cao
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China.
| |
Collapse
|
|
7
|
Lewis D, Jimenez L, Mansour MH, Horton S, Wong WWL. A Systematic Review of Cost-Effectiveness Studies on Gastric Cancer Screening. Cancers (Basel) 2024; 16:2353. [PMID: 39001415 PMCID: PMC11240801 DOI: 10.3390/cancers16132353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
Gastric cancer (GC) poses notable economic and health burdens in settings where the incidence of disease is prevalent. Some countries have established early screening and treatment programs to address these challenges. The objectives of this systematic review were to summarize the cost-effectiveness of gastric cancer screening presented in the literature and to identify the critical factors that influence the cost-effectiveness of screening. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Economic evaluation studies of gastric cancer screening were reviewed from SCOPUS and PubMed. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) was used to assess the quality of reporting presented in the selected articles. Only primary economic evaluation studies addressing the cost-effectiveness, cost-utility, and cost-benefit of gastric cancer screening were selected. Two reviewers scrutinized the selected articles (title, abstract, and full text) to determine suitability for the systematic review based on inclusion and exclusion criteria. Authors' consensus was relied on where disagreements arose. The main outcome measures of concern in the systematic review were cost, effectiveness (as measured by either quality-adjusted life years (QALY) or life-years saved (LYS)), and incremental cost-effectiveness ratio (ICER) of screening versus either no screening or an alternative screening method. Thirty-one studies were selected for the final review. These studies investigated the cost-effectiveness of GC screening based on either primary, secondary, or a combination of primary and secondary interventions. The main primary intervention was Helicobacter pylori (Hp) screening with eradication, while the main secondary intervention was endoscopic screening. Cost-effectiveness was evaluated against no screening or screening using an alternative method in both observational and model-based studies. Screening was mainly cost-effective in Asian countries or their diasporas where the prevalence of GC was high. GC screening was generally not cost-effective among Western countries. GC screening can be cost-effective, but cost-effectiveness is dependent on context-specific factors, including geographical location, the prevalence of GC in the local population, and the screening tool adopted. However, there is benefit in targeting high-risk population groups in Asian countries and their diaspora for GC screening.
Collapse
Affiliation(s)
- Diedron Lewis
- School of Pharmacy, University of Waterloo, Waterloo, ON N2G 1C5, Canada
| | - Laura Jimenez
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Manel Haj Mansour
- Department of Haematology and Oncology, Aga Khan University Hospital, Nairobi P.O. Box 30270-00100, Kenya
| | - Susan Horton
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G5, Canada
| | - William W L Wong
- School of Pharmacy, University of Waterloo, Waterloo, ON N2G 1C5, Canada
| |
Collapse
|
|
8
|
Yang X, Ye T, Rong L, Peng H, Tong J, Xiao X, Wan X, Guo J. GATA4 Forms a Positive Feedback Loop with CDX2 to Transactivate MUC2 in Bile Acids-Induced Gastric Intestinal Metaplasia. Gut Liver 2024; 18:414-425. [PMID: 36860162 PMCID: PMC11096910 DOI: 10.5009/gnl220394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 03/03/2023] Open
Abstract
Background/Aims Gastric intestinal metaplasia (GIM), a common precancerous lesion of gastric cancer, can be caused by bile acid reflux. GATA binding protein 4 (GATA4) is an intestinal transcription factor involved in the progression of gastric cancer. However, the expression and regulation of GATA4 in GIM has not been clarified. Methods The expression of GATA4 in bile acid-induced cell models and human specimens was examined. The transcriptional regulation of GATA4 was investigated by chromatin immunoprecipitation and luciferase reporter gene analysis. An animal model of duodenogastric reflux was used to confirm the regulation of GATA4 and its target genes by bile acids. Results GATA4 expression was elevated in bile acid-induced GIM and human specimens. GATA4 bound to the promoter of mucin 2 (MUC2) and stimulate its transcription. GATA4 and MUC2 expression was positively correlated in GIM tissues. Nuclear transcription factor-κB activation was required for the upregulation of GATA4 and MUC2 in bile acid-induced GIM cell models. GATA4 and caudal-related homeobox 2 (CDX2) reciprocally transactivated each other to drive the transcription of MUC2. In chenodeoxycholic acid-treated mice, MUC2, CDX2, GATA4, p50, and p65 expression levels were increased in the gastric mucosa. Conclusions GATA4 is upregulated and can form a positive feedback loop with CDX2 to transactivate MUC2 in GIM. NF-κB signaling is involved in the upregulation of GATA4 by chenodeoxycholic acid.
Collapse
Affiliation(s)
- Xiaofang Yang
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
| | - Ting Ye
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
| | - Li Rong
- Department of Gastroenterology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Peng
- Department of Gastroenterology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Tong
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
| | - Xiao Xiao
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
| | - Xiaoqiang Wan
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
| | - Jinjun Guo
- Department of Gastroenterology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University School of Medicine, Chongqing, China
- Department of Gastroenterology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
|
9
|
Qiu L, Yao L, Hu P, He T. Analysis of the detection rate and clinical characteristics of early gastric cancer by painless gastroscopy and ordinary gastroscopy. Medicine (Baltimore) 2024; 103:e38120. [PMID: 38701257 PMCID: PMC11062693 DOI: 10.1097/md.0000000000038120] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/12/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE To investigate the difference of early gastric cancer (EGC) detection rate and endoscopic characteristics between painless and ordinary electronic gastroscopy, and summarize the clinical data of gastric cancer (GC) patients. METHODS Clinical data of 72,000 patients who underwent gastroscopy in the First People Hospital of Huzhou (Zhejiang, China) from January 2016 to December 2021 were retrospectively analyzed. The patients were divided into painless gastroscopy group (observation group, 36,000 cases) and ordinary gastroscopy group (control group, 36,000 cases) according to the examination methods. The detection rate of EGC between the 2 groups and the endoscopic characteristics of EGC lesions between the 2 groups were compared, and the clinical data of GC were summarized. RESULTS Painless gastroscopy is safer than ordinary gastroscopy. The detection rate of GC and EGC in the observation group was significantly higher than that in the control group (P < .05); the difference between the 2 groups in the detection rate of advanced GC was not statistically significant. The average length of EGC lesions in the observation group was significantly shorter than that in the control group (P < .05). The proportion of EGC with lesion length <2.0 cm in the observation group was significantly higher than that in the control group (P < .05). The proportion of EGC lesions with type II morphology, normal or pallor mucosal color, and no rupture in mucosa in the control group were significantly lower than that in the observation group, respectively (P < .05). The proportion of EGC distributed in the cardia, fundus and corpus was higher in the observation group than in the control group (P < .05). The incidence of helicobacter pylori (HP) infection, precancerous diseases, first-degree relatives of GC patients, and risk factors in patients with GC was significantly higher than that in non-GC patients (P < .05), multivariate logistic regression analysis showed that these were independent influencing factors for the occurrence of GC. CONCLUSION Painless gastroscopy can effectively improve the screening and diagnostic efficiency of EGC, especially for EGC lesions that are not easy to expose the site, small in size, superficial, without obvious mucosal color change or without mucosal breakage. Therefore, the value of painless gastroscopy in EGC screening is worth further promotion and research.
Collapse
Affiliation(s)
- Lei Qiu
- Departments of Gastroenterology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang, People’s Republic China
| | - Linhua Yao
- Departments of Gastroenterology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang, People’s Republic China
| | - Piwei Hu
- Departments of Pathology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang, People’s Republic China
| | - Tongyun He
- Departments of Anesthesiology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang, People’s Republic China
| |
Collapse
|
|
10
|
Zhang K, Wang H, Cheng Y, Liu H, Gong Q, Zeng Q, Zhang T, Wei G, Wei Z, Chen D. Early gastric cancer detection and lesion segmentation based on deep learning and gastroscopic images. Sci Rep 2024; 14:7847. [PMID: 38570595 PMCID: PMC10991264 DOI: 10.1038/s41598-024-58361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
Gastric cancer is a highly prevalent disease that poses a serious threat to public health. In clinical practice, gastroscopy is frequently used by medical practitioners to screen for gastric cancer. However, the symptoms of gastric cancer at different stages of advancement vary significantly, particularly in the case of early gastric cancer (EGC). The manifestations of EGC are often indistinct, leading to a detection rate of less than 10%. In recent years, researchers have focused on leveraging deep learning algorithms to assist medical professionals in detecting EGC and thereby improve detection rates. To enhance the ability of deep learning to detect EGC and segment lesions in gastroscopic images, an Improved Mask R-CNN (IMR-CNN) model was proposed. This model incorporates a "Bi-directional feature extraction and fusion module" and a "Purification module for feature channel and space" based on the Mask R-CNN (MR-CNN). Our study includes a dataset of 1120 images of EGC for training and validation of the models. The experimental results indicate that the IMR-CNN model outperforms the original MR-CNN model, with Precision, Recall, Accuracy, Specificity and F1-Score values of 92.9%, 95.3%, 93.9%, 92.5% and 94.1%, respectively. Therefore, our proposed IMR-CNN model has superior detection and lesion segmentation capabilities and can effectively aid doctors in diagnosing EGC from gastroscopic images.
Collapse
Affiliation(s)
- Kezhi Zhang
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China
| | - Haibao Wang
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China
| | - Yaru Cheng
- Department of Gastroenterology, Shandong Second Provincial General Hospital, 4 Duan Xing West Road, Jinan, 250022, Shandong, China
| | - Hongyan Liu
- Department of Gastroenterology, Shandong Second Provincial General Hospital, 4 Duan Xing West Road, Jinan, 250022, Shandong, China
| | - Qi Gong
- Department of Gastroenterology, Shandong Second Provincial General Hospital, 4 Duan Xing West Road, Jinan, 250022, Shandong, China
| | - Qian Zeng
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China
| | - Tao Zhang
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China
| | - Guoqiang Wei
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China.
- School of Electronic Engineering, Hunan College of Information, Changsha, 410200, Hunan, China.
| | - Zhi Wei
- Department of Gastroenterology, Shandong Second Provincial General Hospital, 4 Duan Xing West Road, Jinan, 250022, Shandong, China.
| | - Dong Chen
- Guangxi Key Laboratory of Information Functional Materials and Intelligent Information Processing, School of Physics and Electronics, Nanning Normal University, 175 Mingxiu East Road, Nanning, 530001, Guangxi, China.
| |
Collapse
|
|
11
|
Kim DH, Park SY, Kim JW, Kim HS. Feasibility and Efficacy of Gastric Underwater Endoscopic Mucosal Resection. Diagnostics (Basel) 2024; 14:536. [PMID: 38473010 PMCID: PMC10931230 DOI: 10.3390/diagnostics14050536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Gastric cancer, a leading cause of cancer-related deaths globally, necessitates effective and early detection and treatment strategies. Endoscopic resection techniques, particularly endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), have evolved significantly, enhancing the treatment of gastric neoplasms. Underwater endoscopic mucosal resection (UEMR) is a widely used technique for the resection of duodenal and colorectal neoplasms. However, the feasibility and efficacy of UEMR in the stomach are not well established. This retrospective observational study, conducted at a tertiary medical center, evaluated the efficacy and safety of UEMR in 81 patients with gastric neoplasms. Thus, it indicates that UEMR is a highly effective and safe technique for managing small to medium-sized gastric neoplasms, achieving 100% en bloc and 93.8% R0 resection rates with a low incidence of complications. Moreover, the procedure time was found to be significantly shorter for UEMR compared to ESD, thus highlighting its efficiency. While UEMR demonstrates high safety and efficacy, it is not suitable for all patients, with some requiring conversion to ESD as a treatment option. Despite the promising results, broader validation through extensive and randomized trials is recommended to establish UEMR as a standard approach in gastric cancer management.
Collapse
Affiliation(s)
| | | | - Jin Won Kim
- Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, Republic of Korea; (D.H.K.)
| | - Hyun Soo Kim
- Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, Republic of Korea; (D.H.K.)
| |
Collapse
|
|
12
|
Li J, Xu S, Zhu F, Shen F, Zhang T, Wan X, Gong S, Liang G, Zhou Y. Multi-omics Combined with Machine Learning Facilitating the Diagnosis of Gastric Cancer. Curr Med Chem 2024; 31:6692-6712. [PMID: 38351697 DOI: 10.2174/0109298673284520240112055108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/28/2023] [Accepted: 01/03/2024] [Indexed: 10/19/2024]
Abstract
Gastric cancer (GC) is a highly intricate gastrointestinal malignancy. Early detection of gastric cancer forms the cornerstone of precision medicine. Several studies have been conducted to investigate early biomarkers of gastric cancer using genomics, transcriptomics, proteomics, and metabolomics, respectively. However, endogenous substances associated with various omics are concurrently altered during gastric cancer development. Furthermore, environmental exposures and family history can also induce modifications in endogenous substances. Therefore, in this study, we primarily investigated alterations in DNA mutation, DNA methylation, mRNA, lncRNA, miRNA, circRNA, and protein, as well as glucose, amino acid, nucleotide, and lipid metabolism levels in the context of GC development, employing genomics, transcriptomics, proteomics, and metabolomics. Additionally, we elucidate the impact of exposure factors, including HP, EBV, nitrosamines, smoking, alcohol consumption, and family history, on diagnostic biomarkers of gastric cancer. Lastly, we provide a summary of the application of machine learning in integrating multi-omics data. Thus, this review aims to elucidate: i) the biomarkers of gastric cancer related to genomics, transcriptomics, proteomics, and metabolomics; ii) the influence of environmental exposure and family history on multiomics data; iii) the integrated analysis of multi-omics data using machine learning techniques.
Collapse
Affiliation(s)
- Jie Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Siyi Xu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Feng Zhu
- Physical and Chemical Laboratory, Jiangsu Provincial Center for Disease Control & Prevention, 172 Jiangsu Rd, Nanjing, 210009, China
| | - Fei Shen
- Physical and Chemical Laboratory, Jiangsu Provincial Center for Disease Control & Prevention, 172 Jiangsu Rd, Nanjing, 210009, China
| | - Tianyi Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Xin Wan
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Saisai Gong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Geyu Liang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Yonglin Zhou
- Physical and Chemical Laboratory, Jiangsu Provincial Center for Disease Control & Prevention, 172 Jiangsu Rd, Nanjing, 210009, China
| |
Collapse
|
|
13
|
Huang X, He D, Lai L, Chen J, Zhang Y, Mao H. Evaluation of clinical efficacy, adverse reactions, and safety of PD-1 inhibitors combined with chemotherapy when treating advanced gastric cancer. BMC Gastroenterol 2023; 23:374. [PMID: 37915064 PMCID: PMC10619224 DOI: 10.1186/s12876-023-03011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE This paper aimed to assess the clinical efficacy, adverse reactions, and safety of employing PD-1 inhibitors in conjunction with chemotherapy as a treatment strategy for advanced gastric cancer (GC). METHODS Ninety patients with advanced GC from January 2020 to December 2021 were divided into the research group (n = 45) and the control group (n = 45). The control group was treated with apatinib and tigio. The study group was treated with PD-1 inhibitor combined with apatinib and tigio. The remission rate (RR), disease control rate (DCR), overall survival (OS), Eastern Oncology Collaborative Group Physical Status Assessment (ECOG-PS) score, EORTCQLQ-C30 (v3.0) score, and incidence of adverse reactions were compared between the two groups. RESULTS The research group exhibited improved outcomes in several key metrics relative to the control group. Specifically, the RR, DCR, and OS were notably higher in the research group. Additionally, the ECOG-PS score was significantly reduced, indicating better performance. At a median follow-up of 8.7 months, the research group's functional and total health scores on the EORTC QLQ-C30 (v3.0) scale had seen significant improvement compared to their initial scores and were also superior to the control group's scores. Importantly, both groups demonstrated comparable incidence rates for adverse reactions, with no significant difference observed (P > 0.05). CONCLUSION PD-1 inhibitor combined with chemotherapy was more effective when treating patients with advanced GC. It was more beneficial to enhance the patient's condition, promote survival time, and improve physical status and life quality. In addition, the adverse reactions could be controlled.
Collapse
Affiliation(s)
- Xue Huang
- Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China
| | - Du He
- Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China
| | - Lin Lai
- Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China
| | - Jun Chen
- Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China
| | - Yukun Zhang
- Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China
| | - Huilin Mao
- Department of Pediatric Surgery, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, 158 Wuyang Road, Enshi, 445000, Hubei, China.
| |
Collapse
|
|
14
|
Hu ZH, Wang JT, Li RX, Wang GJ, Gao BL. Short-term efficacy of additional laparoscopic-assisted radical gastrectomy after non-curative endoscopic submucosal dissection for early gastric cancer. Langenbecks Arch Surg 2023; 408:354. [PMID: 37697006 DOI: 10.1007/s00423-023-03085-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To investigate short-term efficacy of direct laparoscopic-assisted radical gastrectomy (LAG) versus non-curative endoscopic submucosal dissection (ESD) plus additional LAG for early gastric cancer. MATERIALS AND METHODS 286 patients were retrospectively assigned into two groups: direct LAG group (n = 255) and additional LAG (ESD plus LAG, n = 31) group. A 1:2 propensity score matching was performed to equalize relevant confounding factors between two groups for analysis. RESULTS Ninety-three patients were successfully matched, including 62 in the direct LAG group and 31 in the additional LAG group. A significant (P = 0.013) difference existed in the drainage removal time between the additional LAG and direct LAG group (7 d vs. 6 d). Age, sex, tumor location and surgical approach were significantly (P < 0.05) associated with complications, with age ≥ 60 years (P = 0.002) and total gastrectomy (P = 0.011) as significant independent risk factors. A significant (P = 0.023) difference existed in the surgical time between the early and late groups (193.3 ± 37.6 min vs. 165.5 ± 25.1 min). CONCLUSION Additional LAG (D1 + lymphadenectomy) after ESD may be safe and effective even though non-curative ESD may prolong the drainage removal time and increase the difficulty of surgery.
Collapse
Affiliation(s)
- Zhi-Hao Hu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Jing-Tao Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Rui-Xin Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Guo-Jun Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.
| | - Bu-Lang Gao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| |
Collapse
|
|
15
|
Cheng R, Peng Y, Sun X, Zhang S, Li P. Circulating Tumor Cells as Diagnostic Markers of Early Gastric Cancer and Gastric Precancerous Lesions. Oncology 2023; 101:512-519. [PMID: 37263263 DOI: 10.1159/000531323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/21/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Circulating tumor cells (CTCs) may be potential diagnostic biomarkers of various malignancies including gastric cancer. This study aimed to evaluate whether CTCs could be used to facilitate the diagnosis of early gastric cancer (EGC) or precancerous gastric lesions. METHODS The diagnostic study included consecutive patients with EGC, gastric precancerous lesions, or fundic gland polyps admitted to the Gastroenterology Department, Beijing Friendship Hospital Affiliated to Capital Medical University (National Center for Digestive Diseases) between October 2016 and January 2018. RESULTS A total of 92 patients were enrolled, including 57 patients with EGC, 14 patients with gastric precancerous lesions, and 21 patients with fundic gland polyps (control group). CTCs were detected in 47.89% (34/71) of patients with EGC/gastric precancerous lesions and 4.76% (1/21) of patients with fundic gland polyps (p < 0.001). CTC detection distinguished EGC/precancerous lesions from fundic gland polyps with an area under the receiver operating characteristic curve of 0.740 (95% confidence interval, 0.640-0.840; p = 0.001), a sensitivity of 49.10%, a specificity of 95.00%, a positive predictive value of 97.00%, and a negative predictive value of 64.90%. CONCLUSIONS Peripheral blood CTCs are more common in patients with EGC or gastric precancerous lesions than in patients with fundic gland polyps. Measurement of CTCs may be a useful tool to aid in the diagnosis of EGC and precancerous lesions.
Collapse
Affiliation(s)
- Rui Cheng
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yang Peng
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Gastroenterology, Suining First People's Hospital, Suining, China
| | - Xiujing Sun
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
|
16
|
Liu S, Zhang N, Hao Y, Li P. Global research trends of endoscope in early gastric cancer: A bibliometric and visualized analysis study over past 20 years. Front Oncol 2023; 13:1068747. [PMID: 37091163 PMCID: PMC10118158 DOI: 10.3389/fonc.2023.1068747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
ObjectivesEarly gastric cancer (EGC) is defined as aggressive gastric cancer involving the gastric mucosa and submucosa. Early detection and treatment of gastric cancer are beneficial to patients. In recent years, many studies have focused on endoscopic diagnosis and therapy for EGC. Exploring new methods to analyze data to enhance knowledge is a worthwhile endeavor, especially when numerous studies exist. This study aims to investigate research trends in endoscopy for EGC over the past 20 years using bibliometric analysis.MethodsOriginal articles and reviews examining the use of endoscopy for EGC published from 2000 to 2022 were retrieved from the Web of Science Core Collection, and bibliometric data were extracted. Microsoft Office Excel 2016 was used to show the annual number of published papers for the top 10 countries and specific topics. VOSviewer software was used to generate network maps of the cooccurrences of keywords, authors, and topics to perform visualization network analysis.ResultsIn total, 1,009 published papers met the inclusion criteria. Japan was the most productive country and had the highest number of publications (452, 44.8%), followed by South Korea (183, 18.1%), and China (150, 14.9%). The National Cancer Center of Japan was the institution with the highest number of publications (48, 4.8%). Ono was the most active author and had the highest number of cited publications. Through the network maps, exploring endoscopic diagnosis and therapy were major topics. Artificial intelligence (AI), convolutional neural networks (CNNs), and deep learning are hotspots in endoscopic diagnosis. Helicobacter pylori eradication, second-look endoscopy, and follow-up management were examined.ConclusionsThis bibliometric analysis investigated research trends regarding the use of endoscopy for treating EGC over the past 20 years. AI and deep learning, second-look endoscopy, and management are hotspots in endoscopic diagnosis and endoscopic therapy in the future.
Collapse
Affiliation(s)
- Sifan Liu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Nan Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Yan Hao
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
- *Correspondence: Peng Li,
| |
Collapse
|
|
17
|
Zhao K, Feng LN, Xia SH, Zhou WD, Zhang MY, Zhang Y, Dong RN, Tian DA, Liu M, Liao JZ. Determination of an Appropriate Endoscopic Monitoring Interval for Patients with Gastric Precancerous Conditions in China. Curr Med Sci 2023; 43:268-273. [PMID: 36864248 DOI: 10.1007/s11596-023-2705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/30/2022] [Indexed: 03/04/2023]
Abstract
OBJECTIVE Gastric precancerous conditions such as atrophic gastritis (AG) and intestinal metaplasia (IM) are considered independent risk factors for gastric cancer (GC). The suitable endoscopic monitoring interval is unclear when we attempt to prevent GC development. This study investigated the appropriate monitoring interval for AG/IM patients. METHODS Totally, 957 AG/IM patients who satisfied the criteria for evaluation between 2010 and 2020 were included in the study. Univariate and multivariate analyses were used to determine the risk factors for progression to high-grade intraepithelial neoplasia (HGIN)/GC in AG/IM patients, and to determine an appropriate endoscopic monitoring scheme. RESULTS During follow-up, 28 AG/IM patients developed gastric neoplasia lesions including gastric low-grade intraepithelial neoplasia (LGIN) (0.7%), HGIN (0.9%), and GC (1.3%). Multivariate analysis identified H. pylori infection (P=0.022) and extensive AG/IM lesions (P=0.002) as risk factors for HGIN/GC progression (P=0.025). CONCLUSION In our study, HGIN/GC was present in 2.2% of AG/IM patients. In AG/IM patients with extensive lesions, a 1-2-year surveillance interval is recommended for early detection of HIGN/GC in AG/IM patients with extensive lesions.
Collapse
Affiliation(s)
- Kai Zhao
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Li-Na Feng
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Su-Hong Xia
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wang-Dong Zhou
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ming-Yu Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ruo-Nan Dong
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - De-An Tian
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei Liu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Jia-Zhi Liao
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
|
18
|
Pang L, Yan X, Su D, Wu X, Jiang H. Feasibility of olfactomedin 4 as a molecular biomarker for early diagnosis of gastric neoplasia after intestinal metaplasia. Scand J Gastroenterol 2023; 58:133-141. [PMID: 36124708 DOI: 10.1080/00365521.2022.2116992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study discusses whether olfactomedin 4 (OLFM4) could be used as a sensitive and specific biomarker in the early diagnosis of gastric cancer (GC) after gastric intestinal metaplasia (GIM). METHODS An integrative analysis combining data derived from the Gene Expression Omnibus (GEO) and cBioPortal databases was performed to investigate the potential molecular biomarker. Immunohistochemistry and quantitative real-time polymerase chain reactions were used to measure the expression of messenger ribonucleic acid (mRNA) and protein by OLFM4. In combination with the gastroscopic findings and the OLFM4 expression in GIM-GC, a predictive model was established. The receiver operator characteristic curve (ROC) was applied to assess the diagnostic value of the model for GIM-GC. RESULTS According to the GEO and cBioPortal databases, OLFM4 was identified as a key gene in the diagnosis of GIM-GC. Higher protein expression of OLFM4 was found in GIM and GIM-GC compared with chronic superficial gastritis (GS) (p < 0.05). The positive expression rate of OLFM4 in paracancerous tissue (GCP) was higher than in GIM (p > 0.05). There was no significant difference between GIM-GC and GCP (p > 0.05). The mRNA expression of OLFM4 was similar to the protein expression, and the positive expression rate was higher in early GIM-GC than in GIM (p < 0.05). CONCLUSION Olfactomedin 4 could be used as a biomarker for the early diagnosis of GIM-GC, and the logistic predictive model could be an effective tool for increasing the early diagnostic rate.
Collapse
Affiliation(s)
- Lixing Pang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xin Yan
- Department of Endocrinology, Nanning Second People's Hospital, Nanning, China
| | - Dongxing Su
- Department of Gastroenterology, Nanning Second People's Hospital, Nanning, China
| | - Xianbin Wu
- Department of Gastroenterology, Nanning Second People's Hospital, Nanning, China
| | - Haixing Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| |
Collapse
|
|
19
|
Zheng P, Liu J. Cost-Effectiveness Analysis of Hp and New Gastric Cancer Screening Scoring System for Screening and Prevention of Gastric Cancer. Curr Oncol 2023; 30:1132-1145. [PMID: 36661735 PMCID: PMC9857951 DOI: 10.3390/curroncol30010086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
Gastric cancer is one of the most common gastrointestinal cancers. Early diagnosis can improve the 5-year survival rate. This study aimed to evaluate the cost-effectiveness of Helicobacter pylori (Hp) and a new gastric cancer screening scoring system (NGCS) in areas with a high incidence of gastric cancer. A decision-analytic Markov model was constructed based on the theory and method of cost-effectiveness analysis, which included three decisions: no screening, Hp screening, and NGCS screening. The uncertainty of each parameter in the model was determined using a one-way sensitivity analysis and probability sensitivity analysis. The results of the cost-effectiveness analysis revealed that the application of the NGCS had the highest cost-effectiveness, while the one-way sensitivity analysis revealed that the probability of intestinal metaplasia progression to dysplasia had the most significant effect on the incremental cost-effectiveness ratio. The probability sensitivity analysis concluded that the result of the NGCS having the highest cost-effectiveness was stable. Although the application of the NGCS will require upfront screening costs, it can significantly improve the detection rate of early gastric cancer and save the consequent long-term healthcare costs. It is practicable and can be popularized in China.
Collapse
Affiliation(s)
- Peiyu Zheng
- Graduate School, Shanxi Medical University, Taiyuan 030001, China
| | - Jinchun Liu
- Graduate School, Shanxi Medical University, Taiyuan 030001, China
- Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China
| |
Collapse
|
|
20
|
Gu L, Chen J, Yang Y, Zhang Y, Tian Y, Jiang J, Zhou D, Liao L. Data-independent acquisition mass spectrometry identification of extracellular vesicle biomarkers for gastric adenocarcinoma. Front Oncol 2022; 12:1051450. [PMID: 36505781 PMCID: PMC9731329 DOI: 10.3389/fonc.2022.1051450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Early diagnosis of gastric adenocarcinoma (GAC) can effectively prevent the progression of the disease and significantly improve patient survival. Currently, protein markers in clinical practice barely meet patient needs; it is therefore imperative to develop new diagnostic biomarkers with high sensitivity and specificity. In this study, we extracted extracellular vesicles (EV) from the sera of 33 patients with GAC and 19 healthy controls, then applied data-independent acquisition (DIA) mass spectrometry to measure protein expression profiles. Differential protein expression analysis identified 23 proteins showing expression patterns across different cancer stages, from which 15 proteins were selected as candidate biomarkers for GAC diagnosis. From this subset of 15 proteins, up to 6 proteins were iteratively selected as features and logistic regression was used to distinguish patients from healthy controls. Furthermore, serum-derived EV from a new cohort of 12 patients with gastric cancer and 18 healthy controls were quantified using the same method. A classification panel consisting of GSN, HP, ORM1, PIGR, and TFRC showed the best performance, with a sensitivity and negative predictive value (NPV) of 0.83 and 0.82. The area under curve (AUC) of the receiver operating characteristic (ROC) is 0.80. Finally, to facilitate the diagnosis of advanced stage GAC, we identified a 3-protein panel consisting of LYZ, SAA1, and F12 that showed reasonably good performance with an AUC of 0.83 in the validation dataset. In conclusion, we identified new protein biomarker panels from serum EVs for early diagnosis of gastric cancer that worth further validation.
Collapse
Affiliation(s)
- Lei Gu
- Department of General Surgery, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jin Chen
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Yueying Yang
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Yunpeng Zhang
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Yuying Tian
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Jinhua Jiang
- Department of Interventional Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,*Correspondence: Jinhua Jiang, ; Donglei Zhou, ; Lujian Liao,
| | - Donglei Zhou
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China,*Correspondence: Jinhua Jiang, ; Donglei Zhou, ; Lujian Liao,
| | - Lujian Liao
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China,Durbrain Medical Laboratory, Hangzhou, Zhejiang, China,*Correspondence: Jinhua Jiang, ; Donglei Zhou, ; Lujian Liao,
| |
Collapse
|
|
21
|
Hisada H, Tamura N, Tsuji Y, Nagao S, Fukagawa K, Miura Y, Mizutani H, Ohki D, Yakabi S, Minatsuki C, Takahashi Y, Sakaguchi Y, Yamamichi N, Fujishiro M. The impact of sarcopenia on adverse events associated with gastric endoscopic submucosal dissection. Surg Endosc 2022; 36:6387-6395. [PMID: 34997343 DOI: 10.1007/s00464-021-08965-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) is one of the main methods of treatments for early gastric cancer. Sarcopenia is a known risk factor for postoperative adverse events; however, the effect of sarcopenia on gastric ESD is unclear. We investigated the impact of sarcopenia on short-term prognosis after gastric ESD. METHODS This was a retrospective cohort study. We reviewed 832 patients who underwent gastric ESD between January 2015 and December 2019 and classified them into two groups: sarcopenia and non-sarcopenia groups. The curative resection rate, adverse events, and lengths of hospital stay were evaluated. We also evaluated risk factors associated with adverse events. RESULTS 700 patients were analyzed (239 in the sarcopenia group and 461 in the non-sarcopenia group). The curative resection rates were similar in both groups. Common Terminology Criteria for Adverse Events (CTCAE) grade ≥ 2 (17% vs. 10%) were significantly more common, and the length of hospital stay was longer (8 vs. 7 days) in the sarcopenia group. Univariate analysis identified age ≥ 75 years, antithrombotic medication, history of gastric surgery, submucosal (SM) invasion, and sarcopenia as risk factors for CTCAE grade ≥ 2. Multivariate analysis showed that sarcopenia [odds ratio (OR) 1.79, 95% confidence interval (CI) 1.11-2.89, p = 0.016], history of gastric surgery (OR 9.32, 95% CI 1.97-44.05, p = 0.005), and SM invasion (OR 2.14, 95% CI 1.24-3.70, p = 0.006) were significant independent risk factors. CONCLUSIONS Sarcopenia significantly affected short-term prognosis and is a novel risk factor for gastric ESD.
Collapse
Affiliation(s)
- Hiroyuki Hisada
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoki Tamura
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yosuke Tsuji
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Tokyo, 113-8655, Japan.
| | - Sayaka Nagao
- Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazushi Fukagawa
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuko Miura
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroya Mizutani
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Ohki
- Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Seiichi Yakabi
- Center for International Preventive Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chihiro Minatsuki
- Infection Control and Prevention Service, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yu Takahashi
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshiki Sakaguchi
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nobutake Yamamichi
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| |
Collapse
|
|
22
|
Lin L, Que R, Wang J, Zhu Y, Liu X, Xu R. Prognostic value of the ferroptosis-related gene SLC2A3 in gastric cancer and related immune mechanisms. Front Genet 2022; 13:919313. [PMID: 35957685 PMCID: PMC9358142 DOI: 10.3389/fgene.2022.919313] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
SLC2A3 is a ferroptosis marker engaged in transmembrane glucose transport. However, the effect of SLC2A3 on the prognosis of patients with cancer remains unclear. This study aimed to explore the prognostic implications of SLC2A3 and its underlying immune mechanisms in gastric cancer. The mRNA expression profiles and corresponding clinical data of patients with gastric cancer were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. Differentially expressed genes related to SLC2A3 were identified using the R package “limma.” Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, gene set enrichment analysis, and gene set variation analysis were used to explore the underlying mechanisms. The protein–protein and miRNA interaction networks were analyzed using Cytoscape software. Immune cell infiltration was assessed using single-sample gene set enrichment analysis. Univariate and multivariate Cox regression analyses revealed the relationship between SLC2A3 expression and prognosis. SLC2A3 was found to be highly expressed in tumor tissues and was associated with an unfavorable prognosis in patients with gastric cancer. Functional enrichment analysis showed that SLC2A3 is related to cytokine–cytokine receptor interaction, epithelial–mesenchymal transition, T cell receptor signaling pathway, B cell receptor signaling pathway, and immune checkpoints. SLC2A3 is also involved in immune response regulation and is regulated by multiple miRNAs, including miR-195-5p, miR-106a-5p, miR-424-5p, and miR-16-5p. Univariate and multivariate Cox regression analyses indicated that SLC2A3 can be used as an independent prognostic factor for predicting the outcome in patients with gastric cancer. SLC2A3 and related miRNAs are potential prognostic biomarkers and therapeutic targets.
Collapse
Affiliation(s)
- Liubing Lin
- Department of Gastroenterology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Renye Que
- Department of Gastroenterology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Gastroenterology, Shanghai TCM Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Wang
- Department of Gastroenterology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Zhu
- Department of Internal Medicine I, Shanghai Jiading District Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolin Liu
- Department of Gastroenterology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiaolin Liu, ; Rongzhong Xu,
| | - Rongzhong Xu
- Department of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiaolin Liu, ; Rongzhong Xu,
| |
Collapse
|
|
23
|
Qin S, Wang X, Li S, Tan C, Zeng X, Luo X, Yi L, Peng L, Wu M, Peng Y, Wang L, Wan X. Clinical Benefit and Cost Effectiveness of Risk-Stratified Gastric Cancer Screening Strategies in China: A Modeling Study. PHARMACOECONOMICS 2022; 40:725-737. [PMID: 35701687 DOI: 10.1007/s40273-022-01160-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE A new gastric cancer screening scoring system (NGCS) strategy was recommended for the early gastric cancer (GC) screening process in China. The current study aimed to assess the clinical benefits and the cost effectiveness of the NGCS strategy in GC high-risk areas of China from a societal perspective. METHODS A Markov microsimulation model was developed to evaluate 30 alternative screening strategies with varying initiation age, including the NGCS strategy, the modified NGCS strategy, and the endoscopic screening strategy with various screening intervals. The primary outcomes included GC mortality, number of endoscopies, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Cost estimates were reported in 2021 USD (US$) and both costs and benefits were discounted at 5% annually. Deterministic and probabilistic sensitivity analyses were performed to evaluate model uncertainty. RESULTS Screening with the NGCS strategy from age 40 years (40-NGCS) reduced the GC incidence by 86.4%, which provided the greatest benefit across strategies. Compared with all strategies, at a willingness-to pay threshold of US$17,922 per QALY, the 40-NGCS strategy was a leading cost-effective strategy, with an ICER of US$15,668 per QALY. Results were robust in univariate and probabilistic sensitivity analyses. The probability of the 40-NGCS strategy being cost effective was 0.863. CONCLUSIONS The 40-NGCS strategy was an effective and cost-effective strategy to reduce GC incidence and mortality in China. The findings provide important evidence for decision makers to formulate and optimize targeted approaches for GC prevention and control policies in China.
Collapse
Affiliation(s)
- Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Sini Li
- Xiangya Nursing School, Central South University, Changsha, 410013, Hunan, China
- Faculty of Medicine, Dentistry and Health, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Lidan Yi
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liubao Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
| |
Collapse
|
|
24
|
Tamura N, Sakaguchi Y, Furutani W, Matsui M, Nagao S, Sakuma N, Fukagawa K, Miura Y, Mizutani H, Ohki D, Kataoka Y, Saito I, Ono M, Minatsuki C, Tsuji Y, Ono S, Kodashima S, Abe H, Ushiku T, Yamamichi N, Koike K, Fujishiro M. Magnifying endoscopy with narrow-band imaging is useful in differentiating gastric cancer from matched adenoma in white light imaging. Sci Rep 2022; 12:8349. [PMID: 35589745 PMCID: PMC9120519 DOI: 10.1038/s41598-022-12315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
This study assessed the effect of magnifying endoscopy with narrow-band imaging (M-NBI) on the endoscopic differential diagnosis between intramucosal gastric carcinomas and adenomas with matched characteristics. Associations between magnified endoscopic findings and pathological high-grade cellular and architectural atypia were also investigated. In total, the records of 50 adenomas and 50 intramucosal well-differentiated adenocarcinomas matched by tumor size (≥ 20 mm or < 20 mm), shape (depression or non-depression), and color (red or non-red) were extracted. Fourteen endoscopists diagnosed adenoma or cancer in the 100 cases with conventional white light imaging (C-WLI), then did the same with C-WLI + M-NBI.The cancer diagnostic sensitivity, specificity, and accuracy were assessed. The sensitivity of C-WLI + M-NBI for cancer diagnosis was 79.9% compared to 71.6% with C-WLI (p < 0.001). There were no significant differences in specificity (40.1% vs. 36.3%, p = 0.296) and accuracy (55.9% vs. 58.1%, p = 0.163). High-grade cytological or architectural atypia was diagnosed more often with irregular microvascular pattern (IMVP) or microsurface pattern (IMSP), respectively, than the low-grade forms. In conclusion, IMVP and IMSP correlate with high-grade cytological and architectural atypia. M-NBI is useful in differentiating intramucosal carcinoma from adenoma and can reduce underdiagnosis of cancer.
Collapse
Affiliation(s)
- Naoki Tamura
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Yoshiki Sakaguchi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan.
| | - Wakiko Furutani
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Maki Matsui
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Sayaka Nagao
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Nobuyuki Sakuma
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Kazushi Fukagawa
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Yuko Miura
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Hiroya Mizutani
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Daisuke Ohki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Yosuke Kataoka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Itaru Saito
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Masayoshi Ono
- Department of Gastroenterology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Chihiro Minatsuki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Yosuke Tsuji
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Satoshi Ono
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Shinya Kodashima
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Hiroyuki Abe
- Department of Pathology, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Nobutake Yamamichi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1, Hongo, Tokyo, 113-8655, Japan
| |
Collapse
|
|
25
|
Joo DC, Kim GH. Endoscopic diagnosis of early gastric cancer. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022; 65:267-275. [DOI: 10.5124/jkma.2022.65.5.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/04/2022] [Indexed: 02/06/2025] Open
Abstract
Background: Among the types of gastric cancer, the proportion of early gastric cancer has shown a steady increase because the national screening programs have been conducted in Korea. Accordingly, the paradigm shift of the treatment procedure from surgical gastrectomy to endoscopic resection for selected early gastric cancer has accelerated recently. For successful treatment of early gastric cancer, early detection is essential to accurately predict the histological type, depth of invasion, and horizontal margins of the tumor.Current Concepts: The diagnosis of early gastric cancer and selection of treatment procedures comprises the following steps: (1) presence diagnosis, (2) qualitative diagnosis, and (3) quantitative diagnosis. Presently, early gastric cancer diagnosis is based on the endoscopic detection of a demarcated lesion and irregularity of the mucosal surface or color pattern. If a lesion is diagnosed as early gastric cancer, qualitative and quantitative diagnostic processes should be conducted. Qualitative diagnosis predicts the histological type (differentiated vs. undifferentiated), whereas quantitative diagnosis predicts the invasion depth and horizontal margins of the lesion. The diagnostic processes are based on the macroscopic morphology and color of the lesion, while sometimes using chromoendoscopy, image-enhanced endoscopy, and magnifying endoscopy.Discussion and Conclusion: If gastric cancer is detected at an early stage, most cases can be treated only by endoscopic resection. Therefore, endoscopists should have systematic knowledge regarding the findings of early gastric cancer for timely detection and appropriate selection of the treatment procedure.
Collapse
|
|
26
|
Sumiyama K. History of conventional endoscopy for gastric evaluation in Japan. Dig Endosc 2022; 34 Suppl 2:46-49. [PMID: 34585788 DOI: 10.1111/den.14134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
|
27
|
Koopaie M, Ghafourian M, Manifar S, Younespour S, Davoudi M, Kolahdooz S, Shirkhoda M. Evaluation of CSTB and DMBT1 expression in saliva of gastric cancer patients and controls. BMC Cancer 2022; 22:473. [PMID: 35488257 PMCID: PMC9055774 DOI: 10.1186/s12885-022-09570-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/19/2022] [Indexed: 01/07/2023] Open
Abstract
Background Gastric cancer (GC) is the fifth most common cancer and the third cause of cancer deaths globally, with late diagnosis, low survival rate, and poor prognosis. This case-control study aimed to evaluate the expression of cystatin B (CSTB) and deleted in malignant brain tumor 1 (DMBT1) in the saliva of GC patients with healthy individuals to construct diagnostic algorithms using statistical analysis and machine learning methods. Methods Demographic data, clinical characteristics, and food intake habits of the case and control group were gathered through a standard checklist. Unstimulated whole saliva samples were taken from 31 healthy individuals and 31 GC patients. Through ELISA test and statistical analysis, the expression of salivary CSTB and DMBT1 proteins was evaluated. To construct diagnostic algorithms, we used the machine learning method. Results The mean salivary expression of CSTB in GC patients was significantly lower (115.55 ± 7.06, p = 0.001), and the mean salivary expression of DMBT1 in GC patients was significantly higher (171.88 ± 39.67, p = 0.002) than the control. Multiple linear regression analysis demonstrated that GC was significantly correlated with high levels of DMBT1 after controlling the effects of age of participants (R2 = 0.20, p < 0.001). Considering salivary CSTB greater than 119.06 ng/mL as an optimal cut-off value, the sensitivity and specificity of CSTB in the diagnosis of GC were 83.87 and 70.97%, respectively. The area under the ROC curve was calculated as 0.728. The optimal cut-off value of DMBT1 for differentiating GC patients from controls was greater than 146.33 ng/mL (sensitivity = 80.65% and specificity = 64.52%). The area under the ROC curve was up to 0.741. As a result of the machine learning method, the area under the receiver-operating characteristic curve for the diagnostic ability of CSTB, DMBT1, demographic data, clinical characteristics, and food intake habits was 0.95. The machine learning model’s sensitivity, specificity, and accuracy were 100, 70.8, and 80.5%, respectively. Conclusion Salivary levels of DMBT1 and CSTB may be accurate in diagnosing GCs. Machine learning analyses using salivary biomarkers, demographic, clinical, and nutrition habits data simultaneously could provide affordability models with acceptable accuracy for differentiation of GC by a cost-effective and non-invasive method.
Collapse
Affiliation(s)
- Maryam Koopaie
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghafourian
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Manifar
- Department of Oral Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, North Kargar St, P.O.Box:14395-433, Tehran, 14399-55991, Iran.
| | - Shima Younespour
- Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Davoudi
- Department of Computer Science and Engineering and IT, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Sajad Kolahdooz
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Shirkhoda
- Department of General Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
28
|
Zhao Y, Hu B, Wang Y, Yin X, Jiang Y, Zhu X. Identification of gastric cancer with convolutional neural networks: a systematic review. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 81:11717-11736. [PMID: 35221775 PMCID: PMC8856868 DOI: 10.1007/s11042-022-12258-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/20/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
The identification of diseases is inseparable from artificial intelligence. As an important branch of artificial intelligence, convolutional neural networks play an important role in the identification of gastric cancer. We conducted a systematic review to summarize the current applications of convolutional neural networks in the gastric cancer identification. The original articles published in Embase, Cochrane Library, PubMed and Web of Science database were systematically retrieved according to relevant keywords. Data were extracted from published papers. A total of 27 articles were retrieved for the identification of gastric cancer using medical images. Among them, 19 articles were applied in endoscopic images and 8 articles were applied in pathological images. 16 studies explored the performance of gastric cancer detection, 7 studies explored the performance of gastric cancer classification, 2 studies reported the performance of gastric cancer segmentation and 2 studies analyzed the performance of gastric cancer delineating margins. The convolutional neural network structures involved in the research included AlexNet, ResNet, VGG, Inception, DenseNet and Deeplab, etc. The accuracy of studies was 77.3 - 98.7%. Good performances of the systems based on convolutional neural networks have been showed in the identification of gastric cancer. Artificial intelligence is expected to provide more accurate information and efficient judgments for doctors to diagnose diseases in clinical work.
Collapse
Affiliation(s)
- Yuxue Zhao
- School of Nursing, Department of Medicine, Qingdao University, No. 15, Ningde Road, Shinan District, Qingdao, 266073 China
| | - Bo Hu
- Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Ying Wang
- School of Nursing, Department of Medicine, Qingdao University, No. 15, Ningde Road, Shinan District, Qingdao, 266073 China
| | - Xiaomeng Yin
- Pediatrics Intensive Care Unit, Qingdao Municipal Hospital, Qingdao, China
| | - Yuanyuan Jiang
- International Medical Services, Qilu Hospital of Shandong University, Jinan, China
| | - Xiuli Zhu
- School of Nursing, Department of Medicine, Qingdao University, No. 15, Ningde Road, Shinan District, Qingdao, 266073 China
| |
Collapse
|
|
29
|
Jin Z, Gan T, Wang P, Fu Z, Zhang C, Yan Q, Zheng X, Liang X, Ye X. Deep learning for gastroscopic images: computer-aided techniques for clinicians. Biomed Eng Online 2022; 21:12. [PMID: 35148764 PMCID: PMC8832738 DOI: 10.1186/s12938-022-00979-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/21/2022] [Indexed: 12/13/2022] Open
Abstract
Gastric disease is a major health problem worldwide. Gastroscopy is the main method and the gold standard used to screen and diagnose many gastric diseases. However, several factors, such as the experience and fatigue of endoscopists, limit its performance. With recent advancements in deep learning, an increasing number of studies have used this technology to provide on-site assistance during real-time gastroscopy. This review summarizes the latest publications on deep learning applications in overcoming disease-related and nondisease-related gastroscopy challenges. The former aims to help endoscopists find lesions and characterize them when they appear in the view shed of the gastroscope. The purpose of the latter is to avoid missing lesions due to poor-quality frames, incomplete inspection coverage of gastroscopy, etc., thus improving the quality of gastroscopy. This study aims to provide technical guidance and a comprehensive perspective for physicians to understand deep learning technology in gastroscopy. Some key issues to be handled before the clinical application of deep learning technology and the future direction of disease-related and nondisease-related applications of deep learning to gastroscopy are discussed herein.
Collapse
Affiliation(s)
- Ziyi Jin
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China
| | - Tianyuan Gan
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China
| | - Peng Wang
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China
| | - Zuoming Fu
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China
| | - Chongan Zhang
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China
| | - Qinglai Yan
- Hangzhou Center for Medical Device Quality Supervision and Testing, CFDA, Hangzhou, 310000, People's Republic of China
| | - Xueyong Zheng
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, People's Republic of China
| | - Xiao Liang
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, People's Republic of China
| | - Xuesong Ye
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, People's Republic of China.
| |
Collapse
|
|
30
|
Yao Z, Jin T, Mao B, Lu B, Zhang Y, Li S, Chen W. Construction and Multicenter Diagnostic Verification of Intelligent Recognition System for Endoscopic Images From Early Gastric Cancer Based on YOLO-V3 Algorithm. Front Oncol 2022; 12:815951. [PMID: 35145918 PMCID: PMC8822233 DOI: 10.3389/fonc.2022.815951] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/05/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Endoscopy is an important tool for the diagnosis of early gastric cancer. Therefore, a combination of artificial intelligence and endoscopy has the ability to increase the speed and efficiency of early gastric cancer diagnosis. YOU ONLY LOOK ONCE (YOLO) is an advanced object detection depth neural network algorithm that has not been widely used in gastrointestinal image recognition. Objective We developed an artificial intelligence system herein referred to as “EGC-YOLO” for the rapid and accurate diagnosis of endoscopic images from early gastric cancer. Methods More than 40000 gastroscopic images from 1653 patients in Yixing people’s Hospital were used as the training set for the system, while endoscopic images from the other two hospitals were used as external validation test sets. The sensitivity, specificity, positive predictive value, Youden index and ROC curve were analyzed to evaluate detection efficiencies for EGC-YOLO. Results EGC-YOLO was able to diagnose early gastric cancer in the two test sets with a high superiority and efficiency. The accuracy, sensitivity, specificity and positive predictive value for Test Sets 1 and 2 were 85.15% and 86.02%, 85.36% and 83.02%, 84.41% and 92.21%, and 95.22% and 95.65%, respectively. In Test Sets 1 and 2, the corresponding Threshold-values were 0.02, 0.16 and 0.17 at the maximum of the Youden index. An increase in Threshold-values was associated with a downward trend in sensitivity and accuracy, while specificity remained relatively stable at more than 80%. Conclusions The EGC-YOLO system is superior for the efficient, accurate and rapid detection of early gastric cancer lesions. For different data sets, it is important to select the appropriate threshold-value in advance to achieve the best performance of the EGC-YOLO system.
Collapse
Affiliation(s)
- Zhendong Yao
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Gastroenterology, Yixing People’s Hospital, Yixing, China
| | - Tao Jin
- Department of Gastroenterology, Yixing People’s Hospital, Yixing, China
| | - Boneng Mao
- Department of Gastroenterology, Yixing People’s Hospital, Yixing, China
| | - Bo Lu
- Microsoft Teams Calling Meeting Device of Sharepoint Onedrive eXperience (Teams CMD SOX), Microsoft Ltd Co., Suzhou, China
| | - Yefei Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Sisi Li
- Department of Gastroenterology, Civil Aviation Hospital of Shanghai, Shanghai, China
| | - Weichang Chen
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Weichang Chen,
| |
Collapse
|
|
31
|
Chen J, Zheng Q, Liu F, Jin H, Wu X, Xi Y. LINC00152 acts as a competing endogenous RNA of HMGA1 to promote the growth of gastric cancer cells. J Clin Lab Anal 2022; 36:e24192. [PMID: 35014092 PMCID: PMC8841176 DOI: 10.1002/jcla.24192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Long noncoding RNAs (lncRNAs) play important roles in almost every stage of cancer development. Given the competing endogenous RNA (ceRNA) hypothesis for the regulation of gene expression, we investigated the role of LINC00152 as a ceRNA in gastric cancer (GC) cells. Methods Gastric cancer cell lines were used in this study. Mimics of miRNAs and siRNA were used to evaluate the interaction between LINC00152 and HMGA1. The quantitative real‐time polymerase chain reaction was performed for analyzing gene expression at the transcriptional level. Flow cytometry assay of cell cycle and western blot analysis of related protein expression levels were performed. Online databases such as TCGA and TIMER were used to determine the possibility of HMGA1 and LINC00152 as GC markers and their role in immune infiltration. Results Treating GC cell lines with LINC00152 siRNAs downregulated the expression of HMGA1. The cell cycle was arrested in the S phase following a reduction in LINC00152 or HMGA1 expression, whereas the expression of the cell cycle inhibitor P27 increased. In this study, we showed that acting as a ceRNA of HMGA1, LINC00152 has the same function as HMGA1, considering that it could control the cell cycle and promote GC cell proliferation. The TCGA database showed that LINC00152 might be used as a diagnostic marker for GC. Conclusions These findings provide mechanistic insights into the role of LINC00152 as a ceRNA to regulate HMGA1 expression in GC cells, where it can promote the proliferation of the GC cells by regulating the expression of the P27.
Collapse
Affiliation(s)
- Jiayi Chen
- Department of Experimental Pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo, China.,Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China
| | - Qingfang Zheng
- Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China
| | - Fang Liu
- Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China.,Ningbo Haishu District Center for Disease Control and Prevention, Ningbo, China
| | - Han Jin
- Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoyue Wu
- Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China
| | - Yang Xi
- Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China
| |
Collapse
|
|
32
|
Li C, Wang H, Meng S, Hong J, Yao L, Shao Y, Zhu X. lncRNA GAS8-AS1 regulates cancer cell proliferation and predicts poor survival of patients with gastric cancer. Oncol Lett 2022; 23:48. [PMID: 34992681 DOI: 10.3892/ol.2021.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 09/22/2021] [Indexed: 11/05/2022] Open
Abstract
Long non-coding (lnc)RNAs have been recognized as important regulators in gastric cancer. lncRNA GAS8-AS1 is considered a tumor suppressor in multiple types of cancer, such as papillary thyroid carcinoma, ovarian cancer and colorectal cancer. However, the specific role of GAS8-AS1 in gastric cancer remains to be fully elucidated. The aim of the present study was to investigate the role of GAS8-AS1 in gastric cancer and its potential underlying mechanisms of action. The expression levels of GAS8-AS1, microRNA (miR)-21-3p, PTEN and pyruvate dehydrogenase (E1) alpha subunit gene (PDHA1) in gastric cancer and non-cancerous tissues, as well as in gastric cancer cell lines, were detected using reverse transcription-quantitative PCR. Cell proliferation was detected by using a Cell Counting Kit-8 assay. Cell migration and invasion were detected using a Transwell assay. Results of the present study demonstrated that the expression levels of GAS8-AS1 in gastric cancer tissues were significantly decreased, whereas its expression did not differ among cancer tissues at different clinical stages. Low expression levels of GAS8-AS1 predicted poor 5-year survival rates for 70 patients with gastric adenocarcinoma from the Affiliated Hospital of Xuzhou Medical University (Xuzhou, China) during patient follow-up. In addition, the expression levels of miR-21-3p were markedly increased in cancer tissues, and miR-21-3p expression was negatively associated with the expression of GAS8-AS1. The direct interaction between GAS8-AS1 and miR-21-3p was predicted using the starBase database and was confirmed by using an RNA pull-down assay. In gastric cell lines, the overexpression of GAS8-AS1 reduced the expression levels of mature miR-21-3p but did not affect the expression of miR-21-3p precursor, while the overexpression of miR-21-3p did not, in turn, affect the expression of GAS8-AS1. In addition, the overexpression of GAS8-AS1 inhibited cancer cell proliferation, while the overexpression of miR-21-3p promoted cancer cell proliferation and attenuated the effects of GAS8-AS1. Overexpression of miR-21-3p promoted cancer cell migration and invasion, whereas overexpression of GAS8-AS1 did not affect cell migration or invasion. In summary, results of the present study have demonstrated that GAS8-AS1 acts as a tumor suppressor in gastric cancer, and it may inhibit cancer cell proliferation by downregulating miR-21-3p.
Collapse
Affiliation(s)
- Chao Li
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Hui Wang
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Song Meng
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Jian Hong
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Libin Yao
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Yong Shao
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| | - Xiaocheng Zhu
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
| |
Collapse
|
|
33
|
Ayyaz MS, Lali MIU, Hussain M, Rauf HT, Alouffi B, Alyami H, Wasti S. Hybrid Deep Learning Model for Endoscopic Lesion Detection and Classification Using Endoscopy Videos. Diagnostics (Basel) 2021; 12:diagnostics12010043. [PMID: 35054210 PMCID: PMC8775223 DOI: 10.3390/diagnostics12010043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
In medical imaging, the detection and classification of stomach diseases are challenging due to the resemblance of different symptoms, image contrast, and complex background. Computer-aided diagnosis (CAD) plays a vital role in the medical imaging field, allowing accurate results to be obtained in minimal time. This article proposes a new hybrid method to detect and classify stomach diseases using endoscopy videos. The proposed methodology comprises seven significant steps: data acquisition, preprocessing of data, transfer learning of deep models, feature extraction, feature selection, hybridization, and classification. We selected two different CNN models (VGG19 and Alexnet) to extract features. We applied transfer learning techniques before using them as feature extractors. We used a genetic algorithm (GA) in feature selection, due to its adaptive nature. We fused selected features of both models using a serial-based approach. Finally, the best features were provided to multiple machine learning classifiers for detection and classification. The proposed approach was evaluated on a personally collected dataset of five classes, including gastritis, ulcer, esophagitis, bleeding, and healthy. We observed that the proposed technique performed superbly on Cubic SVM with 99.8% accuracy. For the authenticity of the proposed technique, we considered these statistical measures: classification accuracy, recall, precision, False Negative Rate (FNR), Area Under the Curve (AUC), and time. In addition, we provided a fair state-of-the-art comparison of our proposed technique with existing techniques that proves its worthiness.
Collapse
Affiliation(s)
- M Shahbaz Ayyaz
- Department of Computer Science, University of Gujrat, Gujrat 50700, Pakistan; (M.S.A.); (M.H.)
| | - Muhammad Ikram Ullah Lali
- Department of Information Sciences, University of Education Lahore, Lahore 41000, Pakistan; (M.I.U.L.); (S.W.)
| | - Mubbashar Hussain
- Department of Computer Science, University of Gujrat, Gujrat 50700, Pakistan; (M.S.A.); (M.H.)
| | - Hafiz Tayyab Rauf
- Centre for Smart Systems, AI and Cybersecurity, Staffordshire University, Stoke-on-Trent ST4 2DE, UK
- Correspondence:
| | - Bader Alouffi
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif 21944, Saudi Arabia; (B.A.); (H.A.)
| | - Hashem Alyami
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif 21944, Saudi Arabia; (B.A.); (H.A.)
| | - Shahbaz Wasti
- Department of Information Sciences, University of Education Lahore, Lahore 41000, Pakistan; (M.I.U.L.); (S.W.)
| |
Collapse
|
|
34
|
Fujiyoshi MRA, Inoue H, Fujiyoshi Y, Nishikawa Y, Toshimori A, Shimamura Y, Tanabe M, Ikeda H, Onimaru M. Endoscopic Classifications of Early Gastric Cancer: A Literature Review. Cancers (Basel) 2021; 14:100. [PMID: 35008263 PMCID: PMC8750452 DOI: 10.3390/cancers14010100] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/04/2021] [Accepted: 12/22/2021] [Indexed: 12/14/2022] Open
Abstract
Endoscopic technologies have been continuously advancing throughout the years to facilitate improvement in the detection and diagnosis of gastric lesions. With the development of different endoscopic diagnostic modalities for EGC, several classifications have been advocated for the evaluation of gastric lesions, aiming for an early detection and diagnosis. Sufficient knowledge on the appearance of EGC on white light endoscopy is fundamental for early detection and management. On the other hand, those superficial EGC with subtle morphological changes that are challenging to be detected with white light endoscopy may now be clearly defined by means of image-enhanced endoscopy (IEE). By combining magnifying endoscopy and IEE, irregularities in the surface structures can be evaluated and highlighted, leading to improvements in EGC diagnostic accuracy. The main scope of this review article is to offer a closer look at the different classifications of EGC based on several endoscopic diagnostic modalities, as well as to introduce readers to newer and novel classifications, specifically developed for the stomach, for the assessment and diagnosis of gastric lesions.
Collapse
Affiliation(s)
- Mary Raina Angeli Fujiyoshi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo 135-8577, Japan; (H.I.); (Y.F.); (Y.N.); (A.T.); (Y.S.); (M.T.); (H.I.); (M.O.)
| | | | | | | | | | | | | | | | | |
Collapse
|
|
35
|
Kim GH. Systematic Endoscopic Approach to Early Gastric Cancer in Clinical Practice. Gut Liver 2021; 15:811-817. [PMID: 33790057 PMCID: PMC8593511 DOI: 10.5009/gnl20318] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/09/2020] [Accepted: 12/28/2020] [Indexed: 11/22/2022] Open
Abstract
Early gastric cancers (EGCs) are defined as gastric cancers confined to the mucosa or submucosa, regardless of regional lymph node metastasis. The proportion of EGCs has been increasing due to the increase in screening endoscopy for gastric cancers; therefore, the paradigm shift from surgical resection to endoscopic resection as a treatment modality for selected EGCs is accelerating. For successful endoscopic resection of EGCs, it is important to detect EGCs at an early stage and to accurately predict the histological type, depth of invasion, and horizontal margins of the tumor. The diagnostic process of EGCs can be divided into three steps: presence diagnosis, qualitative diagnosis, and quantitative diagnosis. The presence diagnosis of EGCs is mainly based on two endoscopic findings: a well-demarcated lesion and irregularity in the color/surface pattern. Qualitative diagnosis refers to the prediction of histological type, which is mainly possible based on the macroscopic shape and color of the lesion. Quantitative diagnosis of EGCs consists of predicting the depth of invasion by detailed examination of the macroscopic morphology and determining horizontal margins using chromoendoscopy. Although advanced diagnostic modalities, such as endosonography or magnifying endoscopy, are helpful for the qualitative and quantitative diagnosis of EGCs, these modalities are not available in most hospitals. Therefore, it is still very important to evaluate EGCs systematically during conventional endoscopy for successful endoscopic treatment.
Collapse
Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
|
36
|
Wang Q, Zhang SY, Wu X, Yao F, Zhou WX, Chai NL, Zhang ST, Hao JY, Wu J, Zhang JC, Xu BH, Hu LX, Yang AM. Feasibility of standardized procedures of white light gastroscopy for clinical practice: A multicenter study in China. J Dig Dis 2021; 22:656-662. [PMID: 34693636 DOI: 10.1111/1751-2980.13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to establish a standardized procedure for white light gastroscopy (WLG) to screen gastric lesions including early gastric cancer (EGC) in China and to verify its efficacy and feasibility in clinical practice. METHODS A standardized WLG procedure for outpatients at nine tertiary hospitals in Beijing was established. Clinical information of the participants and details of the endoscopic procedures were recorded. RESULTS A total of 1051 participants were enrolled in a baseline conventional endoscopic survey between March 2014 and December 2015, while 2156 patients were enrolled in the standardized WLG operation from January 2016 to June 2017. The procedure time of the standardized procedure was significantly longer than that of the baseline conventional procedure (P = 0.003). More images were obtained during the standardized procedure compared with the baseline conventional procedure (P < 0.001). The overall detection rate of gastric lesions in the standardized procedure group was significantly higher than that in the baseline procedure group (52.5% vs 38.4%, P < 0.01). The satisfaction scores of both participants and endoscopists in the standardized procedure group were significantly higher than in the baseline procedure group. CONCLUSIONS Compared with the conventional procedure, standardized WLG procedure significantly improves the detection rate of gastric lesions as well as the satisfaction score of participants and endoscopists despite its longer procedure time. It is effective and feasible in clinical practice in China for the use of currently available endoscopic equipment.
Collapse
Affiliation(s)
- Qiang Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sheng Yu Zhang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xi Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Fang Yao
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Xun Zhou
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ning Li Chai
- Department of Gastroenterology, General Hospital of the People's Liberation Army, Beijing, China
| | - Shu Tian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian Yu Hao
- Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jing Wu
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Ji Chang Zhang
- Gastrointestinal Cancer Center, Peking University Cancer Hospital, Beijing, China
| | - Bao Hong Xu
- Department of Gastroenterology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Li Xia Hu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ai Ming Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
|
37
|
pCLE highlights distinctive vascular patterns in early gastric cancer and in gastric diseases with high risk of malignant complications. Sci Rep 2021; 11:21053. [PMID: 34702885 PMCID: PMC8548395 DOI: 10.1038/s41598-021-00550-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/12/2021] [Indexed: 01/13/2023] Open
Abstract
Endoscopy is widely used to detect and diagnose precancerous lesions and gastric cancer (GC). The probe-based Confocal Laser Endomicroscopy (pCLE) is an endoscopic technique suitable for subcellular resolution and for microvasculature analyses. The aim of this study was to use pCLE to identify specific vascular patterns in high-risk and early stage GC. Mucosal architecture, vessel tortuosity, enlargements and leakage were assessed in patients with autoimmune gastritis and early gastric cancer (EGC). We were able to stratify gastritis patients by identifying distinct vascular profiles: gastritis was usually associated with increased vascularization characterized by a high number of tortuous vessels, which were also found in atrophic autoimmune disease. Leaky and tortuous vessels, distributed in a spatially irregular network, characterized the atrophic metaplastic mucosa. The mucosal vasculature of EGC patients displayed tortuous vessels, but unlike what detected in atrophic gastritis, they appeared patchy, as is in neoplastic gastric tissue. Very importantly, we detected vascular changes even in areas without lesions, supporting the contention that vascular alterations may provide a favorable microenvironment for carcinogenesis. This report confirms that pCLE is a valid endoscopic approach to improve the definition of patients with malignant lesions or at increased risk for GC by assessing vascular changes.
Collapse
|
|
38
|
Oh DJ, Nam JH, Park J, Hwang Y, Lim YJ. Gastric examination using a novel three-dimensional magnetically assisted capsule endoscope and a hand-held magnetic controller: A porcine model study. PLoS One 2021; 16:e0256519. [PMID: 34610019 PMCID: PMC8491884 DOI: 10.1371/journal.pone.0256519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/10/2021] [Indexed: 12/24/2022] Open
Abstract
Magnetically assisted capsule endoscopy (MACE) is a noninvasive procedure and can overcome passive capsule movement that limits gastric examination. MACE has been studied in many trials as an alternative to upper endoscopy. However, to increase diagnostic accuracy of various gastric lesions, MACE should be able to provide stereoscopic, clear images and to measure the size of a lesion. So, we conducted the animal experiment using a novel three-dimensional (3D) MACE and a new hand-held magnetic controller for gastric examination. The purpose of this study is to assess the performance and safety of 3D MACE and hand-held magnetic controller through the animal experiment. Subsequently, via the dedicated viewer, we evaluate whether 3D reconstruction images and clear images can be obtained and accurate lesion size can be measured. During real-time gastric examination, the maneuverability and visualization of 3D MACE were adequate. A polypoid mass lesion was incidentally observed at the lesser curvature side of the prepyloric antrum. The mass lesion was estimated to be 10.9 x 11.5 mm in the dedicated viewer, nearly the same size and shape as confirmed by upper endoscopy and postmortem examination. Also, 3D and clear images of the lesion were successfully reconstructed. This animal experiment demonstrates the accuracy and safety of 3D MACE. Further clinical studies are warranted to confirm the feasibility of 3D MACE for human gastric examination.
Collapse
Affiliation(s)
- Dong Jun Oh
- Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Ji Hyung Nam
- Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Junseok Park
- Digestive Disease Center, Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Youngbae Hwang
- Department of Electronics Engineering, Chungbuk National University, Cheongju, Republic of Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
- * E-mail:
| |
Collapse
|
|
39
|
Yang H, Hu B. Early gastrointestinal cancer: The application of artificial intelligence. Artif Intell Gastrointest Endosc 2021; 2:185-197. [DOI: 10.37126/aige.v2.i4.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/25/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Early gastrointestinal (GI) cancer has been the core of clinical endoscopic work. Its early detection and treatment are tightly associated with patients’ prognoses. As a novel technology, artificial intelligence has been improved and applied in the field of endoscopy. Studies on detection, diagnosis, risk, and prognosis evaluation of diseases in the GI tract have been in development, including precancerous lesions, adenoma, early GI cancers, and advanced GI cancers. In this review, research on esophagus, stomach, and colon was concluded, and associated with the process from precancerous lesions to early GI cancer, such as from Barrett’s esophagus to early esophageal cancer, from dysplasia to early gastric cancer, and from adenoma to early colonic cancer. A status quo of research on early GI cancers and artificial intelligence was provided.
Collapse
Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
|
40
|
Li HQ, Xue H, Yuan H, Wan GY, Zhang XY. Preferences of first-degree relatives of gastric cancer patients for gastric cancer screening: a discrete choice experiment. BMC Cancer 2021; 21:959. [PMID: 34445987 PMCID: PMC8393792 DOI: 10.1186/s12885-021-08677-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/12/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND It is very necessary to implement gastric cancer screening in China to reduce the mortality of gastric cancer, but there are no national screening guidelines and programs. Understanding of individual preferences is conducive to formulating more acceptable screening strategies, and discrete choice experiments can quantify individual preferences. In addition, the first-degree relatives of gastric cancer patients are at high risk for gastric cancer. Compared with those without a family history of gastric cancer, the risk of gastric cancer in first-degree relatives of gastric cancer patients is increased by 60%. Therefore, a discrete choice experiment was carried out to quantitatively analyse the preferences of first-degree relatives of gastric cancer patients for gastric cancer screening to serve as a reference for the development of gastric cancer screening strategies. METHODS A questionnaire was designed based on a discrete choice experiment, and 342 first-degree relatives of gastric cancer patients were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model. RESULTS The five attributes included in our study had a significant influence on the preferences of first-degree relatives of gastric cancer patients for gastric cancer screening (P < 0.05). Participants most preferred the sensitivity of the screening program to be 95% (coefficient = 1.424, P < 0.01) with a willingness to pay 2501.902 Yuan (95% CI, 738.074-4265.729). In addition, the participants' sex and screening experiences affected their preferences. An increase in sensitivity 35 to 95% had the greatest impact on the participants' willingness to choose a gastric cancer screening program. CONCLUSION The formulation of gastric cancer screening strategies should be rooted in people's preferences. The influence of sex differences and screening experiences on the preferences of people undergoing screening should be considered, and screening strategies should be formulated according to local conditions to help them play a greater role.
Collapse
Affiliation(s)
- Hui-Qin Li
- Department of Fundamental Nursing, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130021, Jilin Province, P. R. China
| | - Hui Xue
- Department of Histology & Embryology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun, 130021, Jilin Province, P. R. China
| | - Hua Yuan
- Department of Fundamental Nursing, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130021, Jilin Province, P. R. China
| | - Guang-Ying Wan
- Department of Fundamental Nursing, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130021, Jilin Province, P. R. China
| | - Xiu-Ying Zhang
- Department of Fundamental Nursing, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130021, Jilin Province, P. R. China.
| |
Collapse
|
|
41
|
Zhang W, Li Z, Akram MS, Rehman MFU, Khan NH, Hu D, Mustaqeem M, Zeng Y, Kanwal F. Gastric Cancer Screening Methods: A Comparative Study of Two Scoring Methods. Cancer Manag Res 2021; 13:5785-5791. [PMID: 34321925 PMCID: PMC8312504 DOI: 10.2147/cmar.s308395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/18/2021] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the Li’s and Japanese scoring methods scoring for screening early gastric cancer in a healthy population. Methods During January 2016–December 2018, profiles of the healthy people participated in a physical examination in the first people’s Hospital of Shanghai were collected. A total of 342 volunteers, including 137 males and 205 females ageing 40–74, were enrolled. After recording the basic information, all volunteers were scored using the Japan scoring method and the new gastric cancer screening score (ie, Li’s score). The subjects’ work characteristics (ROC curve) were drawn according to the patient’s endoscopic pathological examination to indicate early gastric cancer, to determine the best cut-off point for the diagnosis of early gastric cancer by Japanese scoring and Li’s scoring, respectively. The sensitivity and specificity of both scoring methods were calculated as well. Results The area under the ROC curve of Japanese and Li’s score, in the diagnosis of early gastric cancer, was 0.763 and 0.837, respectively. Japanese and Li’s score ≥14 were considered as the best cut-off point. The sensitivity and specificity of Li’s scoring were 63.60% and 91.10%, respectively. The sensitivity and specificity of the Japanese score were 54.50% and 87.50%, respectively. The area under the ROC curve in Li’s scoring is more significant than that in Japanese scoring, and there was a substantial difference in the two methods (P<0.05). Conclusion Both Li’s scoring and Japanese scoring have shown good screening value for early gastric cancer in a healthy population, but Li’s scoring is more sensitive/specific than Japanese scoring.
Collapse
Affiliation(s)
- Weixing Zhang
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Zhangzhi Li
- Department of Hematology, Taihe Hospital, Hubei University of Medicine, Hubei, 442000, People's Republic of China
| | | | | | - Nazeer Hussain Khan
- Henan International Key Laboratory of Nuclear Protein, School of Life Sciences, Henan University Kaifeng, Henan, 475004, People's Republic of China.,Laboratory of Animal and Human Physiology, Department of Biological Sciences, Quaid I Azam University, Islamabad, 45320, Pakistan
| | - Dan Hu
- Department of Neurology, The Central Hospital of Xiaogan, Hubei, 432100, People's Republic of China
| | - Muhammad Mustaqeem
- Department of Chemistry, University of Sargodha, Sub Campus Bhakkar, Bhakkar, 30000, Pakistan
| | - Yuanyuan Zeng
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Fariha Kanwal
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| |
Collapse
|
|
42
|
Li X, Gu X, Xu J, Chen L, Li H, Meng D, Bai H, Yang J, Qian J. Sustained Clinical Benefit of Pyrotinib Combined with Capecitabine Rescue Therapy After Trastuzumab Resistance in HER2-Positive Advanced Gastric Cancer: A Case Report. Onco Targets Ther 2021; 14:3983-3989. [PMID: 34234467 PMCID: PMC8257064 DOI: 10.2147/ott.s310421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background HER2-positive patients with advanced gastric cancer have a poor prognosis, and trastuzumab-resistant patients lack effective treatment. Case Presentation We report a 72-year-old male with HER2-positive gastric cancer. The patient had metastatic tumor during adjuvant chemotherapy after surgery, followed by second-line chemotherapy, and achieved a progression-free survival (PFS) of 4.5 months. Subsequent third-line chemotherapy treatment also failed. Fortunately, the patient had a significant tumor response and 8.5 months of PFS on trastuzumab combined with chemotherapy. After trastuzumab resistance, the patient was treated with programmed cell death protein-1 inhibitor combined with apatinib, which selectively inhibited VEGFR2, but the effect was not satisfactory. Finally, the patient was treated with capecitabine combined with pyrotinib, an irreversible TKI, acting on HER2. The tumor shrank significantly after this treatment. Conclusion The mechanism and countermeasures of trastuzumab resistance were discussed in this case. For patients with HER2-positive advanced gastric cancer, pyrotinib can achieve good results after trastuzumab resistance.
Collapse
Affiliation(s)
- Xin Li
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Xiaoqiang Gu
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Jiahua Xu
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Ling Chen
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200437, People's Republic of China
| | - Hongwei Li
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Dan Meng
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Haoran Bai
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Jinzu Yang
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| | - Jianxin Qian
- Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, 200032, People's Republic of China
| |
Collapse
|
|
43
|
Kotelevets SM, Chekh SA, Chukov SZ. Updated Kimura-Takemoto classification of atrophic gastritis. World J Clin Cases 2021; 9:3014-3023. [PMID: 33969087 PMCID: PMC8080746 DOI: 10.12998/wjcc.v9.i13.3014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/01/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy via endoscopic observation is subject to sampling error and interobserver variability. The Kimura-Takemoto classification system was developed to overcome these limitations.
AIM To compare the morphological classification of atrophic gastritis between the Kimura-Takemoto system and the Updated Sydney system.
METHODS A total of 169 patients with atrophic gastritis were selected according to diagnosis by the visual endoscopic Kimura-Takemoto method. Following the Updated Kimura-Takemoto classification system, one antrum biopsy and five gastric corpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was then applied to each and showed 165 to have histological mucosal atrophy; the remaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a reference morphological method and applied for the diagnosis of atrophic gastritis. Adding one more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.
RESULTS The sensitivity for degree of mucosal atrophy assessed by the Updated Sydney system was 25% for mild, 36% for moderate, and 42% for severe, when compared with the Updated Kimura-Takemoto classification of atrophic gastritis for morphological diagnosis. Four types of multifocal atrophic gastritis were identified: sequential uniform (type 1; in 28%), sequential non-uniform (type 2; in 7%), diffuse uniform (type 3; in 23%), diffuse non-uniform (type 4; in 24%), and "alternating atrophic – non-atrophic" (type 5; in 18%). The pattern of the spread of atrophy, sequentially from the antrum to the cardiac segment of the stomach, which was described by the Updated Kimura-Takemoto system, was histologically confirmed in 82% of cases evaluated.
CONCLUSION The Updated Sydney system is significantly inferior to the Updated Kimura-Takemoto classification for morphological verification of atrophic gastritis.
Collapse
Affiliation(s)
- Sergey M Kotelevets
- Department of Therapy, Medical Institute, North Caucasus State Academy for Humanities and Technologies, Cherkessk 369000, Russia
| | - Sergey A Chekh
- Department of Software Development, Institute of Applied Mathematics and Information Technology, North Caucasus State Academy of Humanities and Technologies, Cherkessk 369000, Russia
- Department of Mathematics, Institute of Applied Mathematics and Information Technology, North Caucasus State Academy of Humanities and Technologies, Cherkessk 369000, Russia
| | - Sergey Z Chukov
- Department of Pathological Anatomy, Stavropol State Medical University, Stavropol 355017, Russia
| |
Collapse
|
|
44
|
Liu XM, Tang XY, Xu SJ. Application of Kyoto Classification of Gastritis to gastric cancer screening in a primary hospital. Shijie Huaren Xiaohua Zazhi 2021; 29:407-412. [DOI: 10.11569/wcjd.v29.i8.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric cancer is a common malignant digestive system tumor in China, and its prognosis is closely related to the early diagnosis and treatment. The rate of early gastric cancer is less than 10% in China, which is far less than those in Japan (70%) and Korea (50%). Standardization of gastroscopic diagnosis and finding gastric cancer screening program suitable for China are of great significance.
AIM To explore the clinical value of Kyoto Classification of Gastritis in gastric cancer screening in primary hospitals.
METHODS The Kyoto Classification of Gastritisg was used to retrospectively analyze the data of patients who visited Shekou People's Hospital of Shenzhen for digestive symptoms from September 2019 to November 2020 and met the new system for gastric cancer screening requirements. All patients were divided into three groups according to the grading results of the Kyoto Classification of Gastritis: Low-score group (< 2 points), medium-score group (≥ 2 points but < 4 points), and high-score group(≥ 4 points). A comparative analysis was performed on the detection of gastric cancer among the three groups.
RESULTS A total of 1383 patients were included in this study, including 918 (66.4%) in the low-score group, 290 (20.9%) in the medium-score group, and 175 (12.7%) in the high-score group. The total detection rate of gastric cancer was 3.54% (49/1383). There were significant differences in the detection rates of gastric cancer between any two of the three groups (P < 0.05).
CONCLUSION The Kyoto Classification of Gastritis can significantly improve the detection rate of early gastric cancer and gastric cancer.
Collapse
Affiliation(s)
- Xiao-Ming Liu
- Department of Gastroenterology, Shekou People's Hospital, Shenzhen 510001, Guangdong Province, China
| | - Xiang-Yu Tang
- Department of Gastroenterology, Shekou People's Hospital, Shenzhen 510001, Guangdong Province, China
| | - Shu-Jia Xu
- Department of Gastroenterology, Shekou People's Hospital, Shenzhen 510001, Guangdong Province, China
| |
Collapse
|
|
45
|
Chen L, Wang L, Li X, Zhang G, Li Z, Wang Y. Clinic-Pathological Characteristics and Prognostic Value of PD-L1 and HER2 in Gastric Cancer. DNA Cell Biol 2021; 40:405-413. [PMID: 33605797 DOI: 10.1089/dna.2020.6232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this study is to study the relationship between programmed cell death-1 ligand (PD-L1) and human epidermal growth receptor 2 (HER2) and the clinical-pathological features of gastric cancer (GC) and its predictive effect on the prognosis of gastric cancer (GC) patients. A retrospective analysis was performed on 113 patients undergoing GC surgery. The expression of PD-L1 and HER2 in GC and paired adjacent nontumor tissues was detected by immunohistochemistry or fluorescence in situ hybridization, and the relationships between PD-L1 and HER2 expression and clinical-pathological features and survival were analyzed by chi-square analysis, Pearson analysis, logistic regression analysis, Kaplan-Meier analysis, and Cox regression model. PD-L1 and HER2 were expressed in tumor tissues, but not in adjacent nontumor tissues. There was no correlation between the expression of PD-L1 and HER2. The expression of PD-L1 in GC was closely related to gender (p = 0.019), regional lymph node (p = 0.006), metastasis (p = 0.033), and survival status (p = 0.033), while HER2 was closely related to tumor differentiation (p = 0.033), regional lymph node (p = 0.016), and tumor-node-metastasis (TNM) stage (p = 0.036). The survival time of PD-L1-positive patients was longer than that of PD-L1-negative patients (p = 0.020). The expression of HER2 showed no difference in overall survival (p = 0.125). Multivariate analysis suggested that the TNM stage (p = 0.001) and PD-L1 expression (p = 0.047) were independent prognostic factors for survival time of GC. The expression of PD-L1 has biological significance in GC, which is closely related to the clinical-pathological characteristics and prognosis of GC patients.
Collapse
Affiliation(s)
- Ling Chen
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Liyu Wang
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Xin Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Guangtao Zhang
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Zhaoyan Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Yanwen Wang
- Department of Pathology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| |
Collapse
|
|
46
|
The Significance of Exosomal RNAs in the Development, Diagnosis, and Treatment of Gastric Cancer. Genes (Basel) 2021; 12:genes12010073. [PMID: 33430032 PMCID: PMC7826966 DOI: 10.3390/genes12010073] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
Gastric cancer (GC) is one of the most common malignancies in the world. Exosomes, a subset of extracellular vesicles with an average diameter of 100 nm, contain and transfer a variety of functional macromolecules such as proteins, lipids, and nucleic acids. A large number of studies indicated that exosomes can play a significant role in the initiation and development of GC via facilitating intercellular communication between gastric cancer cells and microenvironment. Exosomal RNAs, one of the key functional cargos, are involved in the pathogenesis, development, and metastasis of GC. In addition, recent studies elucidated that exosomal RNAs may serve as diagnostic and prognostic biomarkers or therapeutic targets for GC. In this review, we summarized the function of exosomal RNA in the tumorigenesis, progression, diagnosis, and treatment of GC, which may further unveil the functions of exosome and promote the potentially diagnostic and therapeutic application of exosomes in GC.
Collapse
|
|
47
|
Mahawongkajit P, Kanlerd A. A prospective randomized controlled trial comparing simethicone, N-acetylcysteine, sodium bicarbonate and peppermint for visualization in upper gastrointestinal endoscopy. Surg Endosc 2021; 35:303-308. [PMID: 32016519 DOI: 10.1007/s00464-020-07397-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/28/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Early cancer detection is crucial in improving the patients' quality of life and upper gastrointestinal endoscopy (EGD) plays a key role in this detection. Many clearing mechanisms may be applied to create good endoscopic visualizations for the upper gastrointestinal tract using mucolytic agents, antifoaming agents, proteolytic enzymes and neutralizers. The aim of this study is to compare the effects of simethicone, N-acetylcysteine (NAC), sodium bicarbonate and peppermint as pre-medications for visualization of esophagogastroduodenoscopy (EGD). METHODS This study was a single center prospective randomized controlled trial. The patients were randomly allocated to one of four treatment groups. Group A: water; Group B: water with simethicone; Group C: water with simethicone plus NAC 600 mg; Group D: water with simethicone, NAC, sodium bicarbonate and peppermint. RESULTS A total of 128 patients were enrolled and evaluated in this study. Total visibility score (TVS) of Groups A, B, C, and D were 13.4 ± 1.86, 10.5 ± 1.45, 7.15 ± 0.98 and 6.4 ± 1.43, respectively. Group D showed lower TVS than other groups. The procedural durations of Groups C and D were significantly shorter than Group A. The volume of solution for mucosal cleansing of Groups C and D was significantly lower than Groups A and B. CONCLUSIONS The application of simethicone plus NAC is safe, improves endoscopic visualization and requires a minimal amount of mucosal cleansing solution. The addition of sodium bicarbonate and peppermint further improved visualization for the upper and lower gastric body. Thai Clinical Trials Registry (TCTR) with a reference number; TCTR20190501002.
Collapse
Affiliation(s)
- Prasit Mahawongkajit
- Department of Surgery, Faculty of Medicine, Thammasat University (Rangsit Campus), 99/209 Moo 18, Paholyothin Road, Amphur Klongluang, Pathumthani, 12120, Thailand.
| | - Amonpon Kanlerd
- Department of Surgery, Faculty of Medicine, Thammasat University (Rangsit Campus), 99/209 Moo 18, Paholyothin Road, Amphur Klongluang, Pathumthani, 12120, Thailand
| |
Collapse
|
|
48
|
An P, Yang D, Wang J, Wu L, Zhou J, Zeng Z, Huang X, Xiao Y, Hu S, Chen Y, Yao F, Guo M, Wu Q, Yang Y, Yu H. A deep learning method for delineating early gastric cancer resection margin under chromoendoscopy and white light endoscopy. Gastric Cancer 2020; 23:884-892. [PMID: 32356118 DOI: 10.1007/s10120-020-01071-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accurate delineation of cancer margins is critical for endoscopic curative resection. This study aimed to train and validate real-time fully convolutional networks for delineating the resection margin of early gastric cancer (EGC) under indigo carmine chromoendoscopy (CE) or white light endoscopy (WLE), and evaluated its performance and that of magnifying endoscopy with narrow-band imaging (ME-NBI). METHODS We collected CE and WLE images of EGC lesions to train fully convolutional networks ENDOANGEL. ENDOANGEL was tested both on stationary images and endoscopic submucosal dissection (ESD) videos. The accuracy and reliability of ENDOANGEL and NBI-dependent delineation were further evaluated by a novel endoscopy-pathology point-to-point marking. RESULTS ENDOANGEL had an accuracy of 85.7% in the CE images and 88.9% in the WLE images under an overlap ratio threshold of 0.60 in comparison with the manual markers labeled by the experts. In the ESD videos, the resection margins predicted by ENDOANGEL covered all areas of high-grade intraepithelial neoplasia and cancers. The minimum distance between the margins predicted by ENDOANGEL and the histological cancer boundary was 3.44 ± 1.45 mm which outperformed the resection margin based on ME-NBI. CONCLUSIONS ENDOANGEL has the potential to assist endoscopists in delineating the resection extent of EGC under CE or WLE during ESD.
Collapse
Affiliation(s)
- Ping An
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dongmei Yang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lianlian Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jie Zhou
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhi Zeng
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xu Huang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yong Xiao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shan Hu
- School of Resources and Environmental Sciences of Wuhan University, Wuhan, China
| | - Yiyun Chen
- School of Resources and Environmental Sciences of Wuhan University, Wuhan, China
| | - Fang Yao
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingwen Guo
- Department of Gastroenterology, The first hospital of Yichang, Yichang, China
| | - Qi Wu
- Department of Endoscopy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yanning Yang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
| | - Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China.
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China.
| |
Collapse
|
|
49
|
Zhu X, Xie X, Zhao Q, Zhang L, Li C, Zhao D. Potential Prognostic Value and Mechanism of Stromal-Immune Signature in Tumor Microenvironment for Stomach Adenocarcinoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4673153. [PMID: 32685487 PMCID: PMC7335387 DOI: 10.1155/2020/4673153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/22/2020] [Indexed: 02/07/2023]
Abstract
Stomach adenocarcinoma (STAD) is one of the most common malignancies. But the molecular mechanism is unknown. In this study, we downloaded the transcriptional profiles and clinical data of 344 STAD and 30 normal samples from The Cancer Genome Atlas (TCGA) database. Stromal and immune scores of STAD were calculated by the Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data (ESTIMATE) algorithm, and association of stromal/immune scores with tumor differentiation/T/N/M stage and survival was investigated. The differentially expressed genes (DEGs) between high and low score groups (based on media) were identified, and prognostic genes over-/underexpressed in both STAD and stromal/immune signature were retrieved. Furthermore, proportions of 22 infiltrating immune cells for the cohort from TCGA were estimated by the Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) algorithm, and association of 22 immune cells with tumor differentiation/T/N/M stage and survival was investigated. Next, coexpression analysis of 22 immune cells and intersection genes over-/underexpressed in both STAD and stromal signature was conducted. We found high stromal and immune scores and macrophage infiltration predicting poor tumor differentiation and severe local invasion, obtained a list of prognostic genes based on stromal-immune signature, and explored the interaction of collagen, chemokines such as CXCL9, CXCL10, and CXCL11, and macrophage through coexpression analysis and may provide novel prognostic biomarkers and immunotherapeutic targets for STAD.
Collapse
Affiliation(s)
- Xinying Zhu
- Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang, 050000 Hebei Province, China
- Department of Gastroenterology, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
| | - Xiaoli Xie
- Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang, 050000 Hebei Province, China
| | - Qingchao Zhao
- Department of Gastroenterology, Second Hospital of Baoding, Baoding, 071051 Hebei Province, China
| | - Lixian Zhang
- Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang, 050000 Hebei Province, China
| | - Changjuan Li
- Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang, 050000 Hebei Province, China
| | - Dongqiang Zhao
- Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang, 050000 Hebei Province, China
| |
Collapse
|
|
50
|
Li X, Yang J, Gu X, Xu J, Li H, Qian J, Chen L. The Expression and Clinical Significance of Aldo-Keto Reductase 1 Member B1 in Gastric Carcinoma. DNA Cell Biol 2020; 39:1322-1327. [PMID: 32412859 DOI: 10.1089/dna.2020.5550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To study the expression of aldo-keto reductase 1 member B1 (AKR1B1) in gastric carcinoma (GC), the correlation between AKR1B1 and the clinicopathological characteristics of GC patients, and provide reference for the diagnosis and prognosis of GC patients. One hundred thirty-six patients with GC were collected, and the expression level of AKR1B1 in GC and adjacent tissues was detected by immunohistochemistry assays. The clinicopathological features and prognosis of GC patients were collected to analyze the relationship with AKR1B1 expression. The positive expression of AKR1B1 in GC tissues was significantly higher than that of adjacent nontumor tissues. The difference of AKR1B1 expression between GC tissues and paired adjacent nontumor tissues was statistically significant (p < 0.001). AKR1B1 was closely related to tumor size, regional lymph node (N), metastases (M), and tumor-node-metastasis (TNM) stage (p < 0.05). The overall survival of patients with low expression of AKR1B1 was significantly better than that of patients with high expression of AKR1B1 by Kaplan-Meier survival analysis (p < 0.001). AKR1B1 plays an important role in the occurrence and development of GC, and it has a certain reference value for the prognosis of GC patients.
Collapse
Affiliation(s)
- Xin Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jinzu Yang
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Xiaoqiang Gu
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jiahua Xu
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Hongwei Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jianxin Qian
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Ling Chen
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| |
Collapse
|