Prevalence, clinical characteristics and treatment outcomes of oxyntic gland neoplasm: a single-center retrospective study.

BACKGROUND: Oxyntic gland neoplasm (OGN) is a rare subtype of gastric cancer. The aim of this study is to evaluate the prevalence, clinicopathological features, effectiveness and safety of endoscopic treatment, as well as the prognosis of OGN. METHODS: We retrospectively analyzed the data of patients pathologically diagnosed with OGN at our hospital from November 1, 2019 to May 1, 2023. RESULTS: A total of 36 patients with 45 lesions were identified, resulting in a disease frequency of 0.047% (36/76,832). The mean age was 55.0 ± 7.5 years, with a male-to-female ratio of about 1:1.12. Most lesions were ≤10 mm in size (84.4%), located in the upper third of the stomach (73.3%), exhibited slight elevation (75.5%), appeared whitish (55%), had dilated blood vessels on the surface (75.5%). 16 and 21 lesions were treated by precutting endoscopic mucosal resection (EMR-P) and endoscopic submucosal dissection (ESD), respectively. No significant differences were found between EMR-P and ESD in terms of en bloc resection rate (100% vs 100%, p = 1.000), complete resection rate (100% vs 90.5%, p = 0.495), and curative resection rate (93.8% vs 90.5%, p = 1.000). No complications such as bleeding and perforation were observed. No recurrence or metastasis was observed during the follow-up period. CONCLUSIONS: OGN is a rare tumor with unique clinical, endoscopic, and pathological characteristics. EMR-P and ESD are deemed safe and effective for treating OGNs. The relatively faster and easier EMR-P seems at least non-inferior to ESD, especially for removal of smaller OGNs. The overall prognosis is favorable.

Clinicopathological characteristics of autoimmune gastritis: A single-center retrospective study.

BACKGROUND AND AIM: Autoimmune gastritis (AIG) is a prominent risk factor for pernicious anemia (PA) and gastric neoplasia. This study aimed to investigate the clinicopathological characteristics of AIG patients in China, with a focus on those who had positive anti-intrinsic factor antibodies (AIFA). METHODS: A total of 103 AIG patients who were diagnosed between January 2018 and August 2022 were reviewed in a large academic tertiary teaching hospital. Patients were divided into two groups based on the presence or absence of AIFA, and their serologic and histopathological characteristics were analyzed. RESULTS: The mean age of the 103 AIG patients was 54.16±11.92 years (range 23-79), with 69 (66.99%) being women. AIFA were present in 28.16% of patients. Patients with AIFA-positive had a higher risk of PA than those with AIFA-negative, as demonstrated by a larger mean corpuscular volume (MCV), lower hemoglobin level, and lower vitamin B-12 level (P<0.05). There were no statistically significant differences in gastric histopathology, gastrin level, and pepsinogen level when patients were divided into AIFA-positive and AIFA-negative group. Of the 103 cases, 34 (33.01%) were concomitant with other autoimmune diseases, with autoimmune thyroid diseases being the most common (25.24%, 26/103). Thyroid peroxidase antibody, which accounted for 45.45% (25/55), was the most prevalent thyroid antibody, followed by anti-thyroglobulin antibody (34.55%, 19/55), thyroid stimulating antibody (12.73%, 7/55), and thyrotropin receptor antibody (3.64%, 2/55). CONCLUSION: This study highlights the increased risk of severe anemia in AIFA-positive AIG patients, particularly for PA. Clinicians should consider the presence of AIFA as a warning sign for PA and prioritize early diagnosis and appropriate treatment to prevent serious complications.

The detection rate of granulomas differs between intestinal segments and lesions in Chinese patients with Crohn's disease.

BACKGROUND: Crohn's disease (CD) is characterized by non-caseating intestinal granulomas. However, the reported detection rate of granulomas on endoscopy is low. This study aimed to analyze the differences in the detection rate of granulomas in different intestinal segments and lesions in Chinese patients with CD to improve the detection rate of granulomas in clinical practice. PATIENTS AND METHODS: 113 patients with CD were analyzed retrospectively. Patients were divided into two groups: those with (n = 51) and without granulomas (n = 62) on endoscopic biopsies. Clinical information was collected from the medical records, including age; erythrocyte sedimentation rate (ESR); C-reactive protein (CRP), albumin, and hemoglobin (Hb) levels; platelet count; disease course; sex; smoking history; related operation history; Montreal classification; and lesion location, size, and shape. RESULTS: The detection rates of granulomas in different lesion shapes were significantly different (P < 0.001), with those of longitudinal ulcers and circular ulcers being higher than those of erosion and irregular ulcers. We also found that the detection rates of granulomas in ascending colon and sigmoid colon were relatively higher than other segments of the intestine, however, the difference was not statistically significant (P = 0.716). Additionally, age, sex, smoking history, Montreal classification, related surgical history, disease course, and serum biochemical indicators (ESR; platelet count; and CRP, albumin, and Hb levels) were not significantly different between the two groups. CONCLUSIONS: The detection rate of granulomas in patients with CD is related to the morphology of the intestinal lesions. Meanwhile, lesion location may be correlated with the detection rate of granulomas.

Efficacy and safety profile of two-dose SARS-CoV-2 vaccines in cancer patients: An observational study in China.

BACKGROUND: The new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has produced a global pandemic of coronavirus disease 2019 (COVID-19), resulting in modifications to public health policies on a universal scale. SARS-CoV-2 vaccine has evolved as the most effective and secure way for protecting healthy individuals against COVID-19. Patients with cancer were excluded from clinical trials due to their increased COVID-19 risk and current immunosuppressing therapy. Safety and effectiveness evidence is insufficient for SARS-CoV-2 vaccination in cancer patients. AIM: To assess the efficacy and safety of two-dose SARS-CoV-2 vaccines in cancer patients. METHODS: A multicenter observational study was performed at ten Chinese hospitals between January 1, 2021 and December 31, 2021. Each participant in the research received two doses of vaccination. A total of 215 healthy people were screened and 132 eligible patients with cancer were recruited. In order to verify the safety of the second dose of the vaccine, a side-effect report was compiled. Two weeks following the second vaccination dose, subjects underwent an analogous questionnaire survey. Utilizing a magnetic particle-based chemiluminescence immunoassay, serum levels of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies were measured to determine the effectiveness of vaccination. IgG levels ≥ 10 AU/mL were considered seropositive. RESULTS: All the 347 eligible patients completed the follow-up, and anti-SARS-CoV-2 IgG antibodies were detected. Local pain at the injection location was the most common side effect mentioned by all responders, with an increased incidence in cancer patients than the healthy people after the second dose vaccine (17.2% vs 9.1%; P = 0.035). There was no significant difference in headache, urticaria, or other adverse reactions between patients with cancer and healthy people. In the group of cancer patients, the seropositivity incidence was 83.3%, while it was 96.3% in the group of healthy people. In the group of cancer patients, the seropositivity incidence and antibody levels were significantly lower (P < 0.001). This analysis showed a poorer response rate in patients on active immunosuppressive treatment and elderly cancer patients. CONCLUSION: Two-dose Chinese vaccines are effective and safe in cancer patients. However, further research is required on the efficacy in elderly cancer patients and those on active immunosuppressive treatment.

Texture analysis of contrast-enhanced magnetic resonance imaging predicts microvascular invasion in hepatocellular carcinoma.

BACKGROUND: Microvascular invasion is one of the important risk factors of postoperative recurrence of hepatocellular carcinoma. Texture analysis uses mathematical methods to analyze the gray's quantitative value and distribution of images, for quantifying the heterogeneity of tissues. PURPOSE: To investigate the feasibility of predicting MVI in HCC by analyzing the texture features of hepatic MR-enhanced images. METHODS: 110 patients with HCC who underwent MR-enhanced examinations were included in this study, were divided into MVI-positive group (n = 52) and MVI-negative group (n = 58) according to postoperative pathology. Clinical, pathological data and MR imaging features were collected. 11 texture parameters were selected from the gray histogram and gray level co-occurrence matrix (GLCM). Texture parameters of MR-enhanced images were calculated for statistical analysis. RESULTS: There were statistically significant differences in tumor size, location, degree of differentiation, AFP level, signal, pseudocapsule, margin, peritumoral enhancement and intratumoral artery between MVI-positive group and MVI-negative group (P < 0.05). The AUC value of combining MR image features in prediction of MVI was 0.693(sensitivity and specificity: 53.8 %, 82.8 %, respectively). There were statistically significant differences in the texture parameters of GLCM between two groups (P < 0.05). The AUC value of combining texture parameters in prediction of MVI was 0.797 (sensitivity and specificity: 88.2 %, 62.7 %, respectively). CONCLUSION: MR image features and texture analysis have certain predictive effect on MVI, which are mutually verified and complementary. The texture parameters of GLCM could reflect tumor heterogeneity, which have great potential to help with preoperative decision. The combination of MR image features and texture analysis may improve the efficiency in prediction of MVI.

[Recent advances in therapy of follicular lymphoma].

Follicular lymphoma is a common pathological subtypes of lymphoma, it ranked only second to diffuse large B-cell lymphoma, accounts for 22% of non Hodgkin's lymphoma. Follicular lymphoma is a displaying biologically and clinically diverse disease. Patients may present indolent, asymptomatic disease or more aggressive, symptomatic disease with high tumor burden. Decision-making to treat in the frontline is based on histology manifestation, tumor burden and patient symptoms. Treatment for follicular lymphoma includes radiotherapy, chemotherapy, immunological therapy and autologous stem cell transplantation or allogeneic stem cell transplantation.Radiation therapy is the first treatment of early stage follicular lymphoma. For advanced follicular lymphoma chemotherapy, chemotherapy combined immunotherapy or immune radiotherapy, stem cell transplantation may be chosen. In recent years, drugs for lymphoma including bortezomib, lenalidomide, Ofatumumab, Epratuzumab and so on, and the therapeutic scheme present more and more update. In this article the advances of treatment for follicular lymphoma are summarzied.

Glycoprotein nonmetastatic B as a prognostic indicator in small cell lung cancer.

Glycoprotein nonmetastatic melanoma B (GPNMB) is a type I transmembrane glycoprotein which is overexpressed in many tumors and seems to play a critical role in metastasis of malignant tumors. The purpose of this study was to determine GPNMB expression in small cell lung cancer (SCLC) and analyze the prognostic value in patients with SCLC. A total of 132 cases of SCLCs were analyzed immunohistochemically on tissue microarrays (TMAs). Patients were divided into weak-positive and strong-positive GPNMB groups. In addition, serum GPNMB was evaluated by enzyme-linked immunosorbent assay (ELISA). The average serum GPNMB concentration was 1054.15 ± 363.71 pg/mL in the weak-positive group, 2611.52 ± 457.57 pg/mL in the strong-positive group, and 427.61 ± 273.9 pg/mL in the control. The strong-positive group showed significantly higher serum GPNMB levels than the weak-positive group and healthy control (p < 0.01). Overall survival in the weak-positive GPNMB group was significantly longer than in the strong-positive group (27 months vs 15 months, p < 0.01). These results suggest that the expression of GPNMB may be useful as a prognostic indicator in patients with SCLC.

Ischemic neurons activate astrocytes to disrupt endothelial barrier via increasing VEGF expression.

Blood-brain barrier (BBB) disruption occurring within the first few hours of ischemic stroke onset is closely associated with hemorrhagic transformation following thrombolytic therapy. However, the mechanism of this acute BBB disruption remains unclear. In the neurovascular unit, neurons do not have direct contact with the endothelial barrier; however, they are highly sensitive and vulnerable to ischemic injury, and may act as the initiator for disrupting BBB when cerebral ischemia occurs. Herein, we employed oxygen-glucose deprivation (OGD) and an in vitro BBB system consisting of brain microvascular cells and astrocytes to test this hypothesis. Neurons (CATH.a cells) were exposed to OGD for 3-h before co-culturing with endothelial monolayer (bEnd 3 cells), or endothelial cells plus astrocytes (C8-D1A cells). Incubation of OGD-treated neurons with endothelial monolayer alone did not increase endothelial permeability. However, when astrocytes were present, the endothelial permeability was significantly increased, which was accompanied by loss of occludin and claudin-5 proteins as well as increased vascular endothelial growth factor (VEGF) secretion into the conditioned medium. Importantly, all these changes were abolished when VEGF was knocked down in astrocytes by siRNA. Our findings suggest that ischemic neurons activate astrocytes to increase VEGF production, which in turn induces endothelial barrier disruption.