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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(2): 166-169, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33829686

RESUMEN

The incidence of gastric cancer is the highest among all kinds of malignant tumors in China. Because gastric cancer is very hard to identify in its early stage, the early diagnosis rate of gastric cancer in China is relatively low. At present, the pathological diagnosis of gastric cancer mainly depends on the diagnosis of pathologists. However, the gradual improvement of people's living standards and the growing demand for medical and health care have exacerbated the shortage of medical resources, which has become a even more serious problem. Therefore, there is an urgent need for new technologies to help deal with this challenge. In recent years, with the rapid development of artificial intelligence (AI) and digital pathology, AI-aided pathological diagnosis based on convolutional neural network (CNN) as the core technology is showing promises for improving the diagnostic efficiency of gastric cancer. It is also of great significance for the early diagnosis and treatment of the disease and the reduction of its high incidence and mortality. We herein summarize the application and progress of deep-learning CNN in pathological diagnosis of gastric cancer, as well as the existing problems and prospects of future development.


Asunto(s)
Neoplasias Gástricas , Inteligencia Artificial , China/epidemiología , Humanos , Redes Neurales de la Computación , Neoplasias Gástricas/diagnóstico
2.
Zhonghua Yi Xue Za Zhi ; 101(11): 808-812, 2021 Mar 23.
Artículo en Chino | MEDLINE | ID: mdl-33765723

RESUMEN

Objective: Explore the feasibility of fecal gene methylation for screening gastric cancer and its relationship with clinical characteristics of gastric cancer patients. Methods: One hundred and fifty-six stool samples of patients in general surgery or digestive department of the First Affiliated Hospital of Soochow University from August 2018 to December 2019 were collected, detailed clinical information of gastric cancer patients were recorded. All patients and normal controls were divided into two sets including train sets (n=52)and test sets (n=104). Stool DNA was extracted for detection of methylation (SDC2, SFRP2, RASSF2 and TERT). Meanwhile, hemoglobin in stool samples were detected by immunoassays. A logistic regression model was built to analyze the sensitivity and specificity of single fecal DNA biomarker in detecting gastric cancer by Ct values of each stool-based DNA biomarker; Based on Akaike information criterion (AIC), the gastric cancer early screening model was constructed with each biomarker and the combinations, and evaluate the performance of the model in the test sets. Results: The accuracy of each stool biomarkers and their ranks were showed as SDC2(71.2%)>TERT(67.3%)=RASSF2(67.3%)>Hb(63.5%)>SFRP2(61.5%). By stepwise regression analysis, a combination composed of the methylation of SDC2 and TERT, fecal occult blood testing was well-behaved in the screening of gastric cancer.This combination showed a sensitivity of 66.7% for gastric cancer in train sets and test sets at the specificity of 78.9%. In different stages and parts of gastric cancer samples, the combination of this marker has the highest sensitivity in stage I gastric cancer(78.6%) and gastric body cancer(75.0%). Conclusion: The methylation of SDC2, SFRP2, TERT, RASSF2 has higher accuracy rate in the screening of gastric cancer, which is a potential fecal biomarker of gastric cancer.


Asunto(s)
Neoplasias Colorrectales , Neoplasias Gástricas , Biomarcadores de Tumor/genética , Neoplasias Colorrectales/genética , Metilación de ADN , Detección Precoz del Cáncer , Heces , Humanos , Sensibilidad y Especificidad , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Proteínas Supresoras de Tumor
3.
Medicine (Baltimore) ; 100(12): e24697, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761637

RESUMEN

RATIONALE: Carcinosarcoma and sarcomatoid carcinoma of the stomach are rare, malignant, and biphasic tumors with high mortality. The differential diagnosis of these 2 diseases remains challenging. In the present study, we present 2 cases of carcinosarcoma and sarcomatoid carcinoma of the stomach. PATIENT CONCERNS: A 54-year-old woman was admitted with complaints of epigastric pain for 4 months, but she became serious for 10 days accompanied by melena. A 75-year-old man was admitted with complaints of epigastric pain for 1 month. DIAGNOSIS: The female had a Borrmann type III irregular ulcerative lesion (5.0 × 4.0 × 1.0 cm) originating from the gastric antrum. The male had Borrmann type I tumor polypoid exophytic (5.0 × 4.0 × 2.0 cm) in the fundus of stomach near the cardia. Both cases were identified as malignant neoplasms by endoscopic biopsy and further confirmed by performing laparoscopic proximal gastrectomy, esophagogastrostomy, and palliative distal subtotal gastrectomy. The postoperative histopathological morphology and immunohistochemistry studies revealed sarcomatoid carcinoma for the female and gastric carcinosarcoma for the male respectively. INTERVENTIONS: The female patient subsequently underwent laparoscopy-assisted radical distal gastrectomy for gastric cancer followed by systemic chemotherapy with oxaliplatin plus tegafur. The male patient underwent laparoscopic proximal gastrectomy and esophagogastrostomy were performed. OUTCOMES: The female had a mixture of a little poorly-differentiated adenocarcinoma and abundant sarcomatoid spindle cell elements, and is still alive healthy up to date for 2 and a half years after surgery by phone follow-up. The male patient had both adenocarcinoma and fibrosarcoma in a single tumor, and died 1 month after the operation. LESSONS: The present study provides insight into the clinical findings, differential diagnosis, and prognosis of carcinosarcomas and sarcomatoid carcinomas of the stomach. More cases are needed for further studies in the future.


Asunto(s)
Carcinoma/diagnóstico , Carcinosarcoma/diagnóstico , Neoplasias Gástricas/diagnóstico , Dolor Abdominal/etiología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma/complicaciones , Carcinoma/patología , Carcinoma/terapia , Carcinosarcoma/complicaciones , Carcinosarcoma/patología , Carcinosarcoma/terapia , Quimioterapia Adyuvante , Diagnóstico Diferencial , Resultado Fatal , Femenino , Gastrectomía , Mucosa Gástrica/diagnóstico por imagen , Mucosa Gástrica/patología , Mucosa Gástrica/cirugía , Gastroscopía , Humanos , Biopsia Guiada por Imagen , Laparoscopía , Masculino , Melena/etiología , Persona de Mediana Edad , Oxaliplatino/uso terapéutico , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/patología , Neoplasias Gástricas/terapia , Tegafur/uso terapéutico , Resultado del Tratamiento
4.
Zhonghua Zhong Liu Za Zhi ; 43(3): 282-288, 2021 Mar 23.
Artículo en Chino | MEDLINE | ID: mdl-33752306

RESUMEN

Gastric cancer is a common malignant tumor of digestive tract in China. Precise, minimally invasive and standardized surgical operation is an important part of comprehensive treatment for gastric cancer. In recent years, indications for minimally invasive surgery have been expanding, research on precision surgery has been deepening, and the standardized surgical quality evaluation and control system has been improving. Accurate diagnosis and staging, multi-disciplinary comprehensive diagnosis and treatment model, enhanced recovery after surgery and whole-process management of nutrition support and other aspects have been comprehensively developed. A number of Chinese expert consensus has been issued, which is conducive to the rapid and good recovery of patients, achieving the double benefits of improving the quality of life and prolongation of survival. However, the precise treatment of complex conditions is still full of controversy. This consensus is formulated to facilitate the standardization of the diagnosis and treatment of gastric cancer.


Asunto(s)
Neoplasias Gástricas , China , Consenso , Gastrectomía , Humanos , Calidad de Vida , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía
5.
Zhonghua Nei Ke Za Zhi ; 60(3): 227-232, 2021 Mar 01.
Artículo en Chino | MEDLINE | ID: mdl-33663171

RESUMEN

Objective: To compare the value of new gastric cancer screening scoring system and serum pepsinogen (PG) combined with gastrin-17 (G-17) (new ABC method) in screening gastric cancer and precancerous lesions. Methods: A total of 576 patients were enrolled after the examination of endoscopy at Endoscopy Center,Department of Gastroenterology,from December 2017 to December 2019. There were 275 males and 301 females with an age of 40-72 (52±10) years. According to the new ABC method and the new gastric cancer screening scoring system, the population was divided into three groups according to age,gender,serum helicobacter pylori antibody test, PG Ⅰ/PG Ⅱ(PGR) and G-17 before endoscopy. The detection rates of gastric cancer and atrophic gastritis by two different methods were analyzed and the value in screening gastric cancer and precancerous lesions were evaluated. Statistical analysis was accomplished by Chi-square test and Gamma coefficient analysis. Results: A total of 576 patients were enrolled. According to the new ABC method, 382 patients were classified into low-risk group, 170 patients into middle-risk group and 24 patients into high-risk group, respectively. In the new ABC method, 1 case of gastric cancer (0.3%) was detected in low-risk group, 8 cases (4.7%) in middle-risk group and 3 cases (12.5%) in high-risk group. As for atrophic gastritis, 89 cases (23.3%) was detected in low-risk group, 94 cases (55.3%) in middle-risk group and 18 cases (75.0%) in high-risk group. According to the new gastric cancer screening scoring system, 336 patients were classified into low-risk group, 205 patients into middle-risk group and 35 patients into high-risk group, respectively. One case of gastric cancer (0.3%) was detected in low-risk group, 6 cases (2.9%) in middle-risk group and 5 cases (14.3%) in high-risk group. As for atrophic gastritis, 41 cases (12.2%) were detected in low-risk group, 134 cases (65.4%) in middle-risk group and 26 cases (74.3%) in high-risk group. In this two methods, the prevalence of gastric cancer increased according to the disease stage (χ²=22.509, P<0.01; χ²=24.156, P<0.01); in terms of atrophic gastritis, the detection rate of the new screening scoring system in the low-risk group was significantly lower than that in the new ABC method (χ²=14.844, P<0.01), but higher in the middle-risk group (χ2=3.955, P=0.047). Gamma coefficient test showed that there were strong correlations between gastroscopy pathology and classification grade of both methods (P<0.01). Conclusions: Both methods are suitable for screening gastric cancer and precancerous lesions, and the new scoring system may be more valuable in screening gastric cancer and precancerous lesions.


Asunto(s)
Gastritis Atrófica , Infecciones por Helicobacter , Helicobacter pylori , Lesiones Precancerosas , Neoplasias Gástricas , Adulto , Anciano , Anticuerpos Antibacterianos , Detección Precoz del Cáncer , Femenino , Gastritis Atrófica/diagnóstico , Infecciones por Helicobacter/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Lesiones Precancerosas/diagnóstico , Neoplasias Gástricas/diagnóstico
6.
Medicine (Baltimore) ; 100(10): e24979, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725867

RESUMEN

RATIONALE: Advanced signet ring cell (SRC) carcinoma has a worse prognosis. Therefore, early diagnosis and prevention is particularly important; SRC tumors have lower R0 resection rate and are thought to be less chemosensitive than non-SRCC. Consequently, a novel postoperative adjuvant treatment is urgently needed to improve clinical outcomes. PATIENT CONCERNS: A 41-year-old female with advanced gastric SRC carcinoma was treated with radical gastrectomy and oxaliplatin-based regimen for 6 cycles after surgery. She was suspected of recurrence with the high level of carbohydrate antigen (CA) 72-4. DIAGNOSES: The gastroscopy revealed SRC carcinoma of gastric antrum and poorly differentiated adenocarcinoma in some areas. The diagnosis of postoperative pathology report was gastric cancer with stage III C (T4a, N3a, M0). INTERVENTIONS: The level of CA72-4 rapidly increased during the 2 follow-up after the completion of conventional treatment, ex vivo-cultured allogeneic natural killer (NK) cell infusion was offered to prevent recurrence. OUTCOMES: Intravenous injections of NK cells combination with surgical treatment and chemotherapy showed therapeutic effects in this patient with possible relapse. The patient remained disease-free 46 months after the infusion of NK cells until the latest follow-up. LESSONS: CA72-4 appeared to be the most sensitive and specific marker in the gastric cancer patient, and the high level of CA72-4 may indicate the risk of recurrence. This case report provide rationale for NK cell infusion following the rapid increase of CA72-4 to prevent recurrence.


Asunto(s)
Carcinoma de Células en Anillo de Sello/terapia , Gastrectomía , Células Asesinas Naturales/trasplante , Cuidados Posoperatorios/métodos , Neoplasias Gástricas/terapia , Adulto , Antígenos de Carbohidratos Asociados a Tumores/sangre , Antígenos de Carbohidratos Asociados a Tumores/inmunología , Carcinoma de Células en Anillo de Sello/diagnóstico , Carcinoma de Células en Anillo de Sello/inmunología , Carcinoma de Células en Anillo de Sello/patología , Terapia Combinada/métodos , Femenino , Humanos , Estadificación de Neoplasias , Pronóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/inmunología , Neoplasias Gástricas/patología , Trasplante Homólogo , Resultado del Tratamiento
8.
DNA Cell Biol ; 40(2): 405-413, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33605797

RESUMEN

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.


Asunto(s)
Antígeno B7-H1/metabolismo , Receptor ErbB-2/metabolismo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias Gástricas/patología
9.
BMC Surg ; 21(1): 99, 2021 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-33622302

RESUMEN

BACKGROUND: It is important to understand the branching pattern of the celiac artery for a safe surgery. Various branching anomalies of the celiac artery were classified by Adachi in 1928. In Adachi's classification, type VI (group 26) is a rare anatomical anomaly (0.4%) that requires care when carrying out a surgery in gastric cancer patients with this anomaly. Herein, we reported a case treated successfully with laparoscopic distal gastrectomy with D1+ lymph node dissection for early gastric cancer. CASE PRESENTATION: An 84-year-old female was referred to our division for an additional surgical treatment for early gastric cancer that was resected by endoscopic submucosal dissection. A three-dimensional computed tomography angiography revealed an angioplany of the common hepatic artery branching from the left gastric artery. According to Adachi's classification, the anomaly of this patient corresponded to type VI (group 26). Preoperative anatomical information of this rare anomaly helped us to safely perform a laparoscopic distal gastrectomy and lymph node dissection with common hepatic artery preservation. The patient had an uneventful postoperative course and was discharged on postoperative day 11. CONCLUSIONS: We consider that Group 26 anomalies require the most precise anatomical understanding among Adachi classification type VIs, since it affects hepatic blood flow and can cause serious complications. In this time, we reported a successful case to perform laparoscopic distal gastrectomy with safety and accuracy by preoperative understanding of the precise vascular anatomy.


Asunto(s)
Neoplasias Gástricas , Anciano de 80 o más Años , Femenino , Humanos , Laparoscopía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía
10.
Medicine (Baltimore) ; 100(3): e23934, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545965

RESUMEN

BACKGROUND: Conventional white-light imaging endoscopy (C-WLI) had a significant number of misdiagnosis in early gastric cancer (EGC), and magnifying endoscopy (ME) combined with different optical imaging was more accurate in the diagnosis of EGC. This study aimed to evaluate the accuracy of ME and compare the accuracy of ME with different optical imaging in detecting EGC. METHODS: A comprehensive literature search was conducted to identify all relevant studies. Pair-wise meta-analysis was conducted to evaluate the accuracy of ME, and Bayesian network meta-analysis was performed to combine direct and indirect evidence and estimate the relative effects. RESULTS: Eight prospective studies were identified with a total of 5948 patients and 3 optical imaging in ME (ME with WLI (M-WLI), ME with narrow-band imaging (M-NBI), and ME with blue laser imaging (M-BLI)). Pair-wise meta-analysis showed a higher accuracy of ME than C-WLI (OR: 2.97, 95% CI: 1.68∼5.25). In network meta-analysis, both M-NBI and M-BLI were more accurate than M-WLI (OR: 2.56, 95% CI: 2.13∼3.13; OR: 3.13, 95% CI: 1.85∼5.71). There was no significant difference between M-NBI and M-BLI. CONCLUSION: ME was effective in improving the detecting rate of EGC, especially with NBI or BLI.


Asunto(s)
Endoscopía/métodos , Neoplasias Gástricas/diagnóstico , Detección Precoz del Cáncer/métodos , Endoscopía/normas , Endoscopía/estadística & datos numéricos , Humanos , Metaanálisis en Red , Oportunidad Relativa , Estudios Prospectivos , Neoplasias Gástricas/fisiopatología
11.
Cancer Sci ; 112(4): 1644-1654, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33576114

RESUMEN

The clinical efficacy of DNA cytology test (CY) in gastric cancer (GC) has been retrospectively proposed using cancer-specific methylation of cysteine dioxygenase type 1 (CDO1). We confirmed the clinical utility of DNA CY in a prospective cohort. Four hundred GC samples were prospectively collected for washing cytology (UMIN000026191), and detection of the DNA methylation of CDO1 was assessed by quantitative methylation-specific PCR in the sediments. Endpoint was defined as the match rate between conventional CY1 and DNA CY1 (diagnostic sensitivity), and the DNA CY0 rate (diagnostic specificity) in pStage IA. DNA CY1 was detected in 45 cases (12.5%), while CY1 was seen in 31 cases (8.6%) of 361 chemotherapy-naïve samples, where the sensitivity and specificity of the DNA CY in the peritoneal solutions were 74.2% and 96.5%, respectively. The DNA CY was positive for 3.5/0/4.9/11.4/58.8% in pStage IA/IB/II/III/IV, respectively (P < .01). In the multivariate analysis, DNA CY1 was independently correlated with pathological tumor depth (pT) (P = .0012), female gender (P = .0099), CY1 (P = .0135), P1 (P = .019), and carcinoembryonic antigen (CEA) (P = .036). The combination of DNA CY1 and P factor nearly all covered the potential peritoneal dissemination (P1 and/or CY1 and/or DNA CY1) (58/61:95.1%). DNA CY1 had a significantly poorer prognosis than DNA CY0 in GC patients (P < .0001). DNA CY1 detected by CDO1 promoter DNA methylation has a great value to detect minimal residual disease of the peritoneum in GC clinics, representing poor prognosis as a novel single DNA marker.


Asunto(s)
Líquido Ascítico/patología , ADN/genética , Neoplasias Peritoneales/diagnóstico , Neoplasias Peritoneales/patología , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Anciano , Biomarcadores de Tumor/genética , Cisteína-Dioxigenasa/genética , Citodiagnóstico/métodos , Metilación de ADN/genética , Femenino , Humanos , Masculino , Estadificación de Neoplasias/métodos , Neoplasias Peritoneales/genética , Peritoneo/patología , Pronóstico , Regiones Promotoras Genéticas/genética , Estudios Prospectivos , Neoplasias Gástricas/genética
12.
Int J Mol Sci ; 22(2)2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33435161

RESUMEN

Gastric cancer is the fifth most common cancer worldwide with a poor survival rate. Therefore, it is important to identify predictive and prognostic biomarkers of gastric cancer. Laminin subunit beta 1 (LAMB1) is involved in attachment, migration, and organization during development, and its elevated expression has been associated with several cancers. However, the role and mechanism of LAMB1 in gastric cancer remains unknown. Here, we determined that LAMB1 is upregulated in gastric cancer tissues and contributes to cell growth and motility. Using a public database, we showed that LAMB1 expression was significantly upregulated in gastric cancer compared to normal tissues. LAMB1 was also found to be associated with poor prognosis in patients with gastric cancer. Overexpression of LAMB1 elevated cell proliferation, invasion, and migration; however, knockdown of LAMB1 decreased these effects in gastric cancer cells. U0126, an extracellular signal-regulated kinase (ERK) inhibitor, regulated the expression of LAMB1 in gastric cancer cells. Additionally, we showed that c-Jun directly binds to the LAMB1 promoter as a transcription factor and regulates its gene expression via the ERK pathway in gastric cancer cells. Therefore, our study indicates that LAMB1 promotes cell growth and motility via the ERK/c-Jun axis and is a potential biomarker and therapeutic target of gastric cancer.


Asunto(s)
Adenocarcinoma/genética , Movimiento Celular , Proliferación Celular , Laminina/genética , Neoplasias Gástricas/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma/metabolismo , Adenocarcinoma/fisiopatología , Línea Celular Tumoral , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Regulación Neoplásica de la Expresión Génica , Humanos , Laminina/metabolismo , Laminina/fisiología , Sistema de Señalización de MAP Quinasas , Pronóstico , Proteínas Proto-Oncogénicas c-jun/metabolismo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/fisiopatología
13.
Medicine (Baltimore) ; 100(2): e24223, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466202

RESUMEN

ABSTRACT: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are increasing in incidence. Clinicians urgently need a method that can effectively predict the prognosis of GEP-NENs.A total of 14770 GEP-NENs patients with pathologically confirmed between 1975 and 2016 were obtained from the surveillance, epidemiology, and end results database. All the patients were divided into primary (n = 10377) and validation (n = 4393) cohorts based on the principle of random grouping. Multivariate Cox proportional hazards proportional hazards regression analysis was performed to evaluate predictors associated with overall survival, and a nomogram was constructed based on the primary cohort. An independent external validation cohort and comparison with the eighth edition American Joint Committee on Cancer TNM staging system were subsequently used to assess the predictive performance of the nomogram.The multivariate Cox model indicated that age, tumour differentiation, and distant metastases were independent predictors associated with overall survival. With respect to the primary cohort, the nomogram exhibited better discriminatory power than the TNM classification (C-index: 0.821 vs 0.738). Discrimination was also superior to that of TNM classification for the validation cohort (C-index: 0.823 vs 0.738). The calibrated nomogram predicted 3- and 5-years survival rate that closely corresponded to the actual survival rate.This study developed and validated a prognostic nomogram applied to patients with GEP-NENs, which may help clinicians make reasonable prognostic judgments and treatment plans to a certain extent.


Asunto(s)
Neoplasias Intestinales/diagnóstico , Neoplasias Intestinales/mortalidad , Estadificación de Neoplasias/métodos , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/mortalidad , Nomogramas , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/mortalidad , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , Reproducibilidad de los Resultados , Tasa de Supervivencia
14.
Zhonghua Zhong Liu Za Zhi ; 43(1): 104-107, 2021 Jan 23.
Artículo en Chino | MEDLINE | ID: mdl-33472321

RESUMEN

Hepatoid adenocarcinoma of the stomach is a rare type of gastric cancer. Compared to the common gastric adenocarcinoma, the tumor markers, imaging manifestation, histopathological features, immunophenotype, treatment and prognosis of HAS are distinct. It has characteristics of gastric adenocarcinoma and hepatocellular carcinoma at the same time, which leads to the misdiagnosis and missed diagnosis. The purpose of this paper is to analysis the characteristics of HAS from the above aspects, improve the diagnosis rate, reduce mortality rate and prolong the survival period of HAS patients.


Asunto(s)
Adenocarcinoma , Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias Gástricas , Adenocarcinoma/diagnóstico por imagen , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Pronóstico , Neoplasias Gástricas/diagnóstico , alfa-Fetoproteínas
15.
JAMA Netw Open ; 4(1): e2032542, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33410877

RESUMEN

Importance: The rapidly increasing number of gastric cancer examinations performed over a short period might influence screening performance. Accessing the association between calendar month and gastric cancer detection rates might improve policy and guide institutional support. Objective: To evaluate the association between the increased number of examinations over a certain period and gastric cancer detection rates among a large population included in the Korean National Cancer Screening Program (KNCSP). Design, Setting, and Participants: This retrospective, population-based cohort study used data from the KNCSP comprising 26 765 665 men and women aged 40 years or older who participated in the screening program between January 1, 2013, and December 31, 2016. Data were analyzed from November 1, 2019, to March 31, 2020. Exposures: Gastric cancer screening with endoscopy. Main Outcomes and Measures: The primary outcome was monthly gastric cancer detection rates in the KNCSP. A negative binomial regression model was used to evaluate the association between the screening month and detection rates. Results: In total, 21 535 222 individuals underwent endoscopy (mean [SD] age, 55.61 [10.61] years; 11 761 709 women [54.62%]). The quarterly number of participants was the highest in the last quarter of the study period (2013-2014: 4 094 951 [41.39%], 2015-2016: 4 911 629 [42.19%]); this proportion was 2.48 to 2.84 times greater than that of the first quarter. Cancer detection rates were the lowest in December (2013-2014: 0.22; 95% CI, 0.22-0.23; 2015-2016: 0.21; 95% CI, 0.21-0.22); this was approximately a 40.0% to 45.0% reduction compared with the rates in January. The age group was the significant factor for monthly detection rates. After adjustment for the age group and taking account of the number of screenings, the estimated coefficient range for the screening month was negative and the detection rate in December was significantly different than in January for both the consequent cycles (2013-2014: -0.05 to -0.18; P < .001; and 2015-2016: -0.06 to -0.19; P < .001). In the multivariable logistic model, the association of calendar month with detected cancer remained after adjusting for other confounding factors (December, 2013-2014: odds ratio, 0.82; 95% CI, 0.76-0.87; P < .001; 2015-2016: odds ratio, 0.83; 95% CI, 0.79-0.89; P < .001). Conclusions and Relevance: The findings of this cohort study suggest that the workload of endoscopists increased with the increasing number of examinations toward the end of the year, as demonstrated by the decreased cancer detection rates. These findings may help to improve gastric cancer detection rates of screening programs by controlling the monthly screening number and policy modifications.


Asunto(s)
Gastroscopía , Tamizaje Masivo/estadística & datos numéricos , Neoplasias Gástricas/diagnóstico , Adulto , Anciano , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Retrospectivos , Neoplasias Gástricas/epidemiología , Factores de Tiempo
16.
Anticancer Res ; 41(1): 459-466, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33419844

RESUMEN

BACKGROUND/AIM: Currently, there are no standard guidelines for the waiting time from the diagnosis of gastric neoplasms to endoscopic submucosal dissection (ESD). PATIENTS AND METHODS: A total of 1,605 patients who had undergone ESD for early gastric cancer (EGC) or high-grade dysplasia (HGD) were enrolled. Waiting time for ESD was defined as the time from the first diagnosis to ESD. Multivariable logistic regression analysis was conducted. RESULTS: The curative resection rate was 86.8% and the mean waiting time was 36.8 days. In the multivariable model, longer waiting time did not significantly affect non-curative resection, whereas age >70 years, submucosal fibrosis, and initial cancer diagnosis were significantly associated with non-curative resection. Waiting time was still not identified as a risk factor for non-curative resection in EGC and HGD groups. CONCLUSION: A longer waiting time from diagnosis to ESD was not associated with non-curative resection.


Asunto(s)
Resección Endoscópica de la Mucosa , Cuidados Paliativos , Neoplasias Gástricas/cirugía , Tiempo de Tratamiento , Espera Vigilante , Anciano , Anciano de 80 o más Años , Manejo de la Enfermedad , Resección Endoscópica de la Mucosa/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos/métodos , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/diagnóstico , Resultado del Tratamiento
17.
Clin Nucl Med ; 46(1): 1-7, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33181743

RESUMEN

PURPOSE: The aim was to explore whether baseline total lesion glycolysis (TLG) can improve the prognostic value of the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in primary gastric diffuse large B-cell lymphoma (PG-DLBCL) patients treated with an R-CHOP-like regimen. MATERIALS AND METHODS: Ninety-four PG-DLBCL patients who underwent baseline PET/CT between July 2010 and May 2019 were included in this retrospective study. FDG-avid lesions in each patient were segmented to calculate the SUVmax, total metabolic tumor volume (TMTV), and TLG. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate prognosis. RESULTS: During the follow-up period of 5 to 108 months (35.3 ± 23.5 months), high TLG and a high NCCN-IPI were significantly associated with poor PFS and OS. Total lesion glycolysis and the NCCN-IPI were independent predictors of PFS and OS. Patients were stratified into 3 groups according to the combination of TLG and the NCCN-IPI for PFS (P < 0.001) and OS (P < 0.001): high-risk group (TLG > 1159.1 and NCCN-IPI 4-8) (PFS and OS, 57.7% and 61.5%, respectively, n = 42), intermediate-risk group (TLG > 1159.1 or NCCN-IPI 4-8) (PFS and OS, both 76.9%, n = 26), and low-risk group (TLG ≤ 1159.1 and NCCN-IPI 0-3) (PFS and OS, 97.6% and 100.0%, respectively, n = 26). CONCLUSIONS: Both TLG and the NCCN-IPI are independent predictors of PG-DLBCL patient survival. Moreover, the combination of TLG and the NCCN-IPI improved patient risk stratification and might help personalize therapeutic regimens.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Glucólisis/efectos de los fármacos , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclofosfamida/farmacología , Ciclofosfamida/uso terapéutico , Doxorrubicina/farmacología , Doxorrubicina/uso terapéutico , Femenino , Humanos , Linfoma de Células B Grandes Difuso/metabolismo , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Prednisolona/farmacología , Prednisolona/uso terapéutico , Supervivencia sin Progresión , Estudios Retrospectivos , Neoplasias Gástricas/metabolismo , Vincristina/farmacología , Vincristina/uso terapéutico
18.
Gene ; 772: 145376, 2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33359128

RESUMEN

Gastric cancer (GC) is considered one of the most lethal malignancies worldwide due to poor prognosis. Aberrant methylation has been demonstrated to be involved in PD-L1 dysregulated expression in human cancers and possesses a great value as a diagnostic biomarker. Given that, in this study, we investigated the methylation status of PD-L1 as a promising biomarker in primary gastric tumors and identified functional CpG loci undergoing aberrant methylation through tumorigenesis of GC. PD-L1 methylation was initially evaluated in-silico using TCGA-STAD dataset. Pearson's correlation analysis was further employed to identify the most significant functional methylated CpG loci of PD-L1 gene in TCGA-STAD patient cohort. Methylation status and its correlation with PD-L1 expression were also validated using q-MSP and qRT-PCR in a set of internal samples, including 25 paired primary gastric tumors and adjacent normal tissues. The obtained results from TCGA-STAD showed that PD-L1 is significantly hypermethylated through gastric tumorigenesis, mostly in two CpG loci overlapping with cg19724470 and cg15837913 probes. Besides, PD-L1 DNA methylation was negatively correlated with PD-L1 expression in tumor samples. Furthermore, hypermethylation of cg19724470 and cg15837913 regions was validated in primary gastric tumors compared to adjacent normal samples. Also, ROC curve analysis illustrated the high diagnostic value of PD-L1 methylation for early detection of GC (AUC = 0.8110). In conclusion, the findings of this study suggested that PD-L1 expression is regulated by methylation in functional CpG loci and its methylation could be considered as a valuable diagnostic target for GC.


Asunto(s)
Antígeno B7-H1/genética , Biomarcadores de Tumor/genética , Metilación de ADN , Neoplasias Gástricas/diagnóstico , Estudios de Cohortes , Islas de CpG , Regulación hacia Abajo , Detección Precoz del Cáncer , Epigénesis Genética , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Clasificación del Tumor , Regiones Promotoras Genéticas , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología , Análisis de Supervivencia
19.
Anal Chem ; 93(2): 665-670, 2021 01 19.
Artículo en Inglés | MEDLINE | ID: mdl-33314914

RESUMEN

Gastric cancer (GC) is a major global cancer burden, and only HER2-targeted therapies have been approved in first line clinical therapy. CLDN18.2 has been regarded as a potential therapeutic target for gastrointestinal tumors, and global clinical trials have been in process. Hence, the precise, efficient, and noninvasive detection of CLDN18.2 expression is important for the effective application of this attractive target. A high similarity of protein sequence between CLDN18.1 and -18.2 made RNA become more suitable for the detection of CLDN18.2 expression. In this study, CLDN18.2 molecular beacon (MB) with a stem-loop hairpin structure was optimized by phosphorothioate and 2'-O-methyl for stability and efficiency. The MB could recognize CLDN18.2 RNA rapidly. Its resolution and selectivity has been verified in several model cells, demonstrating that MB can distinguish CLDN18.2 expression in several model cells. Furthermore, it was applied successfully to the circulating tumor cell (CTC) assay. The concordance in the expression of CLDN18.2 between CTCs and tissue biopsy is 100% (negative: 3 vs 3; positive: 7 vs 7), indicating that CLDN18.2 RNA detection in CTCs based on a MB will be a promising approach for searching potential patients to CLDN 18.2 targeted drug.


Asunto(s)
Biomarcadores de Tumor/sangre , Claudinas/genética , ARN/sangre , Neoplasias Gástricas/sangre , Neoplasias Gástricas/diagnóstico , Anticuerpos , Línea Celular Tumoral , Regulación Neoplásica de la Expresión Génica , Humanos , Células Neoplásicas Circulantes
20.
PLoS One ; 15(12): e0244869, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33382829

RESUMEN

BACKGROUND: The diagnosis of gastric cancer mainly relies on endoscopy, which is invasive and costly. The aim of this study is to develop a predictive model for the diagnosis of gastric cancer based on noninvasive characteristics. AIMS: To construct a predictive model for the diagnosis of gastric cancer with high accuracy based on noninvasive characteristics. METHODS: A retrospective study of 709 patients at Zhejiang Provincial People's Hospital was conducted. Variables of age, gender, blood cell count, liver function, kidney function, blood lipids, tumor markers and pathological results were analyzed. We used gradient boosting decision tree (GBDT), a type of machine learning method, to construct a predictive model for the diagnosis of gastric cancer and evaluate the accuracy of the model. RESULTS: Of the 709 patients, 398 were diagnosed with gastric cancer; 311 were health people or diagnosed with benign gastric disease. Multivariate analysis showed that gender, age, neutrophil lymphocyte ratio, hemoglobin, albumin, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) were independent characteristics associated with gastric cancer. We constructed a predictive model using GBDT, and the area under the receiver operating characteristic curve (AUC) of the model was 91%. For the test dataset, sensitivity was 87.0% and specificity 84.1% at the optimal threshold value of 0.56. The overall accuracy was 83.0%. Positive and negative predictive values were 83.0% and 87.8%, respectively. CONCLUSION: We construct a predictive model to diagnose gastric cancer with high sensitivity and specificity. The model is noninvasive and may reduce the medical cost.


Asunto(s)
Biomarcadores de Tumor/sangre , Recuento de Células Sanguíneas , Aprendizaje Automático , Neoplasias Gástricas/diagnóstico , Anciano , Antígeno Ca-125/sangre , Antígeno CA-19-9/sangre , Femenino , Humanos , Pruebas de Función Renal , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Neoplasias Gástricas/sangre , Neoplasias Gástricas/patología
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