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1.
J Infect Chemother ; 27(1): 94-98, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32988730

RESUMO

The effect of systemic corticosteroids on clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains controversial. While the use of corticosteroids raises concerns regarding delayed viral clearance, secondary infections, and long-term complications that can lead to increased mortality, corticosteroids have the potential to reduce mortality if used appropriately. Herein, we report good outcomes in two patients with COVID-19 who received systemic corticosteroids as adjunctive therapy. An 83-year-old man with hypertension and smoking history and a 62-year-old man with a drinking habit were transferred to our hospital with a diagnosis of COVID-19. The patients developed general malaise and loss of appetite with persistent high fever. Despite the prescription of antiviral drugs, their hypoxemia progressed rapidly. However, after the introduction of systemic corticosteroids, their symptoms improved as the fever decreased, and their hypoxemia gradually improved. These results suggest that some patients with COVID-19 may benefit from the appropriate use of systemic corticosteroids as adjunctive therapy.


Assuntos
Corticosteroides/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Metilprednisolona/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Antivirais/uso terapêutico , Betacoronavirus , Terapia Combinada , Infecções por Coronavirus/epidemiologia , Humanos , Hipertensão/epidemiologia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Fumar/epidemiologia , Neoplasias Gástricas/epidemiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
2.
Gastroenterol. hepatol. (Ed. impr.) ; 43(10): 598-606, dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-ET2-7606

RESUMO

OBJECTIVE: Accumulating evidence has demonstrated that long non-coding RNAs (lncRNAs) play important regulatory roles in the tumorigenesis and progression of gastric cancer (GC). The aim of this study was to construct the prognostic predictive model of lncRNAs signature and improve the survival prediction of GC. PATIENTS AND METHODS: The expression profiling of lncRNAs in large GC cohorts was performed from The Cancer Genome Atlas (TCGA) databases using the lncRNAs-mining approach, including training data set (N=160) and testing data set (N=159). A 13-lncRNAs signature significantly associated with overall survival (OS) in the training data set was selected. The prognostic value of this 13-lncRNAs signature was then confirmed in the test validation set and the entire validation set, respectively. RESULTS: Based on lncRNA expression profiling of 319 patients with stomach adenocarcinoma (STAD), prognostic 13-lncRNAs signature was found to be significantly associated with the prognosis of GC. Compared to patients with low-risk scores, patients with high-risk scores had a significantly shorter survival time. Moreover, functional enrichment analysis indicated that this 13-lncRNAs signature was potentially involved in multiple biological processes, such as DNA replication and cell cycle signaling pathway. CONCLUSIONS: The prognostic model of the 13-lncRNAs signature established by our study could improve the survival prediction of GC to a greater extent


OBJETIVO: Las pruebas acumuladas demostraron que los ARN no codificantes de larga duración (ARNlC) desempeñaban los importantes papeles reguladores en la tumorigénesis y la progresión del cáncer gástrico (CG). El objetivo de este estudio fue construir el modelo predictivo de pronóstico de la firma de los lncRNA y mejorar la predicción de supervivencia del GC. PACIENTES Y MÉTODOS: El perfil de expresión de los lncARN en grandes cohortes de GC se realizó a partir de las bases de datos del Atlas del Genoma del Cáncer (TCGA) utilizando el enfoque de minería de lncARN, incluyendo el conjunto de datos de entrenamiento (N=160) y el conjunto de datos de pruebas (N=159). Se eligió la firma de 13 lncARN significativamente asociada con la supervivencia general (OS) en la serie de capacitación. El valor pronóstico de esta firma de 13-lncARN se confirmó luego en la serie de validación de pruebas y en toda la serie de validación, respectivamente. RESULTADOS: Basado en el perfil de expresión de lncRNA de 319 pacientes con adenocarcinoma de estómago (STAD), se encontró que la firma de 13-lncRNA de pronóstico estaba significativamente asociada con el pronóstico de GC. En comparación con los pacientes con puntuaciones de bajo riesgo, los pacientes con puntuaciones de alto riesgo tuvieron un tiempo de supervivencia significativamente más corto. Además, el análisis de enriquecimiento funcional indicó que esta firma de 13-lncARN estaba potencialmente involucrada en múltiples procesos biológicos, como la replicación del ADN y la vía de señalización del ciclo celular. CONCLUSIONES: El modelo de pronóstico de la firma de 13-lncARN establecido por nuestro estudio podría mejorar mejor la predicción de supervivencia del GC


Assuntos
Humanos , RNA Longo não Codificante/análise , Prognóstico , Análise de Sobrevida , Neoplasias Gástricas/epidemiologia , Valor Preditivo dos Testes , RNA Longo não Codificante/metabolismo , Biomarcadores Tumorais , Neoplasias Gástricas/genética , Progressão da Doença
4.
Artigo em Inglês | MEDLINE | ID: mdl-33317154

RESUMO

OBJECTIVE: Previous studies have shown that the incidence of gastric cancer (GC), and particularly intestinal GC, is higher among resettlers from the former Soviet Union (FSU) than in the general German population. Our aim was to investigate if the higher risk remains over time. METHODS: GC cases between 1994 and 2013, in a cohort of 32,972 resettlers, were identified by the respective federal cancer registry. Age-standardized rates (ASRs) and standardized incidence ratios (SIRs) were analyzed in comparison to the general population for GC subtypes according to the Laurén classification. Additionally, the cohort was pooled with data from a second resettler cohort from Saarland to investigate time trends using negative binomial regression. RESULTS: The incidence of intestinal GC was elevated among resettlers in comparison to the general population (SIR (men) 1.64, 95% CI: 1.09-2.37; SIR (women) 1.91, 95% CI: 1.15-2.98). The analysis with the pooled data confirmed an elevated SIR, which was stable over time. CONCLUSION: Resettlers' higher risk of developing intestinal GC does not attenuate towards the incidence in the general German population. Dietary and lifestyle patterns might amplify the risk of GC, and we believe that further investigation of risk behaviors is needed to better understand the development of disease pattern among migrants.


Assuntos
Neoplasias Gástricas , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Fatores de Risco , Neoplasias Gástricas/epidemiologia , U.R.S.S.
5.
Gastroenterol. hepatol. (Ed. impr.) ; 43(9): 506-514, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-7593

RESUMO

INTRODUCCIÓN: En la actualidad, la incidencia del cáncer gástrico (CG) está disminuyendo, sin embargo, la supervivencia continúa siendo baja. El cáncer gástrico precoz (CGP) ofrece un mejor pronóstico y la posibilidad de tratamientos endoscópicos curativos. PACIENTES Y MÉTODOS: Estudio observacional de una cohorte retrospectiva de todos los pacientes con CG en un periodo de 5años en un área sanitaria de España. El CGP incluyó los pacientes con afectación mucosa o submucosa (T1) independientemente de la afectación ganglionar, mientras que el avanzado fueron los T2-T4. RESULTADOS: Se incluyeron 209 pacientes de los cuales 26 (12%) fueron CGP. El CGP no tuvo diferencias en comparación con el avanzado en la edad, sexo, infección por HP, lesiones premalignas ni tipo histológico; sin embargo, tuvo diferencias significativas en la localización (antro e incisura en un 76% vs. 38%, p = 0,01), síntomas de alarma (69% vs. 90%, p < 0,01), tratamiento con intención curativa (100% vs. 30%, p < 0,01), performance status (PS 0-1: 92% vs. 75%, p = 0,03) y supervivencia (85% vs. 20%, p < 0,001). Entre los pacientes tratados con intención curativa, el 98% (79/81) fueron operados y el 2% (2/81) fueron tratados con mucosectomía. Siete (27%) pacientes con CGP se hubiesen podido beneficiar de disección submucosa. DISCUSIÓN: La frecuencia del CGP fue baja en nuestra área sanitaria (12% de los CG). El CGP tuvo síntomas de alarma en un alto porcentaje, se localizó en el tercio distal del estómago (antro e incisura) y tuvo mejor pronóstico en relación con el CG avanzado. Se deben implementar medidas para incrementar la detección y tratamiento endoscópico del CGP


INTRODUCTION: Gastric cancer (GC) incidence is currently decreasing; however, survival is still low. Early GC (EGC) has better prognosis and it could be cured by endoscopic methods. PATIENTS AND METHODS: Observational study of a retrospective cohort of all patients with GC during a five-year period in a health area of Spain. EGC diagnosis was defined as mucosal or submucosal (T1) cancers regardless of lymph node involvement, whereas the advanced GC were T2-T4. RESULTS: 209 patients were included, and 26 (12%) of them were EGC. There was no difference between EGC and advanced GC in age, sex, HP infection, precancerous lesions or histological type. Other characteristics of EGC were different from advanced GC: location (antrum and incisura in 76% vs 38%, p = 0.01), alarm symptoms (69% vs 90%, p < 0.01), curative treatment (100% vs 30%, p < 0.01), performance status (PS 0-1: 92% vs 75%, p = 0.03) and survival (85% vs 20%, p < 0.001). Among patients who received curative treatment, 98% (79/81) underwent surgery and 2% (2/81) were treated by mucosectomy. Seven (27%) patients with EGC could have benefited from treatment by endoscopic submucosal resection. DISCUSSION: EGC frequency was low (12% of GCs) in our health area. EGC had a high percentage of alarm symptoms, and was located in the distal third of the stomach (antrum and incisura) and had better prognosis compared to advanced GC. Strategies to increase detection and endoscopic treatment of EGC should be implemented


Assuntos
Humanos , Masculino , Feminino , Idoso , Neoplasias Gástricas/epidemiologia , Detecção Precoce de Câncer/métodos , Estudos de Coortes , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia , Análise de Sobrevida , Metástase Neoplásica/patologia , Neoplasias Gástricas/patologia , Espanha/epidemiologia , Estudos Retrospectivos , Ressecção Endoscópica de Mucosa/métodos , Endoscopia Gastrointestinal/métodos , Terapia Neoadjuvante/métodos
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(9): 1482-1486, 2020 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-33076603

RESUMO

Objective: To investigate the relationship between smoking status and the onset age of stomach cancer patients and estimate the patients' direct medical cost burden of stomach cancer due to smoking in Anhui province. Methods: The information about the primary stomach cancer patients and their direct treatment expenditures in 10 cancer-registered areas in Anhui were collected in 2017. The association between smoking status and the age of onset of stomach cancer patients was analyzed by univariate regression and multivariate logistic regression models. The median and smoking-attributed risk method was used to describe the direct treatment expenditure of stomach cancer patients in Anhui due to smoking. Results: A total of 736 patients with stomach cancer were analyzed in this study. Univariate regression analysis showed that rural household registration (t=2.091, P=0.037), smoking (t=-2.357, P=0.001 9) and alcohol consumption (t=-2.036, P=0.042) were related to the age of onset of stomach cancer. After adjusting for gender, alcohol consumption, body mass index and household registration type, the risk of early stomach cancer in people who quitted smoking cessation was lower than that in smokers (OR=0.36, 95%CI: 0.17-0.75). The total direct medical cost burden of 736 newly diagnosed stomach cancer patients was 6.939 6 million RMB. The direct medical expenditure in stomach cancer patients who had smoking behavior was higher than that in stomach cancer patients who quitted smoking and never smoked. Conclusions: Smoking is one of the risk factors for the earlier onset of stomach cancer in Anhui. It is necessary to strengthen tobacco control to reduce the economic burden of patients with stomach cancer.


Assuntos
Fumar , Neoplasias Gástricas , Idade de Início , China/epidemiologia , Gastos em Saúde , Humanos , Fumar/epidemiologia , Neoplasias Gástricas/economia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/terapia
7.
PLoS One ; 15(10): e0239434, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002050

RESUMO

BACKGROUND: Gastric intestinal metaplasia (IM) is precancerous lesion of gastric cancer related to H. pylori infection. There has been limited data about IM and associated risk factors. This study aimed to determine risk factors related to development of IM to guide proper management. METHODS: 1,370 patients undergoing UGI endoscopy at Thammasat University Hospital, Thailand were included between January 2018-August 2019. Patients' data including baseline characteristics, laboratory results, and histopathology from medical database were extensively reviewed. Immunohistochemical staining for p53 expression from gastric biopsies was also performed. RESULTS: Overall H. pylori prevalence was 43.8%. Mean age was 60.7 years and 45% of whom were males. Chronic gastritis was observed in 1,064(77.7%) patients, while 223(16.3%) had IM. Of 223 patients with IM, 194(87%) patients had complete IM, while 29 (13%) had incomplete IM. In groups of complete and incomplete IM, current H. pylori infection rates were 66.5% and 58.6%, respectively. The BMI of incomplete IM group(27.4) was significantly higher than BMI of complete IM group (23.6). Overweight and obese patients (BMI ≥23 kg/m2) were significantly associated with higher risk for the development of incomplete IM (OR 3.25; 95%CI 1.14-9.27, p = 0.027). Males, age >50 years, and current H. pylori infection were significantly higher in IM than chronic gastritis group with OR 1.43 (95%CI 1.01-2.03, p = 0.048), OR 1.67 (95% CI 1.08-2.57, p = 0.021), and OR 3.14 (95% CI 2.29-4.30, p<0.001), respectively. During 20 months of study, there were 15 patients (1.1%) diagnosed with gastric cancer and 1-year survival rate was only 60%. CONCLUSIONS: Males, age >50 years, and current H. pylori infection are significant predictors for the presence of intestinal metaplasia. BMI might be beneficial for using as a predictive risk factor to reduce the development of incomplete intestinal metaplasia. H. pylori eradication could be an effective way to prevent the development of gastric precancerous lesions.


Assuntos
Helicobacter pylori/fisiologia , Neoplasias Gástricas/epidemiologia , Estômago/microbiologia , Estômago/patologia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Metaplasia/microbiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/microbiologia
8.
Lancet Oncol ; 21(10): 1378-1386, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33002439

RESUMO

BACKGROUND: Genetic variants and lifestyle factors have been associated with gastric cancer risk, but the extent to which an increased genetic risk can be offset by a healthy lifestyle remains unknown. We aimed to establish a genetic risk model for gastric cancer and assess the benefits of adhering to a healthy lifestyle in individuals with a high genetic risk. METHODS: In this meta-analysis and prospective cohort study, we first did a fixed-effects meta-analysis of the association between genetic variants and gastric cancer in six independent genome-wide association studies (GWAS) with a case-control study design. These GWAS comprised 21 168 Han Chinese individuals, of whom 10 254 had gastric cancer and 10 914 geographically matched controls did not. Using summary statistics from the meta-analysis, we constructed five polygenic risk scores in a range of thresholds (p=5 × 10-4 p=5 × 10-5 p=5 × 10-6 p=5 × 10-7, and p=5 × 10-8) for gastric cancer. We then applied these scores to an independent, prospective, nationwide cohort of 100 220 individuals from the China Kadoorie Biobank (CKB), with more than 10 years of follow-up. The relative and absolute risk of incident gastric cancer associated with healthy lifestyle factors (defined as not smoking, never consuming alcohol, the low consumption of preserved foods, and the frequent intake of fresh fruits and vegetables), was assessed and stratified by genetic risk (low [quintile 1 of the polygenic risk score], intermediate [quintile 2-4 of the polygenic risk score], and high [quintile 5 of the polygenic risk score]). Individuals with a favourable lifestyle were considered as those who adopted all four healthy lifestyle factors, those with an intermediate lifestyle adopted two or three factors, and those with an unfavourable lifestyle adopted none or one factor. FINDINGS: The polygenic risk score derived from 112 single-nucleotide polymorphisms (p<5 × 10-5) showed the strongest association with gastric cancer risk (p=7·56 × 10-10). When this polygenic risk score was applied to the CKB cohort, we found that there was a significant increase in the relative risk of incident gastric cancer across the quintiles of the polygenic risk score (ptrend<0·0001). Compared with individuals who had a low genetic risk, those with an intermediate genetic risk (hazard ratio [HR] 1·54 [95% CI 1·22-1·94], p=2·67 × 10-4) and a high genetic risk (2·08 [1·61-2·69], p<0·0001) had a greater risk of gastric cancer. A similar increase in the relative risk of incident gastric cancer was observed across the lifestyle categories (ptrend<0·0001), with a higher risk of gastric cancer in those with an unfavourable lifestyle than those with a favourable lifestyle (2·03 [1·46-2·83], p<0·0001). Participants with a high genetic risk and a favourable lifestyle had a lower risk of gastric cancer than those with a high genetic risk and an unfavourable lifestyle (0·53 [0·29-0·99], p=0·048), with an absolute risk reduction of 1·12% (95% CI 0·62-1·56). INTERPRETATION: Chinese individuals at an increased risk of incident gastric cancer could be identified by use of our newly developed polygenic risk score. Compared with individuals at a high genetic risk who adopt an unhealthy lifestyle, those who adopt a healthy lifestyle could substantially reduce their risk of incident gastric cancer. FUNDING: National Key R&D Program of China, National Natural Science Foundation of China, 333 High-Level Talents Cultivation Project of Jiangsu Province, and China Postdoctoral Science Foundation.


Assuntos
Predisposição Genética para Doença/genética , Estilo de Vida Saudável , Neoplasias Gástricas/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Feminino , Seguimentos , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/psicologia , Estudo de Associação Genômica Ampla/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Herança Multifatorial , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/psicologia
9.
Anticancer Res ; 40(11): 6381-6385, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109576

RESUMO

BACKGROUND/AIM: Asian Americans (AA) are one of the largest and fastest growing minority groups in the United States consisting of 18 million people. This population is an ethnically diverse group that tends to be classified as one cohort resulting in hidden survival disparities among AA subgroups. PATIENTS AND METHODS: The National Cancer Data Base was queried for patients of Korean, Japanese or Filipino ancestry with gastric adenocarcinoma or esophageal adenocarcinoma between 2004 and 2013. RESULTS: A total of 28,213 patients met the inclusion criteria: 1,542 with gastric adenocarcinoma and 26,671 with esophageal adenocarcinoma. The Korean group with gastric cancer (0.42) showed improved 5-year survival over the Japanese (0.31) and Filipino (0.21; p<0.001) groups. CONCLUSION: A significant difference in survival exists among AA subgroups signifying a need to acknowledge the heterogeneity of AA in future studies. Thus, individual-specific medicine with respect to race-related outcomes is extremely important.


Assuntos
Adenocarcinoma/epidemiologia , Americanos Asiáticos , Neoplasias Esofágicas/epidemiologia , Vigilância da População , Neoplasias Gástricas/epidemiologia , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Gerenciamento de Dados , Neoplasias Esofágicas/patologia , Grupo com Ancestrais do Continente Europeu , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Estados Unidos/epidemiologia
10.
Medicine (Baltimore) ; 99(33): e21085, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871979

RESUMO

The lymph nodal invasion diagnosis is critical for therapeutic-decision and follows up in gastric cancer. However, the number of nodes to be examined for nodal invasion diagnosis is still under controversy, and the model for quantifying risk of missing positive node is currently not reported yet. We analyzed the nodal invasion status of 13,857 gastric cancer samples with records of primary tumor stage, the number of examined and positive lymph nodes in the surveillance, epidemiology, and end results (SEER) database, fitting a beta-binomial model. The nodes need to be examined with different primary tumor stage were determined based on the model. Overall, examining 11 lymph nodes reduces the probability of missing positive nodes to <10%, and the currently median nodes dissected is adequate (12 nodes). While the number of nodes demands to be dissected for T1, T2, T3, and T4 subgroups are 6, 19, 40, and 66, respectively. The currently implemented median value for these samples was 12, 12, 13, and 16, separately. It implies that the number of nodes to be examined is sufficient for early gastric cancer (T1), but it is inadequate for middle and advanced gastric cancer (T2-T3). The clinical significance of nodal staging score was validated with survival information. In summary, we first quantified the lymph nodes to be examined during surgery using a beta-binomial model, and validated with survival information.


Assuntos
Linfonodos/patologia , Metástase Linfática/diagnóstico , Metástase Linfática/patologia , Estadiamento de Neoplasias/métodos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Reações Falso-Negativas , Feminino , Humanos , Linfonodos/cirurgia , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Probabilidade , Estudos Retrospectivos , Programa de SEER , Sensibilidade e Especificidade , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgia , Análise de Sobrevida
11.
Value Health ; 23(9): 1171-1179, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32940235

RESUMO

OBJECTIVES: To evaluate cost-effectiveness of a novel screening strategy using a microRNA (miRNA) blood test as a screen, followed by endoscopy for diagnosis confirmation in a 3-yearly population screening program for gastric cancer. METHODS: A Markov cohort model has been developed in Microsoft Excel 2016 for the population identified to be at intermediate risk (Singaporean men, aged 50-75 years with Chinese ethnicity). The interventions compared were (1) initial screening using miRNA test followed by endoscopy for test-positive individuals and a 3-yearly follow-up screening for test-negative individuals (proposed strategy), and (2) no screening with gastric cancer being diagnosed clinically (current practice). The model was evaluated for 25 years with a healthcare perspective and accounted for test characteristics, compliance, disease progression, cancer recurrence, costs, utilities, and mortality. The outcomes measured included incremental cost-effectiveness ratios, cancer stage at diagnosis, and thresholds for significant variables. RESULTS: The miRNA-based screening was found to be cost-effective with an incremental cost-effectiveness ratio of $40 971/quality-adjusted life-year. Key drivers included test costs, test accuracy, cancer incidence, and recurrence risk. Threshold analysis highlights the need for high accuracy of miRNA tests (threshold sensitivity: 68%; threshold specificity: 77%). A perfect compliance to screening would double the cancer diagnosis in early stages compared to the current practice. Probabilistic sensitivity analysis reported the miRNA-based screening to be cost-effective in >95% of iterations for a willingness to pay of $70 000/quality-adjusted life-year (approximately equivalent to 1 gross domestic product/capita) CONCLUSIONS: The miRNA-based screening intervention was found to be cost-effective and is expected to contribute immensely in early diagnosis of cancer by improving screening compliance.


Assuntos
Detecção Precoce de Câncer/economia , Endoscopia/economia , Programas de Rastreamento/economia , MicroRNAs/economia , Neoplasias Gástricas/diagnóstico , Idoso , Grupo com Ancestrais do Continente Asiático , Análise Custo-Benefício , Detecção Precoce de Câncer/métodos , Humanos , Estudos Longitudinais , Masculino , Programas de Rastreamento/estatística & dados numéricos , MicroRNAs/sangue , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Medição de Risco , Sensibilidade e Especificidade , Singapura/epidemiologia , Neoplasias Gástricas/epidemiologia
12.
PLoS One ; 15(9): e0238379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915799

RESUMO

BACKGROUND: The correlation between the infection of H. pylori and the occurrence of gastric MALT lymphoma (GML) has been well documented. However, the mechanism of how GML is caused by this bacterium is not well understood, although some immunologic mechanisms are thought to be involved. MATERIALS AND METHODS: In this study, we performed both transcriptomic and proteomic analyses on gastric cancer cells infected by H. pylori isolates from GML patients and the gastric ulcer strain 26695 to investigate the differentially expressed molecular signatures that were induced by GML isolates. RESULTS: Transcriptomic analyses revealed that the differentially expressed genes (DEGs) were mainly related to binding, catalytic activity, signal transducer activity, molecular transducer activity, nucleic acid binding transcription factor activity, and molecular function regulator. Fifteen pathways, including the Wnt signaling pathway, the mTOR signaling pathway, the NOD-like receptor signaling pathway and the Hippo signaling pathway, were revealed to be related to GML isolates. Proteomic analyses results showed that there were 116 differentially expressed proteins (DEPs). Most of these DEPs were associated with cancer, and 29 have been used as biomarkers for cancer diagnosis. We also found 63 upstream regulators that can inhibit or activate the expression of the DEPs. Combining the proteomic and transcriptomic analyses revealed 12 common pathways. This study provides novel insights into H. pylori-associated GML. The DEPs we found may be good candidates for GML diagnosis and treatment. CONCLUSIONS: This study revealed specific pathways related to GML and potential biomarkers for GML diagnosis.


Assuntos
Biomarcadores/análise , Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Proteoma/análise , Neoplasias Gástricas/epidemiologia , Transcriptoma , China/epidemiologia , Perfilação da Expressão Gênica , Infecções por Helicobacter/microbiologia , Humanos , Incidência , Linfoma de Zona Marginal Tipo Células B/genética , Linfoma de Zona Marginal Tipo Células B/metabolismo , Linfoma de Zona Marginal Tipo Células B/microbiologia , Neoplasias Gástricas/genética , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/microbiologia , Via de Sinalização Wnt
13.
Croat Med J ; 61(4): 319-325, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32881429

RESUMO

AIM: To assess the relationship between Helicobacter pylori (H. pylori) infection and atrophic gastritis (AG) and intestinal metaplasia (IM) development and to assess the rate of dysplasia or gastric cancer development in patients with AG and/or IM. METHODS: This retrospective endoscopic follow-up study enrolled 2214 patients. The patients were followed for at least five years between 2007 and 2017 at the Department of Endoscopy at Antalya Ataturk Government Hospital. The results of third-year and five-year surveillance biopsy were assessed. RESULTS: The mean follow-up time was 7.77 ± 2.78 years. H. pylori was histologically assessed in 1417 (64.6%) patients. Of 198 patients with severe H. pylori infection, 32 (16%) and 139 (70.3%) developed extensive AG and extensive IM, respectively. There was a significant relationship between H. pylori density and AG and IM degrees. High grade dysplasia, early gastric cancer, and advanced gastric cancer were diagnosed in 73 patients with median age 58.2 (28-80) years, and the incidence rate was 3.29% (73/2214). The annual incidence of gastric neoplastic lesions was 0.46% in total, 0.08% for early GC, and 0.02% for advanced gastric cancer. CONCLUSIONS: H. pylori infection has an important role in the development of AG and IM. H. pylori density is directly related to atrophy and metaplasia degree.


Assuntos
Gastrite Atrófica/epidemiologia , Infecções por Helicobacter/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Neoplasias Gástricas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Endoscopia Gastrointestinal , Feminino , Seguimentos , Mucosa Gástrica/patologia , Gastrite Atrófica/microbiologia , Gastrite Atrófica/patologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Humanos , Incidência , Masculino , Metaplasia/patologia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/patologia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Turquia/epidemiologia
14.
PLoS Pathog ; 16(8): e1008778, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32841292

RESUMO

EBV-associated gastric cancer (EBVaGC) is characterized by high frequency of DNA methylation. In this study, we investigated how epigenetic alteration of host genome contributes to pathogenesis of EBVaGC through the analysis of transcriptomic and epigenomic datasets from NIH TCGA (The Cancer Genome Atlas) consortium. We identified that immune related genes (IRGs) is a group of host genes preferentially silenced in EBV-positive gastric cancers through DNA hypermethylation. Further functional characterizations of selected IRGs reveal their novel antiviral activity against not only EBV but also KSHV. In particular, we showed that metallothionein-1 (MT1) and homeobox A (HOXA) gene clusters are down-regulated via EBV-driven DNA hypermethylation. Several MT1 isoforms suppress EBV lytic replication and release of progeny virions as well as KSHV lytic reactivation, suggesting functional redundancy of these genes. In addition, single HOXA10 isoform exerts antiviral activity against both EBV and KSHV. We also confirmed the antiviral effect of other dysregulated IRGs, such as IRAK2 and MAL, in scenario of EBV and KSHV lytic reactivation. Collectively, our results demonstrated that epigenetic silencing of IRGs is a viral strategy to escape immune surveillance and promote viral propagation, which is overall beneficial to viral oncogenesis of human gamma-herpesviruses (EBV and KSHV), considering that these IRGs possess antiviral activities against these oncoviruses.


Assuntos
Biomarcadores/metabolismo , Epigênese Genética , Gammaherpesvirinae/isolamento & purificação , Regulação Viral da Expressão Gênica , Infecções por Herpesviridae/complicações , Interações Hospedeiro-Patógeno , Neoplasias Gástricas/genética , Biomarcadores/análise , Metilação de DNA , Gammaherpesvirinae/genética , Células HEK293 , Infecções por Herpesviridae/virologia , Proteínas Homeobox A10/genética , Humanos , Incidência , Metalotioneína/genética , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/virologia , Ativação Viral , Replicação Viral
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(8): 892-896, 2020 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842320

RESUMO

A total of 189 new cases of gastric cancer in Sheyang County from 2014 to 2018 were selected as the case group, and 189 other people without gastric cancer were matched according to age and gender as the control group. A case-control study was conducted on the relationship between drinking water and gastric cancer. After adjusting BMI, family annual income, dietary taste, monthly pickle consumption, monthly chili consumption, monthly soy product consumption, whether experiencing misfortune, whether suffering from superficial gastritis, whether having family history of gastric cancer, the results of multivariate logistic regression showed that compared with those who had no sources of pollution at the end of drinking water 10 years ago and who mainly consumed boiled water, those who had sources of pollution at the end of drinking water 10 years ago and who only drank raw water had a higher risk of stomach cancer ï¼»OR (95%CI) were 2.20 (1.13-4.29), 6.12 (1.25-29.93)ï¼½; Compared with drinking water source from tap water, the risk of stomach cancer of those who drink clean water is lower ï¼»OR (95%CI): 0.55 (0.35-0.85)ï¼½; And those who drink more water every day have a lower risk of stomach cancer ï¼»OR (95%CI): 0.67 (0.48-0.92)ï¼½.


Assuntos
Água Potável , Neoplasias Gástricas/epidemiologia , Estudos de Casos e Controles , Dieta , Humanos , Fatores de Risco
16.
Zhonghua Zhong Liu Za Zhi ; 42(7): 603-608, 2020 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-32842452

RESUMO

Objective: Gastric cancer, a common gastrointestinal cancer in the world, threatens people's life and health seriously. Early screening is an effective strategy to reduce the incidence and mortality of gastric cancer, which is of great importance for gastric cancer prevention and control. The review systematically searched CNKI, Wanfang Data knowledge service platform, PubMed and EMbase databases, and summarized the current status on screening for gastric cancer worldwide. We found that the screening on gastric cancer was mainly carried out in eastern Asia. Gastroscopy and biopsy were the main screening techniques of gastric cancer. The starting age of screening is 40 years old or above. It is essential to carry out gastric cancer screening and concentrate on high-risk population in China.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Adulto , China , Detecção Precoce de Câncer , Gastroscopia , Humanos , Programas de Rastreamento , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia
17.
Am Surg ; 86(5): 407-414, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32684044

RESUMO

BACKGROUND: Recent studies have shown an increase in the incidence of gastric cancer (GC) among young adults in Asia and Latin America. However, it is unknown if a similar trend is happening in the United States. METHODS: A retrospective review of the National Cancer Database was conducted to identify patients diagnosed with gastric adenocarcinoma between the years of 2004 and 2013. RESULTS: A total of 93 734 patients were included. The two age groups below 40 did not see a change in GC incidence; however, age groups above 40 had increasing incidence. Patients aged 18 to 25 had the largest proportion of stage 4 disease and a poor survival (median 11.5 months), compared to older patients. CONCLUSION: Despite the increasing trend of GC among individuals, the incidence of GC among young adults is not increasing. However, this subpopulation presents at more advanced stages (clinical stage 4) and thus has worse survival.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Gástricas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
18.
Oncology ; 98(8): 583-588, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521533

RESUMO

BACKGROUND: Gastric cancer (GC) is one of the leading causes of cancer death in China, while the nature of genetic factors related to GC has not been well-studied. OBJECTIVES: To assess the inherited genetic factors regarding pathogenic germline mutations in Chinese GC population. METHODS: Genomic profiling of DNA was performed through next-generation sequencing with 381 cancer-related genes on tissue from patients with GC between January 1, 2017, and May 7, 2019. RESULTS: 470 GC patients were included for analysis. A total of 28 (6.0%) patients were identified to harbor 25 different pathogenic or very likely pathogenic germline mutations in 15 genes. The variants fell most frequently in BRCA2 (n = 6, 1.28%), CHEK2 (n = 5, 1.06%), MUTYH (n = 3, 0.64%), CDH1 (n = 2, 0.43%), and ATM (n = 2, 0.43%). Of all the germline-mutated genes, 66.7% (n = 10) lay in the DNA damage repair pathways. Seven patients were identified to have a high TMB status, among whom two were also identified as MSI-H. Overall, 20 out of the 28 patients (71.4%) carried clinically actionable mutations. CONCLUSIONS: Our study has depicted the spectrum of pathogenic germline mutations in Chinese GC patients, which may provide valuable clues for the assessment of the genetic susceptibility and clinical management in GC.


Assuntos
Mutação em Linhagem Germinativa , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/genética , Idoso , Proteína BRCA2/genética , Quinase do Ponto de Checagem 2/genética , China/epidemiologia , Dano ao DNA/genética , DNA Glicosilases/genética , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Instabilidade de Microssatélites , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia
19.
Medicine (Baltimore) ; 99(23): e20381, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501983

RESUMO

BACKGROUND: This study will be proposed for investigating the effects of high-quality nursing intervention (HQNI) on the psychological disorder in patients with gastric cancer during perioperative period (GC-PPP). METHODS: A cumulative search from inception up to the March 31, 2020 will be performed in the following databases: Cochrane Library, MEDLINE, EMBASE, Web of Science, VIP database, and China National Knowledge Infrastructure. We will search all potential studies from those electronic databases regardless their language and publication status. We will only consider randomized controlled trials (RCTs) for inclusion, which explores the effect of HQNI on the psychological disorder in patients with GC-PPP. Study identification, information extraction, and study quality appraisal will be independently and respectively done by 2 researchers. Any different opinions between 2 researchers will be disentangled by a third researcher after discussion. Cochrane risk of bias tool will be used for study quality assessment, and RevMan 5.3 software will be utilized for statistical analysis. RESULTS: This study will provide a high-quality synthesis of psychological disorder outcomes to evaluate the effects and safety of HQNI for patients with GC-PPP. CONCLUSION: The findings of this study will provide reference and evidence to appraise whether HQNI is an effective on the psychological disorder in patients with GC-PPP STUDY REGISTRATION NUMBER:: INPLASY202040080.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/enfermagem , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/enfermagem , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
20.
Medicine (Baltimore) ; 99(23): e20508, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501997

RESUMO

We conducted a study to evaluate the prognostic and diagnostic values of microRNA-10b (miR-10b) in gastric cancer (GC) based on meta-analysis and TCGA database. Relevant studies were searched in English and Chinese database and meta-analysis was conducted on Stata 12.0. The expression value of miR-10b and clinical parameters of GC patients were downloaded from TCGA database, and relevant analyses were conducted on SPSS. High expression of miR-10b was linked with unfavorable overall survival (OS) in GC (HR = 1.572, 95% CI: 1.240-1.992, P < .001). However, the meta-analysis was significant for patients in early stage, but not for patients in advanced stage. The expression of miR-10b-3p was significantly lower in cancer tissue compared with adjacent tissue (P < .001). Meanwhile, the area under the ROC curve (AUC) value was 0.652 (0.562-0.742), P = .001. Disease-free survival analysis showed increasing miR-10b-5p was correlated with worse survival outcome (HR = 2.366, 95% CI: 1.414-3.959, P = .001). In conclusion, miR-10b acts as a tumor suppressor with prognostic and diagnostic values for GC.


Assuntos
MicroRNAs/análise , Prognóstico , Neoplasias Gástricas/sangue , Neoplasias Gástricas/mortalidade , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/sangue , Humanos , MicroRNAs/sangue , Modelos de Riscos Proporcionais , Curva ROC , Neoplasias Gástricas/epidemiologia
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