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1.
Artigo em Inglês | MEDLINE | ID: mdl-33975687

RESUMO

Gastric cancer remains a major challenge to public health on a global scale, causing the loss of 19 million disability-adjusted life years worldwide in 2017. The future burden will increase due to population growth and ageing. Considering its absolute burden and persisting disparities, in addition to the substantial prevalence of Helicobacter pylori infection worldwide that is treatable, gastric cancer is a logical target for urgent global action for prevention. In this review, we discuss recent progress in gastric cancer prevention and propose a concerted international effort to implement population-based H. pylori treatment programmes, as the best evidence-based strategy that is currently available for gastric cancer prevention, in the context of demonstration projects in selected populations, to be later scaled up. It is time for urgent action to reduce the important loss of life and productivity caused by this preventable malignancy.


Assuntos
Infecções por Helicobacter/complicações , Neoplasias Gástricas/prevenção & controle , Humanos , Neoplasias Gástricas/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-33975689

RESUMO

Gastric cancer (GC) is a significant global health problem, with Helicobacter pylori infection estimated to be responsible for 89% of non-cardiac GC cases, or 78% of all GC cases. The International Agency for Research on Cancer has called for Helicobacter pylori test-and-treat strategies in countries with high rates of GC. However, for countries with low rates of GC, such as most Western countries, the balance between benefits, harms and costs of screening is less clear-cut. GC is a disease with a well-characterized precancerous process, providing the basis for primary and secondary prevention efforts. However, rigorous data assessing the impact of such interventions in Western countries are lacking. In the absence of clinical trials, modelling offers a unique approach to evaluate the potential impact of various screening and surveillance interventions. In this paper, we provide an overview of modelling studies evaluating the cost-effectiveness of GC screening and surveillance in Western countries.


Assuntos
Detecção Precoce de Câncer/métodos , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Neoplasias Gástricas , Análise Custo-Benefício , Humanos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/economia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/prevenção & controle
3.
Eur J Pharmacol ; 900: 174020, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-33741381

RESUMO

Gastric cancer is one of the most common and deadly cancers among men and women and is the third leading cause of cancer mortality worldwide. Thus, discovering and developing novel therapeutics for gastric cancer has become a global priority. In this study, we synthesized two novel anthraquinone-based aspirin derivatives, Asp-X3 and Asp-X3-CH3, with therapeutic potential for gastric cancer. The structures of the two compounds were determined by 1D, 2D-NMR, and High-Resolution Mass (HRSM). Asp-X3 and Asp-X3-CH3 could inhibit the growth of gastric cancer cells (SGC7901), yielding IC50 values 10-fold lower than that of Aspirin. Asp-X3 and Asp-X3-CH3 were less toxic to gastric mucosal cells, yielding IC50 values that were about 2-fold higher than the corresponding IC50 values determined with SGC7901 cells. Asp-X3-CH3 and Asp-X3 also induced SGC7901 cells to undergo apoptosis, yielding apoptotic rates that were about twice the rate induced by Aspirin. Asp-X3-CH3 did not cause significant loss of COX-1 expression in gastric mucosal cells, whereas Asp-X3 and Aspirin both caused significant loss of COX-1 expression as demonstrated by Western blot, consistent with their effects on the content of PGE2 in these cells as determined by ELISA assay. However, both Asp-X3-CH3 and Asp-X3 exerted a similar effect on the level of COX-2 in gastric cancer cells, causing as much as 90% and 95% reduction in COX-2 expression, respectively. Taken together, the results suggested that Asp-X3-CH3 and Asp-X3 were potentially better agents than Aspirin for the inhibition of gastric cancer cell growth, but Asp-X3-CH3 was more effective.


Assuntos
Antraquinonas/síntese química , Antraquinonas/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Aspirina/análogos & derivados , Aspirina/farmacologia , Neoplasias Gástricas/prevenção & controle , Apoptose/efeitos dos fármacos , Aspirina/síntese química , Linhagem Celular Tumoral , Ciclo-Oxigenase 1/metabolismo , Inibidores de Ciclo-Oxigenase 2/farmacologia , Dinoprostona/metabolismo , Mucosa Gástrica/citologia , Mucosa Gástrica/efeitos dos fármacos , Humanos , Espectroscopia de Ressonância Magnética , Neoplasias Gástricas/induzido quimicamente , Relação Estrutura-Atividade
5.
Proc Natl Acad Sci U S A ; 118(1)2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33443161

RESUMO

Fluorescence imaging is currently being actively developed for surgical guidance; however, it remains underutilized for diagnostic and endoscopic surveillance of incipient colorectal cancer in high-risk patients. Here we demonstrate the utility and potential for clinical translation of a fluorescently labeled cathepsin-activated chemical probe to highlight gastrointestinal lesions. This probe stays optically dark until it is activated by proteases produced by tumor-associated macrophages and accumulates within the lesions, enabling their detection using an endoscope outfitted with a fluorescence detector. We evaluated the probe in multiple murine models and a human-scale porcine model of gastrointestinal carcinogenesis. The probe provides fluorescence-guided surveillance of gastrointestinal lesions and augments histopathological analysis by highlighting areas of dysplasia as small as 400 µm, which were visibly discernible with significant tumor-to-background ratios, even in tissues with a background of severe inflammation and ulceration. Given these results, we anticipate that this probe will enable sensitive fluorescence-guided biopsies, even in the presence of highly inflamed colorectal tissue, which will improve early diagnosis to prevent gastrointestinal cancers.


Assuntos
Detecção Precoce de Câncer/métodos , Endoscopia/métodos , Lesões Pré-Cancerosas/diagnóstico , Animais , Colo/patologia , Neoplasias do Colo/patologia , Neoplasias Colorretais/patologia , Modelos Animais de Doenças , Feminino , Fluorescência , Corantes Fluorescentes , Neoplasias Gastrointestinais/patologia , Trato Gastrointestinal/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Imagem Molecular/métodos , Lesões Pré-Cancerosas/patologia , Ratos , Ratos Endogâmicos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/prevenção & controle , Suínos
7.
Medicine (Baltimore) ; 99(33): e21775, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872077

RESUMO

BACKGROUND: Gastric cancer is a common gastrointestinal tumor, seriously threatening human health. Radical surgery is the preferred treatment for gastric cancer. However, due to the late diagnosis and postoperative recurrence and metastasis, the prognosis is dismal. In China, traditional Chinese medicine (TCM) has been used to treat gastric cancer for many years. The purpose of this study is to explore the efficacy and safety of Yiqi Huayu Jiedu decoction in the treatment of postoperative gastric caner. METHODS/DESIGN: 226 eligibility patients altogether will be randomly allocated to the treatment group and the control group at a ratio of 1:1. After enrollment, every patients will obtain 6 months of treatment, as well as 2 years of follow-up. At the end of this study, primary outcomes including 1-year progression-free survival rate, 2-year progression-free survival rate and disease-free survival, secondary outcomes containing tumor markers, TCM syndrome points, quality of life scale, imageological examination and the safety indicators will be assessed. DISCUSSION: This study will provide the evidence-based evidence for the efficacy of Yiqi Huayu Jiedu decoction reducing the risk of postoperative gastric cancer recurrence and metastasis, which will be beneficial to form the therapeutic regimen in postoperative gastric cancer with integrated TCM and Western medicine. TRAIL REGISTRATION: ChiCTR2000032802.


Assuntos
Recidiva Local de Neoplasia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Gástricas/prevenção & controle , Humanos , Metástase Neoplásica/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Gástricas/cirurgia
8.
Cochrane Database Syst Rev ; 7: CD005583, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32628791

RESUMO

BACKGROUND: Gastric cancer is the third most common cause of cancer death worldwide. Individuals infected with Helicobacter pylori have a higher likelihood of developing gastric cancer than individuals who are not infected. Eradication of H. pylori in healthy asymptomatic individuals in the general population may reduce the incidence of gastric cancer, but the magnitude of this effect is unclear. OBJECTIVES: To assess the effectiveness of eradication of H. pylori in healthy asymptomatic individuals in the general population in reducing the incidence of gastric cancer. SEARCH METHODS: We identified trials by searching the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 1), MEDLINE (1946 to February 2020), and EMBASE (1974 to February 2020). We handsearched reference lists from trials selected by electronic searching to identify further relevant trials. We handsearched published abstracts from conference proceedings from the United European Gastroenterology Week (published in Gut) and Digestive Disease Week (published in Gastroenterology) between 2001 and 2019. We contacted members of the Cochrane Upper Gastrointestinal and Pancreatic Diseases Review Group and experts in the field and asked them to provide details of outstanding clinical trials and any relevant unpublished materials. SELECTION CRITERIA: We analysed randomised controlled trials comparing at least one week of H. pylori therapy with placebo or no treatment in preventing subsequent development of gastric cancer in otherwise healthy and asymptomatic H. pylori-positive adults. Trials had to follow up participants for at least two years and needed to have at least two participants with gastric cancer as an outcome. We defined gastric cancer as any gastric adenocarcinoma, including intestinal (differentiated) or diffuse (undifferentiated) type, with or without specified histology. DATA COLLECTION AND ANALYSIS: We collected data on incidence of gastric cancer, incidence of oesophageal cancer, deaths from gastric cancer, deaths from any cause, and adverse effects arising due to therapy. MAIN RESULTS: Six trials met all our eligibility criteria and provided extractable data in the previous version. Following our updated search, one new RCT was identified, meaning that seven trials were included in this updated review. In addition, one previously included trial provided fully published data out to 10 years, and another previously included trial provided fully published data out to 22 years of follow-up. Four trials were at low risk of bias, one trial was at unclear risk, and two trials were at high risk of bias. Six trials were conducted in Asian populations. In preventing development of subsequent gastric cancer, H. pylori eradication therapy was superior to placebo or no treatment (RR 0.54, 95% confidence interval (CI) 0.40 to 0.72, 7 trials, 8323 participants, moderate certainty evidence). Only two trials reported the effect of eradication of H. pylori on the development of subsequent oesophageal cancer. Sixteen (0.8%) of 1947 participants assigned to eradication therapy subsequently developed oesophageal cancer compared with 13 (0.7%) of 1941 participants allocated to placebo (RR 1.22, 95% CI 0.59 to 2.54, moderate certainty evidence). H. pylori eradication reduced mortality from gastric cancer compared with placebo or no treatment (RR 0.61, 95% CI 0.40 to 0.92, 4 trials, 6301 participants, moderate certainty evidence). There was little or no evidence in all-cause mortality (RR 0.97, 95% CI 0.85 to 1.12, 5 trials, 7079 participants, moderate certainty evidence). Adverse events data were poorly reported. AUTHORS' CONCLUSIONS: We found moderate certainty evidence that searching for and eradicating H. pylori reduces the incidence of gastric cancer and death from gastric cancer in healthy asymptomatic infected Asian individuals, but we cannot necessarily extrapolate this data to other populations.


Assuntos
Antibacterianos/uso terapêutico , Infecções Assintomáticas/terapia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Neoplasias Gástricas/prevenção & controle , Antiulcerosos/uso terapêutico , Carcinoma de Células Escamosas/epidemiologia , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Neoplasias Esofágicas/epidemiologia , Humanos , Incidência , Lesões Pré-Cancerosas/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/mortalidade
9.
Life Sci ; 256: 117977, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32603822

RESUMO

AIMS: Silibinin is the major component of flavonolignans complex mixture (Silymarin), which is obtained from Silybum marianum (L.) Gaertn. Despite several reports about silibinin, little is known about its effects on gastric diseases. Then, the present study aims to evaluate the silibinin effect against Helicobacter pylori infection, gastric tumor cells and immunomodulation. MAIN METHODS: The anti-H. pylori effect was performed on 43504 and 43629 strains by minimum inhibitory concentration (MIC) determination, observing morphological alterations by scanning electron microscopy and in silico evaluation by molecular docking. Immunomodulatory activity (Interleukins-6 and 10, TNF-α and NO inhibition) was determined in H. pylori-stimulated macrophages and the cytotoxic activity on gastric adenocarcinoma cells prior and after metabolization by S9 fraction. KEY FINDINGS: Silibinin showed anti-H. pylori activity with MIC of 256 µg/mL, promoted important morphological changes in the bacterial cell wall, as blebs and clusters, suggesting interaction with Penicillin Binding Protein (PBP) subunits. Immunomodulatory potential was observed at 50 µg/mL with the inhibition of produced cytokines and NO by H. pylori-stimulated macrophages of 100% for TNF-ɑ, 56.83% for IL-6, and 70.29% for IL-10 and 73.33% for NO. Moreover, silibinin demonstrated significant cytotoxic activity on adenocarcinoma cells (CI50: 60.17 ± 0.95 µg/mL) with a higher selectivity index (SI: 1.52) compared to cisplatin. After metabolization silibinin showed an increase of cytotoxicity with a CI50 six-fold decrease (10.46 ± 0.25). SIGNIFICANCE: The use of silibinin may become an important alternative tool in the prevention and treatment of H. pylori infection and, consequently, in gastric cancer.


Assuntos
Antineoplásicos Fitogênicos/farmacologia , Infecções por Helicobacter/prevenção & controle , Helicobacter pylori/efeitos dos fármacos , Simulação de Acoplamento Molecular/métodos , Silibina/farmacologia , Neoplasias Gástricas/prevenção & controle , Animais , Antineoplásicos Fitogênicos/uso terapêutico , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori/fisiologia , Camundongos , Testes de Sensibilidade Microbiana/métodos , Células RAW 264.7 , Silibina/química , Silibina/uso terapêutico , Neoplasias Gástricas/patologia
10.
Ann Intern Med ; 172(12): JC66, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32539507

RESUMO

SOURCE CITATION: Choi IJ, Kim CG, Lee JY, et al. Family history of gastric cancer and Helicobacter pylori treatment. N Engl J Med. 2020;382:427-36. 31995688.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Humanos , Anamnese , Neoplasias Gástricas/prevenção & controle
11.
JAMA Netw Open ; 3(6): e206628, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32589229

RESUMO

Importance: The associations of lifestyle factors with gastric cancer (GC) are still underexplored in populations in China. Long-term nutritional supplementation may prevent GC in high-risk populations, but the possible effect modification by lifestyle factors remains unknown. Objective: To evaluate how lifestyle factors, including smoking, alcohol intake, and diet, may change the risk of GC incidence and mortality and whether the effects of vitamin and garlic supplementation on GC are associated with major lifestyle factors. Design, Setting, and Participants: This is a secondary analysis of the Shandong Intervention Trial, a masked, randomized, placebo-controlled trial that aimed to assess the effect of vitamin and garlic supplementations and Helicobacter pylori treatment on GC in a factorial design with 22.3 years of follow-up. The study took place in Linqu County, Shandong province, China, a high-risk area for GC. Data were collected from Jully 1995 to December 2017. Overall, 3365 participants aged 35 to 64 years identified in 13 randomly selected villages who agreed to undergo gastroscopy were invited to participate in the trial and were included in the analysis. Data analysis was conducted from March to May 2019. Interventions: Participants received vitamin and garlic supplementation for 7.3 years, H pylori treatment for 2 weeks (among participants with H pylori ), or placebo. Main Outcomes and Measures: The primary outcomes were GC incidence and GC mortality (1995-2017). We also examined the progression of gastric lesions (1995-2003) as a secondary outcome. Results: Of the 3365 participants (mean [SD] age, 47.1 [9.2] years; 1639 [48.7%] women), 1677 (49.8%) were randomized to receive active vitamin supplementation, with 1688 (50.2%) receiving placebo, and 1678 (49.9%) receiving active garlic supplementation, with 1687 (50.1%) receiving placebo. Overall, 151 GC cases (4.5%) and 94 GC deaths (2.8%) were identified. Smoking was associated with increased risk of GC incidence (odds ratio, 1.72; 95% CI, 1.003-2.93) and mortality (hazard ratio [HR], 2.01; 95% CI, 1.01-3.98). Smoking was not associated with changes to the effects of vitamin or garlic supplementation. The protective effect on GC mortality associated with garlic supplementation was observed only among those not drinking alcohol (never drank alcohol: HR, 0.33; 95% CI, 0.15-0.75; ever drank alcohol: HR, 0.92; 95% CI, 0.55-1.54; P for interaction = .03), and significant interactions were only seen among participants with H pylori (never drank alcohol: HR, 0.31; 95% CI, 0.12-0.78; ever drank alcohol: HR, 0.91; 95% CI, 0.52-1.60; P for interaction = .04). No significant interactions between vitamin supplementation and lifestyle factors were found. Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, smoking was associated with an increased risk of GC incidence and mortality. Not drinking alcohol was associated with a stronger beneficial effect of garlic supplementation on GC prevention. Our findings provide new insights into lifestyle intervention for GC prevention, suggesting that mass GC prevention strategies may need to be tailored to specific population subgroups to maximize the potential beneficial effect. Trial Registration: ClinicalTrials.gov Identifier: NCT00339768.


Assuntos
Alho/química , Helicobacter pylori/efeitos dos fármacos , Neoplasias Gástricas/prevenção & controle , Vitaminas/farmacologia , Adulto , Compostos Alílicos/farmacologia , Estudos de Casos e Controles , China/epidemiologia , Suplementos Nutricionais/efeitos adversos , Feminino , Gastroscopia/métodos , Humanos , Incidência , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Placebos/administração & dosagem , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Sulfetos/farmacologia
13.
Rev. esp. enferm. dig ; 112(5): 367-372, mayo 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-195590

RESUMO

INTRODUCTION AND AIM: hereditary diffuse gastric cancer (HDGC) can be caused by a CDH1 mutation. It often presents as multiple foci of signet ring cell carcinoma (SRCC) that is rarely detected by gastroscopy. Prophylactic total gastrectomy is recommended at a young age. The aim of this study was to determine the adequacy of gastroscopy according to the Cambridge protocol in patients with a CDH1 mutation. METHODS: patients with a CDH1 mutation admitted to our department between September 2016 and October 2018 were evaluated. All patients underwent a baseline gastroscopy according to the Cambridge protocol, followed by a recommended total gastrectomy. Endoscopic findings, the number of biopsies and histological evaluation of biopsy samples were registered. Postoperative histopathological assessment was compared with endoscopic findings in patients that underwent a total gastrectomy (n = 13). RESULTS: twenty-five patients were included and 35 gastroscopies performed. On these, 996 gastric biopsies were performed, which included 952 random and 44 targeted. Only three patients had SRCC foci in random biopsies and one also had SRCC lesions in two targeted biopsies. In our cohort, 332 random and 22 targeted biopsies were needed to identify a single SRCC focus. Total gastrectomy was performed in 13 patients and SRCC foci were identified in 12 surgical specimens, the remaining specimen had a precursor lesion of HDGC. DISCUSSION: gastroscopy has a poor sensitivity to detect SRCC. Even with Cambridge protocol, gastroscopy has a very limited role in the surveillance of patients with a CDH1 mutation and prophylactic total gastrectomy is the most advisable option. Nevertheless, endoscopic protocols should be optimized to favor targeted biopsies over a high number of random biopsies


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Protocolos Clínicos , Gastroscopia , Proteínas Cdh1/genética , Mutação/genética , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Sensibilidade e Especificidade , Neoplasias Gástricas/patologia , Neoplasias Gástricas/prevenção & controle , Gastrectomia , Estudos Prospectivos , Estudos de Coortes , Distribuição Aleatória , Biópsia
15.
J Gastroenterol Hepatol ; 35(9): 1495-1502, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32181516

RESUMO

Gastric cancer (GC) is the fifth most common cancer worldwide, and mortality rates are still high. Primary preventive strategies, aimed to reduce risk factors and promote protective ones, will lead to a decrease in GC incidence. Helicobacter pylori infection is a well-established carcinogen for GC, and its eradication is recommended as the best strategy for the primary prevention. However, the role of other factors such as lifestyle, diet, and drug use is still under debate in GC carcinogenesis. Unfortunately, most patients with GC are diagnosed at late stages when treatment is often ineffective. Neoplastic transformation of the gastric mucosa is a multistep process, and appropriate diagnosis and management of preneoplastic conditions can reduce GC-related mortality. Several screening strategies in relation to GC incidence have been proposed in order to detect neoplastic lesions at early stages. The efficacy of screening strategies in reducing GC mortality needs to be confirmed. This review provides an overview of current international guidelines and recent literature on primary and secondary prevention strategies for GC.


Assuntos
Prevenção Primária , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/prevenção & controle , Aciltransferases/efeitos adversos , Biomarcadores Tumorais , Dieta , Endoscopia , Exercício Físico , Gastrite/complicações , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Infecções por Helicobacter , Humanos , Estilo de Vida , Programas de Rastreamento , Segunda Neoplasia Primária/prevenção & controle , Lesões Pré-Cancerosas/diagnóstico , Inibidores da Bomba de Prótons/efeitos adversos , Fatores de Risco , Fumar/efeitos adversos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia
16.
Dig Dis ; 38(4): 280-285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32062657

RESUMO

BACKGROUND: Despite its decreasing incidence, gastric cancer (GC) remains one of the leading cancers in the world and an important global healthcare problem due to its overall high prevalence and high mortality rate. SUMMARY: GC is a consequence of Helicobacter pylori infection in 90% of cases, while in 10% Epstein Barr Virus may be responsible. Moreover, some recent epidemiological data suggest an increasing incidence in some young patients groups possibly due to autoimmunity, and if this tendency is confirmed, it may change the epidemiology of GC in the future. The pathogenesis of GC is mainly related to H. pylori infection, but recent data indicate the possible role of other bacteria and their metabolites, like N-nitrosocompounds or acetaldehyde, interfering during the last steps of carcinogenesis. The new molecular classifications of GCs show a great heterogeneity of this neoplasia, which may in the future help to define personalized treatment strategies for the patients. Early detection and proper surveillance of high risk patients should be our major objectives. Key Messages: GC is still an important healthcare problem, with its several aspects which remain the major challenges for the future.


Assuntos
Neoplasias Gástricas/patologia , Detecção Precoce de Câncer , Infecções por Helicobacter/complicações , Humanos , Incidência , Prevalência , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/fisiopatologia , Neoplasias Gástricas/prevenção & controle
17.
Epidemiol Health ; 42: e2020004, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023777

RESUMO

OBJECTIVES: This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs. METHODS: PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model. RESULTS: Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies. CONCLUSIONS: This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.


Assuntos
Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/prevenção & controle , Comportamentos de Risco à Saúde , Humanos , Estado Nutricional , Fatores de Risco
19.
J Gastroenterol Hepatol ; 35(9): 1540-1548, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32090375

RESUMO

BACKGROUND AND AIM: Few studies have evaluated the change in serum pepsinogen (sPG) levels after the eradication of Helicobacter pylori. The aim of this study was to evaluate the effect of H. pylori eradication on sPG levels in patients with gastric cancer/dysplasia in comparison to a control group. METHODS: We prospectively enrolled 368 patients with gastric cancer/dysplasia and 610 control subjects. H. pylori status and sPG levels were measured before and after eradication. The follow-up time points were classified as < 12, 12-23, 24-35, and ≥ 36 months. RESULTS: In 179 H. pylori-eradicated patients with gastric cancer/dysplasia and 168 control group subjects, sPG I significantly decreased, and the sPG I/II ratio significantly increased after eradication compared to baseline, and this improvement in sPG values was maintained during all follow-up time points. Significant differences in sPG I and the sPG I/II ratio were observed between the gastric cancer/dysplasia group and the control group < 24 months after eradication. However, these differences in sPG values disappeared after ≥ 24 months of follow up. Moreover, significant differences in the intestinal metaplasia grade were observed between these two groups before eradication until < 24 months after eradication. However, these differences in the intestinal metaplasia grade disappeared after ≥ 24 months of follow up in the corpus. CONCLUSION: The sPG values and intestinal metaplasia grade (corpus) in the gastric cancer/dysplasia group became similar to those in the control group at long-term follow up after H. pylori eradication. It might be related with the reduction of metachronous gastric neoplasm.


Assuntos
Gastrite/tratamento farmacológico , Gastrite/microbiologia , Infecções por Helicobacter , Helicobacter pylori , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/prevenção & controle , Pepsinogênios/sangue , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/prevenção & controle , Estômago/patologia , Biomarcadores/sangue , Seguimentos , Gastrite/complicações , Humanos , Metaplasia/diagnóstico , Metaplasia/etiologia , Metaplasia/prevenção & controle , Segunda Neoplasia Primária/etiologia , Neoplasias Gástricas/etiologia , Fatores de Tempo
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