Tests for serum levels of trefoil factor family proteins can improve gastric cancer screening.

BACKGROUND & AIMS: Improving methods for early detection of gastric cancer could reduce mortality. Measurements of serum pepsinogen levels have been used for screening in Japan without satisfactory levels of sensitivity or specificity. Trefoil factor family (TFF) proteins (TFF1, TFF2, and TFF3) are small and stable molecules secreted by the mammalian gastrointestinal tract. Foveolar hyperplasia, spasmolytic polypeptide (TFF2)-expressing metaplasia, and intestinal metaplasia are histologic changes observed in patients with atrophic gastritis; they express TFF1, TFF2, and TFF3, respectively. We investigated whether serum levels of TFF can be used as markers for gastric cancer screening. METHODS: Serum was collected from 183 patients with gastric cancer and 280 healthy individuals without cancer. Serum levels of anti-Helicobacter pylori immunoglobulin G, pepsinogen I, pepsinogen II, TFF1, TFF2, and TFF3 were measured by enzyme-linked immunosorbent assay and associated with gastric cancer. RESULTS: Using a cutoff of 3.6 ng/mL, the level of TFF3 was significantly increased in serum samples from patients with cancer (odds ratio, 18.1; 95% confidence interval, 11.2-29.2); using this test, patients with cancer were identified with 80.9% sensitivity and 81.0% specificity. The test for TFF3 had a significantly higher odds ratio than that for pepsinogen. A test for the combination of TFF3 and pepsinogen had better results than the test for only pepsinogen. CONCLUSIONS: Serum levels of TFF3 are a better marker of gastric cancer than pepsinogen; a test for the combined levels of serum pepsinogen and TFF3 could improve gastric cancer screening.

[What is ghrelin for gastric cancer?].

Ghrelin is a novel and 28-amino-acid peptide hormone. It was identified in the stomach as the endogenous ligand for the growth hormone secretagogue receptor by a Japanese researcher in 1999. Besides the stimulation, ghrelin has been known to have a wide spectrum of biological functions such as regulation of appetite and food intake, gastrointestinal motility, gastric acid secretion, cell proliferation, glucose and lipid metabolism, and cardiovascular and immunologic processes. Therefore, studies of ghrelin have been rapidly increasing. However, the reports on the relationship between ghrelin and gastric cancer are few, though ghrelin is secreted mainly from the stomach. The purpose of this review is to consider what ghrelin is from a gastric cancer perspective. The studies and clinical applications of ghrelin in near future are also discussed.

Consumption of alpha-linolenic acid-enriched diacylglycerol induces increase in dietary fat oxidation compared with alpha-linolenic acid-enriched triacylglycerol: A randomized, double-blind trial.

Fat metabolism is an important consideration in obesity. Alpha-linolenic acid-enriched diacylglycerol (ALA-DAG), which mainly occurs as ALA esterifies to 1,3-diacyl-sn-glycerol (1,3-DAG), has beneficial effects on fat metabolism and body weight compared with triacylglycerol (TAG). Moreover, compared with ALA-TAG, ALA-DAG enhances ß-oxidation activity in the small intestine and liver in rodents. We hypothesized that ALA-DAG consumption may increase dietary fat oxidation compared with ALA-TAG in humans. To examine this hypothesis, we conducted a randomized double-blind cross-over trial in 17 normal and moderately obese men and women (BMI: 25.7±2.0 kg/m2, mean±SD). Each participant was assigned to a 4-week intervention period with 2.5 g/day of ALA-DAG or ALA-TAG consumption, followed by a 4-week washout period between consumption of each diet. Dietary fat oxidation, assessed based on the 13CO2 recovery rate in the breath, was significantly increased by ALA-DAG consumption compared with ALA-TAG consumption (17.0±4.5% and 14.1±5.9%, respectively, P<.05). In addition, ALA-DAG consumption significantly decreased the visceral fat area compared with ALA-TAG (102.9±51.9 cm2 and 110.9±51.7 cm2, respectively; P<.05). These results indicate that ALA-DAG consumption may be useful for preventing obesity.

Serum TFF1 and TFF3 but not TFF2 are higher in women with breast cancer than in women without breast cancer.

Breast cancer remains a common malignancy in women, but the take-up for breast cancer screening programs in Japan is still low, possibly due to its perceived inconvenience. TFF1 and TFF3 are expressed in both breast cancer tissue and normal breast. Serum trefoil proteins were reported as cancer screening markers for gastric, prostate, lung, pancreatic cancer and cholangio carcinoma. The purpose of this study was to examine whether serum trefoil proteins could be screening biomarkers for breast cancer. Serum trefoil proteins in 94 breast cancer patients and 84 health check females were measured by ELISA. Serum TFF1 and TFF3 were significantly higher and serum TFF2 was significantly lower in breast cancer patients. Area under the curve of receiver operating characteristic of TFF1, TFF2, and TFF3 was 0.69, 0.83, and. 0.72, respectively. AUC of the combination of TFF1, TFF2, and TFF3 was 0.96. Immunohistochemically, TFF1 expression was positive in 56.5% and TFF3 was positive in 73.9% of breast cancers, while TFF2 was negative in all tumors. Serum TFF1 had positive correlation with expression of TFF1 in breast cancer tissue. Serum concentrations of TFF1 and TFF3 but not TFF2 are higher in women with breast cancer than in women without breast cancer.

Case report: A breast cancer patient treated with GcMAF, sonodynamic therapy and hormone therapy.

BACKGROUND: Gc protein-derived macrophage-activating factor (GcMAF) occurs naturally in the human body. It has various functions, such as macrophage activation and antitumor activities. Recently, immunotherapy has become an attractive new strategy in the treatment of cancer. GcMAF-based immunotherapy can be combined with many other therapies. Sonodynamic therapy (SDT) using low-intensity ultrasound is a novel therapeutic modality. Ultrasound has been demonstrated to activate a number of sonosensitive agents allowing for the possibility of non-invasive targeted treatment for both superficial and deep-seated tumors. The current case study demonstrates that GcMAF and SDT can be used in combination with conventional therapies in patients with metastatic cancer, especially where treatment options are limited due to factors such as toxicity. This case study also suggests a new concept of cancer treatment using local destruction of cancer tissue, in this case conducted with SDT, to be used in combination with GcMAF immunotherapy as a systemic treatment.