scholarly journals Is There an Optimal Age Threshold for Searching for Intestinal Metaplasia on Gastric Mucosa in Western Populations?

2021 ◽  
pp. 1-5
Author(s):  
Angelo Zullo ◽  
Edith Lahner ◽  
Cesare Hassan ◽  
Bruno Annibale ◽  
Gianluca Esposito
Keyword(s):  
Gastric Cancer ◽  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Smoking Habit ◽  
Gastric Body ◽  
Screening Programs ◽  
Gastric Cancer Screening

<b><i>Introduction:</i></b> Since screening programs for gastric cancer are not applicable in Western countries, identification and follow-up of gastric precancerous lesions, such as extensive intestinal metaplasia (IM), are worthwhile to increase the diagnosis of cancer at an early stage. We investigated whether an optimal age threshold to detect extensive IM in a European country exists. <b><i>Methods:</i></b> This was a post hoc analysis of prospectively collected data in a nationwide study involving consecutive patients aged between 50 and 65 years who underwent an upper endoscopy with the standard 5 gastric biopsies. The presence of extensive (antral and gastric body) IM on gastric mucosa was considered. <b><i>Results:</i></b> Data found that the prevalence of extensive IM was distinctly higher in patients aged 60–65 years, with a 2.28-fold increased probability compared to younger patients. None of the other considered factors (sex, BMI, smoking habit, first-degree family history, and symptoms) emerged as an independent predictor of extensive IM in the stomach. <b><i>Conclusion:</i></b> When deciding for an occasional gastric cancer screening in Western populations, the choice of an age range of 60–65 years might be appropriate, allowing detection of a distinctly high prevalence of extensive IM deserving scheduled follow-up.

scholarly journals Onset and Progression of Precancerous Lesions on Gastric Mucosa of Patients Treated for Gastric Lymphoma

2020 ◽  
Vol 29 (1) ◽  
pp. 27-31
Author(s):  
Angelo Zullo ◽  
Angela Rago ◽  
Stefano Felici ◽  
Stefano Licci ◽  
Lerenzo Ridola ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Mucosa ◽  
Malt Lymphoma ◽  
Precancerous Lesions ◽  
Gastric Lymphoma ◽  
B Cell Lymphoma ◽  
Low Grade ◽  
Primary Gastric Lymphoma ◽  
Low Grade Dysplasia

Background and Aims: Patients with primary gastric lymphoma are at an increased risk of developing gastric cancer. Data on gastric precancerous lesions development in these patients are scanty. We assessed gastric precancerous lesions in a cohort of patients with primary lymphoma. Methods: Data of patients with primary gastric lymphoma [mucosa-associated lymphoid tissue (MALT)- lymphoma or diffuse large B-cell lymphoma (DLBCL)] were analysed. Multiple (>10) biopsies were performed on gastric mucosa at each endoscopic control, beyond macroscopic lesions. Presence and distribution of intestinal metaplasia (IM) at baseline, the onset at follow-up, and progression through the stomach or transformation in the incomplete IM type were assessed. The onset of neoplastic lesions was recorded. Results: Data of 50 patients (mean age of 63.6 ± 10.7 years; M/F: 25/25), including 40 with MALT-lymphoma and 10 with DLBCL, with median follow-up of 30.5 months (range: 9-108) and a median of 6 endoscopic controls (range: 3-14) were evaluated. At entry, IM was present in 12 (24%), and it developed in other 22 (57.9%) patients at a median follow-up of 6 (range: 3-40) months. Overall, progression of IM was observed in 7 (21.2%) cases, including extension in the stomach (n=5) or transformation into the incomplete type (n=2). Low-grade dysplasia was detected in 4, and indefinite dysplasia in other 7 patients. In one patient, low-grade dysplasia had progressed to high-grade and gastric adenocarcinoma of the fundus. Conclusions: Our data found a frequent onset and rapid progression of precancerous lesions on gastric mucosa of lymphoma patients. This observation could explain the increased incidence of metachronous gastric cancer in these patients.

scholarly journals Intestinal Metaplasia and the Risk of Gastric Cancer in an Immigrant Asian Population

2012 ◽  
Vol 5 ◽  
pp. CGast.S10070 ◽  
Author(s):  
Amir Abadir ◽  
Catherine Streutker ◽  
Christine Brezden-Masley ◽  
Andrea Grin ◽  
Young-In Kim
Keyword(s):  
Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Asian Population ◽  
Female Gender ◽  
Asian Immigrants ◽  
Human Populations ◽  
Asian Populations ◽  
History Of ◽  
Gastric Cancer Screening

The development of intestinal metaplasia (IM) has been purported to be a critical step in the pathogenesis of gastric cancer. However, the natural history of IM in migrant human populations has not been well elucidated. The purpose of this study was to determine the risk of gastric cancer posed by IM in Asian immigrants undergoing gastric cancer screening. A retrospective review of Asian immigrants found to have IM during screening was conducted over an 18-month period. In total, 222 patients were found to have IM. Altogether, 24% had a history of smoking, 48% had a family history of gastric cancer, and 52% had a history of Helicobacter pylori (H. pylori) infection with a 96% eradication rate. Patients with stable IM (SIM) were then compared with those who developed high risk pathology (HRP), specifically dysplasia and/or adenocarcinoma. Thirty-five patients (16%) were included in the HRP group. 31 with dysplasia (14%) and 4 with adenocarcinoma (2%). Of those with dysplasia, 55% demonstrated regression to IM over the course of follow-up. Patients in the SIM group were more likely to be female (60% vs. 31%, P = 0.002) and more likely to have had a normal biopsy during follow-up (32% vs. 9%, P = 0.005). Odds ratios for IM stability were 3.3 (95% CI 1.5-7.0) and 5.0 (95% CI 1.5-17.1) for female gender and presence of a normal biopsy, respectively. Intestinal metaplasia in immigrant Asian populations is predominantly a stable histologic finding associated with a low rate of persistent dysplasia and adenocarcinoma.

scholarly journals Biomarkers for Gastric Cancer Screening and Early Diagnosis

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1448
Author(s):  
Cristina Herrera-Pariente ◽  
Sheyla Montori ◽  
Joan Llach ◽  
Alex Bofill ◽  
Eduardo Albeniz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Screening ◽  
Early Stage ◽  
Cost Effective ◽  
Screening Strategy ◽  
Daily Routine ◽  
Screening Programs ◽  
Low Incidence ◽  
Gastric Cancer Screening ◽  
Noninvasive Biomarkers

Gastric cancer is one of the most common cancers worldwide, with a bad prognosis associated with late-stage diagnosis, significantly decreasing the overall survival. This highlights the importance of early detection to improve the clinical course of these patients. Although screening programs, based on endoscopic or radiologic approaches, have been useful in countries with high incidence, they are not cost-effective in low-incidence populations as a massive screening strategy. Additionally, current biomarkers used in daily routine are not specific and sensitive enough, and most of them are obtained invasively. Thus, it is imperative to discover new noninvasive biomarkers able to diagnose early-stage gastric cancer. In this context, liquid biopsy is a promising strategy. In this review, we briefly discuss some of the potential biomarkers for gastric cancer screening and diagnosis identified in blood, saliva, urine, stool, and gastric juice.

scholarly journals Diagnostic value of macrophage inhibitory cytokine 1 as a novel prognostic biomarkers for early gastric cancer screening

2020 ◽  
Author(s):  
Xin Ge ◽  
Xiaolei Zhang ◽  
Yanling Ma ◽  
Shaohua Chen ◽  
Zhaowu Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Diagnostic Value ◽  
Low Grade ◽  
Serum Samples ◽  
Early Screening ◽  
Roc Curve Analysis

Abstract BACKGROUND Early diagnosis is very important to improve the survival rate of patients with gastric cancer, especially in asymptomatic participants. However, low sensitivity of common biomarkers has caused difficulties in early screening of gastric cancer. In this study, we explored whether MIC-1 can improve the detection rate of early gastric cancer.METHODS We screened 8,257 participants based on risk factors such as age, gender, and family history for physical examination including gastroscopy. Participant blood samples were taken for measure MIC-1, CA-199, CA72-4 and PG1/PG2 levels. The diagnostic performance of MIC-1 was assessed and compared with CA-199, CA72-4 and PG1/PG2, and its role in early gastric cancer diagnosis and the assessment of the risk of precancerous lesions have also been studied.RESULTS Based on endoscopic and histopathological findings, 55 participants had gastric cancer, 566 participants had low-grade neoplasia, 2605 participants had chronic gastritis. MIC-1 levels were significantly elevated in gastric cancer serum samples as compared to controls (p<0.001). The sensitivity of serum MIC-1 for gastric cancer diagnosis was much higher than that of CA-199 (49.1% vs. 20.0%) with similar specificities. Moreover, receiver operating characteristic (ROC) curve analysis also showed that serum MIC-1 had a better performance compared with CA-199, CA72-4 and PG1/PG2 in distinguishing early-stage gastric cancer (AUC: 72.9% vs. 69.5%, 67.5%, 44.0% respectively).CONCLUSIONS Serum MIC-1 is significantly elevated in most patients with early gastric cancer. MIC-1 can serve as a novel diagnostic marker of early gastric cancer and value the risk of gastric cancer.

scholarly journals HypermethylatedFAM5CandMYLKin Serum as Diagnosis and Pre-Warning Markers for Gastric Cancer

2012 ◽  
Vol 32 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Lu Chen ◽  
Liping Su ◽  
Jianfang Li ◽  
Yanan Zheng ◽  
Beiqin Yu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Candidate Genes ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Single Gene ◽  
High Specificity ◽  
Serum Samples ◽  
Promoter Regions ◽  
Gastric Cancer Cell Lines ◽  
Combined Detection

Most cases of gastric cancer (GC) are not diagnosed at early stage which can be curable, so it is necessary to identify effective biomarkers for its diagnosis and pre-warning. We have used methylated DNA immunoprecipitation (MeDIP) to identify genes that are frequently methylated in gastric cancer cell lines. Promoter regions hypermethylation of candidate genes were tested by methylation-specific polymerase chain reaction (MSP) in serum samples, including GC (n= 58), gastric precancerous lesions (GPL,n= 46), and normal controls (NC,n= 30). Eighty two hypermethylated genes were acquired by array analysis and 5 genes (BCAS4, CHRM2, FAM5C, PRACandMYLK) were selected as the candidate genes. Three genes (CHRM2, FAM5CandMYLK) were further confirmed to show methylation rates increased with progression from NC to GPL, then to GC. There was obvious decrease in detection ofFAM5CandMYLKhypermethylation, but notCHRM2, from preoperative to postoperative evaluation (P< 0.001). Combined detection of FAM5C and MYLK hypermethylation had a higher sensitivity in GC diagnosis (77.6%,45/58) and pre-warning (30.4%,14/46) than one single gene detection and also had a high specificity of 90%. The combined hypermethylated status ofFAM5CandMYLKcorrelated with tumor size (P< 0.001), tumor invasion depth (P= 0.001) and tumor-node-metastasis (TNM) stage (P= 0.003). HypermethylatedFAM5CandMYLKcan be used as potential biomarkers for diagnosis and pre-warning of GC.

scholarly journals The status of compliance with guidelines of cancer screening in Japan

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Kono ◽  
K Matsuda ◽  
R Machii ◽  
K Saika ◽  
H Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Screening Methods ◽  
General Tendency ◽  
Screening Guidelines ◽  
Screening Programs ◽  
The Status ◽  
Gastric Cancer Screening

Abstract Background The Ministry of Health, Labour and Welfare (MHLW) establishes screening recommendations specifying screening methods, age, and interval for gastric, colon, lung, breast, and cervical cancers. Screening programs are provided via local healthcare departments (LHD), who are responsible for managing programs and reporting the screening status through a survey annually. Methods We analyzed screening status provided by LHDs in fiscal 2017 in regards to appropriate screening age and interval. Briefly, current recommended screening age by MHLW is followed: colon, lung, breast cancer screening are age 40 years and older, and cervical cancer for aged 20 and older, and gastric cancer for aged 50 and older. Screening intervals are gastric, breast, and cervical cancer screening are two years, and colon and lung cancer screening are one year. Results The survey was completed by 1736 LHD (response rate: 99.9%). Regarding age-appropriate compliance, in cervical cancer, 96.4% of LHDs reported following recommended target age, while compliance was lower for lung, colon, breast, and gastric cancers at 79.4%, 75.7%, 60.2% and 4.2%, respectively. High compliance with recommendations for screening interval was identified for colon (99.7%) and lung (98.7%) cancers; this was substantially less for breast, cervical, and gastric cancer screening at 39.8%, 34.1%, and 4.6%, respectively. Conclusions In 2016, MLHW changed the starting screening age for gastric cancer from 40 to 50 years old, likely resulting in the lowest compliance in our analysis. Though it may take time for screening facilities to come into compliance with newer recommendations. Many LHDs provide screening without adhering to recommended starting ages, with a general tendency to provide screening at younger than recommended ages. This is a barrier to maximizing effectiveness and minimize harms of screening and warrants closer monitoring to promote efficiency in cancer screening programs. Key messages There is relatively low compliance with cancer screening guidelines in Japan. Establishing an environment of appropriate monitoring and support to achieve the goal of cancer screening is warranted.

scholarly journals Will Treatment of Helicobacter Pylori Infection in Childhood Alter the Risk of Developing Gastric Cancer?

2005 ◽  
Vol 19 (7) ◽  
pp. 409-411 ◽  
Author(s):  
Billy Bourke
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Precancerous Lesions ◽  
Positive Family History ◽  
Population Based ◽  
Screening Programs ◽  
History Of ◽  
Different Populations ◽  
H Pylori ◽  
Developed Nations

Helicobacter pylori has been classified as a group 1 carcinogen for gastric cancer. It is estimated that there is between a two- and sixfold increase in the risk of developing gastric cancer among infected patients. Among different populations, the risk of H pylori-infected individuals developing gastric cancer varies greatly. However, on a worldwide scale, gastric cancer is the second most common cause of cancer-related death. Therefore, H pylori eradication could help prevent up to three to four million gastric cancer deaths per year. H pylori is usually acquired in childhood. Because infected children have not harboured the organism for long enough to have developed precancerous lesions, childhood is theoretically an attractive time for H pylori eradication and, thus, could help prevent gastric cancer later in life. However, as H pylori prevalence and the incidence of gastric cancer are falling rapidly in developed nations, widespread population screening programs aimed at the eradication of H pylori in these countries would be enormously expensive. Therefore, except in groups with a high risk for development of gastric cancer (eg, Japanese or those with a strong positive family history of gastric cancer), a population-based test-and-treat policy is not justified.

scholarly journals Neutrophil Infiltration and the Distribution of Intestinal Metaplasia Is Associated with Metachronous Gastric Cancer following Endoscopic Submucosal Dissection

2015 ◽  
Vol 29 (6) ◽  
pp. 321-325 ◽  
Author(s):  
Takafumi Sugimoto ◽  
Yutaka Yamaji ◽  
Kosuke Sakitani ◽  
Yoshihiro Isomura ◽  
Shuntaro Yoshida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Intestinal Metaplasia ◽  
Neutrophil Infiltration ◽  
Rank Test ◽  
Gastric Cancers ◽  
Submucosal Dissection ◽  
Metachronous Gastric Cancer

BACKGROUND: Endoscopic submucosal dissection (ESD) of early gastric cancer is a minimally invasive procedure. However, the risk for metachronous cancers after successful cancer treatment remains high and the risk factors for metachronous cancers have not been elucidated.OBJECTIVE: To evaluate the risk factors for metachronous gastric cancers after ESD with a long-term follow-up.METHODS: A total of 155 consecutive patients (119 men, 36 women, mean age 68.9 years) were treated with ESD between September 2000 and September 2009. Biopsy specimens were obtained from the greater curvature of the antrum and middle corpus to evaluate gastric mucosal status, includingHelicobacter pylori, intestinal metaplasia (IM) and neutrophil infiltration (NI) before ESD. Follow-up endoscopy after ESD was scheduled at two and six months, one year and annually thereafter.H pylorieradication was recommended when possible.RESULTS: The median follow-up period was 4.2 years. Metachronous gastric cancers were found in 23 of 155 patients (3.5% per year). No local recurrences were observed. The cumulative incidence of metachronous gastric cancer was significantly high in IM and NI in the corpus (P=0.0093 and P=0.0025, respectively [log-rank test]). The ORs for IM and NI in the corpus were 2.65 and 3.06, respectively, according to the Cox proportional hazards model (P=0.024 and P=0.0091, respectively).CONCLUSIONS: The presence of IM and NI in the corpus was closely related to the development of metachronous gastric cancer after ESD.

Predictive factors for metastasis in patients (pts) with gastric cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15056-15056
Author(s):  
S. Kilickap ◽  
O. Dizdar ◽  
H. Harputluoglu ◽  
S. Aksoy ◽  
S. Yalcin
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Early Stage ◽  
Stage Iv ◽  
Stage I ◽  
Early Stage Disease ◽  
Increased Risk ◽  
Metastasis Development ◽  
The Mean

15056 Background: Determination of patients (pts) with early stage disease who have a high risk for developing metastatic disease is crucial. We investigated the risk factors associated with metastases development in pts with operable gastric cancer. Patients and Methods: In this retrospective study, pts with stage I-III and non-metastatic stage IV gastric cancer diagnosed between 1990 and 2006 were evaluated. The medical records of all pts including patient characteristics, laboratory results, histopathological examinations, were reviewed. Logistic regression methods were used to determine the risk factors for developing metastasis and to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: 184 pts (70% male, 30% female) were analyzed. The mean age ± standard deviation was 56.5±11.9. The mean age of female were higher than male (p=0.014). At the time of diagnosis, 13.6% of the pts had stage I, 19.0% had stage II, 53.3% had stage III, and 14.1% had non-metastatic stage IV disease. The tumors were distally localized in 80% of the cases. Median follow-up period was 35 months. During follow up, 51 pts developed metastases. Median time to metastases development was 14 months. Overall survival was shorter in pts who developed metastasis than those who did not. (20 months vs. not reached, respectively, p=0.002). In univariate analyses, stage (p=0.020), tumor localization (p=0.006), extracapsular lymphatic extension (ELE) (p<0.001), the number of metastatic lymph nodes (p=0.001), CEA level (p<0.001), lymphovascular invasion (LVI) (p=0.001), and perineural invasion (p=0.007) were associated with metastasis development. In multivariate analysis, elevated CEA levels (p=0.009; OR: 2.8; CI 95%: 1.29–6.19), LVI (p=0.041; OR: 2.2; CI 95%: 1.03–4.64) and ELE (p=0.029; OR: 2.3; CI 95%: 1.09–4.78) were associated with increased risk of metastasis development while distal localization (p=0.038; OR: 0.42; CI%: 0.18–0.95) was associated with decreased risk in pts with gastric cancer. Discussion: In pts with early stage or locally advanced gastric cancer, elevated CEA levels, LVI, proximal localization and ELE were associated with increased risk of developing metastasis. Aggressive treatment options and closer follow up should be considered for pts with these risk factors. No significant financial relationships to disclose.

scholarly journals Validation of the pepsinogen test method for gastric cancer screening using a follow-up study

2009 ◽  
Vol 12 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Shigeto Mizuno ◽  
Masao Kobayashi ◽  
Shohken Tomita ◽  
Ikuya Miki ◽  
Atsuhiro Masuda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Screening ◽  
Test Method ◽  
Follow Up Study ◽  
Gastric Cancer Screening
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