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World Journal of Gastroenterology 2024年第17期30卷 2308-2310页

作者： Veronika Papp Pál Miheller Department of Surgery Transplantation and GastroenterologySemmelweis UniversityBudapest 1082Hungary

Gastric cystica profunda(GCP)is an uncommon but underestimated gastric lesion.Its precancerous potential determines its significance.In addition to previous mucosa injury due to operations,biopsy or polypectomy,chronic active and atrophic gastritis may also lead to the development of GCPs.By carefully examining the stomach and taking biopsy samples from the susceptible regions,the stage of atrophy can be determined.Chronic atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs formation.GCPs frequently occur close to early gastric cancers(EGCs)or EGC can arise from the cystic glands.Endoscopic resection is an effective and minimally invasive treat-ment in GCP.

关键词： Gastric cystica profunda Chronic active gastritis atrophic gastritis Operative Link for gastritis Assessment staging Early gastric cancer Endoscopic resection

atrophic gastritis and gastric cancer tissue miRNome analysis reveals hsa-miR-129-1 and hsa-miR-196a as potential early diagnostic biomarkers

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World Journal of Gastroenterology 2022年第6期28卷 653-664页

作者： Greta Varkalaite Evelina Vaitkeviciute Ruta Inciuraite Violeta Salteniene Simonas Juzenas Vytenis Petkevicius Rita Gudaityte Antanas Mickevicius Alexander Link Limas Kupcinskas Marcis Leja Juozas Kupcinskas Jurgita Skieceviciene Institute for Digestive Research Lithuanian University of Health SciencesKaunas 44307Lithuania Department of Gastroenterology Lithuanian University of Health SciencesKaunas 44307Lithuania Department of Surgery Lithuanian University of Health SciencesKaunas 44307Lithuania Department of Gastroenterology Hepatology and Infectious DiseasesOttovon-Guericke University HospitalMagdeburg 39120Germany Institute of Clinical and Preventive Medicine&Faculty of Medicine University of LatviaRiga 1586Latvia

BACKGROUND Gastric cancer(GC)is one of the most frequently diagnosed tumor globally.In most cases,GC develops in a stepwise manner from chronic gastritis or atrophic gastritis(AG)to cancer.One of the major issues in clinical settings of GC is diagnosis at advanced disease stages resulting in poor prognosis.Micro RNAs(mi RNAs)are small noncoding molecules that play an essential role in a variety of fundamental biological processes.However,clinical potential of mi RNA profiling in the gastric cancerogenesis,especially in premalignant GC cases,remains unclear.AIM To evaluate the AG and GC tissue mi RNomes and identify specific mi RNAs’potential for clinical applications(e.g.,non-invasive diagnostics).METHODS Study included a total of 125 subjects:Controls(CON),AG,and GC patients.All study subjects were recruited at the Departments of Surgery or Gastroenterology,Hospital of Lithuanian University of Health Sciences and divided into the profiling(n=60)and validation(n=65)cohorts.Total RNA isolated from tissue samples was used for preparation of small RNA sequencing libraries and profiled using next-generation sequencing(NGS).Based on NGS data,deregulated mi RNAs hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p were analyzed in plasma samples of independent cohort consisting of CON,AG,and GC patients.Expression level of hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p was determined using the quantitative real-time polymerase chain reaction and 2-ΔΔCt method.RESULTS Results of tissue analysis revealed 20 differentially expressed mi RNAs in AG group compared to CON group,129 deregulated mi RNAs in GC compared to CON,and 99 altered mi RNAs comparing GC and AG groups.Only 2 mi RNAs(hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p)were identified to be step-wise deregulated in healthy-premalignant-malignant sequence.Area under the curve(AUC)-receiver operating characteristic analysis revealed that expression level of hsa-mi R-196 a-5 p is significant for discrimination of CON vs AG,CON vs GC and AG vs GC and resulted in AUCs:88.0%,93.1%and 66.3

关键词： Gastric cancer atrophic gastritis Tumorigenesis Helicobacter pylori MicroRNAs Biomarkers

Inverse correlation between gastroesophageal reflux disease and atrophic gastritis assessed by endoscopy and serology

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World Journal of Gastroenterology 2022年第8期28卷 853-867页

作者： Yoo Min Han Su Jin Chung Seokha Yoo Jong In Yang Ji Min Choi Jooyoung Lee Joo Sung Kim Department of Internal Medicine and Healthcare Research Institute Seoul National University Hospital Healthcare System Gangnam CenterSeoul 06236South Korea Department of Anesthesiology and Pain Medicine Seoul National University College of MedicineSeoul 03080South Korea Department of Internal Medicine and Liver Research Institute Seoul National University College of MedicineSeoul 03080South Korea

BACKGROUND Helicobacter pylori(H.pylori)infection is known to prevent the occurrence of gastroesophageal reflux disease(GERD)by inducing gastric mucosal atrophy.However,little is known about the relationship between atrophic gastritis(AG)and GERD.AIM To confirm the inverse correlation between AG and the occurrence and severity of GERD.METHODS Individuals receiving health checkups who underwent upper gastrointestinal endoscopy at Seoul National University Healthcare System Gangnam Center were included.The grade of reflux esophagitis was evaluated according to the Los Angeles classification.Endoscopic AG(EAG)was categorized into six grades.Serologic AG(SAG)was defined as pepsinogen I≤70 ng/m L and pepsinogen I/II ratio≤3.0.The association between the extent of EAG and SAG and the occurrence and severity of GERD was evaluated using multivariate logistic regression analysis.RESULTS In total,4684 individuals with GERD were compared with 21901 healthy controls.In multivariate logistic regression analysis,advanced age,male sex,body mass index>23 kg/m2,presence of metabolic syndrome,current smoking,and alcohol consumption were associated with an increased risk of GERD.Seropositivity for H.pylori immunoglobulin G antibodies was associated with a decreased risk of GERD.There was an inverse correlation between the extent of EAG and occurrence of GERD:Odds ratio(OR),1.01[95%confidence interval(CI):0.90-1.14]in C1,0.87(0.78-0.97)in C2,0.71(0.62-0.80)in C3,0.52(0.44-0.61)in O1,0.37(0.29-0.48)in O2,and 0.28(0.18-0.43)in O3.Additionally,the extent of EAG showed an inverse correlation with the severity of GERD.The presence of SAG was correlated with a reduced risk of GERD(OR=0.49,95%CI:0.28-0.87,P=0.014).CONCLUSION The extent of EAG and SAG exhibited strong inverse relationships with the occurrence and severity of GERD.AG followed by H.pylori infection may be independently protect against GERD.

关键词： Gastroesophageal reflux disease Reflux esophagitis Helicobacter pylori atrophic gastritis Pepsinogen

Incidence and prevalence of gastric neuroendocrine tumors in patients with chronic atrophic autoimmune gastritis

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World Journal of Gastrointestinal Oncology 2023年第8期15卷 1451-1460页

作者： Sara Massironi Camilla Gallo Alessandra Elvevi Marta Stegagnini Lorenzo Andrea Coltro Pietro Invernizzi Division of Gastroenterology Fondazione IRCCS San Gerardo dei TintoriUniversity of Milano-BicoccaSchool of MedicineMonza 20900Italy

BACKGROUND The incidence of type I gastric neuroendocrine neoplasms(gNENs)has increased significantly over the past 50 years.Although autoimmune gastritis(AIG)increases the likelihood of developing gNENs,the exact incidence and prevalence of this association remain unclear.AIM To evaluate the incidence and prevalence of type I gNENs in a cohort of patients with a histological diagnosis of AIG.METHODS Patients with a histological diagnosis of AIG were enrolled between October 2020 and May 2022.Circulating levels of CgA and gastrin were assessed at enrollment.Included patients underwent regular endoscopic follow-up to detect gastric neoplastic lesions,enterochromaffin-like(ECL)cell hyperplasia,and the development of gNEN.RESULTS We included 176 patients[142 women(80.7%),median age 64 years,interquartile range(IQR)53–71 years]diagnosed with AIG between January 1990 and June 2022.At enrollment.One hundred and sixteen patients(65.9%)had ECL hyperplasia,of whom,29.5%had simple/linear,30.7%had micronodular,and 5.7%had macronodular type.The median follow-up time was 5(3–7.5)years.After 1032 person-years,33 patients developed a total of 50 type I gNENs,with an incidence rate of 0.057 person-years,corresponding to an annual cumulative incidence of 5.7%.Circulating CgA levels did not significantly differ between AIG patients who developed gNENs and those who did not.Conversely,gastrin levels were significantly higher in AIG patients who developed gNENs[median 992 pg/mL IQR=449–1500 vs 688 pg/mL IQR=423–1200,P=0.03].Calculated gastrin sensitivity and specificity were 90.9%and 1.4%,respectively,with an overall diagnostic accuracy of 30%and a calculated area under the gastrin receiver operating characteristic curve(AUROC or AUC)of 0.53.CONCLUSION Type I gNENs are a significant complication in AIG.Gastrin’s low diagnostic accuracy prevents it from serving as a marker for early diagnosis.Effective strategies for early detection and treatment are needed.

关键词： atrophic gastritis Autoimmune gastritis Gastrin Gastric neuroendocrine tumors

Mucosal patterns change after Helicobacter pylori eradication:Evaluation using blue laser imaging in patients with atrophic gastritis

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World Journal of Gastroenterology 2023年第17期29卷 2657-2665页

作者： Yoshiyuki Nishikawa Yoshio Ikeda Hidehiro Murakami Shin-Ichiro Hori Megumi Yoshimatsu Naoki Nishikawa Department of Gastroenterology Nishikawa Gastrointestinal ClinicMatsuyama 790-0878EhimeJapan Endoscopy Center Ehime University HospitalToon 791-0295EhimeJapan Department of Internal Medicine Saiseikai Matsuyama HospitalMatsuyama 791-8026EhimeJapan Department of Gastroenterology Himeji Red Cross HospitalHimeji 670-8540HyogoJapan Department of Gastroenterology National Hospital Organization Shikoku Cancer CenterMatsuyama 791-0280EhimeJapan Department of Gastroenterology Matsuyama Shimin HospitalMatsuyama 790-0067EhimeJapan

BACKGROUND Mucosal patterns(MPs)observed on blue laser imaging in patients with atrophic gastritis can be classified as spotty,cracked,and mottled.Furthermore,we hypothesized that the spotty pattern may change to the cracked pattern after Helicobacter pylori(H.pylori)eradication.AIM To further substantiate and comprehensively investigate MP changes after H.pylori eradication in a larger number of patients.METHODS We included 768 patients who were diagnosed with atrophic gastritis with evaluable MP using upper gastrointestinal endoscopy at the Nishikawa Gastrointestinal Clinic,Japan.Among them,325 patients were H.pylori-positive,and of them,101 patients who underwent upper gastrointestinal endoscopy before and after H.pylori eradication were evaluated for post-eradication MP changes.The patients’MPs were interpreted by three experienced endoscopists who were blinded to their clinical features.RESULTS Among 76 patients with the spotty pattern before or after H.pylori eradication,the pattern disappeared or decreased in 67 patients[88.2%,95%confidence interval(CI):79.0%-93.6%),appeared or increased in 8 patients(10.5%,95%CI:5.4%-19.4%),and showed no change in 1 patient(1.3%,95%CI:0.2%-7.1%).In 90 patients with the cracked pattern before or after H.pylori eradication,the pattern disappeared or decreased in 7 patients(7.8%,95%CI:3.8%-15.2%),appeared or increased in 79 patients(87.8%,95%CI:79.4%-93.0%),and showed no change in 4 patients(4.4%,95%CI:1.7%-10.9%).In 70 patients with the mottled pattern before or after H.pylori eradication,the pattern disappeared or decreased in 28 patients(40.0%,95%CI:29.3%-51.7%),appeared or increased in 35 patients(50.0%,95%CI:38.6%-61.4%),and showed no change in 7 patients(10.0%,95%CI:4.9%-19.2%).CONCLUSION After H.pylori eradication,MPs changed from spotty to cracked in most patients,which may help endoscopists easily and precisely evaluate H.pylori-related gastritis status.

关键词： atrophic gastritis Helicobacter pylori Gastrointestinal endoscopy Image enhancement Classification

HOGG1 polymorphism in atrophic gastritis and gastric cancer after Helicobacter pylori eradication

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World Journal of Gastroenterology 2010年第35期16卷 4476-4482页

作者： Lei-Min Sun Yan Shang Ya-Min Zeng Yan-Yong Deng Jian-Feng Cheng Department of Gastroenterology Sir Run Run Shaw Hospital Zhejiang University Hangzhou 310016 Zhejiang Province China the First People’Hospital of Xiaoshan District Hangzhou 311200Zhejiang ProvinceChina Department of Gastroenterology Internal MedicineVirginia Commonwealth UniversityRichmondVA 23298United States

AIM:To investigate the association between Ser326Cys human oxoguanine glycosylase 1(hOGG1) polymorphism and atrophic gastritis and gastric cancer after Helicobacter pylori(H.pylori) eradication.METHODS:A total of 488 subjects(73 patients with gastric cancer,160 with atrophic gastritis after H.pylori eradication and 255 controls) were prospectively collected.Polymerase chain reaction-restriction fragment length polymorphism analysis was performed to distinguish hOGG1 Ser326Cys polymorphism.Statistical analysis was conducted by two-sample t test for continuous variables and χ2 test for categorical variables.Logistic regression models were used to f ind the risk factors for gastric cancer and atrophic gastritis.RESULTS:Neither the hOGG1 Ser/Cys nor the Cys/Cys genotype was associated with gastric cancer.Compared with the Ser/Ser genotype,odds ratio(OR) for Ser/Cys was 0.96,(95% CI:0.51-1.84) and OR for Cys/Cys was 1.1(95% CI:0.48-2.1).No association was detected between hOGG1 polymorphism and Lauren type of gastric cancer(P=0.61) either.However,Ser/Cys and Cys/Cys were signif icantly associated with atrophic gastritis with OR:1.76 for Ser/Cys(95% CI:1.03-3.0) and 2.38 for Cys/Cys(95% CI:1.34-4.23).After controlling for age,gender,smoking and alcohol,there were still signif icant associations with OR:2.05 for Ser/Cys(95% CI:1.14-3.68) and 2.76 for Cys/Cys(95% CI:1.47-5.18).CONCLUSION:HOGG1 polymorphisms(Cys/Cys and Ser/Cys) are associated with atrophic gastritis.No significant association is detected between hOGG1 polymorphisms(Cys/Cys or Ser/Cys) and gastric cancer.

关键词： Human oxoguanine glycosylase 1 polymorphism atrophic gastritis Gastric cancer

Comparison of operative link for gastritis assessment, operative link on gastric intestinal metaplasia assessment, and TAIM stagings among men with atrophic gastritis

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World Journal of Gastroenterology 2020年第24期26卷 3447-3457页

作者： Anna A Nieminen Jukka Kontto Pauli Puolakkainen Jarmo Virtamo Arto Kokkola Department of Surgery Abdominal CenterHelsinki University Hospital and University of HelsinkiHelsinki 00290Finland Department of Public Health Solutions National Institute for Health and Welfare(THL)Helsinki 00271Finland

BACKGROUND Gastric cancer is the world’s third most lethal malignancy. Most gastric cancers develop through precancerous states of atrophic gastritis and intestinal metaplasia. Two staging systems, operative link for gastritis assessment(OLGA)and operative link on gastric intestinal metaplasia assessment(OLGIM), have been developed to detect high gastric cancer risk. European guidelines recommend surveillance for high-risk OLGA/OLGIM patients(stages Ⅲ–Ⅳ),and for those with advanced stage of atrophic gastritis in the whole stomach mucosa. We hypothesize, that by combining atrophy and intestinal metaplasia into one staging named TAIM, more patients with increased gastric cancer risk could be detected.AIM To evaluate the clinical value of the OLGA, OLGIM, and novel TAIM stagings as prognostic indicators for gastric cancer.METHODS In the Helsinki gastritis Study, 22346 elderly male smokers from southwestern Finland were screened for serum pepsinogen I(PGI). Between the years 1989 and1993, men with low PGI values(PGI < 25 μg/L), were invited to undergo an oesophagogastroduodenoscopy. In this retrospective cohort study, 1147 men that underwent gastroscopy were followed for gastric cancer for a median of 13.7 years, and a maximum of 27.3 years. We developed a new staging system, TAIM,by combining the topography with the severity of atrophy or intestinal metaplasia in gastric biopsies. In TAIM staging, the gastric cancer risk is classified as low or high.RESULTS Twenty-eight gastric cancers were diagnosed during the follow-up, and the incidence rate was 1.72 per 1000 patient-years. The cancer risk associated positively with TAIM [Hazard ratio(HR) 2.70, 95%CI: 1.09–6.69, P = 0.03]. The risk increased through OLGIM stages 0-Ⅳ(0 vs Ⅳ: HR 5.72, 95%CI: 1.03–31.77, P for trend = 0.004), but not through OLGA stages 0–Ⅳ(0 vs Ⅳ: HR 5.77, 95%CI:0.67–49.77, P for trend = 0.10). The sensitivities of OLGA and OLGIM stages Ⅲ–Ⅳ were low, 21% and 32%, respectively, whereas that of TAIM high-risk was good, 79%. On the contrary, OLGA and

关键词： Operative link for gastritis assessment Operative link on gastric intestinal metaplasia assessment TAIM atrophic gastritis Intestinal metaplasia Gastric cancer

Updated Kimura-Takemoto classification of atrophic gastritis

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World Journal of Clinical Cases 2021年第13期9卷 3014-3023页

作者： Sergey M Kotelevets Sergey A Chekh Sergey Z Chukov Department of Therapy Medical InstituteNorth Caucasus State Academy for Humanities and TechnologiesCherkessk 369000Russia Department of Software Development Institute of Applied Mathematics and Information TechnologyNorth Caucasus State Academy of Humanities and TechnologiesCherkessk 369000Russia Department of Mathematics Institute of Applied Mathematics and Information TechnologyNorth Caucasus State Academy of Humanities and TechnologiesCherkessk 369000Russia Department of Pathological Anatomy Stavropol State Medical UniversityStavropol 355017Russia

BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly i

关键词： Updated Sydney system Kimura-Takemoto classification Prevention Gastric cancer atrophic gastritis Morphology

Study on Professor Diangui Li's Medication Experience in Treating atrophic gastritis Concomitant with Helicobacter Pylori Infection Based on Data Mining

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Chinese Medicine and Natural Products 2023年第4期3卷 172-182页

作者： Hujie Zhang Diangui Li Yulei Tao Jiaxin Wu Zhongqiang Sun Fuping Zhai Xiaofa Liu The Department of Spleen and Stomach Diseases Hebei Provincial Hospital of Chinese MedicineShijiazhuangHebeiChina

Objective Our objective was to explore the national traditional Chinese medicine by studying master Diangui Li's medication experience in treating atrophic gastritis(AG)concomitant with Helicobacter pylori(Hp)infection based on data mining,and to provide the reference for the clinical treatment of relevant diseases.Methods The Chinese medicine prescriptions of the patients'first visits to the Famous Doctors'Consultation Room in Hebei Provincial Hospital of Chinese Medicine from May 2019 to December 2022 were collected and frequency analysis of the Chinese herbs,association rules analysis of the Chinese herbs,and cluster analysis were conducted using the Famous Doctor Inheritance Assistance Platform.ResultsA total of 188 prescriptions were collected,with 136 kinds of Chinese herbs.The highest use frequency of Chinese herbs was 185 and the lowest was 1.There were 28 kinds of Chinese herbs with high use frequency.The top 10 herbs with the high use frequency include Baihuasheshecao(Hedyotis Diffusae Herba),Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),jigucao(Abriherba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),Banzhilian(Scutellariae Barbatae Herba),Baihe(Lili Bulbus),Zhishi(Auranti Immaturus Fructus),Chuanxiong(Chuanxiong Rhizoma).Chinese herbs with high frequency use are mostly heat-clearing herbs and qi-regulating herbs;the flavors of the herbs are mainly pungent,bitter,and sweet;the properties are mainly warm,cold,and neutral;the meridian tropism is mainly the spleen,liver,and stomach meridians.The core herbal medicines are Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),etc.;the results of association rules:Jigucao(Abriherba)-Kushen(Sophorae Flavescentis Radix),Jjiaogulan(Gynostemmatis Pentaphylli Rhizoma seu Herba)-Banlangen(lsatidis Radix),Huangqin(Scutellariae Radix)-Banlangen(lsatidis Radix),etc.;the results of cluster analysis showed that there were 10 clusters:(1)Yinchen(Artemisiae Scopari

关键词： atrophic gastritis Helicobacter pylori infection data mining medication Diangui Li

Study on Tongue Coating Microbiota in Patients with atrophic gastritis

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Advances in Microbiology 2020年第12期10卷 681-690页

作者： Lingshan Bao Yingcong Yu Department of Gastroenterology Wenzhou No. 3 Clinical Institute Affiliated to Wenzhou Medical University Wenzhou People’s Hospital Wenzhou China

Aims: To explore the tongue coating microbiota composition in patients with atrophic gastritis by using the 16S rRNA gene sequencing technology. Methods: The study included 29 atrophic gastritis patients and 29 age and gender-matched non-atrophic gastritis controls. By sequencing the V3-V4 region of the 16S rRNA, we investigated the microbial community structure and diversity on the tongue coating. Results: There was no significant difference in the microbial diversity on the tongue coating between the two groups. However, compared with the control, the atrophic gastritis group had a smaller number of operational taxonomic units (OTUs). At the class level, patients with atrophic gastritis had lower relative abundances of Betaproteobacteria and Spirochaetia than the control group. At the gene level, the abundance of Neisseria and Aggregatibacter in atrophic gastritis group had significantly decreased compared with control ones. Furthermore, functional prediction revealed that 24 metabolic pathways significantly differed between the two groups. Conclusions: Our findings provide novel evidence that tongue coating microbiota may be a biomarker for characterizing patient with atrophic gastritis, but its mechanism needs to be further elaborated.

关键词： atrophic gastritis Tongue Coating Microbiota 16S rRNA Sequencing