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Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection

World Journal of Gastroenterology 2017年第23期23卷 4262-4269页

作者： Chieko Tsuchida Naoto Yoshitake Hitoshi Kino Yoshihito Kaneko Masakazu Nakano Kohei Tsuchida Keiichi Tominaga Takako Sasai Hironori Masuyama Hidetsugu Yamagishi Yasuo Imai Hideyuki Hiraishi Department of Gastroenterology Dokkyo Medical University Department of Diagnostic Pathology Dokkyo Medical University

To evaluate the usefulness of total colonoscopy (TCS) for patients undergoing gastric endoscopic submucosal dissection (ESD) and to assess risk factors for colorectal *** the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test (FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for *** revealed adenoma less than 10 mm in 53 patients (33.6%), advanced adenoma in 17 (10.8%), early colorectal cancer in 5 (3.2%), and advanced colorectal cancer in 4 (2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FIT-positive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women (P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus (P = 0.019).CONCLUSIONIn patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.

关键词： Colonoscopy Colorectal neoplasm gastric neoplasm Endoscopic submucosal dissection Fecal immunochemical test

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Colonoscopy plays an important role in detecting colorectal neoplasms in patients with gastric neoplasms

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 133-143页

作者： Xu-Rui Liu Ze-Lin Wen Fei Liu Zi-Wei Li Xiao-Yu Liu Wei Zhang Dong Peng Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Gastrointestinal Surgery Yongchuan Hospital of Chongqing Medical UniversityChongqing 402160China

BACKGROUND gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,***,GC is reported to have a potential predictive value for CRC,especially for advanced *** To evaluate the necessity of colonoscopy for gastric neoplasm(GN)*** Four databases,including PubMed,EMBASE,the Cochrane Library,and Ovid,were used to perform the search strategy on May 2,*** prevalence of colorectal neoplasms(CRN)and baseline characteristics were compared between the neoplasm group and the control *** variables are expressed as the mean difference and standard *** of categorical variables in the two groups are expressed as odds ratios(OR)and 95%confidence intervals(95%CIs).Subgroup analysis according to different kinds of GNs was conducted for more in-depth *** results of this study are represented by forest *** bias was evaluated by a funnel *** data analyses were performed by STATA SE 16.0 *** A total of 3018 patients with GNs and 3905 healthy controls(age and sex matched)were enrolled for *** comparing the prevalence of CRNs between the two groups,CRNs were detected significantly more frequently in GN patients than in controls(OR=1.69,95%CI=1.28 to 2.23,I^(2)=85.12%,P=0.00),especially in patients with GC(OR=1.80,95%CI=1.49 to 2.18,I^(2)=25.55%,P<0.1).Moreover,other risk factors including age(OR=1.08,95%CI=1.00 to 1.17,I^(2)=90.13%,P=0.00)and male sex(OR=2.31,95%CI=1.26 to 4.22,I^(2)=87.35%,P=0.00),were related to the prevalence of *** patients in the GN group,body mass index(BMI,OR=0.88,95%CI=0.80 to 0.98,I^(2)=0.00%,P=0.92)and smoking(OR=1.03,95%CI=1.01 to 1.05,I^(2)=0.00%,P=0.57)were protective and risk factors for CRNs,*** Patients are recommended to undergo colonoscopy when diagnosed with GNs,especially GC patients with a low BMI and a history of smoking.

关键词： gastric neoplasm gastric cancer Colorectal neoplasm Colonoscopy

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Usefulness of artificial intelligence in gastric neoplasms

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World Journal of Gastroenterology 2021年第24期27卷 3543-3555页

作者： Ji Hyun Kim Seung-Joo Nam Sung Chul Park Division of Gastroenterology and Hepatology Department of Internal MedicineKangwon National University School of MedicineChuncheon 24289Kangwon DoSouth Korea

Recently,studies in many medical fields have reported that image analysis based on artificial intelligence(AI)can be used to analyze structures or features that are difficult to identify with human *** diagnose early gastric cancer,related efforts such as narrow-band imaging technology are ***,diagnosis is often ***,a diagnostic method based on AI for endoscopic imaging was developed and its effectiveness was confirmed in many *** gastric cancer diagnostic program based on AI showed relatively high diagnostic accuracy and could differentially diagnose non-neoplastic lesions including benign gastric ulcers and *** AI system has also been developed that helps to predict the invasion depth of gastric cancer through endoscopic images and observe the stomach during endoscopy without blind ***,if AI is used in the field of endoscopy,it is expected to aid in the diagnosis of gastric neoplasms and determine the application of endoscopic therapy by predicting the invasion depth.

关键词： Artificial intelligence Convolutional neural network gastric neoplasm Esophagogastroduodenoscopy Diagnosis Invasion depth

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Recent advances in endoscopic management of gastric neoplasms

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World Journal of Gastrointestinal Endoscopy 2023年第5期15卷 319-337页

作者： Hira Imad Cheema Benjamin Tharian Sumant Inamdar Mauricio Garcia-Saenz-de-Sicilia Cem Cengiz Department of Internal Medicine Baptist Health Medical CenterLittle RockAR 72205United States Department of Interventional Endoscopy/Gastroenterology Bayfront HealthDigestive Health InstituteSt.PetersbergFL 33701United States Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Division of Gastroenterology and Hepatology Department of Internal MedicineJohn L.McClellan Memorial Veterans HospitalLittle RockAR 72205United States Division of Gastroenterology and Hepatology Department of Internal MedicineTOBB University of Economics and TechnologyAnkara 06510Turkey

The development and clinical application of new diagnostic endoscopic technologies such as endoscopic ultrasonography with biopsy,magnification endoscopy,and narrow-band imaging,more recently supplemented by artificial intelligence,have enabled wider recognition and detection of various gastric neoplasms including early gastric cancer(EGC)and subepithelial tumors,such as gastrointestinal stromal tumors and neuroendocrine *** the last decade,the evolution of novel advanced therapeutic endoscopic techniques,such as endoscopic mucosal resection,endoscopic submucosal dissection,endoscopic fullthickness resection,and submucosal tunneling endoscopic resection,along with the advent of a broad array of endoscopic accessories,has provided a promising and yet less invasive strategy for treating gastric neoplasms with the advantage of a reduced need for gastric ***,the management algorithms of various gastric tumors in a defined subset of the patient population at low risk of lymph node metastasis and amenable to endoscopic resection,may require revision considering upcoming data given the high success rate of en bloc resection by experienced ***,endoscopic surveillance protocols for precancerous gastric lesions will continue to be refined by systematic reviews and meta-analyses of further ***,the lack of familiarity with subtle endoscopic changes associated with EGC,as well as longer procedural time,evolving resection techniques and tools,a steep learning curve of such high-risk procedures,and lack of coding are issues that do not appeal to many gastroenterologists in the *** review summarizes recent advances in the endoscopic management of gastric neoplasms,with special emphasis on diagnostic and therapeutic methods and their future prospects.

关键词： gastric tumors Endoscopic ultrasound Endoscopic mucosal resection Endoscopic submucosal dissection Endoscopic surveillance gastric neoplasm

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Induction of apoptosis of human gastric carcinoma SGC-7901 cell line by 5,7-dihydroxy-8-nitrochrysin in vitro

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World Journal of Gastroenterology 2007年第28期13卷 3824-3828页

作者： Xiao-Hong Ai Xing Zheng Xiao-Qing Tang Li Sun Yang-Qin Zhang Yong Qin Hua-Qing Liu Hong Xia Jian-Guo Cao Department of Oncology First Affiliated Hospital Nahua University Hengyang 421001 Hunan Province China Institute of Oncology Nahua University Hengyang 421001 Hunan Province China Institute of Pharmacology Nahua University Hengyang 421001 Hunan Province China School of Pharmaceutical Science Central South University Changsha 410078 Hunan Province China

AIM： To investigate the effect of 5, 7-dihydroxy-8- nitrochrysin （NOChR） on apoptosis of human gastric carcinoma SGC-7901 cell line.METHODS： SGC-7901 cells were cultured in vitro and the inhibitory effect of NOChR on proliferation of SGC-7901 cells was measured by using an Ml-r assay. NOChR-induced apoptosis rate of SGC-7901 cells was detected using flow cytometry （FCM） with PI staining. DNA ladder bands were observed by DNA agarose gel electrophoresis. The influence of NOChR on the proxisome proliferator-activated receptor-γ （PPARγ）, Bcl-2 and Bax protein expression of SGC-7901 cells was analyzed by Western blot.RESULTS： MIF assay showed that NOChR markedly inhibited proliferation of SGC-7901 cells in a dose- dependent manner, and when ICso was 4.14 μmol/L, the potency of NOChR was 10 times than that of lead compound, chrysin （ChR, IC50 was 40.56 μmol/L）, and was similar to 5-fluorouracil （5-FU, IC50 was 4.51 μmol/L）. FCM with propidium iodide （PI） staining demonstrated that the apoptosis rates of SGC-7901 cells treated with 1.25, 5.00 and 20.00 μmol/L NOChR for 48 h were 9.8% 4- 0.2%, 36.8% 4- 1.9% and 45.5% 4- 3.5%, respectively, and were significantly higher when treated with 5.00 and 20.00 μmol/L NOChR than that with 20.00 μmol/L ChR （12.9% 4- 1.5%）. DNA agarose gel electrophoresis showed that treatment of SGC-7901 cells with 20.00 μmol/L NOChR for 48 h resulted in typical DNA ladder bands of DNA of SGC-7901 cells, which could be eliminated by treating with 10.00 μmol/L GW9662, a blocker of PPARy. Western blot analysis revealed that after 24 h of treatment with 20.00 μmol/L NOChR, PPARgamma and Bax protein expression of SGC-7901 cells increased but Bcl-2 expression decreased; however, pre-incubation with 10.00 μmol/L GW9662 could efficiently antagonize and weaken the regulatory effect of 20.00 μmol/L NOChR on Bax and Bcl-2 protein expression of SGC-7901 cells. CONCLUSION： NOChR induces apoptosis of SGO7901 cell lines by activating PPARy and decreasing rat

关键词： gastric neoplasm Chrysin Chrysin derivatives Apoptosis Proxisome proliferator-activated receptorγ Bcl-2 Bax

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Correlative studies on bFGF mRNA and MMP-9 mRNA expressions with microvascular density,progression, and prognosis of gastric carcinomas

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World Journal of Gastroenterology 2005年第21期11卷 3227-3233页

作者： Zhong-ShengZhao Ji-LinZhou Gen-YouYao Guo-QingRu JieMa JunRuan DepartmentofPathology ZhejiangProvincialHospitalHangzhou310014ZhejiangProvinceChina CollegeofMedicalSciences ZhejiangUniversityHangzhou310031ZhejiangProvinceChina

AIM: To investigate the mRNA expressions of bFGF and MMP-9 in gastric carcinomas so as to reveal their correlations with tumor microvascular density (MVD), invasion, metastasis, and ***: In situ hybridization and immunohistochemical techniques were used to detect the expressions of bFGFmRNA and MMP-9mRNA and the proteins of CD34 in 105 specimens of gastric ***: In situ hybridization study showed that positive rates of bFGF mRNA and MMP-9mRNA expressions were 60.95% and 59.19%; the mean MVD was 46.09±11.52 and 43.75±13.41, respectively in piece/0.72 mm2 in tumors with bFGFmRNA and MMP-9mRNA positive expressions,which were significantly higher than those with negative expression (29.41±12.47; 33.45±13.92 piece/0.72 mm2,respectively). The positive expression rates of bFGFmRNA and MMP-9mRNA were correlated to the tumor invasion depth (rs = 0.211, P= 0.031; rs = 0.335, P= 0.001), growing pattern (rs= 0.324, P= 0.001; rs= 0.267, P= 0.006), vessel invasion (rs = 0.579, P = 0.001; rs = 0.209, P = 0.032),lymph node metastasis (rs = 0.405, P = 0.001; rs= 0.343,P = 0.001) and distant metastasis (rs= 0.474, P = 0.001;rs = 0.468, P = 0.001), but not correlated to tumortype (rs= 0.134, P= 0.173; rs= 0.103, P= 0.145) anddifferentiations (rs = 0.096, P= 0.332; rs = 0.102, P= 0.298).The mean MVD was much higher in the tumors withinfiltrating growth at stage T3-T4, with vessel invasion, lymph node metastasis and distant metastasis than those with expanding growth type (t = 10.105, P= 0.001) at stage T1-T2 (t = 5.961, P = 0.001), with non-vessel invasion (t= 7.394, P= 0.001), non-lymph node metastasis (t= 3.819, P= 0.01) and non-distant metastasis (t= 10.578, P = 0.001). Positive correlation was observed between MVD and the expressions of bFGFmRNA and MMP-9mRNA(t= 3.207, P= 0.002; t= 7.035, P= 0.001, respectively). The mean survival time and 5-year survival rate werelower in cases with MVD over 39.5 and the positive expressions of bFGFmRNA and MMP-9mRNA th

关键词： gastric neoplasm bFGF MMP-9 Microvascular density Prognosis

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CXC chemokines and chemokine receptors in gastric cancer: From basic findings towards therapeutic targeting

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World Journal of Gastroenterology 2014年第7期20卷 1681-1693页

作者： Hyo Jin Lee Ik-Chan Song Hwan-Jung Yun Deog-Yeon Jo Samyong Kim Division of Hematology/Oncology Department of Internal MedicineSchool of Medicine Chungnam National University and Chungnam National University HospitalDaejeon 301-721South Korea Cancer Research Institute Chungnam National UniversityDaejeon 301-721South Korea Division of Hematology/Oncology Department of Internal MedicineChungnam National University HospitalDaejeon 301-721South Korea

gastric cancer is the fourth most common cancer,and the second-highest cause of cancer-related deaths *** extensive research to identify novel diagnostic and therapeutic agents,patients with advanced gastric cancer suffer from a poor quality of life and poor prognosis,and treatment is dependent mainly on conventional cytotoxic *** improve the quality of life and survival of gastric cancer patients,a better understanding of the underlying molecular pathologies,and their application towards the development of novel targeted therapies,is urgently *** are a group of small proteins associated with cytoskeletal rearrangements,the directional migration of several cell types during development and physiology,and the host immune response via interactions with G-protein coupled *** is also growing evidence to suggest that chemokines not only play a role in the immune system,but are also involved in the development and progression of *** gastric cancer,CXC chemokines and chemokine receptors regulate the trafficking of cells in and out of the tumor *** chemokines and their receptors can also directly influence tumorigenesis by modulating tumor transformation,survival,growth,invasion and metastasis,as well as indirectly by regulating angiogenesis,and tumor-leukocyte *** this review,we will focus on the roles of CXC chemokines and their receptors in the development,progression,and metastasis of gastric tumors,and discuss their therapeutic potential for gastric cancer.

关键词： Chemokine Chemokine receptor gastric neoplasm Therapeutic target

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Survivin:Potential role in diagnosis,prognosis and targeted therapy of gastric cancer

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World Journal of Gastroenterology 2007年第20期13卷 2784-2790页

作者： Ting-Ting Wang Xiao-Ping Qian Bao-Rui Liu (Department of Oncology Affiliated Gulou Hospital Medical School of Nanjing University Nanjing 210008 Jiangsu Province China )

Survivin is a protein that is highly expressed in a vast number of malignancies,but is minimally expressed in normal tissues. It plays a role as an inhibitor of cell death in cancer cells,thus facilitating the growth of these cells. In the case of gastric cancer,survivin is over-expressed in tumor cells and plays a role in the carcinogenesis process. Several studies on gastric cancer have indicated that there is a relationship between survivin expression and the ultimate behavior of the carcinoma. Since the expression pattern of survivin is selective to cancer cells,it has been described as an "ideal target" for cancer therapy. Currently,several pre-clinical and clinical trials are on-going to investigate the effects of interfering with survivin function in cancer cells as a biologic therapy. Survivin is a potentially significant protein in the diagnosis,prognosis and treatment of gastric tumors.

关键词： Survivin gastric neoplasm Diagnosis Prognosis Targeted therapy

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Effect of p27^(KIP1) on cell cycle and apoptosis in gastric cancer cells

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World Journal of Gastroenterology 2005年第45期11卷 7072-7077页

作者： Jian-Yong Zheng Wei-Zhong Wang Kai-Zong Li Wen-Xian Guan Wei Yan Department of Gastrointestinal Surgery Xijing Hospital FourthMilitary Medical University Xi'an 710032 Shaanxi ProvinceChina Department of Hepatobiliary Surgery XijingHospital Fourth Military Medical University Xi'an 710032Shaanxi Province China Department of Pathology Fourth Military MedicalUniversity Xi'an 710032 Shaanxi Province China

AIM： To elucidate the effect of p27^KIP1 on cell cycle and apoptosis regulation in gastric carcinoma cells. METHODS： The whole length of p27^KIP1 cDNA was transfected into human gastric cancer cell line SCG7901 by lipofectamine. Expression of p27^KIP1 protein or mRNA was analyzed by Western blot and RNA dot blotting, respectively. Effect of p27^KIP1 on cell growth was observed by MTT assay and anchorage-independent growth in soft agar. Tumorigenicity in nude mice was used to assess the in vivo biological effect of p27^KIP1. Flow cytometry, TUNEL, and electron microscopy were used to assess the effect of p27^KIP1 on cell cycle and apoptosis. RESULTS： Expression of p27^KIP1 protein or mRNA increased evidently in SCG7901 cells transfected with p27^KIP1. The cell growth was reduced by 31% at 48 h after induction with zinc determined by cell viability assay. The alteration of cell malignant phenotype was evidently indicated by the loss of anchorage-independent growth ability in soft agar. The tumorigenicity in nude mice was reduced evidently （0.55±0.14 cm vs 1.36±0.13cm, P〈0.01）. p27^KIP1 overexpression caused cell arrest with 36% increase （from 33.7% to 69.3%, P〈0.01） in G1 population. Prolonged p27^KIP1 expression induced apoptotic cell death reflected by pre-G1 peak in the histogram of FACS, which was also confirmed by TUNEL assay and electron microscopy. CONCLUSION： p27^KIP1 can prolong cell cycle in G1 phase and lead to apoptosis, p27^KIP1 may be a good candidate for cancer gene therapy.

关键词： Cell cycle Apoptosis gastric neoplasm p27^KIP1

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Survival analysis based on human epidermal growth factor 2 status in stage Ⅱ-Ⅲ gastric cancer

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World Journal of Gastroenterology 2017年第41期23卷 7407-7414页

作者： Jang Ho Cho Jae Yun Lim Jae Yong Cho Division of Medical Oncology Department of Internal Medicine Gangnam Severance Hospital Yonsei University College of Medicine

AIM To investigate human epidermal growth factor 2(HER2) overexpression and validate its prognostic effect in stage Ⅱ-Ⅲ gastric *** We reviewed the data of patients who were diagnosed with gastric cancer between March 2008 and October 2013 at the Yonsei University Medical Center. Among these patients, 384 patients who met the inclusion criteria were analyzed retrospectively. RESULTS Thirty-two(8.3%) of the 384 stage Ⅱ-Ⅲ gastric cancer patients exhibited HER2 overexpression. The median follow-up duration was 26.0 mo. HER2-negative patients had superior recurrence-free survival(RFS) compared to HER2-positive patients(HR = 0.52, 95%CI: 0.30-0.89; P = 0.015). The median overall survival(OS) was significantly prolonged in the HER2-negative group compared with the HER2-positive group(55.0 mo vs 38.0 mo, HR = 0.43, 95%CI: 0.21-0.88, P = 0.021). OS was also prolonged in HER2-negative patients who received adjuvant chemotherapy compared to HER2-positive patients(55.0 vs 38.0mo, HR = 0.42, 95%CI: 0.18-1.00, P = 0.051). In patients who did not receive adjuvant chemotherapy,the median RFS was prolonged in the HER2-negative group compared to the HER2-positive group(not reached vs 12.0 mo, HR = 0.17, 95%CI: 0.06-0.49, P= 0.001). In a multivariate analysis, HER2 status(HR= 0.421, 95%CI: 0.206-0.861, P = 0.018) and Eastern Cooperative Oncology Group performance status(HR = 2.002, 95%CI: 1.530-2.618, P < 0.001) were independent predictors of *** Our findings showed that HER2-positive patients had inferior OS and RFS. Stage Ⅱ-Ⅲ HER2-positive patients might be potential candidates for targeted therapies involving trastuzumab.

关键词： Trastuzumab gastric neoplasm Human epidermal growth factor 2

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