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Can patients with mild non-neoplastic lesions diagnosed at baseline screening be safely exempt from surveillance: evidence from multicenter community-based cohorts

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Science China Life Sciences 2025年第1期68卷 263-271页

作者： Siyi He Zhiyi Zhang Guohui Song Zhenhai Wang Chunyun Dai Shipeng Yan Kun Jiang Bingbing Song He Li Maomao Cao Dianqin Sun Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Qianru Li Changfa Xia Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Department of gastroenterology Gansu Wuwei Tumor Hospital Cixian Cancer Institute Linzhou Cancer Hospital center for disease Control and Prevention of Sheyang County Department of Cancer Prevention and Control Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South University Luoshan center for disease Control and Prevention Office for Cancer Control and research Affiliated Cancer Hospital of Harbin Medical University

Surveillance recommendations for gastric cancer（GC） in current guidelines focused on advanced precancerous lesions and were based on precise diagnosis of severity/extent of baseline lesions. We aimed to develop a less endoscopy-related equipment-dependent risk-stratification tool, and assessed whether mild-precursor-lesion patients can be safely exempt from surveillance. In the multicenter communitybased cohort, 75,051 participants receiving baseline endoscopy were enrolled during 2015–2017 and followed-up until 2021. Cumulative incidence rates（CIRs） of GC for precancerous-conditions were calculated by Kaplan-Meier method and compared by Log-rank tests. Mixedeffects Cox regression models were used to detect potential factors for progression towards GC. A risk score was calculated as counts of selected factors. An independent cohort, including 26,586 participants was used for external validation. During a median follow-up of 6.25 years, CIRs of GC were 0.302%, 0.436%, and 4.756% for normal group, non-neoplastic（atrophic gastritis/intestinal metaplasia） and neoplastic lesions（low-grade/high-grade dysplasia）, respectively(Ptrend<0.001). Four predictors, including male, ≥60 years, smoking, and limited vegetable consumption, were selected for risk-stratification. High-risk patients（≥3 risk factors） with non-neoplastic lesions showed higher GC risks（adjusted HR=7.73, 95%CI: 4.29–13.92）, and their four-year CIR reached the one-year CIR of neoplastic lesions. Further categorizing non-neoplastic lesions by histological grade, both patients with moderate-to-severe lesions（aHR=3.07, 95%CI: 1.67–5.64） and high-risk patients with mild lesions（aHR=7.29, 95%CI: 3.58–14.86） showed higher risks. Consistent trends were observed in validation cohort. High-risk mild-precursor-lesion patients should receive surveillance within 3–5 years after baseline screening. Our study provides evidence on supplementing current guideline recommendations.

关键词： stomach neoplasms precancerous conditions cancer screening cumulative incidence risk stratification

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A shield against a monster:Hepatitis C in hemodialysis patients

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World Journal of gastroenterology 2009年第6期15卷 641-646页

作者： Seyed-Moayed Alavian Baqiyatallah research center for gastroenterology and liver disease Baqiyatallah Research Center for Gastroenterology and Liver DiseaseTehran ***Iran

Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to *** factors are especially related to these high prevalence rates,such as blood transfusions and length of dialysis time. Nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure is considered more *** prophylactic measures have been suggested to avoid infection by HCV in the HD environment.

关键词： Dialysis Epidemiology Hepatitis C virus Incidence Isolation Nosocomial transmission Prevalence Prevention Universal precaution

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^(14)C-urea breath test in patients undergoing anti-tuberculosis therapy

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World Journal of gastroenterology 2005年第11期11卷 1712-1714页

作者： Sayed Amir Mirbagheri Amir Ali Sohrabpour Mehrdad Hasibi Babak Moghimi Mehdi Mohamadnejad Department of gastroenterology Digestive disease research center Department of Infectious diseases GI and liver disease research center

AIM: Urea breath test (UBT) is a non-invasive diagnostic test for detecting the presence of Helicobacter pylori(H pylori).In this study we evaluated the effect of anti-tuberculosis therapy on the results of ***: Patients, with the diagnosis of tuberculosis (TB) who had a positive UBT at the point of starting antiTB therapy, were included. None had a history of peptic ulcer disease or had taken antibiotics, bismuth compounds and/or PPI in the previous month, 14C-UBT was repeated at the end of the second month and the end of treatment period and one month after completion of treatment ***: Thirty-five patients (23 males) were enrolled.14C-UBT was negative in all 35 patients (100%) at the end of the second month and remained negative in 30cases (85.7%) at the end of the treatment course. One month after completion of treatment course, UBT remained negative in 13 patients (37.1%).CONCLUSION: Our report underscores the need for caution while interpreting urea breath test results in patients undergoing anti-TB therapy. Furthermore, the combination of drugs used in this study resulted in H pylori eradication in a minority of patients.

关键词： Urea breath test (UBT) Helicobacter pylori Tuberculosis

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Helicobacter pylori infection and expression of DNA mismatch repair proteins

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World Journal of gastroenterology 2008年第43期14卷 6717-6721页

作者： Vahid Mirzaee Mahsa Molaei Hamid Mohaghegh Shalmani Mohammad Reza Zali Department of gastroenterology Rafsanjan University of Medical SciencesRafsanjanIran Department of Patholology Research Center for Gastroenterology and Liver DiseaseShaheed Beheshti UniversityM.C.TehranIran research assistant Research Center for Gastroenterology and Liver DiseaseShaheed Beheshti UniversityM.C.TehranIran Department of gastroenterology Head of Research Center for Gastroenterology and Liver DiseaseShaheed Beheshti UniversityM.C.TehranIran

AIM： TO determine the expression of DNA （MMR） proteins, including hMLH1 and hMSH2, in gastric epithelial cells in the patients with or without Helicobacter pylori （H pylori）-infected gastritis. METHODS： Fifty Hpylori-positive patients and 50 H pylori-negative patients were enrolled in the study. During endoscopy of patients with non-ulcer dyspepsia, two antral and two corpus biopsies were taken for histological examination （Giemsa stain） and for immunohistochemical staining of hMLH1 and hMSH2. RESULTS： The percentage of epithelial cell nuclei that demonstrated positivity for hMLH1 staining was 84.14 ± 7.32% in Hpylori-negative patients, while it was 73.34 ±10.10% in Hpylori-positive patients （P 〈 0.0001）. No significant difference was seen between the two groups regarding the percentage of epithelial cell nuclei that demonstrated positivity for hMSH2 staining （81.16±8.32% in H pylori-negative versus 78.24 ± 8.71% in Hpylori-positive patients; P = 0.09）. CONCLUSION： This study indicates that Hpylori might promote development of gastric carcinoma at least in part through its ability to affect the DNA MMR system

关键词： Helicobacter pylori DNA mismatch repair hMLH1, hMSH2

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Immunohistochemical analysis of p53,cyclinD1,RB1,c-fos and N-ras gene expression in hepatocellular carcinoma in Iran

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World Journal of gastroenterology 2007年第4期13卷 588-593页

作者： SJ Moghaddam EN Haghighi S Samiee N Shahid AR Keramati S Dadgar MR Zali research center for gastroenterology and liver disease Shaheed Beheshti University of Medical Sciences and Academy of Medical Sciences Iran

AIM： TO study the effect of some genes especially those involved in cell cycle regulation on hepatocellular carcinoma. METHODS： Paraffin-embedded tissue samples of 25 patients （18 males and 7 females） with hepatocellular carcinoma were collected from 22 pathology centers in Tehran during 2000-2001, and stained using immunohistochemistry method （avidin-biotin-peroxidase） for detection of p53, cyclinD1, RB1, c-los and N-ras proteins. RESULTS： Six （24%）, 5 （20%）, 12 （48%） and 2 samples （8%） were positive for p53, cyclinDl, C-los and N-ras expression, respectively. Twenty-two （88%） samples had alterations in the （31 cell-cycle checkpoint protein expression （RBI or cyclinD1）. P53 positive samples showed a higher （9 times） risk of being positive for RBI protein than p53 negative samples. Loss of expression of RBI in association with p53 over-expression was observed in 4 （66.7%） of 6 samples. Loss of expression of RBI was seen in all cyclinD1 positive, 20 （90.9%） N-ras negative, and ii （50%） C-fos positive samples, respectively. CyclinD1 positive samples showed a higher （2.85 and 4.75 times） risk of being positive for c-los and N-ras expression than cyclinD1 negative samples. CONCLUSION： The expression of p53, RB1 and c-los genes appears to have a key role in the pathogenesis of hepatocellular carcinoma in Iran. Simultaneous overexpression of these genes is significantly associated with their loss of expression during development of hepatocellular carcinoma.

关键词： Hepatocellular Carcinoma Iran Expressionof p53, cyclinD1, RB1, c-fos and N-ras genes

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Intra-familial prevalence of hepatitis B virologic markers in HBsAg positive family members in Nahavand, Iran

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World Journal of gastroenterology 2005年第31期11卷 4857-4860页

作者： Amir Houshang Mohammad Alizadeh Mitra Ranjbar Shahin Ansari Seyed Moayed Alavian Hamid Mohaghegh Shalmani Leila Hekmat Mohammad Reza Zali research center for gastroenterology and liver disease Hemedan University of Medical Sciences Baghiatallah University of Medical Sciences

AIM, To determine the prevalence of hepatitis B in Nahavand and evaluate the HBsAg positive prevalence in families with a member who was confirmed to have HBV infection. METHODS： This study was performed in two phases. In the first phase, 1 824 subjects in Nahavand city were selected. The interviewers visited the houses of chosen families to flU the questionnaire and take the blood samples. All subjects signed an informed consent before interviews and blood sampling. The samples were evaluated for HBV virologic markers. In the second phase, 115 HBsAg-positive cases were enrolled and evaluated for HBV virologic markers. RESULTS： The prevalence of positive HBsAg in Nahavand was 2.3%. The most frequent relatives of index cases were sons and daughters （32.2% and 23.5% respectively）. Twelve （11%） of all family members were HBsAg positive. Fifty （56.2%） were isolated HBsAb positive and only one person （2.5%） was isolated HBcAb positive. The higher rates of HBsAg marker were detected in the brothers （1-25%） and fathers （1-12.5%）. The infection rate in husbands and wives of index cases was 10%. Only two （16.7%） of all HBsAg-positive participants reported previous HBV vaccination. CONCLUSION： The prevalence of intr-familial HBV infection is lower in Nahavand of Iran compared to other studies. More attention should be paid to HBV vaccination and risk-lowering activities.

关键词： Intra-familial prevalence Hepatitis B Nahavand Iran

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Immune response to an indigenously developed r-Hepatitis B vaccine in mixed population: Study of an accelerated vaccination schedule

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World Journal of gastroenterology 2005年第7期11卷 1037-1039页

作者： A Chowdhury A Santra CM Habibullah AA Khan J Karunakaramaiah TSA Kishore AVR Raju S Lahiri Dept of gastroenterology center for liver disease Biological E.Limited

AIM: To establish the safety and efficacy of an indigenously developed r-hepatitis B vaccine using an accelerated schedule and to highlight the social awareness and commitment in preventing the spreading of hepatitis B virus infection. METHODS: The study was a multicentric, double blind, randomized (3:1) study using three doses of vaccine immunization schedule (20μg for those above 10 years old and 10 μg for those below 10 years old) on d 0, 30 and 60. One hundred and sixty-six subjects were enrolled (87 males and 76 females aged 5-35 years). The main outcome measure was assessment of immunogenicity and safety. RESULTS: A 100% seroconversion response was observed on the 30th d after the 1st injection in both the experimental groups. The sero-protection data reported a 41.2-65.6% response on the 30th d after the 1st injection and reached 100% on the 60th d. Descriptive statistical analysis showed a geometric mean titer value of 13.77 mIU/mL in the test (BEVAC) group and 10.95 mlU/mL in the commercial control (ENGERIX-B) group on the 30th d after the 1st injection. The response on the 60th d showed a geometric mean titre value (GMT) of 519.84 mlU/mL in the BEVAC group and 475.46 mlU/mL in the ENGERIX-B group. On the 90th d, the antibody titer response was observed to be 2627.58 mlU/mL in the BEVAC group and 2272.72 mlU/mL in the ENGERIX-B group. Two subjects in each group experienced pains at injection site after the first vaccination. A total of six subjects in both groups experienced a solicited adverse reaction, which included pains, swelling and redness at the injection site, three subjects in the group-B had a pain at the injection site after the third dose. No other serious adverse events occurred and no dose-related local or general symptoms were observed during the study. CONCLUSION: The vaccine is safe, efficacious and immunogenic in comparison with the well documented ENGERIX-B.

关键词： Hepatitis B r-Hepatitis B Vaccines Immune response Accelerated vaccination schedule

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Non-alcohol fatty liver disease in Asia:Prevention and planning

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World Journal of Hepatology 2015年第13期7卷 1788-1796页

作者： Sara Ashtari Mohamad Amin Pourhoseingholi Mohamad Reza Zali gastroenterology and liver disease research center Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical Science

AIM:To review all of epidemiological aspects of nonalcoholic fatty liver disease(NAFLD) and also prevent this disease is ***:We conducted a systematic review according to the PRISMA *** searches for writing this review is based on the papers was found in Pub Med(MEDLINE),Cochrane database and Scopus in August and September 2014 for topic of NAFLD in Asia and the way of prevention of this disease,with no language *** relevant articles were accessed in full text and all relevant materials was evaluated and ***:NAFLD is the most common liver disorder in worldwide,with an estimated with 20%-30% prevalence in Western countries and 2%-4% *** prevalence of NAFLD in Asia,depending on location(urban vs rural),gender,ethnicity,and age is variable between 15%-20%.According to the many studies in the world,the relationship between NAFLD,obesity,diabetes mellitus,and metabolic syndrome(MS) is quiet *** of NAFLD in Asian countries seems to be lower than the Western countries but,it has increased recently due to the rise of obesity,type 2 diabetes and MS in this *** of the main reasons for the increase in obesity,diabetes and MS in Asia is a lifestyle change and ***,NAFLD is recognized as a major chronic liver disease in ***,prevention of this disease in Asian countries is very important and the best strategy for prevention and control of NAFLD is lifestyle *** modification programs are typically designed to change bad eating habits and increase physical activity that is associated with clinically significant improvements in obesity,type 2 diabetes and ***:Prevention of NAFLD is very importantin Asian countries particularly in Arab countries because of high prevalence of obesity,diabetes and MS.

关键词： Non-alcoholic fatty liver disease Metabolicrisk factors Asian countries Prevention

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Cytotoxic T-lymphocyte antigen 4 gene polymorphisms and susceptibility to chronic hepatitis B

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World Journal of gastroenterology 2006年第4期12卷 630-635页

作者： AmirHoushangMohammadAlizadeh FarahnazFallahian SeyedMohsenMousavi MehrdadHajilooi MithraRanjbar research center for gastroenterology and liver disease Shahid Beheshti University of Medical SciencesTehranIran Hamedan University of Medical Sciences Iran

AIM： To assess the three polymorphJsm regions within cytotoxic T-lymphocyte antigen 4 （CTLA-4） gene, a C/T base exchange in the promoter region-318 （CTLA-4 -318C/T）, an A/G substitution in the exon 1 position 49 （CTLA-4 49A/G）, a T/C substitution in 1172 （CTLA-4 -1172T/C） in patients with chronic hepatitis B. METHODS： Fifty-one patients with chronic hepatitis B virus infection and 150 healthy subjects were recruited sequentially as they presented to the hepatic clinic. Classification of chronic hepatitis B virus （HBV）-infected patients was as asymptomatic carrier state （26 patients） and chronic hepatitis B （25 patients）. Genomic DNA was isolated from anti-coagulated peripheral blood Bully coat using Miller＇s salting-out method. The presence of the CTLA-4 gene polymorphisms was determined using polymerase chain reaction amplification refractory mutation system （ARMS）. RESULTS： We observed a significant association between -318 genotypes frequency （T＋C-, T＋C＋, T-C＋） and susceptibility to chronic hepatitis B （P=0.012, OR=0.49, 95%CI： 0.206-1.162）. However, we did not observe a significant association for ＋49 genotype frequency （T＋C＋, T＋C- T-C＋） and -1172 genotype frequency （C＋T＋, T＋C- C＋T-） and state of disease. CONCLUSION： Our results suggest that CTLA-4 gene polymorphisms may partially be involved in the susceptibility to chronic hepatitis B.

关键词： Cytotoxic T-lymphocyte antigen 4 Chronic hepatitis B Gene polymorphism

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Association of promoter polymorphism of the CD14 C (-159) T endotoxin receptor gene with chronic hepatitis B

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World Journal of gastroenterology 2006年第35期12卷 5717-5720页

作者： Amir Houshang Mohammad Alizadeh Mitra Ranjbar Mehrdad Hajilooi Farahnaz Fallahian research center for gastroenterology and liver disease ShaheedBeheshti University of Medical Sciences Tehran Iran Hamedan University ofMedical Sciences Hamedan Iran

AIM: To investigate whether single-nucleotide polymor- phisms in the promoter regions of endotoxin-responsive genes CD14 C (-159) T is associated with chronic hepatitis B. METHODS: We obtained genomic DNA from 80 patients with established diagnosis of chronic hepatitis B and 126 healthy subjects served as a control population. The CD 14 C (-159) T polymorphism was investigated using an allele specific PCR method. RESULTS: Twenty seven percent of chronic hepatitis B patients and 75% of controls were heterozygous for CT genotype. The difference between the chronic hepatitis B and control groups was statistically significant [P < 0.0001; Odds ratio (OR) = 2.887; 95% CI: 1.609-5.178]. Twenty four point six percent of chronic hepatitis B and patients 12.3% of the control group were heterozygous for TT genotype. The difference between groups was not statistically significant (P = 0.256; OR = 0.658; 95% CI: 0.319-1.358). Forty eight point four percent of chronic hepatitis B patients and 12.7% of control were homozy- gote for CC genotype (P < 0.004; OR = 0.416; 95% CI: 0.229-0.755). The frequency of allele C was 61.9% and allele T was 38.1% in hepatitis B patients group. The frequency of allele C was 55.2% and allele T was 44.8% for the control group (P = 0.179; OR = 1.319; 95% CI: 0.881-1.977). CONCLUSION: The TT heterozygous genotype was not a risk factor for chronic hepatitis B. CC homozygote genotype is protective for hepatitis B. Lack of heterozy- gosis of genotype CT is a risk factor for chronic hepatitis B. Alleles C or T were not risk factors for chronic hepatitis B. These findings show the role of a single-nucleotide polymorphism at CD14/-159 on the development ofchronic hepatitis B. Endotoxin susceptibility may play a role in the pathogenesis of chronic hepatitis B.

关键词： CD14 C (-159) T gene Single nucleotide polymorphism Chronic hepatitis B Endotoxin susceptibility

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