Analysis of demographic characteristics in 3242 young age gastric cancer patients in Korea

AIM:To evaluate the epidemiologic features of young age gastric cancer(GC). METHODS:Retrospectively,a total of 3242 patients with GC between 18 and 45 years of age and 3000 sex-and age-matched controls were reviewed.All subjects were stratified into 3 groups based on age (A,18-30 years;B,31-40 years;C,41-45 years). Epidemiologic characteristics and risk factors were investigated with reference to their age and gender. RESULTS:Compared to controls,more frequent intake of high risk diet(P=0.00075),history of heavy smoking(P=0.00087),intake of heavy alcohol(P= 0.00091),lower social economic status(P=0.00083), body mass index>30(P=0.00097),urban residence(P=0.00065),and more frequent exposure to harmful occupational environments(P=0.00072)were observed in all age groups and both genders in young age GC.These relationships were weaker in females compared to males of the same age,and were stronger as the age of patients increased.However,in group C of young age GC patients,environmental factors played important roles in females and males with a similar body weight.In females,older age at first delivery(> 35 years),lack of lactation history,nulliparity,and poor nutritional status during pregnancy were significantly associated with an increased risk of GC(P=0.00034). In this study,252 patients(7.8%)had a family history of GC with high odds ratio(OR)(3.22-4.21).In particular, family history was more closely associated with GC in males(OR,4.21 in male vs 3.46 in female)and more advanced cases(P=0.00051). CONCLUSION:Hormonal associated factors were more commonly associated with females whereas environmental factors were more commonly associated with males in young age GC patients.

Role of the tumor microenvironment in the pathogenesis of gastric carcinoma

Gastric carcinoma(GC)is the 4thmost prevalent cancer and has the 2ndhighest cancer-related mortality rate worldwide.Despite the incidence of GC has decreased over the past few decades,it is still a serious health problem.Chronic inflammatory status of the stomach,caused by the infection of Helicobacter pylori(H.pylori)and through the production of inflammatory mediators within the parenchyma is suspected to play an important role in the initiation and progression of GC.In this review,the correlation between chronic inflammation and H.pylori infection as an important factor for the development of GC will be discussed.Major components,including tumor-associated macrophages,lymphocytes,cancer-associated fibroblasts,angiogenic factors,cytokines,and chemokines of GC microenvironment and their mechanism of action on signaling pathways will also be discussed.Increasing our understanding of how the components of the tumor microenviroment interact with GC cells and the signaling pathways involved could help identify new therapeutic and chemopreventive targets.

Clinical significance and usefulness of soluble heparin binding-epidermal growth factor in gastric cancer

AIM:To evaluate the clinical usefulness of solubleheparin-binding epidermal growth factor(s HB-EGF)as a serum biomarker for gastric cancer(GC).METHODS:Serum s HB-EGF levels were measured by a commercially available human HB-EGF ELISA Kit and compared among 60 normal controls,30 highrisk patients,37 early gastric cancer(EGC),and30 advanced gastric cancer(AGC)through ANOVA test.Correlations between serum s HB-EGF and clinicopathological features of GC were analyzed through Spearman’s correlation.The diagnostic performance of serum s HB-EGF for GC was evaluated through receiver operating characteristic(ROC)curve and logistic regression analysis.RESULTS:Serum s HB-EGF levels were significantly higher in AGC group(314.4±127.5 pg/m L)than EGC(165.3±123.2 pg/m L),high-risk(98.7±67.3 pg/m L),and control(94.7±83.6 pg/m L)groups(post-hoc Bonferroni,all P<0.001),respectively.Serum s HB-EGF levels were also significantly higher in EGC group than high-risk(P=0.049)and control(P=0.006)groups.Clinicopathologically,serum s HB-EGF levels closely correlated with depth of invasion(T-stage,γs=0.669,P<0.001),lymph node metastasis(N-stage,γs=0.407,P=0.001),and distant metastasis(M-stage,γs=0.261,P=0.030).ROC curve and logistic regression analysis demonstrated a remarkable diagnostic potential of serum s HB-EGF.CONCLUSION:Serum s HB-EGF is closely correlated with advanced stage GC and can be a promising serological biomarker for GC.