Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment

AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer(GC)most frequently develops.The operative link for gas-tritis assessment(OLGA)staging system ranks the GC risk according to both the topography and the severity of gastric atrophy(as assessed histologically on the ba-sis of the Sydney protocol for gastric mucosal biopsy).Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages Ⅲ-Ⅳ with a higher risk of GC.A recently-proposed modification of the OLGA staging system(OLGIM)basically incorporates the OLGA frame,but replaces the atrophy score with an assessment of intestinal metaplasia(IM)alone.A series of 4552 consecutive biopsy sets(2007-2009)was re-trieved and reassessed according to both the OLGA and the OLGIM staging systems.A set of at least 5 biopsy samples was available for all the cases considered.RESULTS:In 4460 of 4552 cases(98.0%),both the high-risk stages(Ⅲ + Ⅳ)and the low-risk stages(0 +Ⅰ + Ⅱ)were assessed applying the OLGA and OL-GIM criteria.Among the 243 OLGA high-risk stages,14(5.8%)were down-staged to a low risk using OLGIM.The 67(1.5%)incidentally-found neoplastic lesions(intraepithelial or invasive)were consistently associated with high-risk stages,as assessed by both OLGA and OLGIM(P < 0.001 for both).Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage(stage Ⅲ)were associated with a low-risk OLGIM stage(stage Ⅱ).CONCLUSION:Gastritis staging systems(both OLGA and OLGIM)convey prognostically important informa-tion on the gastritis-associated cancer risk.Because of its clinical impact,the stage of gastritis should be included as a conclusive message in the gastritis histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA staging in the identif ication of patients at high risk of gastric cancer.

Nonlinear Diffusion and Transient Osmosis

We investigate both analytically and numerically the concentration dynamics of a solution in two containersconnected by a narrow and short channel,in which diffusion obeys a porous medium equation.We also considerthe variation of the pressure in the containers due to the How of matter in the channel.In particular,we identifya phenomenon,which depends on the transport of matter across nano-porous membranes,which we call 'transientosmosis'.We find that nonlinear diffusion of the porous medium equation type allows numerous different osmotic-likephenomena,which are not present in the case of ordinary Fickian diffusion.Experimental results suggest one possiblecandidate for transiently osmotic processes.

Plasma small-extracellular vesicles enriched in miR-122-5p promote disease aggressiveness in pediatric anaplastic large-cell lymphoma

Dear Editor,Anaplastic lymphoma kinase-positive(ALK+)anaplastic large cell lymphoma(ALCL)is an aggressive peripheral Tcell lymphoma representing 10%-15%of pediatric lymphoid neoplasms.The constitutively activated nucleophosmin-ALK(NPM-ALK)fusion protein is the main driver of ALK+ALCL oncogenesis[1].Current clinical protocols can achieve high cure rates,with 75%event-free survival(EFS)at 5 years[2],but the patients’outcome with relapsed/refractory disease still remains poor[3].Liquid biopsy is widely applied for the prognostic and therapeutic stratification of onco-hematological patients.As a non-invasive procedure,it can be used to identify several biomarkers,such as small extracellular vesicles(S-EVs)[4].S-EVs are stable carriers of molecules that mediate genetic exchange between distant cells,alter the microenvironment,facilitate cancer cell progression and promote drug resistance[5].