Lamb’s tripe extract and vitamin B12 capsule plus celecoxib reverses intestinal metaplasia and atrophy:A retrospective cohort study

BACKGROUND Chronic atrophic gastritis(AG)with intestinal metaplasia(IM)significantly increases the risk of gastric cancer.Some medicines have showed definite therapeutic effects in AG and IM regression.AIM To validate the efficacy of Lamb’s tripe extract and vitamin B12 capsule(LTEVB12)initial therapy and celecoxib rescue therapy for IM and AG.METHODS A total of 255 patients were included to receive LTEVB12 initial therapy(2 capsules each time,three times daily for 6 mo)in hospital in this study.The patients with failure of IM regression continued to receive celecoxib rescue therapy(200 mg,once daily for 6 mo).After each therapy finished,the patients underwent endoscopy and biopsy examination.The regression efficiency was assessed by the operative link on gastritis assessment(OLGA)and the operative link on the gastric intestinal metaplasia assessment(OLGIM)staging system.Logistic regression analysis was applied to identify factors associated with the curative effect.RESULTS For LTEVB12 initial therapy,the reversal rates of IM and AG were 52.95%and 48.24%,respectively.Analogously,for celecoxib rescue therapy,the effective rates for IM and AG were 56.25%and 51.56%,respectively.The IM regression rate of complete therapy was up to 85.03%.In different OLGA and OLGIM stages of IM patients,therapeutic efficiency showed a significant difference in each group(P<0.05).For both therapies,patients with high stages(III or IV)of both the OLGA and OLGIM evaluation systems showed a higher IM or AG regression rate than those with low stages(I or II).Among patients with high stages(OLGIM III and IV),the IM regression rate was above 70%for each therapy.Eating habits,fresh vegetable intake,and high-salt diet were identified as independent factors for the IM reversal effect of LTEVB12 therapy,especially high-salt diet(odds ratio=1.852,P<0.05).CONCLUSION Monotherapy could reverse IM and AG.LTEVB12 initial therapy and celecoxib rescue therapy significantly increase the regression effect.IM may not be the point of no return among gastric precancerous lesions.

Recent advances of miRNAs in the development and clinical application of gastric cancer

Gastric cancer(GC)is one of the most common malignant tumors.The mechanism of how GC develops is vague,and therapies are inefficient.The function of microRNAs(miRNAs)in tumorigenesis has attracted the attention from many scientists.During the development of GC,miRNAs function in the regulation of different phenotypes,such as proliferation,apoptosis,invasion and metastasis,drug sensitivity and resistance,and stem-cell-like properties.MiRNAs were evaluated for use in diagnostic and prognostic predictions and exhibited considerable accuracy.Although many problems exist for the application of therapy,current studies showed the antitumor effects of miRNAs.This paper reviews recent advances in miRNA mechanisms in the development of GC and the potential use of miRNAs in the diagnosis and treatment of GC.

Is intestinal metaplasia the point of no return in the progression of gastric carcinogenesis?

Gastric cancer(GC)is one of the most common malignant tumors worldwide.In China,GC is the second most common malignant tumor,and it is the second leading cause of cancer mortality.[1]Correa model showed that the development of intestinal-type GC was a consecutive cancerous process including normal gastric mucosa,non-atrophic gastritis,atrophic gastritis(AG),intestinal metaplasia(IM),dysplasia and intestinal-type GC in sequence.[2]Epithelium-resembling intestinal morphology replaced gastric mucosa which was defined as IM.[3]Among these precancerous conditions,IM was demonstrated to be a vital risk factor for GC,especially incomplete IM and extensive IM.[4,5].