Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of c...Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.展开更多
Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-f...Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-funded national screening programs for GC and other major cancers.GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs(Japan and Korea)and in studies based on selected Chinese populations.The screening of GC relies mostly on gastroendoscopy,the accuracy,reliability and safety of which have been indicated by previous studies.However,considering its invasive screening approach,requirements on skilled endoscopists and pathologists,and a high cost,developing noninvasive methods to amend endoscopic screening would be highly needed.Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen,gastrin,and Helicobacter pylori antibodies has been proposed for risk stratification,seeking to narrow down the high-risk populations for further endoscopy.Despite all the achievements of endoscopic screening,evidence on appropriate screening age,intervals for repeated screening,novel biomarkers promoting precision prevention,and health economics need to be accumulated to inform policymakers on endoscopic screening in China.With the guide of Health China 2030 Planning Outline,we have golden opportunities to promote prevention and control of GC.In this review,we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening,aiming for featuring the latest advances and key challenges,and illustrating future visions of GC screening.展开更多
Objective:Upper gastrointestinal(UGI)cancers,predominantly gastric cancer(GC)and esophageal cancer(EC),are malignant tumor types with high morbidity and mortality rates.Accumulating studies have focused on metabolomic...Objective:Upper gastrointestinal(UGI)cancers,predominantly gastric cancer(GC)and esophageal cancer(EC),are malignant tumor types with high morbidity and mortality rates.Accumulating studies have focused on metabolomic profiling of UGI cancers in recent years.In this systematic review,we have provided a collective summary of previous findings on metabolites and metabolomic profiling associated with GC and EC.Methods:A systematic search of three databases(Embase,PubMed,and Web of Science)for molecular epidemiologic studies on the metabolomic profiles of GC and EC was conducted.The Newcastle–Ottawa Scale(NOS)was used to assess the quality of the included articles.Results:A total of 52 original studies were included for review.A number of metabolites were differentially distributed between GC and EC cases and non-cases,including those involved in glycolysis,anaerobic respiration,tricarboxylic acid cycle,and protein and lipid metabolism.Lactic acid,glucose,citrate,and fumaric acid were among the most frequently reported metabolites of cellular respiration while glutamine,glutamate,and valine were among the most commonly reported amino acids.The lipid metabolites identified previously included saturated and unsaturated free fatty acids,aldehydes,and ketones.However,the key findings across studies to date have been inconsistent,potentially due to limited sample sizes and the majority being hospital-based case-control analyses lacking an independent replication group.Conclusions:Studies on metabolomics have thus far provided insights into etiological factors and biomarkers for UGI cancers,supporting the potential of applying metabolomic profiling in cancer prevention and management efforts.展开更多
Objective： To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter gylori （H. pylori） treatment, a follow-up study was performed based on an intervention trial in Linqu Co...Objective： To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter gylori （H. pylori） treatment, a follow-up study was performed based on an intervention trial in Linqu County, China. Methods： A total of 529 subjects were selected randomly from 1,803 participants to evaluate total anti-H, pylori immunoglobulin G （IgG） and 10 specific antibody levels before and after treatment at 1-, 2- and 7.3-year. The outcomes of anti-H, pylori treatment were also parallelly assessed by 13C-urea breath test at 45-d after treatment and 7.3-year at the end of follow-up. Results： We found the medians of anti-H, pylori IgG titers were consistently below cut-off value through 7.3 years in eradicated group, however, the medians declined in recurrence group to 1.2 at 1-year after treatment and slightly increased to 2.0 at 7.3-year. While the medians were significantly higher （〉3.0 at 2- and 7.3-year） among subjects who failed the eradication or received placebo. For specific antibody responses, baseline seropositivities of FliD and HpaA were reversely associated with eradication failure [for FIiD, odds ratio （OR）=0.44, 95% confidence interval （95% CI）： 0.27-0.73; for HpaA, OR=0.32, 95% Ch 0.I7-0.60]. The subjects with multiple positive specific antibodies at baseline were more likely to be successfully eradicated in a linear fashion （Ptrend=0.006）. Conclusions： Our study suggested that total anti-H, pylori IgG level may serve as a potential monitor of long- term impact on anti-H, pylori treatment, and priority for H. pylori treatment may be endowed to the subjects with multiple seropositive antibodies at baseline, especially for FliD and HapA.展开更多
Objective:This study aimed at examining the alterations in metabolomic profiles caused by treatment of H.pylori infection,and the associations between key plasma metabolites and the risk of gastric lesion progression ...Objective:This study aimed at examining the alterations in metabolomic profiles caused by treatment of H.pylori infection,and the associations between key plasma metabolites and the risk of gastric lesion progression during follow-up after treatment.Methods:An intervention trial was performed in 183 participants,117 of whom were H.pylori positive participants receiving treatment for H.pylori infection.H.pylori positive participants were prospectively followed for 182 to 1,289 days.Untargeted metabolomics assays were conducted on plasma samples collected at baseline,6 months after treatment,and during continued follow-up.Results:We identified 59 metabolites with differential posttreatment changes between participants with successful and failed H.pylori eradication,17 metabolites significantly distinguished participants with successful vs.failed eradication.Two metabolites[PC(18:1(11Z)/14:1(9Z))and(2S)-6-amino-2-formamidohexanamide]showed posttreatment changes positively associated with successful H.pylori eradication,and were inversely associated with the risk of gastric lesion progression among participants with successful eradication.In contrast,9-decenoic acid showed posttreatment changes inversely associated with successful eradication:its level was positively associated with the risk of gastric lesion progression among participants with successful eradication.Although the identified metabolites showed a temporary but significant decline after treatment,the trend generally reversed during continued follow-up,and pretreatment levels were restored.Conclusions:Treatment of H.pylori infection significantly altered plasma metabolic profiles in the short term,and key metabolites were capable of distinguishing participants with successful vs.failed eradication,but might not substantially affect metabolic regulation in the long term.Several plasma metabolites were differentially associated with the risk of gastric lesion progression among participants with successful or failed eradication.展开更多
基金supported in part by the Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (No. ZLRK202325)a grant from National Key R&D Program of China (No. 2018YFC 1313105)。
文摘Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.
基金supported by the National Key R&D Program of China(No.2018YFC1313105)the third batch of public welfare development and reform pilot projects of Beijing Municipal Medical Research Institutes(Beijing Medical Research Institute,2019-1)Beijing Municipal Administration of Hospitals’Ascent Plan(No.DFL 20181102)。
文摘Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-funded national screening programs for GC and other major cancers.GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs(Japan and Korea)and in studies based on selected Chinese populations.The screening of GC relies mostly on gastroendoscopy,the accuracy,reliability and safety of which have been indicated by previous studies.However,considering its invasive screening approach,requirements on skilled endoscopists and pathologists,and a high cost,developing noninvasive methods to amend endoscopic screening would be highly needed.Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen,gastrin,and Helicobacter pylori antibodies has been proposed for risk stratification,seeking to narrow down the high-risk populations for further endoscopy.Despite all the achievements of endoscopic screening,evidence on appropriate screening age,intervals for repeated screening,novel biomarkers promoting precision prevention,and health economics need to be accumulated to inform policymakers on endoscopic screening in China.With the guide of Health China 2030 Planning Outline,we have golden opportunities to promote prevention and control of GC.In this review,we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening,aiming for featuring the latest advances and key challenges,and illustrating future visions of GC screening.
基金supported by grants from the Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research(Grant No.BMU2020JI004)Capital’s Funds for Health Improvement and Research(CFH)。
文摘Objective:Upper gastrointestinal(UGI)cancers,predominantly gastric cancer(GC)and esophageal cancer(EC),are malignant tumor types with high morbidity and mortality rates.Accumulating studies have focused on metabolomic profiling of UGI cancers in recent years.In this systematic review,we have provided a collective summary of previous findings on metabolites and metabolomic profiling associated with GC and EC.Methods:A systematic search of three databases(Embase,PubMed,and Web of Science)for molecular epidemiologic studies on the metabolomic profiles of GC and EC was conducted.The Newcastle–Ottawa Scale(NOS)was used to assess the quality of the included articles.Results:A total of 52 original studies were included for review.A number of metabolites were differentially distributed between GC and EC cases and non-cases,including those involved in glycolysis,anaerobic respiration,tricarboxylic acid cycle,and protein and lipid metabolism.Lactic acid,glucose,citrate,and fumaric acid were among the most frequently reported metabolites of cellular respiration while glutamine,glutamate,and valine were among the most commonly reported amino acids.The lipid metabolites identified previously included saturated and unsaturated free fatty acids,aldehydes,and ketones.However,the key findings across studies to date have been inconsistent,potentially due to limited sample sizes and the majority being hospital-based case-control analyses lacking an independent replication group.Conclusions:Studies on metabolomics have thus far provided insights into etiological factors and biomarkers for UGI cancers,supporting the potential of applying metabolomic profiling in cancer prevention and management efforts.
基金supported by the National Natural Science Foundation of China (No. 81171989, 30801346)National Basic Research Program of China (973 Program: 2010CB529303)the Capital Health Research and Development of Special (2014-2-1022)
文摘Objective： To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter gylori （H. pylori） treatment, a follow-up study was performed based on an intervention trial in Linqu County, China. Methods： A total of 529 subjects were selected randomly from 1,803 participants to evaluate total anti-H, pylori immunoglobulin G （IgG） and 10 specific antibody levels before and after treatment at 1-, 2- and 7.3-year. The outcomes of anti-H, pylori treatment were also parallelly assessed by 13C-urea breath test at 45-d after treatment and 7.3-year at the end of follow-up. Results： We found the medians of anti-H, pylori IgG titers were consistently below cut-off value through 7.3 years in eradicated group, however, the medians declined in recurrence group to 1.2 at 1-year after treatment and slightly increased to 2.0 at 7.3-year. While the medians were significantly higher （〉3.0 at 2- and 7.3-year） among subjects who failed the eradication or received placebo. For specific antibody responses, baseline seropositivities of FliD and HpaA were reversely associated with eradication failure [for FIiD, odds ratio （OR）=0.44, 95% confidence interval （95% CI）： 0.27-0.73; for HpaA, OR=0.32, 95% Ch 0.I7-0.60]. The subjects with multiple positive specific antibodies at baseline were more likely to be successfully eradicated in a linear fashion （Ptrend=0.006）. Conclusions： Our study suggested that total anti-H, pylori IgG level may serve as a potential monitor of long- term impact on anti-H, pylori treatment, and priority for H. pylori treatment may be endowed to the subjects with multiple seropositive antibodies at baseline, especially for FliD and HapA.
基金supported by grants from the Capital’s Funds for Health Improvement and Research(Grant No.CFH 2020-2-1026)Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research(Grant No.BMU2020JI004)+1 种基金Beijing Talents foundation(Grant No.2018000021223ZK01)PKU-Baidu Fund(Grant No.2020BD034).
文摘Objective:This study aimed at examining the alterations in metabolomic profiles caused by treatment of H.pylori infection,and the associations between key plasma metabolites and the risk of gastric lesion progression during follow-up after treatment.Methods:An intervention trial was performed in 183 participants,117 of whom were H.pylori positive participants receiving treatment for H.pylori infection.H.pylori positive participants were prospectively followed for 182 to 1,289 days.Untargeted metabolomics assays were conducted on plasma samples collected at baseline,6 months after treatment,and during continued follow-up.Results:We identified 59 metabolites with differential posttreatment changes between participants with successful and failed H.pylori eradication,17 metabolites significantly distinguished participants with successful vs.failed eradication.Two metabolites[PC(18:1(11Z)/14:1(9Z))and(2S)-6-amino-2-formamidohexanamide]showed posttreatment changes positively associated with successful H.pylori eradication,and were inversely associated with the risk of gastric lesion progression among participants with successful eradication.In contrast,9-decenoic acid showed posttreatment changes inversely associated with successful eradication:its level was positively associated with the risk of gastric lesion progression among participants with successful eradication.Although the identified metabolites showed a temporary but significant decline after treatment,the trend generally reversed during continued follow-up,and pretreatment levels were restored.Conclusions:Treatment of H.pylori infection significantly altered plasma metabolic profiles in the short term,and key metabolites were capable of distinguishing participants with successful vs.failed eradication,but might not substantially affect metabolic regulation in the long term.Several plasma metabolites were differentially associated with the risk of gastric lesion progression among participants with successful or failed eradication.
