Background: Cell adhesion molecule abnormalities are given as one reason for the occurrence of invasion and metastasis in various cancers. In this study, we conducted an immunohistochemical examination of cell adhesio...Background: Cell adhesion molecule abnormalities are given as one reason for the occurrence of invasion and metastasis in various cancers. In this study, we conducted an immunohistochemical examination of cell adhesion molecule claudin-1 in mucosa and invasive front of gastric cancer, and investigated the correlation of claudin-1 expression and clinicopathological factors. Methods: Immunohistochemical examination was performed for 35 patients who underwent surgery be-tween January 2010 and October 2011, to assess the correlation of claudin-1 with primary gastric cancer. Results: The expression rate of claudin-1 was 48.6% (17/35) in 35 gastric carcinoma patients. The positive rates of claudin-1 were 42.9% (15/35) in mucosa and 28.6% (10/35) in invasive front of gastric cancer. The expression rate of claudin-1 in invasive front was lower than in mucosa. From comparing claudin-1 expression in mucosa, it was found that well-to moderately-differentiated adenocarcinoma had significantly more claudin-1 expression than poorly-differrentiated adenocarcinoma. Claudin-1 expression of well-to moderately-differentiated adenocar-cinoma decreased in the invasive front of gastric cancer. Expression of claudin-1 in mucosa was negative in many cases with advanced tumor invasion (T2, T3, T4) and positive in many cases with early tumor invasion (T1), with a significant difference between the two展开更多
AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to Jun...AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.展开更多
Helicobacter pylori(H. pylori) infection is highly prevalent in human,affecting nearly half of the world's population; however,infection remains asymptomatic in majority of population. During its co-existence with...Helicobacter pylori(H. pylori) infection is highly prevalent in human,affecting nearly half of the world's population; however,infection remains asymptomatic in majority of population. During its co-existence with humans,H. pylori has evolved various strategies to maintain a mild gastritis and limit the immune response of host. On the other side,presence of H.pylori is also associated with increased risk for the development of various gastric pathologies including gastric cancer(GC). A complex combination of host genetics,environmental agents,and bacterial virulence factors are considered to determine the susceptibility as well as the severity of outcome in a subset of individuals. GC is one of the most common cancers and considered as the third most common cause of cancer related death worldwide. Many studies had proved H. pylori as an important risk factor in the development of non-cardia GC. Although both H. pylori infection and GC are showing decreasing trends in the developed world,they still remain a major threat to human population in the developing countries. The current review attempts to highlight recent progress in the field of research on H. pylori induced GC and aims to provide brief insight into H. pylori pathogenesis,the role of major virulence factors of H. pylori that modulates the host environment and transform the normal gastric epithelium to neoplastic one. This review also emphasizes on the mechanistic understanding of how colonization and various virulence attributes of H. pylori as well as the host innate and adaptive immune responses modulate the diverse signaling pathways that leads to different disease outcomes including GC.展开更多
Gastric cancer is the most common cancer worldwide and it is often diagnosed in an advanced stage. In countries where screening endoscopy is performed widely, early detection is possible. In fact, early gastric cancer...Gastric cancer is the most common cancer worldwide and it is often diagnosed in an advanced stage. In countries where screening endoscopy is performed widely, early detection is possible. In fact, early gastric cancer incidence is increasing during the last years worldwide and screening could be a major factor in such increase. In the past, the standard treatment of gastric cancer was surgical resection;however, the endoscopic treatment has increased due to advances in the instruments available and clinician experience. In fact, endoscopic resection has become one of the greatest advances in EGC treatment. It is the standard treatment in most of the cases because early gastric cancer is associated with a low rate of lymph node metastasis and a high survival rate. Endoscopic Mucosal Resection and more recently Endoscopic Submucosal Dissection are the two main developed procedures. Endoscopic Submucosal Dissection achieves a higher rate of en-bloc resection, complete resection, curative resection and lower local recurrence compared with Endoscopic Mucosal Resection group. The disadvantages associated with Endoscopic Submucosal Dissection, such as higher perforation rates and longer procedure time, will probably improve as the endoscopists experience increases and new endoscopic tools are developed. The aim of this paper is to review the management of EGC with a special focus on endoscopic detection, staging, therapy, surveillance, and prevention.展开更多
文摘Background: Cell adhesion molecule abnormalities are given as one reason for the occurrence of invasion and metastasis in various cancers. In this study, we conducted an immunohistochemical examination of cell adhesion molecule claudin-1 in mucosa and invasive front of gastric cancer, and investigated the correlation of claudin-1 expression and clinicopathological factors. Methods: Immunohistochemical examination was performed for 35 patients who underwent surgery be-tween January 2010 and October 2011, to assess the correlation of claudin-1 with primary gastric cancer. Results: The expression rate of claudin-1 was 48.6% (17/35) in 35 gastric carcinoma patients. The positive rates of claudin-1 were 42.9% (15/35) in mucosa and 28.6% (10/35) in invasive front of gastric cancer. The expression rate of claudin-1 in invasive front was lower than in mucosa. From comparing claudin-1 expression in mucosa, it was found that well-to moderately-differentiated adenocarcinoma had significantly more claudin-1 expression than poorly-differrentiated adenocarcinoma. Claudin-1 expression of well-to moderately-differentiated adenocar-cinoma decreased in the invasive front of gastric cancer. Expression of claudin-1 in mucosa was negative in many cases with advanced tumor invasion (T2, T3, T4) and positive in many cases with early tumor invasion (T1), with a significant difference between the two
基金Supported by Profession Specific Funded Projects in Standar-dization of Targeted Therapy and Cell Therapy and Applied Research of Early Diagnosis and Treatment for Cancer from Chinese Ministry of Health,No.200902002
文摘AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.
文摘Helicobacter pylori(H. pylori) infection is highly prevalent in human,affecting nearly half of the world's population; however,infection remains asymptomatic in majority of population. During its co-existence with humans,H. pylori has evolved various strategies to maintain a mild gastritis and limit the immune response of host. On the other side,presence of H.pylori is also associated with increased risk for the development of various gastric pathologies including gastric cancer(GC). A complex combination of host genetics,environmental agents,and bacterial virulence factors are considered to determine the susceptibility as well as the severity of outcome in a subset of individuals. GC is one of the most common cancers and considered as the third most common cause of cancer related death worldwide. Many studies had proved H. pylori as an important risk factor in the development of non-cardia GC. Although both H. pylori infection and GC are showing decreasing trends in the developed world,they still remain a major threat to human population in the developing countries. The current review attempts to highlight recent progress in the field of research on H. pylori induced GC and aims to provide brief insight into H. pylori pathogenesis,the role of major virulence factors of H. pylori that modulates the host environment and transform the normal gastric epithelium to neoplastic one. This review also emphasizes on the mechanistic understanding of how colonization and various virulence attributes of H. pylori as well as the host innate and adaptive immune responses modulate the diverse signaling pathways that leads to different disease outcomes including GC.
文摘Gastric cancer is the most common cancer worldwide and it is often diagnosed in an advanced stage. In countries where screening endoscopy is performed widely, early detection is possible. In fact, early gastric cancer incidence is increasing during the last years worldwide and screening could be a major factor in such increase. In the past, the standard treatment of gastric cancer was surgical resection;however, the endoscopic treatment has increased due to advances in the instruments available and clinician experience. In fact, endoscopic resection has become one of the greatest advances in EGC treatment. It is the standard treatment in most of the cases because early gastric cancer is associated with a low rate of lymph node metastasis and a high survival rate. Endoscopic Mucosal Resection and more recently Endoscopic Submucosal Dissection are the two main developed procedures. Endoscopic Submucosal Dissection achieves a higher rate of en-bloc resection, complete resection, curative resection and lower local recurrence compared with Endoscopic Mucosal Resection group. The disadvantages associated with Endoscopic Submucosal Dissection, such as higher perforation rates and longer procedure time, will probably improve as the endoscopists experience increases and new endoscopic tools are developed. The aim of this paper is to review the management of EGC with a special focus on endoscopic detection, staging, therapy, surveillance, and prevention.
