Background： In Padova and Vienna International Classification, the usual intestinal metaplasia （UIM） of the stomach, including complete and incomplete type, is defined as negative for dysplasia, and hyperproliferat...Background： In Padova and Vienna International Classification, the usual intestinal metaplasia （UIM） of the stomach, including complete and incomplete type, is defined as negative for dysplasia, and hyperproliferative intestinal metaplasia （HIM） as indefinite for dysplasia, but the biological characteristics of these two types of intestinal metaplasia （IM）remain to be studied. Objective： To investigate the biological differences between UIM, HIM and intestinal type gastric cancer （IGC）, a panel of biomarkers were detected. Methods： A total of 38 cases of IGC, 41 HIM and 56 UIM adjacent to gastric cancer were studied. Immunohistochemistry was used to detect the expressions of pS2, MUC2, MUC5AC, MUC6, Ki-67, EGFR, p53 and sulfo-Lewisa in UIM, HIM and IGC. Microsatellite instability （MSI） in UIM, HIM and IGC was detected by using Denaturing High Performance Liquid Chromatography （DHPLC）. Results： The pS2 antigen expression in UIM （78.6%） was significantly higher than in HIM and IGC （9.8%, 10.5%）, p〈0.01. The MUC6, sulfo-Lewisa and EGFR protein expressions were significant increased in HIM （24.4%, 82.9%, 48.7%） and IGC （34.2%, 75.0%, 42.1%） than in UIM （3.6%, 25.5%, 17.9%）, p〈0.01. A reversed pattern of expressions of MUC2 and MUC5AC was observed in UIM （96.4%, 50.0%） and HIM （82.9%, 36.6%） compared with IGC （52.6%, 13.2%）, p〈0.05; and the p53 gene expression was increased from UIM （1.8%） to HIM （19.5%） to IGC （57.9%）, p〈0.01. The Ki-67 labeling index was significantiy different among three lesions （UIM： 16%±6%, HIM： 45%±9%, IGC： 63%±10%, p〈0.01）. Conclusion： These findings suggest that there are different bio-characteristics among UIM, HIM and IGC, and HIM may have higher potential to progress to more advanced lesions in comparison with UIM.展开更多
BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT...BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.METHODS Clinical data of patients with gastric mesenchymal or gastric smooth muscle tu-mours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed.Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively(n=50 cases per group).Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group.Serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups.The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic(ROC)curve.The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identi-fying gastric mesenchymal tumours.RESULTS CEA levels varied among the three groups in the following order:The gastric mesenchymal tumour group>the control group>the gastric smooth muscle tumour group.CA19-9 levels varied among the three groups in the following order:The gastric mesenchymal group>the gastric smooth muscle group>the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the area under the curve of CEA and CA19-9 was 0.879 and 0.782,respectively.CONCLUSION Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.展开更多
INTRODUCTIONThe field of gastrointestinal hormones has expanded at a dizzying rate[1-4].Gastrointestinal hormones as regulatory peptides that appear to be major components of bodily integration and have important regu...INTRODUCTIONThe field of gastrointestinal hormones has expanded at a dizzying rate[1-4].Gastrointestinal hormones as regulatory peptides that appear to be major components of bodily integration and have important regulatory actions on physioligical function of the gastrointestinal tract .The successful isolation of some gastrointestinal hormones and the development of sensitive methods for their detection have led to the unexpected finding that they also exist in the brain .展开更多
Gastrointestinal lymphomas represent up to 10%of gastrointestinal malignancies and about one third of nonHodgkin lymphomas.The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse larg...Gastrointestinal lymphomas represent up to 10%of gastrointestinal malignancies and about one third of nonHodgkin lymphomas.The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma.However,the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization.Due to their rarity and the multifaceted histology,an endoscopic classification has not been validated yet.This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up,according to the involved site and lymphoma subtype.Existing,new and emerging endoscopic technologies have been examined.In particular,we investigated the diagnostic,prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas,lymphomatous polyposis and mantle cell lymphoma,follicular lymphoma,plasma cell related disease,gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract.Contrarily to more frequent gastrointestinal lymphomas,data about rare lymphomas are mostly extracted from case series and case reports.Due to the data paucity,a synergism between gastroenterologists and hematologists is required inorder to better manage the disease.Indeed,clinical and prognostic features are different from nodal and extranodal or the bone marrow(in case of plasma cell disease)counterpart.Therefore,the approach should be based on the knowledge of the peculiar behavior and natural history of disease.展开更多
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...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.展开更多
基金This work was supported by a Grant from the State Key Basic Research Program (G1998051203).
文摘Background： In Padova and Vienna International Classification, the usual intestinal metaplasia （UIM） of the stomach, including complete and incomplete type, is defined as negative for dysplasia, and hyperproliferative intestinal metaplasia （HIM） as indefinite for dysplasia, but the biological characteristics of these two types of intestinal metaplasia （IM）remain to be studied. Objective： To investigate the biological differences between UIM, HIM and intestinal type gastric cancer （IGC）, a panel of biomarkers were detected. Methods： A total of 38 cases of IGC, 41 HIM and 56 UIM adjacent to gastric cancer were studied. Immunohistochemistry was used to detect the expressions of pS2, MUC2, MUC5AC, MUC6, Ki-67, EGFR, p53 and sulfo-Lewisa in UIM, HIM and IGC. Microsatellite instability （MSI） in UIM, HIM and IGC was detected by using Denaturing High Performance Liquid Chromatography （DHPLC）. Results： The pS2 antigen expression in UIM （78.6%） was significantly higher than in HIM and IGC （9.8%, 10.5%）, p〈0.01. The MUC6, sulfo-Lewisa and EGFR protein expressions were significant increased in HIM （24.4%, 82.9%, 48.7%） and IGC （34.2%, 75.0%, 42.1%） than in UIM （3.6%, 25.5%, 17.9%）, p〈0.01. A reversed pattern of expressions of MUC2 and MUC5AC was observed in UIM （96.4%, 50.0%） and HIM （82.9%, 36.6%） compared with IGC （52.6%, 13.2%）, p〈0.05; and the p53 gene expression was increased from UIM （1.8%） to HIM （19.5%） to IGC （57.9%）, p〈0.01. The Ki-67 labeling index was significantiy different among three lesions （UIM： 16%±6%, HIM： 45%±9%, IGC： 63%±10%, p〈0.01）. Conclusion： These findings suggest that there are different bio-characteristics among UIM, HIM and IGC, and HIM may have higher potential to progress to more advanced lesions in comparison with UIM.
文摘BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.METHODS Clinical data of patients with gastric mesenchymal or gastric smooth muscle tu-mours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed.Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively(n=50 cases per group).Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group.Serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups.The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic(ROC)curve.The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identi-fying gastric mesenchymal tumours.RESULTS CEA levels varied among the three groups in the following order:The gastric mesenchymal tumour group>the control group>the gastric smooth muscle tumour group.CA19-9 levels varied among the three groups in the following order:The gastric mesenchymal group>the gastric smooth muscle group>the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the area under the curve of CEA and CA19-9 was 0.879 and 0.782,respectively.CONCLUSION Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.
基金Supported by the Military Science Foundation of China,No.96M060
文摘INTRODUCTIONThe field of gastrointestinal hormones has expanded at a dizzying rate[1-4].Gastrointestinal hormones as regulatory peptides that appear to be major components of bodily integration and have important regulatory actions on physioligical function of the gastrointestinal tract .The successful isolation of some gastrointestinal hormones and the development of sensitive methods for their detection have led to the unexpected finding that they also exist in the brain .
文摘Gastrointestinal lymphomas represent up to 10%of gastrointestinal malignancies and about one third of nonHodgkin lymphomas.The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma.However,the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization.Due to their rarity and the multifaceted histology,an endoscopic classification has not been validated yet.This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up,according to the involved site and lymphoma subtype.Existing,new and emerging endoscopic technologies have been examined.In particular,we investigated the diagnostic,prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas,lymphomatous polyposis and mantle cell lymphoma,follicular lymphoma,plasma cell related disease,gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract.Contrarily to more frequent gastrointestinal lymphomas,data about rare lymphomas are mostly extracted from case series and case reports.Due to the data paucity,a synergism between gastroenterologists and hematologists is required inorder to better manage the disease.Indeed,clinical and prognostic features are different from nodal and extranodal or the bone marrow(in case of plasma cell disease)counterpart.Therefore,the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
基金Shaanxi Foundation for Innovation Team of Science and Technology,No.2018TD-003Project from State Key Laboratory of Cancer Biology,No.2019CBSKL2019ZZ07.
文摘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.
