Dynamic observation of the progression of chronic gastritis to gastric cancer in a diseasee-TCM pattern rat model

Objective:To dynamically observe the progression of chronic gastritis to gastric cancer(GC)in diseasetraditional Chinese medicine(TCM)pattern rats to provide data for understanding the disease progression and effective approaches for drug screening and mechanism exploration.Methods:Wistar rats were randomly divided into control(n=96,half female and half male)and model(n=336,half female and half male)groups.Model rats received free access to N-methyl-N0-nitro-Nnitrosoguanidine(120 mg/mL),sodium deoxycholate(20 mmol/L),and alcohol(45%),and were subjected to intermittent fasting.Mortality rate,body weight,water consumption,food intake,gastric pathology,blood content analysis,and liver and kidney function of model rats were dynamically monitored over 30 weeks.In the 30th week,pattern characteristics were assessed.Gastric pathology and pattern characteristics were observed for an additional 8 weeks to evaluate stability.Results:The overall mortality of the model group was 34.82%(33.10%for females and 36.55%for males)at 30 weeks post-intervention.Inflammatory cell infiltration,glandular atrophy,atypical hyperplasia,and GC manifested successively in the gastric mucosa of rats.In model rats,N-methyl-N0-nitro-N-nitrosoguanidine intake was lower in males than in females,whereas pathological changes in the gastric mucosa occurred earlier in females than in males.Notably,gastric mucosal lesions were more severe in males than in females.Our modeling methods maintained stable gastric mucosal lesions for at least 8 weeks after final intervention.The pattern characteristics observed in model rats at the 30th and 38th week were consistent with those of spleen deficiency,blood stasis,and yin deficiency pattern.Blood content and indexes of liver and kidney function in the model group were normal.Conclusion:Our findings provide evidence for the pathological stages underscoring the progression of chronic gastritis to GC in disease-TCM pattern rats,which may facilitate development of relevant pharmacotherapies.

History of chronic gastritis:How our perceptions have changed

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular patient.Modern classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a patient.However,this attitude to the patient suffering from CG was far from always.The present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

Role of the HLA-DQ locus in the development of chronic gastritis and gastric carcinoma in Mexican patients

AIM： To determine the HLA-DQ locus in Mexican patients with Chronic gastritis and gastric adenocarcinoma.METHODS： Oligotyping for HLA-DQ locus was performed in 45 Mexican patients with chronic gastritis and 13 Mexican patients with diffuse-type gastric adenocarcinoma, and was then compared with 99 clinically healthy unrelated individuals. H pylori infection and CagA status were assessed in patients by enzyme-linked immunosorbent assay （EUSA） method. RESULTS： We found a significant increased frequency of HLA-DQBI＊0401 allele in Hpylori-positive patients with chronic gastritis when compared with healthy subjects [19 vs 0%, P = 1 × 10^-7, odds ratio （OR） = 4.96; 95% confidence interval （95% CI）, 3.87-6.35]. We also found a significant increased frequency of HLA-DQBI＊0501 in patients with diffuse-type gastric carcinoma in comparison with healthy individuals （P = 1 × 10^4, OR = 13.07; 95% CI, 2.82-85.14）.CONCLUSION： HLA-DQ locus may play a different role in the development of H pylori-related chronic gastritis and difffuse-type gastric adenocarcinoma in the Mexican Mestizo population.

CAMPYLOBACTER-PYLORIDIS INFECTION OF GASTRIC MUCOSA IN THE HIGH AND LOW RISK AREAS OF STOMACH CANCER IN CHINA

Gastric biopsies in 690 subjects from the high and low risk areas of gastric cancer were examined for identification of Cp in the gastric mucosa by Warthin-Starry, Gimenez and Gram' s stains. The result showed that the positive rate was 60-62% in the high risk area whereas it was only 12. 6% in the low risk area in Liaoning province. 80-92% of the positive subjects had active chronic gastritis including chronic superficial and atrophic gastritis. The result Indicates a close correlation between the active chronic gastritis and Cp infection. Therefore, control of the Cp Infection in the gastric mucosa is very important for lowering the incidence of chronic gastritis, a well known precursor of gastric cancer.

Chronic active and atrophic gastritis as significant contributing factor to the development of gastric cystica profunda

Gastric cystica profunda(GCP)is an uncommon but underestimated gastric lesion.Its precancerous potential determines its significance.In addition to previous mucosa injury due to operations,biopsy or polypectomy,chronic active and atrophic gastritis may also lead to the development of GCPs.By carefully examining the stomach and taking biopsy samples from the susceptible regions,the stage of atrophy can be determined.Chronic atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs formation.GCPs frequently occur close to early gastric cancers(EGCs)or EGC can arise from the cystic glands.Endoscopic resection is an effective and minimally invasive treat-ment in GCP.

Risk for gastric neoplasias in patients with chronic atrophic gastritis:A critical reappraisal

Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.

Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice

Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for gastric cancer(GC) development. There are several approaches to identifying these subjects,including noninvasive methods, esophagogastroduodenoscopy and histology.The main approach in Western countries is histology-based while that in Eastern countries with a high prevalence of GC is endoscopy-based. Regarding asymptomatic individuals, the key issues in selecting applicable approaches are the ability to reduce GC mortality and the cost-effectiveness of the approach. At present, population-based screening programs have only been applied in a few Asian countries with a high risk of GC. Pre-endoscopic risk assessment based on demographic and clinical features, such as ethnicity, age, gender, smoking and Helicobacter pylori status, is helpful for identifying subjects with high pre-test probability for a possibly cost-effective approach, especially in intermediate-and low-risk countries. Regarding symptomatic patients with indications for esophagogastroduodenoscopy, the importance of opportunistic screening should be emphasized. The combination of endoscopic and histological approaches should always be considered as endoscopy provides a real-time assessment of the patient’s risk level. In addition, imaging enhanced endoscopy(IEE) has been shown to facilitate targeted biopsies resulting in better correlation between endoscopic and histological findings. Currently, the use of IEE is recommended for endoscopic examinations, and the Operative Link for Gastric Intestinal Metaplasia or Operative Link on Gastritis Assessment grading systems are recommended for histological examinations whenever available. However,resource limitations are an important barrier in many regions worldwide. Thus,for an approach to be applicable in real-life practice, it should be not only evidence-based but also resource-sensitive. In this review, we discuss the current understanding and approaches to identifying high-risk individuals from western and eastern perspectives, as well as the possibility of an integrated, resourcesensitive approach.

Chronic atrophic gastritis detection with a convolutional neural network considering stomach regions

BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.

Detection and evaluation of antibodies against neutrophil-activating protein of Helicobacter pylori in patients with gastric cancer

AIM： To detect and evaluate the antibodies against Helicobacter pylori （H pylori） neutrophil-activating protein （HP-NAP） in patients with gastric cancer and other gastroduodenal diseases.METHODS： Recombinant HP-NAP was prepared from a prokaryotic expression system in Escherichia coll. Serum positivity and level of HP-NAP-specific antibodies in sera from 43 patients with gastric cancer, 28 with chronic gastritis, 28 with peptic ulcer, and 89 healthy controls were measured by rHP-NAP-based ELISA. rHP-NAP-stimulated production of interleukin-8 （IL-8） and growth-related oncogene （GROα） cytokines in the culture supernatant of SGC7901 gastric epithelial cells was also detected.RESULTS： The serum positivity and mean absorbancevalue of HP-NAP-specific antibodies in the gastriccancer group （97.7% and 1.01 ± 0.24） were significantly higher than those in the chronic gastritisgroup （85.7% and 0.89 ± 0.14, P 〈 0.005） and healthy control group （27.7% and 0.65 ± 0.18, P 〈 0.001）. The sensitivity and specificity of ELISA for the detection of HP-NAP-specific antibodies were 95.5% and 91.5%, respectively. HP-NAP could slightly upregulate IL-8 production in gastric epithelial cell lines but had no effect on GROα production.CONCLUSION： Infection with virulent H py/ori strains secreting HP-NAP is associated with severe gastroduodenal diseases, and HP-NAP may play a role in the development of gastric carcinoma, rHP-NAP- based ELISA can be used as a new method to detect H pylori infection. The direct effect of HP-NAP on gastric epithelial cells may be limited, but HP-NAP may contribute to inflammatory response or carcinogenesis by activating neutrophils.

Characterization and strong risk association of TLR2 del-196 to-174 polymorphism and Helicobacter pylori and their influence on mRNA expression in gastric cancer

BACKGROUND Toll-like receptor-2(TLR2) is responsible for recognizing Helicobacter pylori(H.pylori) and activating the immune response. Polymorphisms in TLR2 may modulate gastric carcinogenesis.AIM To evaluate whether the TLR2 19216 T/C(rs3804099) and TLR2-196 to-174 ins/del(rs111200466) polymorphisms contribute to gastric carcinogenesis in the Brazilian population, and to determine the influence of both polymorphisms and H. pylori infection on TLR2 mRNA expression.METHODS DNA was extracted from 854 peripheral blood leukocyte or gastric tissue samples[202 gastric cancer(GC), 269 chronic gastritis(CG), and 383 control/healthy(C)]and genotyped by allele-specific PCR or restriction fragment length polymorphism(RFLP)-PCR. Quantitative polymerase chain reaction by Taq Man■ assay was used to quantify TLR2 mRNA levels in fresh gastric tissues(48 GC, 36 CG, and 14 C).RESULTS Regarding the TLR2-196 to -174 polymorphism, the ins/del and del/del genotypes were associated with a higher risk of GC by comparison with the C in all of the analyzed inheritance models(codominant, dominant, recessive, overdominant and log-additive;P < 0.0001). Similarly, an increased risk was observed when comparing the GC and CG groups [codominant(P < 0.0001), dominant(P <0.0001), recessive(P = 0.0260), overdominant(P < 0.0001) and log-additive(P <0.0001)]. In contrast, TLR2 19216 T/C was associated with a protective effect in the GC group compared to the C group [dominant(P = 0.0420) and log-additive(P =0.0300)]. Regarding the association of polymorphisms with H. pylori infection,individuals infected with H. pylori and harboring the TLR2-196 to-174 ins/del polymorphism had an increased risk of gastric carcinogenesis [codominant(P =0.0120), dominant(P = 0.0051), overdominant(P = 0.0240) and log-additive(P =0.0030)], while TLR2 19216 T/C was associated with a protective effect[codominant(P = 0.0039), dominant(P < 0.0001), overdominant(P = 0.0097) and log-additive(P = 0.0021)]. TLR2 mRNA levels were significantly increased in the GC group(median RQ = 6.95) compared to the CG group(RQ = 0.84, P < 0.0001)and to the normal mucosa group(RQ = 1.0). In addition, both H. pylori infection(P < 0.0001) and the presence of the polymorphic TLR2-196 to -174 del(P = 0.0010)and TLR2 19216 C(P = 0.0004) alleles influenced TLR2 mRNA expression.CONCLUSION The TLR2-196 to-174 ins/del and TLR2 19216 T/C polymorphisms are strongly associated with GC. TLR2 mRNA expression levels are upregulated in neoplastic tissues and influenced by both the presence of H. pylori and variant genotypes.

A cross-sectional study on traditional Chinese medicine syndromes distribution for chronic atrophic gastritis based on data mining

Background:Chronic atrophic gastritis(CAG)is a common digestive system disease characterized by reduced gastric mucosa inherent glands and often accompanied by intestinal metaplasia and dysplasia.Traditional Chinese medicine believes that syndrome elements dampness and blood stasis are closely related to the occurrence and development of CAG and promote the occurrence of precancerous lesions of gastric cancer.However,there is a lacking of more in-depth and detailed study on the above syndrome elements.This study aimed to made a quantitative description by cross-sectional study on the frequency of key syndrome elements dampness and blood stasis of CAG.Methods:201 CAG patients who met with inclusion criteria were divided into 4 groups including:only dampness group,only blood stasis group,none of dampness and blood stasis group,dampness and blood stasis group according to their four diagnostic information.The severities and levels of patients’clinical symptoms,pathological signs and patient-reported outcome scale used as evaluation indexes were collected.Data mining method of exploratory factor analysis was used for statistics.Results:The results suggested that the frequencies of dampness and blood stasis were reflected in the severity and levels of gastric symptoms,helicobacter pylori infection and the distribution and severity of dysplasia.And blood stasis played a more prominent role in promoting the progression of the CAG to cancer.Conclusion:Our results might provide a quantitative syndrome description for the traditional Chinese medicine differentiation in treating precancerous lesions of gastric cancer and preventing gastric cancer.

Toll-like receptor 9 polymorphisms and Helicobacter pylori influence gene expression and risk of gastric carcinogenesis in the Brazilian population

BACKGROUND Toll-like receptors(TLRs)are the first line of host defense,and are involved in Helicobacter pylori(H.pylori)recognition and activation of both inflammatory and carcinogenic processes.The presence of single nucleotide polymorphisms(SNPs)in genes that activate the immune response may modulate the risk of precancerous lesions and gastric cancer(GC).Among them,Toll-like receptor 9(TLR9)polymorphisms have emerged with a risk factor of infectious diseases and cancer,however the studies are still inconclusive.AIM To evaluate whether TLR9 rs5743836 and rs187084 SNPs contribute to the risk of gastric carcinogenesis,and its influence on mRNA expression.METHODS A case-control study was conducted to evaluate two TLR9 SNPs(TLR9-1237 TCrs5743836 and TLR9-1486 CT-rs187084)in chronic gastritis(CG)and GC patients.A total of 609 DNA samples of peripheral blood[248 CG,161 GC,and 200 samples from healthy individuals(C)]were genotyped by polymerase chain reaction-restriction fragment length polymorphism.All samples were tested for the H.pylori infection using Hpx1 and Hpx2 primers.Quantitative polymerase chain reaction by TaqMan?assay was used to quantify TLR9 mRNA from fresh gastric tissues(48 GC,26 CG,and 14 C).RESULTS For TLR9-1237,the TC+CC or CC genotypes were associated with a higher risk of GC than C[recessive model odds ratio(OR)=5.01,95%confidence interval(CI):2.52-9.94,P<0.0001],and the CG(recessive model OR=4.63;95%CI:2.44-8.79,P<0.0001)groups.For TLR9-1486,an association between the CT+TT genotypes and increased risk of both GC(dominant model OR=2.72,95%CI:1.57-4.72,P<0.0001)and CG(dominant model OR=1.79,95%CI:1.15-2.79,P=0.0094)was observed when compared to the C group.Moreover,the presence of TLR9-1237 TC/CC+TLR9-1486 CC genotypes potentiate the risk for this neoplasm(OR=18.57;95%CI:5.06-68.15,P<0.0001).The TLR9 mRNA level was significantly higher in the GC group(RQ=9.24,P<0.0001)in relation to the CG group(RQ=1.55,P=0.0010)and normal mucosa(RQ=1.0).When the samples were grouped according to the polymorphic genotypes and the presence of H.pylori infection,an influence of TLR9-1237 TC+CC polymorphic genotypes(P=0.0083)and H.pylori infection(P<0.0001)was observed on the upregulation of mRNA expression.CONCLUSION Our findings show that TLR9 rs5743836 and rs187084 polymorphisms are associated with a higher risk of carcinogenesis gastric,and that TLR9 mRNA levels can be modulated by TLR9-1237 TC+CC variant genotypes and H.pylori infection.

Regulatory effect of traditional Chinese medicines on signaling pathways of process from chronic atrophic gastritis to gastric cancer

Chronic atrophic gastritis(CAG),a common disease of digestive system,is an extremely important cause of gastric cancer(GC).The occurrence and development of CAG involves the abnormality of multiple signaling pathways.Traditional Chinese medicines(TCMs)has the advantages of mild action,multi-target and small adverse reaction,etc.,which broadens the way for the treatment of the disease,and TCMs can play a therapeutic role by regulating multiple signaling pathways.In this review,based on the related experiments of TCMs and Chinese herbal compounds in recent years,the related literatures were searched and 10 kinds of signaling pathways involved were summarized,in order to provide a reference for further research on reversing or delaying the progress of CAG and preventing gastric cancer.

Use of Fourier-transform infrared spectroscopy to rapidly diagnose gastric endoscopic biopsies

AIM: To determine if Fourier-transform infrared (FT-IR)spectroscopy of endoscopic biopsies could accurately diagnose gastritis and malignancy.METHODS: A total of 123 gastroscopic samples, including 11 cases of cancerous tissues, 63 cases of chronic atrophic gastritis tissues, 47 cases of chronic superficial gastritis tissues and 2 cases of normal tissues, were obtained from the First Hospital of Xi'an Jiaotong University, China. A modified attenuated total reflectance (ATR) accessory was linked to a WQD-500 FT-IR spectrometer for spectral measurement followed by submission of the samples for pathologic analysis. The spectral characteristics for different types of gastroscopic tissues were summarized and correlated with the corresponding pathologic results.RESULTS: Distinct differences were observed in the FTIR spectra of normal, atrophic gastritis, superficial gastritis and malignant gastric tissues. The sensitivity of FT-IR for detection of gastric cancer, chronic atrophic gastritis and superficial gastritis was 90.9%, 82.5%, 91.5%, and specificity was 97.3%, 91.7%, 89.5% respectively.CONCLUSION: FT-IR spectroscopy can distinguish gastric inflammation from malignancy.

慢性萎缩性胃炎的中医辨治思路与对策

慢性萎缩性胃炎(CAG)是临床上公认的胃癌前疾病,中医药治疗CAG具有明显的优势及鲜明的特色。从CAG病因病机等方面的研究入手,对中医药治疗CAG提出治本独取阳明,补虚泻实,顾护脾胃,升降气机,调气和血,祛瘀通络,祛邪解毒,甘平凉润,和胃护络的辨治思路与对策,以期进一步提高中医药治疗CAG的临床疗效。

胃癌与慢性萎缩性胃炎胃黏膜SLC26A9基因表达情况分析

目的分析胃癌与慢性萎缩性胃炎(CAG)胃黏膜SLC26A9基因表达情况。方法回顾性分析200例过往CAG入院复查患者,以其中69例CAG患者为胃炎组,40例胃黏膜低级别上皮细胞瘤变患者为低级别瘤变组,34例胃黏膜高级别上皮细胞瘤变患者为高级别瘤变组,57例胃癌患者为胃癌组;胃癌组根据胃癌进展程度分为早期组(n=31)和进展期组(n=26)。200例患者均进行胃黏膜SLC26A9基因表达水平检测,比较胃炎组、低级别瘤变组、高级别瘤变组、胃癌组4组患者胃黏膜SLC26A9基因表达水平;比较早期组和进展期组患者胃黏膜SLC26A9基因表达水平。使用logistic相关性模型分析SLC26A9基因表达水平与胃癌发生、胃癌进展程度的相关性。使用受试者工作曲线(ROC)分析SLC26A9基因表达对胃癌的诊断价值;使用ROC曲线分析SLC26A9基因表达对胃癌进展程度的判断价值。结果胃炎组、低级别瘤变组、高级别瘤变组、胃癌组4组胃黏膜SLC26A9基因表达水平均存在明显差异,且胃炎组>低级别瘤变组>高级别瘤变组>胃癌组(P<0.05);早期组患者胃黏膜SLC26A9基因表达水平显著高于进展期组(P<0.05)。经logistic相关性分析,胃黏膜SLC26A9基因表达水平与胃癌发生、胃癌进展程度均呈负相关(P<0.05)。ROC曲线中,胃黏膜SLC26A9基因表达水平诊断胃癌发生的曲线下面积(AUC)为0.935,95%CI为0.892~0.965,敏感度为91.23%,特异度为87.41%,截断值为0.2787;胃黏膜SLC26A9基因表达水平诊断胃癌进展程度AUC为0.881,95%CI为0.768~0.952,敏感度为92.31%,特异度为80.65%,截断值为0.2368。结论胃黏膜SLC26A9基因表达水平与胃癌发生密切相关,可为临床诊断CAG患者疾病恶化为胃癌及其胃癌进展程度。

胃癌前病变病证结合动物模型研究进展

中医药在胃癌前病变(precancerous lesions of gastric cancer,PLGC)诊疗中发挥着重要作用,病证结合动物模型是进行PLGC相关实验研究的前提。文章从模型动物选择、胃癌前病变疾病模型和病证结合模型三方面,对近年来PLGC病证结合模型的制备方法进行了归纳分析,介绍了脾胃虚弱、胃阴不足、肝胃气滞、脾胃湿热和胃络瘀血5个常见PLGC病证结合模型的造模方法,并对当前模型制备中存在的问题提出了思考与展望。

趋化因子CXCL5与慢性萎缩性胃炎及胃癌前病变的相关性

目的明确慢性萎缩性胃炎(CAG)及胃癌前病变(PLGC)患者血清及胃组织中CXCL5水平变化情况,并探究CXCL5用于诊断CAG及PLGC的预测价值。方法纳入2022年6月至2023年6月在安徽中医药大学第二附属医院脾胃科收治并行胃镜及病理确诊的CAG 72例,以及同期在我科接受胃镜检查的健康受试者68例。收集所有受试者的临床信息和实验室结果,通过logistic回归分析方法明确CAG的影响因素及CXCL5的诊断价值。此外,为了明确CXCL5在CAG发展进程中的作用,选取2023年6-12月于本院收治的CAG、肠化、异型增生患者各15例,以及健康受试者15例。采用ELISA法、PCR法和免疫组化法验证各组CXCL5的表达情况以及与临床病理程度之间的关系,对CXCL5的诊断效能进行验证评估。结果本病的影响因素包括肿瘤家族史、吸烟史、饮酒史、饮食规律与否、幽门螺杆菌感染、病灶数量、病理程度、胃功能三项、CXCL5等(P<0.05)。受试者工作特征(ROC)曲线显示,曲线下面积(AUC)为1.00,约登指数为0.986,展现了良好的预测能力。ELISA结果显示,与正常组相比,CAG、肠化和异型增生组患者血清CXCL5表达水平显著升高,且与病理程度呈正相关;PCR及免疫组化染色结果显示,与正常组相比,CAG、肠化和异型增生组患者胃组织CXCL5 mRNA及蛋白表达水平均显著升高,且与病理程度呈正相关。结论CXCL5在CAG和PLGC患者血清及胃组织中呈高表达,其表达水平与病理程度呈正相关。因此,CXCL5有望成为诊断CAG及PLGC的预测指标和新的治疗靶点。

慢性萎缩性胃炎及癌前病变复合造模法评价

目的 评价复合造模法构建慢性萎缩性胃炎(chronic atrophic gastritis, CAG)及胃癌前病变(precancerous lesions of gastric cancer, PLGC)大鼠模型的可行性。方法 将60只SPF级雄性SD大鼠随机分为对照组(n=10)及模型组(n=50)。对照组正常饲养,模型组用N-甲基-N′-硝基-N-亚硝基胍(MNNG)自由饮用+水杨酸钠隔日灌胃+脱氧胆酸钠隔日灌胃+不定期禁食复合造模法构建慢性萎缩性胃炎大鼠模型,造模时间为6个月。于造模第3,4,5,6个月比较模型组与对照组大鼠胃黏膜病理程度,造模后采血,采用ELISA检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素17(G-17)。结果 模型组大鼠复合刺激4个月开始出现胃腺体萎缩,5个月出现纤维化,6个月出现胃腺消失及异型增生,1只出现癌变。模型组6只大鼠异常死亡,造模死亡率为12%。与对照组比较,模型组血清PGⅠ升高(P<0.05),PGⅠ与PGⅡ比值(PG R)降低(P<0.05),G-17降低(P<0.05)。结论 采用复合造模法制备大鼠CAG模型成功率高,结果较稳定,但制备时间较长,且由于大鼠个体差异,造模进程难以完全统一,所有大鼠均出现胃黏膜萎缩,部分大鼠出现PLGC特征,个别大鼠出现癌变。

中西医治疗慢性萎缩性胃炎进展

慢性萎缩性胃炎(chronic atrophic gastritis,CAG)指胃黏膜腺体体积减小,量少,伴有或不伴有肠腺化生及(或)假幽门腺化生的慢性疾病,被认为是消化系统癌前疾病的一种。慢性萎缩性胃炎病程漫长,缠绵难愈,给患者生活带来极大不利影响。一般采用根除幽门螺杆菌、促进胃动力等对症治疗方法,对慢性萎缩性胃炎进行西医治疗。中医药通过不同的药物组合,随证加减,在改善症状方面有优势。慢性萎缩性胃炎的中西医结合治疗,在改善症状的同时,对胃黏膜的萎缩和肠上皮化生起到阻断和逆转作用。文章从慢性萎缩性胃炎的病因、病机、辨证论治、中药西药并用、中成药治疗、针药并用、经验方治疗、内窥镜治疗等方面,对近年来我国慢性萎缩性胃炎的中医西医治疗进展进行了概述。