BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of ...BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.展开更多
Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pyl...Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori(H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important,the efficacy of interventions in their modification,as in the use of antioxidant supplements,is unconvincing. No organized screening programs can be found outside Asia(Japan and South Korea). Although several screening approaches have been proposed,including indirect atrophy detection by measuring pepsinogen in the circulation,none of them have so far been implemented,and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective,but its adverse effects and resistance remain a concern. Searches for new screening biomarkers,including microRNA and cancer-autoantibody panels,as well as detection of volatile organic compounds in the breath,are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time,new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications(classifications),including OLGA and OLGIM,have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention,the available and emerging methods for screening,and new developments in endoscopic detection of early lesions of the stomach.展开更多
AIM:To determine the frequencies of mutations that cause inherited monogenic liver disorders in patients with chronic hepatitis C. METHODS:This study included 86 patients with chronic hepatitis C(55 men, 31 women; mea...AIM:To determine the frequencies of mutations that cause inherited monogenic liver disorders in patients with chronic hepatitis C. METHODS:This study included 86 patients with chronic hepatitis C(55 men, 31 women; mean age at diagnosis, 38.36 ± 14.52 years) who had undergone antiviral therapy comprising pegylated interferon and ribavirin. Viral load, biochemical parameter changes, and liver biopsy morphological data were evaluated in all patients. The control group comprised 271 unrelated individuals representing the general population of Latvia for mutation frequency calculations. The most frequent mutations that cause inherited liver disorders [gene(mutation): ATP7B(H1069Q), HFE(C282Y, H63D),UGT1A1(TA)7, and SERPINA1(PiZ)] were detected by polymerase chain reaction(PCR), bidirectional PCR allele-specific amplification, restriction fragment length polymorphism analysis, and sequencing. RESULTS: The viral genotype was detected in 80 of the 86 patients. Viral genotypes 1, 2, and 3 were present in 61(76%), 7(9%), and 12(15%) patients, respectively. Among all 86 patients, 50(58%) reached an early viral response and 70(81%) reached a sustained viral response. All 16 patients who did not reach a sustained viral response had viral genotype 1. Casecontrol analysis revealed a statistically significant difference in only the H1069Q mutation between patients and controls(patients, 0.057; controls, 0.012; odds ratio, 5.514; 95%CI: 1.119-29.827, P = 0.022). However, the H1069Q mutation was not associated with antiviral treatment outcomes or biochemical indices. The(TA) 7 mutation of the UGT1A1 gene was associated with decreased ferritin levels(beta regression coefficient =-295.7, P = 0.0087). CONCLUSION: Genetic mutations that cause inherited liver diseases in patients with hepatitis C should be studied in detail.展开更多
The objective of the study was to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in detection of vital tumor cell infiltration presence in peritumoral brain areas and...The objective of the study was to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in detection of vital tumor cell infiltration presence in peritumoral brain areas and determination of biochemical changes in the brain parenchyma after received treatment. 73 patients with present, morphologically conformed brain gliomas and 77 gliomas patients in remission stage after combined therapy underwent magnetic resonance imaging (MRI) including MRS and DTI. Fractional anisotropy (FA) and metabolite ratios—choline/creatine (Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine (LL/Cr), N-acetyl aspartate/creatine (NAA/Cr)—were measured in the tumor, perifocal edema zone, distant and contra-lateral normal appearing white matter. We observed gradual reduction of Cho/Cr, MI/Cr, LL/Cr mean ratios and step-by-step increase of NAA/Cr, FA mean values in the direction from the tumor to the distant and contra-lateral normal-appearing white matter. LL/Cr ratios within distal normal appearing white matter decreased in patients after radiotherapy/chemotherapy. Our study suggests that MRS and DTI in combination with structural MRI sequences enhance vital glial tumor cells areas and possible infiltration border. MRS and DTI quantitative measurements in the glioma peritumoral area reveal pathological changes, despite the normal signal intensity in structural MRI. We suggest that increased LL/Cr ratios and decreased FA values may have the superior implications in the detecting of glial tumors extent along the white matter tracts. NAA/Cr reduction and Cho/Cr increase may provide additional diagnostic value. LL/Cr ratio in distal normal signal intensity area could be used as radiation/chemotherapy effectiveness criteria, as this will reduce after the received treatment and in remission period.展开更多
文摘BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.
文摘Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori(H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important,the efficacy of interventions in their modification,as in the use of antioxidant supplements,is unconvincing. No organized screening programs can be found outside Asia(Japan and South Korea). Although several screening approaches have been proposed,including indirect atrophy detection by measuring pepsinogen in the circulation,none of them have so far been implemented,and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective,but its adverse effects and resistance remain a concern. Searches for new screening biomarkers,including microRNA and cancer-autoantibody panels,as well as detection of volatile organic compounds in the breath,are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time,new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications(classifications),including OLGA and OLGIM,have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention,the available and emerging methods for screening,and new developments in endoscopic detection of early lesions of the stomach.
基金Supported by The Latvian Council of Science,National Project,Nos.09.1384 and 10.0010.02
文摘AIM:To determine the frequencies of mutations that cause inherited monogenic liver disorders in patients with chronic hepatitis C. METHODS:This study included 86 patients with chronic hepatitis C(55 men, 31 women; mean age at diagnosis, 38.36 ± 14.52 years) who had undergone antiviral therapy comprising pegylated interferon and ribavirin. Viral load, biochemical parameter changes, and liver biopsy morphological data were evaluated in all patients. The control group comprised 271 unrelated individuals representing the general population of Latvia for mutation frequency calculations. The most frequent mutations that cause inherited liver disorders [gene(mutation): ATP7B(H1069Q), HFE(C282Y, H63D),UGT1A1(TA)7, and SERPINA1(PiZ)] were detected by polymerase chain reaction(PCR), bidirectional PCR allele-specific amplification, restriction fragment length polymorphism analysis, and sequencing. RESULTS: The viral genotype was detected in 80 of the 86 patients. Viral genotypes 1, 2, and 3 were present in 61(76%), 7(9%), and 12(15%) patients, respectively. Among all 86 patients, 50(58%) reached an early viral response and 70(81%) reached a sustained viral response. All 16 patients who did not reach a sustained viral response had viral genotype 1. Casecontrol analysis revealed a statistically significant difference in only the H1069Q mutation between patients and controls(patients, 0.057; controls, 0.012; odds ratio, 5.514; 95%CI: 1.119-29.827, P = 0.022). However, the H1069Q mutation was not associated with antiviral treatment outcomes or biochemical indices. The(TA) 7 mutation of the UGT1A1 gene was associated with decreased ferritin levels(beta regression coefficient =-295.7, P = 0.0087). CONCLUSION: Genetic mutations that cause inherited liver diseases in patients with hepatitis C should be studied in detail.
文摘The objective of the study was to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in detection of vital tumor cell infiltration presence in peritumoral brain areas and determination of biochemical changes in the brain parenchyma after received treatment. 73 patients with present, morphologically conformed brain gliomas and 77 gliomas patients in remission stage after combined therapy underwent magnetic resonance imaging (MRI) including MRS and DTI. Fractional anisotropy (FA) and metabolite ratios—choline/creatine (Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine (LL/Cr), N-acetyl aspartate/creatine (NAA/Cr)—were measured in the tumor, perifocal edema zone, distant and contra-lateral normal appearing white matter. We observed gradual reduction of Cho/Cr, MI/Cr, LL/Cr mean ratios and step-by-step increase of NAA/Cr, FA mean values in the direction from the tumor to the distant and contra-lateral normal-appearing white matter. LL/Cr ratios within distal normal appearing white matter decreased in patients after radiotherapy/chemotherapy. Our study suggests that MRS and DTI in combination with structural MRI sequences enhance vital glial tumor cells areas and possible infiltration border. MRS and DTI quantitative measurements in the glioma peritumoral area reveal pathological changes, despite the normal signal intensity in structural MRI. We suggest that increased LL/Cr ratios and decreased FA values may have the superior implications in the detecting of glial tumors extent along the white matter tracts. NAA/Cr reduction and Cho/Cr increase may provide additional diagnostic value. LL/Cr ratio in distal normal signal intensity area could be used as radiation/chemotherapy effectiveness criteria, as this will reduce after the received treatment and in remission period.
