Atrophic Gastritis Patients Research Articles

Diagnostic value of combined detection of three gastric functions and Helicobacter pylori typing in chronic gastritis and gastric cancer

This research attempted to clarify the clinical diagnostic value of combined detection of gastric function and Helicobacter pylori (Hp) serotyping in chronic gastritis and gastric cancer (GC). The 80 chronic non atrophic gastritis (CNAG) patients treated in our hospital from October 2021 to October 2022 received selection as the CNAG group. The 96 chronic atrophic gastritis (CAG) patients diagnosed by gastroscopy and pathology in the same period received selection as CAG group. During the same period, 50 patients diagnosed with GC received inclusion in GC group. Pepsin I (PG I), PG II (PG II), gastrin-17 (G-17) and Hp serotyping received detection and comparison in three groups. The diagnostic efficacy of PG Ⅰ, PG Ⅱ, G-17, the ratio of serum PG I to PG II (PGR), and Hp serotyping in chronic gastritis and GC received evaluation by receiver operating characteristic (ROC). Relative to in the CNAG group, PG I and PGR levels in the other two groups exhibited depletion (P < 0.05); no statistical significance was observed in the PG II level among the three groups (P > 0.05); relative to the CNAG group, the G-17 level in the other two groups exhibited elevation (P < 0.05). Total Hp positive rate was 61.06 %, among which GC group exhibited the highest positive rate (72.00 %), and type I Hp positive rate also exhibited the highest in GC group (60.00 %). The type II Hp positive rate exhibited the highest in CNAG group (15.00 %). The PG I and PGR levels in type I Hp positive patients exhibited depletion relative to those in type II Hp positive patients, whereas PG II and G-17 levels exhibited elevation. When testing each indicator alone, the area under the curve (AUC) of PG I exhibited the highest in CNAG group, which was 0.874. When testing each indicator alone, AUC of Hp typing exhibited the highest in CAG group, which was 0.515. When testing each indicator alone, AUC of G-17 exhibited the highest in GC group, which was 0.787. The performance of combined detection was better than that of individual detection, with AUCs greater than 0.9 in three groups. In conclusion, changes in PG I, PG II, PGR and G-17 levels and Hp serotyping can receive application as screening indicators for chronic gastritis and GC, which can reflect relevant status of gastric mucosa to varying degrees. Combined detection of indicators has higher diagnostic performance and can receive application as an auxiliary diagnostic indicator in addition to gastroscopy biopsy, providing a reference basis for the formulation of clinical diagnosis and treatment plans.

Risk Assessment of Gastric Cancer and Precancerous Condition Using Serum Pepsinogen and H. Pylori Antibody Test

Objectives: We aimed to determine serum PGs (serum pepsinogens) and H. Pylori IgG in atrophic gastritis and gastric cancer patients and evaluate the gastric cancer risk.Method: We enrolled 40 gastric cancer patients, 40 chronic atrophic gastritis patients and 40 healthy control subjects. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA. The PGI to PGII ratio was calculated.Results: The mean age of the subjects was 60±10.9 years, We found that 52.6% (n=60) were male. H. Pylori IgG was positive in 67 subjects. The serum PGI and PGR levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC (D), group D had higher proportion of atrophic gastritis cases, group C had higher proportion of gastric cancer cases than others. Additionally, we evaluated all subjects by giving one point to each of the age ≤40, positive family history of gastric cancer, positive previous gastric disease history, PGI ≤75.07 ng/ml, PGR ≤6.25, or two point to each of PGI ≤35.25 ng/ml, and PGR ≤5.27, with score ranging between 0-7. As score increased, the risk of atrophic gastritis or gastric cancer increased.Conclusion: A combination of methods involving PGs and other risk factors may predict the probability of gastric cancer and could identify individuals who may need upper endoscopy.

Study on tongue coating microbes of bitter taste, sticky and greasy taste in chronic atrophic gastritis.

To objectively reveal the relationship between tongue coating microbes and bitter taste, sticky and greasy taste in chronic atrophic gastritis (CAG) patients. 16S rRNA high-throughput sequencing was used to detect bacterial diversity and community composition of tongue coating microbes from samples of CAG patients. LEfSe algorithm was used for discovering the different tongue coating microbes in CAG patients with or without bitter taste, also that in CAG patients with or without sticky and greasy taste. We respectively compared the features of tongue coating microbes in bitter taste, sticky and greasy taste of CAG patients. At the genus level, 25 tongue coating microbes were significantly different in CAG patients with bitter taste or without bitter taste; 17 tongue coating microbes were significantly different in CAG patients with sticky and greasy taste or without sticky and greasy taste. and were closely related to CAG patients with bitter taste. , , and were closely related to CAG patients with stick and greasy taste. and possibly contribute to bitter taste of CAG patients, and and contribute to stick and greasy taste of CAG patients, which is potential for the diagnosis and treatment of CAG.

The correlation of serum sirt6 with clinical outcome and prognosis in patients with gastric cancer

We aimed to evaluate the correlation between serum sirtuin 6 (sirt6) level and clinicopathological characteristics and prognosis of gastric cancer (GC) patients. The serum sirt6 levels of subjects (135 cases of GC, 68 cases of atrophic gastritis, 60 cases of healthy controls) were analyzed by enzyme-linked immunosorbent assay. The predictive and prognostic values of sirt6 serum level for GC were determined by performing receiver operating characteristic curve (ROC), Kaplan-Meier analysis, as well as univariate and multivariate Cox regression, respectively. GC patients showed lower sirt6 serum levels than that of atrophic gastritis patients and healthy control. Taking the healthy control as a reference, the area under the ROC curve (AUC) of sirt6 serum level for diagnosing GC was 0.955 with a sensitivity of 91.85% and a specificity of 90.0%. Based on ROC analysis using atrophic gastritis as the state variable, serum sirt6 had a high diagnostic efficiency for GC (AUC = 0.754). Serum sirt6 was related to the clinicopathological features (tumor size, Lauren's classification, tumor node metastasis staging, lymph node metastasis) and overall survival (log-rank χ2 = 12.22, P < .001). The AUC of serum sirt6 predicting death in GC patients was 0.731. At the optimal cutoff value (16.83 ng/mL), the sensitivity and specificity of sirt6 were 59.57% and 79.55%, respectively. Moreover, lower sirt6 level as independent risk factor was revealed to affect prognosis of GC patients (P = .018). Serum sirt6 level was positively associated with the tumor stage and metastasis conditions, which could be served as diagnostic and predictive biomarkers in GC.

Targeted metabolomic profiles of serum amino acids and acylcarnitines related to gastric cancer.

BackgroundEarly diagnosis and treatment are imperative for improving survival in gastric cancer (GC). This work aimed to assess the ability of human serum amino acid and acylcarnitine profiles in distinguishing GC cases from atrophic gastritis (AG) and control superficial gastritis (SG) patients.MethodsSixty-nine GC, seventy-four AG and seventy-two SG control patients treated from May 2018 to May 2019 in Gansu Provincial Hospitalwere included. The levels of 42 serum metabolites in the GC, AG and SG groups were detected by liquid chromatography-tandem mass spectrometry (LC–MS/MS). Then, orthogonal partial least squares discriminant analysis (OPLS-DA) and the Kruskal-Wallis H test were used to identify a metabolomic signature among the three groups. Metabolites with highest significance were examined for further validation. Receiver operating characteristic (ROC) curve analysis was carried out for evaluating diagnostic utility.ResultsThe metabolomic analysis found adipylcarnitine (C6DC), 3-hydroxy-hexadecanoylcarnitine (C16OH), hexanoylcarnitine (C6), free carnitine (C0) and arginine (ARG) were differentially expressed (all VIP >1) and could distinguish GC patients from AG and SG cases. In comparison with the AG and SG groups, GC cases had significantly higher C6DC, C16OH, C6, C0 and ARG amounts. Jointly quantitating these five metabolites had specificity and sensitivity in GC diagnosis of 98.55% and 99.32%, respectively, with an area under the ROC curve (AUC) of 0.9977.ConclusionThis study indicates C6DC, C16OH, C6, C0 and ARG could effectively differentiate GC cases from AG and SG patients, and may jointly serve as a valuable circulating multi-marker panel for GC detection.

Salivary Fusobacterium nucleatum serves as a potential diagnostic biomarker for gastric cancer.

BACKGROUNDAs one of the most common tumors, gastric cancer (GC) has a high mortality rate, since current examination approaches cannot achieve early diagnosis. Fusobacterium nucleatum (Fn) primarily colonized in the oral cavity, has been reported to be involved in the development of gastrointestinal tumor. Until now, little is known about the relationship between salivary Fn and GC.AIMTo determine whether salivary Fn could be a biomarker to diagnose GC and explore the influence of Fn on GC cells.METHODSThe abundance of Fn in saliva was quantified by droplet digital polymerase chain reaction in 120 GC patients, 31 atrophic gastritis (AG) patients, 35 non-AG (NAG) patients, 26 gastric polyp (GP) patients, and 20 normal controls (NC) from Qilu Hospital of Shandong University from January 2019 to December 2020. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of Fn as well as traditional serum tumor markers, including carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA72-4. Transwell assay and wound-healing assay were conducted to assess the influence of Fn infection on GC cells. The expression of epithelial-mesenchymal transition (EMT) markers was detected using western blot assay.RESULTSWe found that the level of salivary Fn in GC patients was significantly increased compared with those in AG, NAG, and GP patients and NC (P < 0.001). ROC curve analysis showed a favorable capability of Fn (73.33% sensitivity; 82.14% specificity; area under the curve: 0.813) in GC diagnosis, which was superior to that of CEA, CA19-9, CA72-4, ferritin, and sialic acid. The Fn level in saliva of GC patients was increased as the TNM stage increased. GC patients with lymph node metastasis had higher Fn levels than those without metastasis. Both transwell and wound-healing assays indicated that Fn infection promoted the migration and invasion of GC cells. Western blot analysis showed that Fn infection decreased the expression of E-cadherin and increased the expressions of N-cadherin, vimentin, and snail.CONCLUSIONFn abundance in saliva could be used as a promising biomarker to diagnose GC, and Fn infection could promote GC metastasis by accelerating the EMT process.

CORRELATION ANALYSIS OF STOMACH AND ORAL CAVITY DISEASES

In the mucous membrane of the periodontium and the mucous membrane of the stomach, it is possible to note both similar inflammatory processes and processes that distinguish them. Such are the similarities in the indicators of the mitotic regime in the mucous membrane of the stomach in comparison with the mucous membrane of the periodontium. Chronic stomach diseases associated with Helicobacter pylori are common diseases, and the degree of expression of inflammatory processes of the gastric mucosa has a certain relationship with the development and degree of expression of periodontitis in this group of patients.According to the indicators of the mitotic regime, the Pearson rxy correlation coefficient between chronic gastric ulcer, chronic duodenal ulcer and atrophic gastritis in patients with chronic periodontitis is 0.607, 0.881 and 0.931, respectively, which indicates the existence of a significant, strong and very strong close relationship, respectively. This confirms the intercurrent connection of chronic diseases of the digestive tract.

Ultrasound criteria for predicting pre-cancer changes of the gastric mucosa in patients with chronic atrophic gastritis combined with thyroid pathology

Precancerous conditions increase the risk of gastric cancer by 2–3 % every 10 years. Among comorbid pathology, 46 % of all endocrinopathies are diseases of the thyroid gland. An urgent issue today is the definition of non-invasive criteria for the formation of a risk group for the detection of precancerous changes in the gastric mucosa in patients with comorbid pathology. The aim of the study was to evaluate the structure of the thyroid gland as ultrasound criterion for predicting precancerous lesions in the stomach in patients with atrophic gastritis under conditions of comorbidity. Materials and methods. The study was conducted among 81 patients with gastric precancerous conditions. The upper endoscopy was performed using EVIS EXERA III systems with an Olympus 190 gastroscope (Japan). All the patients in this study underwent a sonological examination of the thyroid gland on an ultrasound scanner Toshiba Xario (Japan). Results. In patients with atrophic gastritis, a high frequency of structural changes in the thyroid gland (77 %) was observed. Focal changes were determined in 33 % of atrophic gastritis patients with a predominance of their diagnostic frequency in patients with gastric mucosal dysplasia (χ2 = 5.32, P &lt; 0.05 as compared to the patients with gastric mucosal atrophy and χ2 = 4.25, P &lt; 0.05 as compared to the patients from the intestinal metaplasia group). Patients with gastric mucosal dysplasia were characterized by coarse-grained thyroid parenchyma, which was more common by 2.2 times as compared to the group of patients with atrophy (P &gt; 0.05) and by 1.8 times as compared to the patients with intestinal metaplasia (χ2 = 4.09, P &lt; 0.05). Conclusions. Diagnostic criteria for the formation of a risk group for the detection of gastric mucosal dysplasia are focal changes in the thyroid parenchyma (sensitivity 63.6 %, specificity 71.4 %), coarse granularity of the thyroid parenchyma (sensitivity 72.7 %, specificity 61.4 %) and an increased vascularization of parenchyma at the sonological examination of the thyroid gland (sensitivity 63.6 %, specificity 70.0 %).

Risk Factors Analysis and Prediction Model Establishment of Intestinal Metaplasia or Dysplasia in Patients With Chronic Atrophic Gastritis: A Multi-Center Retrospective Study.

ObjectiveTo investigate the risk factors and construct a prediction model of chronic atrophic gastritis (CAG) patients with intestinal metaplasia or dysplasia.MethodThe clinical data of 450 patients with CAG who were diagnosed and treated in the Department of Gastroenterology of the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2016 to February 2022 were collected. Single and multiple factors logistic regression analysis were used to explore the risk factors of intestinal metaplasia or dysplasia in patients of training cohort. Then, we constructed a model to predict the onset of intestinal metaplasia or dysplasia based on the data of training cohort, following which we tested the model in an external validation cohort of 193 patients from a local university teaching hospital. The ROC curve, calibration curve, and decision curve analysis were used to evaluate the accuracy of the prediction model.ResultHelicobacter pylori (H. pylori, HP) infection, pepsinogen I, gastrin-17, and the number of lesions were found to be independent rick factors of the model. The liner prediction model showed excellent predictive value in both training cohort and validation cohort.ConclusionHP infection, pepsinogen I, gastrin-17, and the number of lesions are independent risk factors for intestinal metaplasia or dysplasia in patients with CAG. The prediction model constructed based on these factors has a high accuracy and excellent calibration, which can provide a great basis for condition assessment and individualized treatment of the patients.

Efficacy of Self-Made Hewei Decoction for Chronic Atrophic Gastritis and Its Effect on Gastrin and Pepsinogen Expression Levels.

We aim to investigate the therapeutic effect of self-made Hewei decoction based on the differences-in-differences (DID) model for treating chronic atrophic gastritis and its effect on the gastrin and pepsinogen expression. A total of 166 chronic atrophic gastritis patients treated in our hospital from January 2019 to September 2020 were recruited and randomly assigned to a treatment group and a control group (n = 83 per group). In the control group, patients were given conventional western medicine. In the treatment group, patients were administered self-made Hewei decoction besides conventional western medicine. The general data, total effective rate, and histological changes before and after treatment were compared between the two groups. The DID model was utilized to compare the changes in three items of gastric function and traditional Chinese medicine (TCM) syndrome scores at various time points (before treatment and 1, 3, 6, and 12 months after treatment) between the two groups. In the treatment group, 5 cases were lost to follow-up, and 78 cases remained. In the control group, 4 cases were lost to follow-up, and 79 cases remained. The total effective rate in the treatment group (93.59%) was significantly higher than that in the control group (82.28%) (P < 0.05). The histological score was not significantly different between the two groups before treatment (P > 0.05). The histological score at 12 months after treatment was lower than those before treatment in the two groups (P < 0.05). The histological score was lower in the treatment group than that in the control group (P < 0.05). After treatment, the TCM syndrome score and PGR17 level were lower in the treatment group than those in the control group at each time point (P < 0.05). PGI and PGII levels were higher in the treatment group than those in the control group at each time point (P < 0.05). DID regression model showed that TCM syndrome score and PGR17 level decreased by 106.2% and 65.8%, respectively, after treatment in patients with chronic atrophic gastritis (P < 0.05), but the treatment mode was opposite to the overall therapeutic effect in terms of time. The PGI and PGII levels increased by 102.9% and 97.8%, respectively, in patients with chronic atrophic gastritis (P < 0.05), and the treatment mode was the same as the overall therapeutic effect in terms of time. There was no significant difference in the therapeutic effect between the two groups at 1 month after treatment. A significant difference in the therapeutic effect was detected between the two groups at 3 months after treatment, and the difference showed a decreasing trend after 6 months after treatment. Self-made Hewei decoction can improve the histological alterations in chronic atrophic gastritis, relieve clinical symptoms, and ameliorate the expression levels of three items of gastric function.

Is intestinal metaplasia the point of no return in the progression of gastric carcinogenesis?

Is intestinal metaplasia the point of no return in the progression of gastric carcinogenesis?

Preventive and inhibitive effects of Yiwei Xiaoyu granules on the development and progression of spasmolytic polypeptide-expressing metaplasia lesions.

BACKGROUNDSpasmolytic polypeptide-expressing metaplasia (SPEM) is a potential preneoplastic lesion.AIMTo elucidate the microRNA (miR)-7-mediated preventive and inhibitive effects of Yiwei Xiaoyu granules (YWXY) in SPEM lesions.METHODSGastric mucosa biopsies were collected from chronic atrophic gastritis patients and healthy people with signed informed consent. YWXY was administered to the mice with induced SPEM by tamoxifen, and the gastric mucosa was harvested on the tenth day of the experiment. Then immunohistochemistry and immunofluorescence were performed to validate the SPEM, lesions and the potential mechanism was investigated. RNA transcripts were detected with reverse transcription-quantitative polymerase chain reaction.RESULTSThe expression of miR-7 was downregulated in the SPEM lesions, and expression of trefoil factor 2 (TFF2) and clusterin was high in the human gastric mucosa. In vivo experiments showed that YWXY could inhibit the cell proliferation in the tamoxifen-induced SPEM lesions by regulating Ki67. Simultaneously, YWXY could restore the expression of miR-7 by regulating TFF2 by detection with immunofluorescence but not with reverse transcription-quantitative polymerase chain reaction, indicating its potential mechanism of targeting miR-7 by mediating TFF2. The expression of vascular endothelial growth factor-β and gastric intrinsic factor was restored within 3 d of YWXY administration for the SPEM lesions, speculating that the possible mechanism of YWXY is to inhibit the development and progression of SPEM by regulating vascular endothelial growth factor-β and gastric intrinsic factor.CONCLUSIONmiR-7 downregulation is an early event in SPEM through regulation of TFF2 in human gastric mucosa. YWXY is able to inhibit the cell proliferation and restore the expression of miR-7 by mediating TFF2 in the SPEM mouse model.

Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG.

ObjectiveThe aim of this study was to integrate the serum exosomal miRNA miR-122-5p with canonical serological biomarkers for the non-invasive screening of chronic atrophic gastritis (CAG) patients.MethodsmiR-122-5p and U6 were amplified by the quantitative reverse transcription polymerase chain reaction (RT-qPCR), gastrin (GAS), pepsinogen I (PG-I), and PG-II and were measured by ELISA. The area under the receiver operating characteristic (ROC) curves and their correlation were analyzed.ResultsIn the present study, GAS level and PG-I/PG-II ratio (PGR) were increased in CAG group, but there was no significant difference in PG-I or PG-II levels between CAG group and chronic non-atrophic gastritis (CNAG) group. Only GAS level and PG-I/PG-II ratio were significantly correlated with atrophy, and not any other clinicopathologic factors. Expression of hsa-miR-122-5p positively correlated with GAS level, PG-I level, and PGR, while it negatively correlated with PG-II level; however, none of them had significant difference. The combination of GAS, PGR, and hsa-miR-122-5p presented as a better model for non-invasive screening of CAG compared to others.ConclusionThese results suggested that serum exosomal hsa-miR-122-5p combined with GAS and PGR would elevate accuracy and specificity in non-invasive screening of CAG.

Clinicopathological features of nodular gastritis in three classes of age.

Nodular gastritis is most often one of the manifestations of Helicobacter pylori (H.pylori) infection, which is a risk factor for gastric cancer. This study aimed to determine if the histological characteristics of nodular gastritis differed across classes of age. We conducted a retrospective analysis of consecutive patients who had undergone esophagogastroduodenoscopy with multiple mucosal biopsies of the stomach between 2003 and 2019 for evaluation of updated Sydney System scores. We analyzed and compared the histological characteristics of pediatric (≤15years old), young (16-29years old), and older (≥30years old) patients. Of the 1321 patients enrolled, 1027 patients (78%) had H.pylori infection, with 214 patients (21%) of them displaying nodular gastritis. Among nodular gastritis patients, mononuclear cell infiltration Sydney System scores in the gastric body were significantly higher in the older group than in the pediatric (p<.001) and young (p<.001) groups. Similar results were seen for neutrophil infiltration scores in the gastric body. To clarify the characteristics of older nodular gastritis, we investigated 1056 older patients (66 with nodular gastritis, 754 with atrophic gastritis, and 236 H.pylori-negative). The scores for mononuclear and neutrophil cell infiltration in the gastric body were significantly higher in nodular gastritis patients than in atrophic gastritis patients (both p<.001) and patients negative for H.pylori (both p<.001). The inflammatory changes in the gastric body in older nodular gastritis patients were more severe as compared with those in pediatric and young nodular gastritis patients in addition to older atrophic gastritis patients.

Association of eating habits and clinical symptoms in atrophic gastritis patients

Atrophic gastritis is one of the most common gastric diseases, and many risk factors may increase the risk. This study aimed to assess the relationship between dietary factors and clinical symptoms of patients with atrophic gastritis. A cross-sectional study was conducted from October 2018 to October 2020 in the Center of Gastroenterology and Hepatology of Bach Mai Hospital with a total of 3508 atrophic gastritis patients aged ≥40 years (female/male ratio was 1.68). All patients were interviewed based on a designed questionnaire and underwent a gastroscopy procedure. The most common symptoms were epigastric pain (73.9%), belching/heartburn (42.4%), the feeling of fullness (41%), reflux symptom (15.4%). A majority of patients had mild atrophic gastritis (C1, C2) (80.4%), followed by moderate atrophic gastritis (C3, O1) (17%), and severe atrophic gastritis (O2, O3) (2.6%). A diet with much deep-fried or grilled food increased the risk of epigastric pain (OR 1.343; 95%CI 1.002-1.801); diets with much meat or nuts increased the risk of the feeling of fullness (meat: OR 1.296; 95%CI 1.100-1.526 and nuts: OR 1.316; 95%CI 1.033-1.676), and belching/heartburn (meat: OR 1.243; 95%CI 1.058-1.461 and nuts: OR 1.376; 95%CI 1.082-1.751). Diets with much salt or nuts increased the risk of reflux symptoms (salt: OR 1.359; 95%CI 1.055-1.752 and nuts: OR 1.532; 95%CI 1.023-2.293). A diet with many vegetables was a protective factor that can help to decrease the risk of moderate and severe atrophic gastritis (OR 0.616; 95%CI 0.403-0.941). In conclusion, diets and food types are factors that affect the risk of clinical symptoms among patients with atrophic gastritis, so the action of adjusting diets and daily food also play an important role in atrophic gastritis.

Effect of gastric microbiota on quadruple Helicobacter pylori eradication therapy containing bismuth.

BACKGROUND Helicobacter pylori (H. pylori) is an important pathogen that can cause a variety of diseases. Yet, full eradication of H. pylori remains a significant challenge in clinical practice. H. pylori and other microbial communities have complex interactions in the unique gastric microecological environment. However, it is not clear whether the interactions have any effect on the therapeutic effect of H. pylori.AIMThe aim was to investigate the characteristics of the gastric microbiota with H. pylori infection and the influence on the H. pylori eradication treatment.METHODSPatients with H. pylori infection underwent gastroscopy and received treatment for eradication. The prescription included esomeprazole 20 mg bid, Livzon Dele 220 mg bid, amoxicillin 1000 mg bid, and clarithromycin 500 mg bid for 14 d. Patients who did not respond to treatment and failed eradication were compared with those who achieved eradication by 1:2 propensity matching. High-throughput sequencing of the gastric mucosal microbiota was performed, and the results were evaluated by alpha diversity analysis, beta diversity analysis, species correlation analysis, and metabolic pathway correlation analysis.RESULTSThe eradication rate of all the patients was 95.5% (171/179). Twenty-four patients were enrolled in the study after propensity-matched scoring. There were eight cases in the failure group (patients who did not respond well to therapy) and 16 cases in the success group. The majority phyla in the two groups were the same, and included Proteobacteria, Bacteroides, Firmicutes, Actinomycetes, and Fusobacteria. The microbial diversity in the failure group had a decreasing trend (P = 0.092) and the species abundance was significantly lower (P = 0.031) compared with the success group. The high rate of H. pylori eradication was associated with Rhodococcus, Lactobacillus, and Sphingomonas, as they were significantly enriched in the successful group (P < 0.05). Veronococcus and Cilium were enriched in the mucosa of chronic atrophic gastritis patients compared with chronic superficial gastritis patients (P = 0.0466 and 0.0122, respectively). In both study groups, H. pylori was negatively correlated with other bacterial genera. More bacterial genera were directly related to H. pylori in the successful group compared with the failure group.CONCLUSIONThe effectiveness of quadruple H. pylori eradication therapy containing bismuth depended on gastric microbiota, and the high rate of H. pylori eradication was associated with the presence of Rhodococcus, Lactobacillus, and Sphingomonas.

A Deep Recurrent Neural Network-Based Explainable Prediction Model for Progression from Atrophic Gastritis to Gastric Cancer

Gastric cancer is the fifth most common cancer type worldwide and one of the most frequently diagnosed cancers in South Korea. In this study, we propose DeepPrevention, which comprises a prediction module to predict the possibility of progression from atrophic gastritis to gastric cancer and an explanation module to identify risk factors for progression from atrophic gastritis to gastric cancer, to identify patients with atrophic gastritis who are at high risk of gastric cancer. The data set used in this study was South Korea National Health Insurance Service (NHIS) medical checkup data for atrophic gastritis patients from 2002 to 2013. Our experimental results showed that the most influential predictors of gastric cancer development were sex, smoking duration, and current smoking status. In addition, we found that the average age of gastric cancer diagnosis in a group of high-risk patients was 57, and income, BMI, regular exercise, and the number of endoscopic screenings did not show any significant difference between groups. At the individual level, we identified that there were relatively strong associations between gastric cancer and smoking duration and smoking status.

Diagnostic Accuracy of EndoFaster® and Narrow-Band Imaging Endoscopy in Patients with Impaired Gastric Acid Secretion: A Real-Time Prospective Study.

Background EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis. Aims To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies. Methods Prospective study on consecutive adult patients undergoing gastroscopy between April and November 2018. Patients in therapy with proton pump inhibitors, previous gastric surgery, and/or known gastric neoplasia were excluded. At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster® in 15 seconds. Endoscopists were blinded to the report of EndoFaster®. Evaluation of gastric mucosa in HR-white light was firstly performed, then with HR-NBI allowing to perform targeted biopsies on areas suspected for intestinal metaplasia; otherwise, biopsies were performed according to the updated Sydney System protocol and sent for histopathological evaluation. Results Overall, 124 patients were included [64% F; 56 (18-85) years]. Corpus atrophic gastritis was present in 41.9% of patients. EndoFaster® showed an accuracy for corpus atrophic gastritis diagnosis, compared to histopathological evaluation as gold standard, of 87.1% and a sensitivity, specificity, PPV, and NPV of 78.8%, 93.1%, 89.1%, and 85.9%, respectively. pH showed a positive correlation with the severity score of atrophy (r = 0.67, 95% CI: 0.73-0.81, and p < 0.0001). EndoFaster® allowed to diagnose corpus atrophic gastritis in 3.7% of patients negative to NBI (corpus atrophic gastritis without intestinal metaplasia). Conclusion EndoFaster® seems a promising tool to diagnose corpus atrophic gastritis. The evaluation of hypo-achlorhydria during gastroscopy can address bioptic sampling in corpus atrophic gastritis patients without intestinal metaplasia.

Helicobacter pylori eradication prevents secondary gastric cancer in patients with mild-to-moderate atrophic gastritis.

Whether Helicobacter pylori eradication prevents metachronous recurrence after endoscopic resection (ER) of early gastric cancer remains controversial. This multicenter retrospective study aimed to evaluate the long-term (>5years) effects of H.pylori eradication by stratifying patients' baseline degrees of atrophic gastritis. A total of 483 H.pylori-positive patients who had undergone ER for early gastric cancer were divided into two groups-(i) those having undergone successful H.pylori eradication within 1year after ER (eradicated group, n=294) and (ii) those with failed or not attempted H.pylori eradication (non-eradicated group, n=189). The cumulative incidences of metachronous gastric cancer between the two groups were compared for all patients, for patients with mild-to-moderate atrophic gastritis (n=182), and for patients with severe atrophic gastritis (n=301). During a median follow-up of 5.2years (range 1.1-14.8), metachronous cancer developed in 52 (17.7%) patients in the eradicated group and in 35 (18.5%) patients in the non-eradicated group (P=0.11, log-rank test). In patients with mild-to-moderate atrophic gastritis (111 and 71 in the eradicated and non-eradicated groups, respectively), the cumulative incidence of metachronous cancer was significantly lower in the eradicated group than that in the non-eradicated group (P=0.03, log-rank test). However, no significant intergroup difference was observed in patients with severe atrophic gastritis (P=0.69, log-rank test). Helicobacter pylori eradication had a preventive effect on the development of metachronous gastric cancer in patients with mild-to-moderate atrophic gastritis.

Efficacy of Banxia Xiexin decoction for chronic atrophic gastritis: A systematic review and meta-analysis.

BackgroundBanxia Xiexin decoction (BXD), a classical formula of traditional Chinese medicine (TCM), has been wildly used for chronic atrophic gastritis (CAG) patients with the cold-heat complex syndrome in China, and achieved satisfied effects. However, the clinical effects of it remains unclear.PurposeThe purpose of this article is to evaluate the clinical efficacy and safety of BXD for CAG treatment.MethodsWe searched seven electronic databases including Ovid, Embase, PubMed, Cochrane Library, Wan-fang database, VIP (Chinese Scientific Journals Database) and CNKI (China National Knowledge Infrastructure) from their inception to September 21, 2020. We used Jadad scale and Cochrane Collaboration’s risk of bias tool to make evaluation of methodological quality. Revman 5.3 statistical software was used for statistical processing to evaluate the clinical efficacy and safety of BXD.Results26 randomized controlled trials (RCTs) totaling 1985 patients were identified for analysis. Meta-analysis showed that BXD treatment was more effective (RR 1.29; 95%CI 1.24, 1.35; P<0.00001) and safe (MD 0.33; 95%CI 0.18, 0.58; P = 0.0002) than Chinese patent medicine + western medicine. Furthermore, BXD had improvement on symptoms scores such as stomach distending pain, and belching. Besides, BXD was more effective in inhibiting Helicobacter Pylori (HP), improving HP-related inflammation, and relieving the degree of glandular atrophy, intestinal metaplasia (IM), and dysplasia of gastric mucosa (GM).ConclusionsThe meta-analysis showed that BXD was more effective and safer for CAG patients than the control group. However, due to limitations of methodological quality and small sample size of the included studies, further standardized research of rigorous design should be needed.