Gastric Cancer Cases Research Articles

Identification of dMMR in metastatic colorectal and non-colorectal cancers in a private Mexican institution.

177 Background: DNA mismatch repair is a process in which normal cells maintain their original genomic information avoiding errors in mismatched nucleotides or base modifications from recombination processes. The failure of this process could drive carcinogenesis due to increased mutation rate as well as high microsatellite instability. It is estimated that the global average prevalence of dMMR/MSI-H across tumor types and stages is approximately 16%, with higher rates reported for early stages. However, the prevalence for colorectal (CRC) and non-colorectal cancers for this biomarker in Mexico has not been reported. Objective:To explore the prevalence of dMMR in metastatic CRC (mCRC) and non-CRC (gastric, esophageal, and endometrial cancer) from a private Mexican institution. Methods: In this retrospective study, the dMMR status of 215 samples were analyzed from a primary database of stored biopsies from patients diagnosed with metastatic CRC, gastric, esophageal, or endometrial cancers between January 2017 and December 2020. 65 records had information about MMR status. Samples were analyzed using a commercial kit to detect dMMR (BioSb). Prevalence of dMMR was stratified by age and gender and expressed as frequencies. Statistical analysis was conducted in SPSS. Results: dMMR was found in 18.5% (N=27) endometrial cancer cases, 12.7% (N=150) of CRC cases, and 8.3% (N=24) of gastric cancer cases. However, it was not detected in any cases of esophageal cancer (N=14). In CRC, we found a higher percentage of incidence in men than in women, 15.6% (n = 14/90) vs. 8.3% (n = 5/60) respectively. By age groups, the highest total percentage (20%) was observed among those 41-50 years old. The age group with the lowest dMMR rate was 31- 40 yo, with 7.7%. All cases of CRC patients over 91 yo (n=3), were pMMR. Conclusions: Even though this data is not representative for the entire Mexican population, it provides preliminary prevalence dMMR estimates for some key cancers. Additional research is needed to give the limited sample sizes available for non-CRC.

Is routine gastrointestinal endoscopy required in every woman with mucinous ovarian cancer? An analysis of survival rates and metastatic tumours in a cancer centre

IntroductionMucinous ovarian cancer (MOC) represents a rare entity of ovarian malignant neoplasms. The true incidence could be as low as 3% of all ovarian cancers. The aim of this study is to compare and understand the clinicopathological characteristics of patients with mucinous ovarian cancer, report on the survival rates and evaluate the role of gastrointestinal (GI) endoscopy as part of the peri-operative investigations and the impact it has on the survival rates. MethodologyThis is a retrospective data collection on patients with MOC operated in Nottingham gynaecological oncology centre over a 10-year period. Data were analysed using SPSS software. Results43 cases were included in the final analysis. The median maximal tumour diameter was 180 mm. 32 (74.5 %) and 11 (25.5 %) women presented with unilateral and bilateral tumours respectively. 30 patients (69.7 %) presented with stage 1 disease, 1 (2.3 %) presented with stage 2 disease, 7 women (16.4 %) had stage 3 disease and 1 woman (11.6 %) had stage 4 disease. 41 women had staging surgical procedures and 2 women had limited surgery due to poor performance status. After final histology, 5 cases found to have metastatic disease to the ovary rather than primary MOC. 14 women had GI endoscopy as part of their investigation. The total estimated cost of the endoscopies that have been performed is £5635. Primary GI cancer was diagnosed in 1 case during the endoscopy (1 case of gastric cancer). The 5-year overall survival of the women included in this study is 62.8 %. The 5-year overall survival of the women in the endoscopy and non-endoscopy groups was 60 % and 64.3 % respectively (p-value: 0.767). ConclusionThe findings of this study show that the survival rates of patients treated for mucinous ovarian cancer in our centre are similar to other published studies. Our findings do not support the routine use of GI endoscopy in the peri-operative investigations of every patient with MOC due to the non-statistically significant difference in the overall survival.

Radical surgery for highly advanced gastric cancer with direct invasion to transverse colon, splenic serosa, and pancreas inducing pancreatic duct infection: A case report

Background: According to the GLOBOCAN 2020 results, gastric cancer is the fifth most commonly diagnosed cancer, and fourth most common cause of cancer death worldwide. An estimated 6-27% of patients with gastric cancer show invasion of the adjacent organs at diagnosis. In a previous study, curative resection was shown to significantly improve the prognosis of patients without peritoneal or liver metastases. Herein, we present a case of gastric cancer with invasion of the adjacent organs in a patient who underwent curative surgery. Case presentation: An 80-year-old woman presented with body weight loss and slight fever. Upper gastrointestinal endoscopy revealed Borrmann type 3 gastric cancer extending from the gastric fundus to the corpus. Contrast-enhanced computed tomography (eCT) revealed extensive invasion of the gastric cancer into the transverse colon and pancreas. The eCT also revealed gas in the pancreatic duct, indicating that the gastric lumen was connected to the pancreatic duct because of the tumor. We performed en-bloc tumor resection via total gastrectomy with D2 lymph node dissection, distal pancreatectomy, and partial colectomy. The patient was postoperatively diagnosed with T4b (SI: pancreatic, transverse colon, and splenic serosa), N0 Stage IIIA gastric cancer. The histological type was poorly differentiated adenocarcinoma. Adjuvant chemotherapy was initiated two months after surgery, but was continued for only two months because of severe adverse events. Two years after surgery, the patient remains well. Conclusion: Advanced gastric cancer with extensive invasion of the adjacent organs but no distant metastasis can be treated with en-bloc tumor resection.

Polyphenol intake and gastric cancer: A case-control study in the Brazilian Amazon region

BackgroundPolyphenol intake has been associated with a decreased risk of some types of cancer, including gastric cancer (GC). However, few studies address this topic in the Latin American population. In the present study, we evaluated the association between polyphenol intake and the risk of GC in the Brazilian Amazon region. MethodsA case-control study was conducted in Belém (Amazon region) from July 2017 to February 2021. A total of 193 GC cases and 194 controls of both sexes, between 18 and 75 years old, were included in the study. Dietary data were collected using a validated food-frequency questionnaire and polyphenol intake identified using the Phenol-Explorer database. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI), with adjustement for potential confounders. ResultsCases and controls had similar total polyphenol intake (356.4 mg/1000 kcal/d and 331.1 mg/1000 kcal/d, respectively; p = 0.086). After adjusting for potential confounders, high consumption of flavan-3-ols (highest vs. lowest tertile: OR 0.41, 95% CI 0.18–0.94) and hydroxybenzoic acids (highest vs. lowest tertile: OR 0.24, 95% CI 0.10–0.56) was associated with a decreased risk of GC. The opposite was true regarding the intake of flavones (OR 2.46, 95% IC 1.17–5.18) and other polyphenols (OR 2.54, 95% IC 1.16–5.54). When stratifying according to anatomical topography, we observed that the intake of total flavonoids, flavan-3-ols, and flavanones reduced the risk of cardia GC while that of hydroxybenzoic acids reduced the risk of non-cardia GC. In addition, the intake of flavones and other polyphenols was associated with an increased risk of non-cardia GC. According to histologic subtypes, hydroxybenzoic acid intake was associated with a reduced risk of intestinal-type GC (OR 0.21, 95% IC 0.07–0.64), while flavone consumption was associated with an increased risk of diffuse-type GC (OR 2.59, 95% IC 1.05–6.42). ConclusionsOur findings suggest that in the Brazilian Amazon region the high intake of flavan-3-ols and hydroxybenzoic acids is associated with a reduced risk of GC, suggesting a potential beneficial role of these compounds against GC.

A Retrospective Observational Study of Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer and Colorectal Cancer From a Single Center in the Recent 5 years.

To retrospectively analyze the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) on the progression free survival (PFS) of advanced gastric cancer (GC) and colorectal cancer (CRC). We retrospectively collected all the HIPEC data of GC and CRC in the Chongqing University Cancer Hospital from August 2018 to April 2023. Data were extracted from inpatient records and outpatient examination records. The IBM SPSS statistics 23.0 software was used to analyze the data. We mainly compared the PFS of HIPEC cases with that of non-HIPEC cases (both from our center and from the literature). PFS was analyzed with the Kaplan-Meier method. Log Rank (Mantel Cox), Breslow (Generalized Wilcoxon), and Tarone-Ware were used for univariate analyses. A total of 342 HIPEC cases were analyzed in this study. Stage IV GC and CRC accounted for 48.5% of the total number of cases. Abdominal pain and distension (47.4%) were the most common side effects from HIPEC. Serious complications were rare (1.8%, including bleeding, perforation, obstruction, and death). The PFS and disease-free survival (DFS) of abdominal malignancy treated with HIPEC were significantly associated with the TNM stage, but not HIPEC numbers nor HIPEC drugs. In stage IV HIPEC cases, adding adjuvant chemotherapy after HIPEC resulted in better PFS. In addition, the association between peritoneal carcinomatosis index (PCI) and PFS of stage IV HIPEC cases was close to significant. Compared with the 33 stage IV (with peritoneal metastases) GC cases without HIPEC in our center from the last 15years, the PFS of the 56 stage Ⅳ GC cases with HIPEC was not improved significantly (median PFS: 6 ± 2.92months vs 7 ± 1.63months for with vs without HIPEC in stage IV GC, respectively; P ≥ 0.05). Compared with the 58 stage IV (with peritoneal metastases) CRC cases without HIPEC in our center from the last 15years, the PFS of the 86 stage IV CRC cases with HIPEC was not improved significantly either (median PFS: 7 ± 1.68months vs 7 ± 0.62months for with vs without HIPEC in stage IV CRC, respectively; P ≥ 0.05). When comparing our HIPEC data with the non-HIPEC data reported by other scholars for the PFS of advanced GC and CRC, the negative results were similar. The PFS/DFS of HIPEC cases was associated with the TNM stage, but not with the HIPEC numbers or HIPEC drugs. PCI may be related to the PFS of stage IV HIPEC cases. Adding chemotherapy or targeted therapy after HIPEC may improve the PFS of stage IV cases. HIPEC did not significantly improve the PFS of stage IV GC or CRC cases in our center.

Impact of Smoking and Alcohol Consumption on Early-Onset Gastric Cancer Development in Young Koreans: A Population-Based Study.

Although smoking and alcohol consumption are known risk factors for gastric cancer (GC), studies assessing their effects on early-onset GC are limited. In this nationwide, population-based, prospective cohort study, we assessed the effects of smoking and alcohol consumption on early-onset GC in patients aged <50 years. We analyzed data of patients aged 20-39 years who underwent cancer and general health screening in the Korean National Health Screening Program between 2009 and 2012. We calculated the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for GC incidence until December 2020. We enrolled 6,793,699 individuals (men:women=4,077,292:2,716,407) in this cohort. The mean duration of follow-up was 9.4 years. During follow-up, 9,893 cases of GC (men:women=6,304:3,589) were reported. Compared with the aHRs (95% CI) of never-smokers, those of former and current-smokers were 1.121 (1.044-1.205) and 1.282 (1.212-1.355), respectively. Compared with the aHRs (95% CI) of non-consumers, those of low-moderate- and high-risk alcohol consumers were 1.095 (1.046-1.146) and 1.212 (1.113-1.321), respectively. GC risk was the highest in current-smokers and high-risk alcohol consumers (1.447 [1.297-1.615]). Interestingly, alcohol consumption and smoking additively increased the GC risk in men but not in women (Pinteraction=0.002). Smoking and alcohol consumption are significant risk factors for early-onset GC in young Koreans. Further studies are needed to investigate sex-based impact of alcohol consumption and smoking on GC incidence in young individuals.

Evaluations of Biomarkers CDX1 and CDX2 in Gastric Cancer Prognosis: A Meta-analysis.

CDX1 and CDX2 are homeobox-type transcription factors that are potential biomarkers and are associated with prognostic significance in intestinal-type gastric cancer early disease before lymph node metastasis is associated with better prognosis. In addition, the genes IDH 1 and IDH 2 previously known to be involved in brain cancer are implicated in cancer-related molecular signatures as a result new targeted personalized therapies may be possible. Our retrospective study determined the correlation between CDX markers and clinicopathologic data including survival in patients with gastric cancer. This study included studies from 1997 to December 2022 a meta-analysis to provide odds ratios (ORs) and relative risks (RRs). We discussed in detail the impact of IDH 1/2 on the prognosis of gastric cancer outcomes and potential therapeutic strategies. Our meta-analysis included 20 studies identifying 11,163 patients with gastric cancer. We found that CDX 1 overexpression was associated with better overall survival (pooled HR: 1.28) and CDX 2 expression and better 3-year survival (pooled HR: 1.64) and 5-year survival was the pooled HR was correlated 1 94 with both showing statistical correlation. Evidence suggests that IDH 1/2 mutations and CDX 1/2 overexpression are closely associated with metabolic abnormalities epigenetic changes and mutations evidence suggests the potential for novel targeted therapies in gastric cancer. CDX 1/2 overexpression is associated with a favorable prognosis in gastric cancer cases. Further studies are needed to explore the clinical significance of IDH 1/2 mutations and CDX 1/2 expression.

Oxyntic Gland Neoplasms - From Adenoma to Advanced Gastric Cancer: A Review of 29 Cases.

Oxyntic gland neoplasm (OGN) is a rare condition that can be classified as oxyntic gland adenoma (OGA) or gastric adenocarcinoma of fundic-gland type (GA-FG). GA-FG primarily presents as early gastric cancer, with only a few reported cases of advanced gastric cancer (AGC). We aimed to investigate the clinicopathological features of OGN and describe an aggressive variant. We investigated a total of 29 cases, including a patient with double primary cases, diagnosed with OGN or differentiated-type adenocarcinoma with GA-FG morphology, between November 2016 and April 2022. We analyzed 54 pathological specimens and reviewed their clinicopathological, endoscopic, and histological features. The lesions were reclassified as OGA or GA-FG, and immunohistochemical (IHC) staining for MUC-5AC and MUC-6 was performed on available resected GA-FG cases. The median patient age was 65 years and males accounted for 58.6% of patients. Most cases occurred in the body horizontally (69.0%) and on the greater curvature side cross-sectionally (48.3%). Endoscopically, type 0-IIa (41.4%) and a subepithelial tumor-like appearance (24.1%) were the most common findings. Histologically, there were 8 cases of OGA (27.6%) and 21 cases of GA-FG (72.4%). In GA-FG, MUC-6 was positive in 13 cases (81.3%), whereas MUC-5AC was positive in 8 cases (50.0%). Three cases presented as AGCs. Although OGNs are generally considered low-grade, they can present as AGCs and may exhibit features of lymphovascular or perineural invasion. Recognizing the clinicopathological features and accurately diagnosing OGN are important for providing adequate treatment.

Diagnostic Accuracy of Transabdominal Ultrasonography in Evaluation of Gastric Malignancies: A Cross-sectional Study

Introduction: Gastric cancer (GC) is the fifth most common malignancy worldwide. Transabdominal Ultrasonography (TA- USG) is a non invasive and inexpensive imaging modality that is widely available. However, there is a lack of knowledge regarding the utility of USG among radiologists in the diagnosis of GC. Aim: To evaluate the accuracy of TA-USG in the detection of gastric malignancy. Materials and Methods: This was a cross-sectional study conducted in the Department of Radiodiagnosis at Father Muller Hospital, Mangaluru, Karnataka, India from October 2021 to February 2023. Patients with Upper Gastrointestinal (UGI) symptoms and suspected Gastric Carcinoma, who underwent UGI scopy (n=107) referred from the Departments of Gastrosurgery, Medical Gastroenterology, and Oncosurgery, were included. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of TA-USG in the diagnosis of GC were determined. Results: The TA-USG could diagnose 94 out of 107 cases of malignancy, with the best results in detecting antropyloric malignancy. TA-USG performed worst in early GC. The authors had four cases of early GC, all of which were not diagnosed with TA-USG. The sensitivity, specificity, PPV, NPV, Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), and accuracy were calculated to be 87.85%, 93.83%, 86.24%, 94.61%, 14.23, 0.13, and 92%, respectively, with a p-value of &lt;0.001. Conclusion: The TA-USG is a valuable tool for detecting gastric malignancy, especially in patients with gastric outlet obstruction, a non distensible stomach, or other risk factors that preclude endoscopy. It can also play a role in regions where UGI endoscopy is not available.

Hsa_Circ_0002762 may be a New Marker for the Gastric Cancer Diagnosis and Prognosis.

The global incidence and mortality rate of gastric carcinoma (GC) persists at elevated levels, often manifesting no overt symptoms in its early stages. Hsa_circ_0002762 has been identified as an important modulator in cervical cancer. This study aims to explore its role in the context of GC. A quantitative real-time polymerase chain reaction (qPCR) was implemented to assess the expression level of hsa_circ_0002762. The over-expression was confirmed through an examination of 28 cases of gastric cancer and their corresponding adjacent tissues. In addition, plasma samples from 78 healthy individuals, from 45 benign gastritis patients, and from 106 gastric cancer patients were collected, and the diagnostic efficacy was assessed by analyzing the receiver operating characteristic (ROC) curve. Simultaneously, postoperative specimens from 36 GC cases were collected, and a Kaplan-Meier survival analysis curve was used to evaluate the prognosis of GC. The study revealed an up-regulation in the expression of hsa_circ_0002762 in gastric cancer plasma and tissues. The area under the receiver operating characteristic (ROC) curve for serum hsa_circ_0002762 was 0.784 (95% CI: 0.719 - 0.851), indicating a higher diagnostic efficiency compared to CEA (0.687, 95% CI: 0.611 - 0.763) and CA199 (0.699, 95% CI: 0.625 - 0.744). Combining these three biomarkers demonstrated an increased sensitivity in the diagnostic effectiveness. Finally, postoperative dynamic monitoring revealed a practical utility in predicting the clinical prognosis using serum has_circ_0002762. The findings from our study suggest that hsa_circ_0002762 holds promise as a novel diagnostic and prognostic marker for individuals with GC.

Characteristics of gastric neuroendocrine tumors and the PDX-1 transcription factor expression

To study the features of gastric neuroendocrine tumors (NETs) and the diagnostic and prognostic significance of PDX-1 expression in them. 207 NETs identified in 56 men and 115 women (59 had multiple NETs), and 94 cases of gastric cancer (comparison group) were studied morphologically and immunohistochemically. In more than half of the cases (54.93%), NETs were localized in the body of the stomach; the cardiac and antral parts of the stomach accounted for 8.64% and 11.73%, respectively. NETs of the cardiac region predominated in men, and of the body and antrum - in women. NETs of the cardiac region predominated in men, and of the body and antrum - in women. The vast majority of NETs were highly differentiated (89.20%), of which Grade 1, 2 and 3 were 55.41%, 40.76% and 3.82%, respectively. Neuroendocrine carcinomas (NEC) accounted for 10.80% of all NET cases. NECs were more often localized in the cardiac part of the stomach and accounted for 35.71% of all NETs in the cardiac part. The share of NEC among all NETs of the antrum was 15.79%, of the body of the stomach - only 3.37%. Metastases were found in 17.90% of NETs. Expression of PDX-1 was detected in 44.73% of NETs, 70% of NECs and 74.50% of gastric cancers. PDX-1 is involved in the mechanisms of precancerous and cancerous lesions of the stomach and its overexpression is detected in the majority of the most malignant NETs and gastric cancers.

An Observational Analysis on the Epidemiological Status of Gastric Cancer Prevalence in the Saudi Population

Abstract Introduction: Gastric cancer, also called stomach cancer, is one of the most fatal cancers with widespread global prevalence, despite declining incidences and mortality rates in the past decade. The data for the study are gathered from the Saudi Cancer Registry, created and maintained by the National Health Information Center, used to undertake the observational analysis on the epidemiological status of gastric cancer prevalence, a cohort-based epidemiological research on stomach cancer. The study examined the age-standardized incidence rates (ASIRs) and crude incidence rates (CIRs) of stomach cancer as per the different anthropometric parameters, such as age group, diagnostic year, and administrative districts, among Saudi inhabitants to analyze the gastric cancer prevalence, distribution, and trends. The study highlights consumption of high salt, high red meat, and highly processed food as some of the major causes of stomach cancer prevalence in Saudi Arabia. Materials and Methods: The data were analyzed using SPSS version 2.0 and GraphPad Prism software, which included the Kruskal–Wallis, sex ratio, t-test, and detailed statistics information. Saudi documented 1972 and 1296 instances of stomach cancer in both sexes, respectively, between 2006 and 2016. Results: The highest mean numbers and percentage of gastric cancer cases were found among men and women over 75 years old, meanwhile men and women aged between 0 and 19 years showed lowest percentage of gastric cancer cases. The greatest mean CIR (2.4) was found in males in Asir, followed by Najran and Makkah (2.1). CIRs of stomach cancer cases in Saudi women decreased somewhat. The highest CIR was 1.5 in 2007, followed by 1.4 in 2011 and 2014, respectively. The highest mean ASIR was observed among both sexes in the Najran and Northern regions. Males and females in Asir and Riyadh, respectively, had the highest mean CIR. Conclusion: In the present study, Saudi males had a modest increase in CIRs and a drop in ASIRs of gastric cancer in males and females, whereas females had a slight decrease in CIRs. Between 2006 and 2016, the mean ASIR in males and females in Riyadh and the Northern area was the highest.

Ex-situ Open Approach Spleen Preserving Splenic Hilum Lymphadenectomy.

Background: multiple studies showed important benefices arising from splenic preservation in patients with digestive cancer in general and gastric cancer in particular. The minimally invasive approach remains controversial in locally advanced gastric cancer cases whilst the open approach still has an important role. This paper's aim is to describe and present the feasibility of an open surgical technique that allows removing stations 10 together with 11p and 11d with spleen and splenic vessels preservation in pacients operated upon by open surgery. Material and Methods: We present an open "Ex-situ" spleen and pancreas preserving surgical technique that removes the anterior and posterior ganglia from the splenic hilum, the splenic vessels and the distal pancreas in locally advanced gastric cancer cases of the upper two thirds of the stomach. Forty-three consecutive patients since 2003 were operated upon by the author in multiple centers. during upper two thirds gastric cancer resections requiring no. 10 lymphadenectomy. Results: no splenectomy was needed . All the spleens were viable at postoperative Doppler echography and CT scans. No spleen migrated nor caused mechanical complications. No clinically significant pancreatic leaks were noticed. Two patients died during hospital stay, one of miocardial infarction and one of massive stroke. Pertinent follow up data and survival were not available. Conclusions: The method enables the surgeon to remove the lymph nodes no. 10 along with 11p and 11d without needing to sacrifice the spleen. All spleens were reattached sucessfully using the preserved spleno-renal ligament fold, no wandering spleen was noticed.

THE RESULTS OF THE JAPANESE GASTRIC CANCER SOCIETY MORPHOLOGICAL&#x0D; CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION

Relevance: Gastric cancer (GC) morbidity is growing in Kazakhstan every year. In 2022, 2 915 new GC cases were detected (15 per 100,000&#x0D; population), making GC the third most common cancer. The early detection rate of GC does not exceed 10-20%, and advanced forms of GC are&#x0D; over 40%. Mortality increases in the first year after the diagnosis (up to 40%).&#x0D; The best way of solving early detection of gastric cancer is carrying out diagnostics at the stage of pre-tumor stomach diseases. Timely diagnosis and treatment of surgical and borderline diseases of the upper gastrointestinal tract (metaplastic and dysplastic changes in the mucous&#x0D; ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ&#x0D; Онкология и Радиология Казахстана, №4 (70) 2023 17&#x0D; membrane of the esophagus, stomach, and duodenum and adenocarcinomas and early cancer arising against this background) are a complex&#x0D; medical and social problem.&#x0D; Endoscopic methods for diagnosing esophagus, stomach, and duodenum diseases are the most highly informative nowadays. However, precancerous changes (atrophy, metaplasia, and dysplasia) in conventional endoscopic examination may not have specific features. It is necessary&#x0D; to improve the results of endoscopic diagnosis. The chromoscopy method may be one of the methods used to identify precancerous pathology&#x0D; and GC methods.&#x0D; The study aimed to increase the efficiency of gastric cancer early detection by adapting the morphological classification of the Japanese&#x0D; Gastric Cancer Society (JGCA) for the Kazakh population.&#x0D; Methods: We conducted endoscopic studies of 500 residents of the Republic of Kazakhstan using chromoscopy and morphological studies of&#x0D; the biopsy obtained during endoscopic examination. These patients had digestive system problems but previously did not have a GC diagnosis.&#x0D; We formed the risk groups according to JGCA (editions 13th and 14th).&#x0D; Results: We identified 3(0.6%) morbidity of severe dysplasia according to the results of 500 patients’ biopsy samples morphological study.&#x0D; This morphological structure is classified as a well-differentiated adenocarcinoma. We recommended a surgical treatment for identified patients.&#x0D; Conclusion: The identified cases of obligate pre-cancer with an extremely high probability of degeneration into a malignant neoplasm&#x0D; prove the importance of using JGCA for the early diagnosis of gastric cancer and allow us to recommend the use of chromoscopy in stomach&#x0D; endoscopic examination.

L3MBTL3 Is a Potential Prognostic Biomarker and Correlates with Immune Infiltrations in Gastric Cancer.

Recent research has linked lethal (3) malignant brain tumor-like 3 (L3MBTL3) to cancer aggressiveness and a dismal prognosis, but its function in gastric cancer (GC) is unclear. This research investigated the association between L3MBTL3 expression and clinicopathological characteristics of GC cases, as well as its prognostic value and biological function based on large-scale databases and clinical samples. The results showed that L3MBTL3 expression was upregulated in malignant GC tissues, which was associated with a shortened survival time and poor clinicopathological characteristics, including TNM staging. A functional enrichment analysis including GO/KEGG and GSEA illustrated the enrichment of different L3MBTL3-associated pathways involved in carcinogenesis and immune response. In addition, the correlations between L3MBTL3 and tumor-infiltrating immune cells were determined based on the TIMER database; the results showed that L3MBTL3 was associated with the immune infiltration of macrophages and their polarization from M1 to M2. Furthermore, our findings suggested a possible function for L3MBTL3 in the regulation of the tumor immune microenvironment of GC. In summary, L3MBTL3 has diagnostic potential, and it also offers new insights into the development of aggressiveness and prognosis in GC.

Infectious pathogens and risk of esophageal, gastric and duodenal cancers and ulcers in China: A case-cohort study.

Infection by certain pathogens is associated with cancer development. We conducted a case-cohort study of ~2500 incident cases of esophageal, gastric and duodenal cancer, and gastric and duodenal ulcer and a randomly selected subcohort of ~2000 individuals within the China Kadoorie Biobank study of >0.5 million adults. We used a bead-based multiplex serology assay to measure antibodies against 19 pathogens (total 43 antigens) in baseline plasma samples. Associations between pathogens and antigen-specific antibodies with risks of site-specific cancers and ulcers were assessed using Cox regression fitted using the Prentice pseudo-partial likelihood. Seroprevalence varied for different pathogens, from 0.7% for Hepatitis C virus (HCV) to 99.8% for Epstein-Barr virus (EBV) in the subcohort. Compared to participants seronegative for the corresponding pathogen,Helicobacter pylori seropositivity was associated with a higher risk of non-cardia (adjusted hazard ratio [HR] 2.73 [95% CI: 2.09-3.58]) and cardia (1.67 [1.18-2.38]) gastric cancer and duodenal ulcer (2.71 [1.79-4.08]). HCV was associated with a higher risk of duodenal cancer (6.23 [1.52-25.62]) and Hepatitis B virus was associated with higher risk of duodenal ulcer (1.46 [1.04-2.05]). There were some associations of antibodies again some herpesviruses and human papillomaviruses with risks of gastrointestinal cancers and ulcers but these should be interpreted with caution. This first study of multiple pathogens with risk of gastrointestinal cancers and ulcers demonstrated that several pathogens are associated with risks of gastrointestinal cancers and ulcers. This will inform future investigations into the role of infection in the etiology of these diseases.

Risk factors associated with lymph node metastasis in early-stage distal gastric cancer.

This study was designed to explore the risk factors of lymph node metastasis (LNM) in distal gastric cancer with early stage, and to provide reference for the choice of treatment protocols. In this retrospective observational study, 824 early distal gastric cancer (EDGC) cases who treated at our unit from 2010 to 2020 were selected as research objects. Subsequently, univariate and multivariate logistic regression analyses were conducted to investigate the associations between LNM and clinicopathological features. Of these 824 EDGC cases, 140 (17.0%) developed LNM, including 72 N1 stage and 68 N2-3 stage LNM. Multivariate logistic regression analysis identified the tumor diameter ≥1.75cm (odds ratio (OR)=2.361, p<0.001), tumor location (OR=1.552, p=0.046), histological classification (p=0.004), tumor infiltration depth (OR=2.154, p=0.001), and vascular infiltration (OR=4.354, p<0.001) as independent predictors for LNM. Logistic regression analyses based on 756 N0-1 LNM cases identified the smoking history (OR=0.507, p=0.043), tumor diameter ≥1.75cm (OR=2.265, p=0.010), tumor location (OR=1.834, p=0.036), histological classification (p=0.018), tumor infiltration depth (OR=1.939, p=0.034), and vascular infiltration (OR=3.225, p<0.001) as independent predictors for N1 LNM. Moreover, preoperative hypoalbuminemia (OR=7.087, p=0.015), significant preoperative weight loss (OR=2.724, p=0.023), tumor diameter ≥1.75cm (OR=5.484, p=0.001), multiple tumors (OR=9.986, p=0.038), histological classification (p=0.029), and vascular infiltration (OR=33.704, p<0.001) were proved to be associated with LNM for T1a tumors. The tumor diameter, location and infiltration depth, histological classification, and vascular infiltration were expected to be used as predictors of LNM in EDGC, and preoperative hypoalbuminemia, significant weight loss, tumor diameter and number, histological classification, and vascular infiltration were associated with LNM for T1a tumors.

Cardiac tamponade due to advanced gastric cancer: a pathomorphological systematic review of clinical cases

Annotation. Pericardial involvement due to gastric cancer is uncommon, especially when it’s secondary to direct transdiaphragmatic tumor infiltration, and its manifestation in the form of cardiac tamponade is an exceptional situation. The aim of this review is to provide a pathomorphological overview of three rare clinical cases of cardiac tamponade, which was the first clinical manifestation of advanced gastric cancer. To realize the goal, a meta-analysis of 15 publications included in the Medline and Scopus scientific databases was conducted. The statistical substantiation of the research was carried out using Microsoft Excel 2016 and Statistica 12.0. According to the results of histological analysis, these three cases of gastric cancer were classified as: poorly differentiated adenocarcinoma of the antrum in a 52-year-old patient; sarcomatoid carcinoma of the fundus in a 49-year-old patient; and scirrhous carcinoma of the fundus in a 70-year-old patient. The tropism of gastric tumor infiltration into the pericardium is substantiated with the help of transforming growth factor, which increases the expression of CD44 adhesion molecules in tumor cells and stimulates the ability of the tumor to infiltrate the pericardium due to adhesion to the mesothelium. The hepatocyte growth factor, which enhances the invasive properties of the tumor, also played an important role: the C-Met receptors were determined on tumor cells in all cases. Thus, cardiac tamponade, which is a terminal condition, can occur in patients with various histological types of gastric cancer, including the three described. Furthermore, in the medical literature this over review is probably the only one attempt to analyze cardiac tamponade due to advanced gastric cancer with a comparison of different clinical cases.

Risk of gastric cancer in relation with serum cholesterol profiles: A nationwide population-based cohort study.

Obesity is a known risk factor for gastric cancer. However, the relationship between serum lipids and gastric cancer risk has not been fully established. We investigated the relationship between serum cholesterol levels and gastric cancer risk using a nationwide population cohort. Adults who received health care screening in 2009 from the Korean National Health Insurance Service were enrolled. Gastric cancer risk in relation to quartiles of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were compared according to sex, using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Among 9690,168 subjects enrolled, 92,403 gastric cancer cases were diagnosed. Higher HDL-C levels were associated with lower gastric cancer risk in the total population, men, and women (aHR [for the highest quartile] = 0.98 [0.96-0.99, P < .0001], aHR = 0.98 [0.96-1.004, P = .0004], and aHR = 0.91 [0.88-0.94, P < .0001], respectively). HDL-C showed consistent trends regardless of age or statin use. Higher LDL-C levels were also associated with lower gastric cancer risk in the total population (aHR = 0.92 [0.91-0.94], P < .0001) and men (aHR = 0.94 [0.91-0.96], P < .0001), but not in women (P = .4073). A subgroup analysis of LDL-C showed significant interactions with age and statin use (Pinteraction < .0001 and Pinteraction = .0497, respectively). The risk of gastric cancer was higher in subjects with elevated LDL-C levels in the younger group (age < 55, HR [for the highest quartile] = 1.02 [0.99-1.04] in the total population; HR = 1.03 [1.003-1.06] in men), the risk was lower in subjects with elevated LDL-C in the elderly (age ≥ 55, HR = 0.93 [0.91-0.95] in the total population; HR = 0.94 [0.92-0.96] in men). Elevated TC was associated with lower gastric cancer risk in the total population (aHR = 0.95 [0.94-0.97], P < .0001), but not in each sex separately (P = .3922 in men; P = .1046 in women). Overall, higher HDL-C levels may play a protective role in gastric cancer pathogenesis. The association between LDL-C/TC and gastric cancer seems to vary according to sex, age, and statin use. Especially in young males under age 55, high LDL-C and TC levels were associated with higher risk of gastric cancer.

Evaluating STC2 gene RNA in peripheral blood serum of gastric cancer patients.

Cancer is one of the leading causes of death in the world. Invasive microscopic and endoscopic methods are not suitable for routine screening of gastric cancer. Therefore, the need for biomarkers that can detect quickly, efficiently, and with high sensitivity in the early stages of cancer is strongly felt. Stanniocalcin plays a role in regulating calcium and phosphorus in the body. In addition, it plays a role in neuron cell differentiation, angiogenesis, wound healing, fertility and embryo development, and cancer. This study investigated the level of expression of the Stanniocalcin 2 (STC2) gene in the serum of patients with gastric cancer. This case-control study was conducted on the samples of 60 patients with gastric cancer (cases) and 60 healthy individuals (controls). Peripheral blood samples from gastric cancer patients and volunteers as control groups were collected in tubes containing EDTA anticoagulant and were immediately subjected to serum separation. After centrifugation, serum RNA was extracted, and after cDNA synthesis, STC2 gene serum RNA level was measured by the Taq Man method and Real-time PCR using specific primers and probes. Then, the results of serum evaluations and clinicopathological information of patients and control group were collected along with the information obtained from reviewing patients' files and demographic findings, regulatory tables, and related charts. SPSS22 software was used to analyze descriptive data. According to the study results, the high expression of the STC2 gene was 31 cases in the case group and 13 cases in the control group. However, there was a significant relationship between the high expression of the STC2 gene and gastric cancer (p = 0.0001). However, there was no significant relationship between the gender of patients and high expression of the STC2 gene. However, the age of 35% of the patients was more than 65 years, and there was a significant relationship between the age of the patients and the high expression of the STC2 gene (P = 0.028). Although there was no significant relationship between the anatomical location of the cancer and the subtypes of the cancer and the high expression of the STC2 gene, there was a significant relationship between the degree of cancer differentiation and the high expression of STC2 gene (P<0.05). In general, STC2 can be used as a biomarker to determine the border and margins of the tumor. Analysis of STC2 gene expression during surgery can reduce surgical error in tumor removal and increase the success of surgery for tumor removal.