Gastric Cancer Group Research Articles

The Effect of Partial Gastrectomy in the Treatment of Early Gastric Cancer and Its Impact on the Gastrointestinal Function of Patients

Objective: To investigate the impact of partial gastrectomy on gastrointestinal function in the treatment of patients with early gastric cancer. Methods: A sample of 20 patients with early-stage gastric cancer treated from January 2022 to January 2023 was randomly divided into two groups. Group A underwent partial gastrectomy, while Group B underwent distal subtotal gastrectomy. Surgical outcomes, complication rates, BMI indices, and quality of life were compared. Result: All surgical outcomes of patients with early gastric cancer in group A were better than those in group B (P < 0.05); the postoperative complication rate for early gastric cancer in group A was lower than that in group B (P < 0.05); the BMI index for patients with early gastric cancer in group A was higher than that in group B at different times (P < 0.05); the postoperative quality of life (SF-36) score of group A for early gastric cancer was higher than that of group B (P < 0.05). Conclusion: Partial gastrectomy for patients with early gastric cancer can increase BMI, optimize surgical outcomes, improve gastric function, and enhance the quality of life for gastric cancer patients.

A pragmatic approach improves the clinical management of stage IV gastric cancer: Comparison between the Meta-Gastro results and the GIRCG's retrospective series

IntroductionThe Italian Research Group for Gastric Cancer developed a prospective database about stage IV gastric cancer, to evaluate how a pragmatic attitude impacts the management of these patients. Materials and methodsWe prospectively collected data about metastatic gastric cancer patients thanks to cooperation between radiologists, oncologists and surgeons and we analyzed survival and prognostic factors, comparing the results to those obtained in our retrospective study. ResultsThree-hundred and eighty-three patients were enrolled from 2018 to September 2022. We observed a higher percentage of laparoscopic exploration with peritoneal lavage in the prospective cohort. In the registry only 3.6 % of patients was submitted to surgery without associated chemotherapy, while in the retrospective population 44.3 % of patients were operated on without any chemotherapy. At univariate and multivariate analyses, the different metastatic sites did not show any survival differences among each other (OS 20.0 vs 16.10 vs 16.7 months for lymphnodal, peritoneal and hepatic metastases, respectively), while the number of metastatic sites and the type of treatment showed a statistical significance (OS 16,7 vs 13,0 vs 4,5 months for 1, 2 and 3 different metastatic sites respectively, p < 0.001; 24,2 vs 12,0 vs 2,5 months for surgery with/without chemotherapy, chemotherapy alone and best supportive treatment respectively, p < 0.001). ConclusionsOur data highlight that the different metastatic sites did not show different survivals, but survival is worse in case of multiple localization. In patients where a curative resection can be achieved, acceptable survival rates are possible. A better diagnostic workup and a more accurate staging impact favorably upon survival.

OGC P47 Yield of staging laparoscopy in upper GI cancer; post COVID

Abstract Background Staging laparoscopy is a useful adjunct in preoperative staging process of oesophago-gastric cancer. NICE recommends use of staging laparoscopy in oesophageal cancer cases where it is likely to guide further management. In cases of gastric cancer there is strong evidence to suggest a high specificity of staging laparoscopy in detection of peritoneal metastasis. During COVID very selective use of staging laparoscopy was adopted by our unit. In this study we aimed to evaluate yield of staging laparoscopy in context of gastric and selective oesophageal cancers in our unit during post-COVID period Methods Retrospective analysis of our prospectively kept database in patients undergoing staging laparoscopy between January 2022 to May 2023 in upper GI tertiary cancer centre was performed. Age, sex, tumour grade, nodal status on radiology, histologic type, differentiation, and site of tumour was assessed against positive cytology and presence of peritoneal or occult visceral metastasis. Multivariate logistic regression was applied to identify independent factors associated with findings. Statistical analysis was carried out using EXCEL® and MedCalc® software. Results Among 104 patients, 69 had oesophageal cancer (OC) and 35 had gastric cancer (GC). In OC group cytology was positive in 4 (5.8%), peritoneal metastasis was present in 7 (10.1%) patients. In GC group positive cytology in 8 (22.8%), peritoneal metastasis was found in 8 (22.8%) patients. On multivariate analysis differentiation, T3+ tumour, lower third cancer, male sex was linked with positive findings in OC group. In GC group poor differentiation, T4 disease, mid body tumour, nodal status of N3 were associated positive findings. Yield of laparoscopy was found to be 17.6% and 34.6% in OC and GC groups respectively. Conclusions Despite of recent advances in radiological modalities, staging laparoscopy remains a useful adjunct in diagnosing peritoneal disease. With negligible complication rates and its relatively high yield in lower third and junctional oesophageal cancer it can be utilised to guide further management and reduce unnecessary laparotomies. Mid gastric body site and T4 cancers in our cohort were strong predictors of peritoneal disease further multi centre research on site of tumour is needed to affirm any such association.

Oral microbiota disorder in GC patients revealed by 2b-RAD-M

BackgroundMicrobiota alterations are linked with gastric cancer (GC). However, the relationship between the oral microbiota (especially oral fungi) and GC is not known. In this study, we aimed to apply 2b-RAD sequencing for Microbiome (2b-RAD-M) to characterize the oral microbiota in patients with GC.MethodsWe performed 2b-RAD-M analysis on the saliva and tongue coating of GC patients and healthy controls. We carried out diversity, relative abundance, and composition analyses of saliva and tongue coating bacteria and fungi in the two groups. In addition, indicator analysis, the Gini index, and the mean decrease accuracy were used to identify oral fungal indicators of GC.ResultsIn this study, fungal imbalance in the saliva and tongue coating was observed in the GC group. At the species level, enriched Malassezia globosa (M. globosa) and decreased Saccharomyces cerevisiae (S. cerevisiae) were observed in saliva and tongue coating samples of the GC group. Random forest analysis indicated that M. globosa in saliva and tongue coating samples could serve as biomarkers to diagnose GC. The Gini index and mean decreases in accuracy for M. globosa in saliva and tongue coating samples were the largest. In addition, M. globosa in saliva and tongue coating samples classified GC from the control with areas under the receiver operating curve (AUCs) of 0.976 and 0.846, respectively. Further ecological analysis revealed correlations between oral bacteria and fungi.ConclusionFor the first time, our data suggested that changes in oral fungi between GC patients and controls may help deepen our understanding of the complex spectrum of the different microbiotas involved in GC development. Although the cohort size was small, this study is the first to use 2b-RAD-M to reveal that oral M. globosa can be a fungal biomarker for detecting GC.

Sensitivity and specificity of folate receptor α-positive circulating tumour cells in gastric cancer.

We aimed to investigate whether folate receptor α (FRα)-positive circulating tumour cells (CTCs) could be used as a noninvasive liquid biopsy approach in gastric cancer (GC). Tissue microarray and bioinformatic analyses were used to evaluate FRα expression in GC. Patients with FRα-positive CTC examinations at our institute between July 2021 and May 2022 were retrospectively evaluated. Receiver operating characteristic curves were used to evaluate the diagnostic performance of FRα-positive CTCs in GC. FRα was highly expressed and associated with poor prognosis in GC based on public database. Data for 163 patients (20 with benign disease and 143 with GC) were retrospectively collected. FRα-positive CTC levels were significantly higher in the GC group than in the benign disease group (12.15 ± 1.47 FU/3ml vs. 10.47 ± 1.63 FU/3ml, P < 0.01). FRα-positive CTC levels were also elevated in GC patients with vessel/neuron invasion or extra-nodal tumour deposits (12.31 ± 1.47 FU/3ml vs. 11.77 ± 1.38 FU/3ml, P = 0.037). Areas under the curve of FRα-positive CTC levels for GC and early GC were 0.774 (P < 0.001) and 0.736 (P = 0.005). With a cut-off value of 10.95 FU/3ml, the Youden indexes for GC and early GC were 0.502 (sensitivity = 85.2% and specificity = 65.0%) and 0.450 (sensitivity = 80.0% and specificity = 65.0%), respectively. FRα-positive CTC detection by noninvasive liquid biopsy is a useful and effective approach for screening of patients with GC.

The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer.

This study aimed to explore the value of color Doppler ultrasonography combined with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in differential diagnosis of gastric stromal tumor (GST) and gastric cancer (GC). An analysis of the clinical data of 180 patients with clinically suspected gastric space occupying lesions. According to the postoperative pathological results, 180 suspected gastric space-occupying lesion patients were divided into GST group (n = 83) and GC group (n = 97). Color Doppler ultrasonography, serum tumor markers CEA and CA19-9 were compared. The research results showed that serum CEA and CA19-9 levels were lower in patients with GST group than those with GC group (both P < 0.001). With postoperative pathology as the gold standard, detection rates of GST and GC by combination of color Doppler ultrasound (CDUS), serum CEA, and CA19-9 were higher than those of each index alone (both P < 0.001). There was no difference between detection rates of GST and GC by combination of CDUS, serum CEA, and CA19-9 (P = 0.058). Color Doppler ultrasonography combined with serum tumor markers CEA and CA19-9 tests has a certain differential diagnostic value for GST and GC, which may provide a reliable reference basis for clinical diagnosis and treatment.

Clinicopathological and molecular diagnostic features of early-onset gastric cancer: a study based on data from a single-center dedicated gastric cancer database

Objective: To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies. Methods: In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups. Results: The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ2=5.442,P<0.001). HER-2 and Epstein-Barr virus positivity rates did not differ significantly between the two groups. Conclusion: Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.

The clinical significance and diagnostic value of serum Dickkopf1 and CKAP4 levels in patients with gastric cancer: a prospective study.

Gastric cancer is diagnosed at an advanced stage in most patients, and the prognosis is poor. Novel biochemical markers of high diagnostic value for the detection of the disease are therefore important. Dickkopf1 (DKK1) and cytoskeleton-associated protein 4 (CKAP4) have been extensively studied as biomarkers in cancer patients. Serum DKK1 and CKAP4 levels in 58 patients with gastric cancer and 41 healthy controls were examined using an ELISA kit in this prospective study. The patients were subdivided into groups based on pathological TNM staging and histological grades. Serum levels of both proteins in the patients with gastric cancer were measured preoperatively, 10 and 30 days after surgery. Serum DKK1 and CKAP4 levels were significantly higher in the gastric cancer group compared to the healthy controls (p<0.05). Serum levels of both proteins increased in line with the pathological stage and histological grade of the gastric cancer. Serum CKAP4 and DKK1 levels decreased after surgical resection. Both serum levels also decreased significantly on day 30 after surgery compared to day 10 (p<0.05). Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) positivity rates were below 20% in the gastric cancer group, while the diagnostic value (sensitivity and specificity) of serum CKAP-4 and DKK1 exceeded 80%. DKK1 and CKAP4 are biomarkers of high diagnostic value that can be used to diagnose and predict the severity of gastric cancer. These proteins can also be employed for disease monitoring after surgical resection. The diagnostic value of these proteins is higher than that of biomarkers such as CEA and CA19-9, which are routinely used in clinical practice.

Comprehensive microbial network analysis of gastric microbiome reveal key species affecting gastric carcinogenesis

Gastric cancer continues to be one of the most significant cancers globally. Changes in microbiome composition and diversity have been implicated in gastric carcinogenesis; however, little is known about microbial community interactions and keystone species that drive these changes toward carcinogenesis. The aim of this work was to elucidate essential microbial interactions and community drivers that affect gastric carcinogenesis. We mined and utilized publicly available gastric microbiome data of adult human gastric biopsies with specific gastric diseases (gastric cancer, gastritis (chronic, superficial, atrophic), intestinal metaplasia) and healthy controls. We analysed the combined dataset using standard microbiome data analytics. Network topological properties of the various networks for gastric conditions revealed that the clustering coefficient decreased with increasing carcinogenesis. Higher modularity and lower averaged path were observed in the healthy control group as compared to the pre-cancerous and cancer groups. Sucinnate-producing and utilizing species, Bacteroides coprocola, Blautia wexlerae, and Phascolarctobacterium succinatutens, were also identified as important hubs in the precancerous conditions (gastritis and intestinal metaplasia) while nitrate-reducing bacteria Rothia mucilaginosa, Haemophilus haemolyticus, Haemophilus parainfluenzae, and Veillonella dispar were revealed as hubs in the gastric cancer group. Haemophilus parainfluenzae, which is an opportunistic oral pathogen, was identified as a potential network connector in three gastric conditions (healthy, intestinal metaplasia, and gastric cancer). Sphingobium fontiphilum and Rothia mucilaginosa were also revealed as keystone species for the control and cancer groups, respectively. The results from the clustering revealed distinct clusters in different gastric networks, indicating that microbial communities formed different functional groups during carcinogenesis. The random forest models also revealed pathogenic species Fusobacterium nucleatum be highly discriminative between healthy controls and gastric cancer groups.

Mide Kanserli Hastaların Hematolojik Parametre Sonuçlarının Değerlendirilmesi

Objective: Gastric cancer is a major health concern which fourth leading cause of cancer death and fifth most common cancer. It has difficulties such as having a poor prognosis and diagnoses at an advanced stage. There are studies to find prognostic indicators that are easily and less invasively obtained in gastric cancer and hematological tests are one of them. In this study, we aimed to investigate the relation between hematological test and gastric cancer.&#x0D; Materials-Methods: In this study, 48 patients diagnosed with gastric cancer and 45 healthy adults in the control group were examined prospectively. All participants' demographic data and laboratuary results were obtained from the hospital database and recorded.&#x0D; Results: In the gastric cancer group compared to the healthy control group, while red blood cells (RBC), hemoglobin (HBG), hematocrit (HTC), mean cell hemoglobin concentration (MCHC), platelet distribution width (PDW), lymphocyte (LYM), eosinophil (EU) values were statistically lower, mean corpuscular hemoglobin (MCH), red cell distribution width-standard deviation, red cell distribution width-coefficent of variation (RDW-CV), nucleated red blood cells (NRBC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and monocyte lymphocyte ratio (MLR) values were observed to be statistically higher (p

Gastric Cancer Growth Modulated by circSNTB2/miR-6938-5p/G0S2 and PDCD4.

Gastric cancer (GC) is the third most common cause of cancer-related death worldwide. Increasing studies have indicated that circular RNAs (circRNAs) play critical roles in cancer progression. However, the precise mechanism and functions of most circRNAs are still unknown in gastric cancer. In the present study, we aim to uncover the mechanism by which circRNAs regulate gastric cancer tumorigenesis. By analyzing the microarray data, we screened differential expressed circRNAs in the gastric cancer group and identified a down-regulated circRNA, hsa_circ_0040039 (circSNTB2). Mechanically, circSNTB2 served as a sponge for the miR-6938-5p and up-regulated its expression. Meanwhile, G0/G1 switch gene 2 (G0S2) and programmed cell death gene 4 (PDCD4) were identified to be the aim genes of miR-6938-5p, constructing circSNTB2/miR-6938-5p/G0S2 and PDCD4 pathways. Taken together, our findings demonstrated that circSNTB2 plays an essential role in gastric cancer by regulating miR-6938-5p through G0S2 and PDCD4 genes. CircSNTB2 could be a promising biomarker for GC diagnosis and targeted therapy.

The relation between gastric cancer and ABO blood groups: multicenter, observational, case-control study

Giriş ve Amaç: Bu çalışmanın amacı, kan grupları ile mide kanseri riski arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Çok merkezli, gözlemsel, vaka-kontrol çalışmasına 2000-2016 yılları arasında mide kanseri tanısı ile takip edilen ve serolojik olarak ABO kan grubu belli olan hastalar dahil edildi. Kontrol grubu olarak ise Türk Kızılayı’na kan bağışında bulunan sağlıklı kişiler seçildi ve sağlıklı kişilerin kan gruplarına Türk Kızılayı’nın kayıtlarından ulaşıldı. İstatistiksel analizler için SPSS versiyon 13 kullanıldı. Bulgular: Mide kanseri tanısı olan grup ile kontrol grubu arasında kan grupları açısından dağılımlar istatistiksel olarak farklı idi. Mide kanseri tanısı olan hastalarda A kan grubu daha fazla görülmekteydi (p &lt; 0.001). Gruplar O grubu, non-O grubu olarak sınıflandırıldığında; mide kanseri tanısı olan grupta hastaların %29’unda (n: 253) O grubu, %71’inde (n: 627) non-O grubu tespit edildi. Kontrol grubunda ise vakaların %34’ünde O grubu ve %66’sında non-O grubu saptandı. Mide kanseri tanısı olan hastalar ile kontrol grubu karşılaştırıldığında mide kanserli hastalarda O grubu dışı kan gruplarının daha fazla görüldüğü tespit edildi (p: 0.010). Sonuç: Bu çalışmada, daha önce farklı ülkelerde yapılmış çalışmalara benzer olarak ülkemizde de O dışı (özellikle A grubu) kan grubuna sahip olmak artmış mide kanseri riski ile ilişkili bulundu.

Serum Pseudocholinesterase as a Biomarker in the Differentiation between Gastric Cancer and Benign Gastric Diseases

Background: Worldwide gastric cancer is the fifth most common cancer with poor prognosis. In early stages, it is hard to distinguish gastric cancer from benign gastric diseases, resulting in delayed diagnosis. There is a need to develop a biomarker for differentiating between gastric cancer and benign gastric diseases. Serum cholinesterase is synthesized in liver and released into plasma, and it has an important role in oncogenesis. Objectives: To determine the correlation between serum cholinesterase activity and gastric cancer, in comparison to benign gastric diseases. Subjects and Methods: A case control study carried out at Medical City Directorate\ Gastroenterology, Hepatology Hospital, and at Oncology Teaching Hospital from April 2022 to September 2022. It involved 25 patients with gastric cancer and age matched 25 patients with benign gastric diseases. Serum cholinesterase activity was determined by a colorimetric method.. Results: There was a significant difference in the mean level of serum cholinesterase between gastric cancer group (5339.28 U/L±1816) and benign gastric diseases group (7516.92 U/L±2351) with (P value&lt;0.001). Significant association between low levels of serum cholinesterase and early cancer stages and grades (P value&lt;0.001). Serum cholinesterase showed 60% sensitivity and 80% specificity in differentiating between gastric cancer and benign gastric diseases with optimal cutoff value of 5568U\L. Conclusions: Serum cholinesterase can be considered as a potential rapid and non-invasive biomarker for differentiating between gastric cancer and benign gastric diseases.

Analysis of the development of gastric cancer after resecting colorectal lesions using large-scale health insurance claims data.

Colorectal endoscopic resection (C-ER) is spreading due to the increase of colorectal cancer (CRC) in Japan. Gastric cancer (GC) sometimes occurs after C-ER. We aimed to analyze the status of GC after C-ER using large-scale data. We retrospectively used commercially anonymized health insurance claims data of 5.71 million patients from 2005 to 2018, and extracted 62,392 patients ≥ 50years old who received C-ER. The incidence and risk factors of GC were analyzed. Additionally, subjects were divided into ≥ 2cm group and < 2cm group and risks of GC were analyzed. The median age (range) was 58 (50-75) years and the overall rate of GC was 0.68% (423/62,392). Multivariate analysis showed that significant risk factors for GC [odds rates (OR), 95% confidence interval (CI)] were colorectal lesion size ≥ 2cm (1.75, 1.24-2.47, p = 0.002), age ≥ 65y.o. (1.65, 1.31-2.07, p < 0.001), male (2.35, 1. 76-3.13, p < 0.001), diabetes mellitus (1.40, 1.02-1.92, p = 0.035), liver disease (1.54, 1.06-2.24, p = 0.025), Helicobacter pylori infection (2.10, 1.65-2.67, p < 0.001), chronic atrophic gastritis (1.58, 1.14-2.18, p = 0.006), and CRC (1.72, 1.10-2.68, p = 0.017). The rate of GC in the ≥ 2cm was significantly higher than that in < 2cm groups (1.17% and 0.65%, p < 0.001). According to the number of significant risk factors, the rates of GC and the hazard ratios of GC (95%CI) were 0.64% and 3.64 (2.20-6.02) and 1.95% and 11.17 (6.57-19.00) for patient with 1-2 and ≥ 3 risk factors, compared with patients without risk factors. Using large-scale data, risk factors for GC,including colorecallesions ≥ 2cmafter C-ER could be investigated.

Genetic mutation rs972283 of the KLF14 gene and the incidence of gastric cancer

Introduction and Aim: Genetic factors and family gene clustering constitute an important ratio for gastric cancer. Kruppel Like Factor 14 (KLF14) gene has a carcinogenic role and a clear role in metabolic diseases, but how this gene regulates these metabolic traits is still obscure. Previous studies proposed that the accumulation of single nucleotide polymorphisms (SNPs) in KLF14 may be associated with gastric cancer. The current study aimed to investigate whether single nucleotide polymorphisms (SNP) rs972283 in KLF14 is associated with an increased risk of gastric cancer in the Iraqi population. Materials and Methods: The SNP was genotyped using tetra primer ARMS-PCR in 101 (79 men and 22 women) gastric cancer patients who did not receive chemotherapy, and 80 healthy controls (53 men and 27 women). All patient samples were taken from the Baghdad Hospital of Gastroenterology and Hepatology laboratories. Patient records included age, sex, histological type, and H. pylori infection status Results: The KLF14 rs972283 genotype was significantly different between the gastric cancer and control groups. The heterozygous AG genotype and A mutant allele were significantly higher in gastric cancer patients compared to controls (56.4% vs 38.7%, p&lt;0.01 and 61% vs 40.6%, p&lt;0.01, respectively). In contrast, the GG wildtype genotype and G wildtype allele were significantly higher in controls (40% vs 11%, p&lt;0.01 and 59.4% vs 39%, p&lt;0.01, respectively). The AA homozygous mutant genotype also showed a weak correlation with increased gastric cancer risk. These results indicate the A allele is a risk factor while the G allele has a protective effect for gastric cancer. Conclusion: the KLF14 polymorphism rs972283 exhibits a significant association with gastric cancer risk in our Iraqi cohort. The SNP may serve as a useful prognostic marker, pending validation in larger studies.

Carcinoembryonic antigen, carbohydrate antigen 199 and carbohydrate antigen 724 in gastric cancer and their relationship with clinical prognosis.

Gastric cancer (GC) is a common malignant tumor of the digestive system with a high degree of malignancy. It usually develops insidiously without any specific symptoms in the early stages. As one of the diseases caused by abnormal gene changes, GC has abnormal expression of various oncogenes and products during its development. Tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199) and carbohydrate antigen 724 (CA724) are not expressed or lowly expressed in normal people, but significantly increased after carcinogenesis. Monitoring the changes in the levels of tumor markers such as CEA, CA199 and CA724 is conducive to early diagnosis and evaluation of the occurrence of some solid tumors. To investigate the expression of CEA, CA199 and CA724 in GC and their correlation with clinical features, hoping to provide more effective markers for the early preventive diagnosis of GC. Of 87 patients with GC admitted to our hospital from September 2020 to December 2021 were included in the GC group, and another 80 healthy people who came to our hospital for physical examination with normal results during the same period were selected as the control group. The serum CEA, CA199, and CA724 levels were compared between the two groups, and the serum CEA, CA199, and CA724 levels were compared in patients with GC at different TNM stages, and the differences in the positive rates of CEA, CA199, and CA724 alone and in combination in detecting TNM stages of GC and GC were compared. In addition, the relationship between the levels of tumor markers CEA, CA199 and CA724 and the clinicopathological characteristics of GC patients was also analyzed. The relationship between the serum levels of CEA, CA199 and CA724 and the survival period of GC patients was analyzed by Pearson. The serum levels of CEA, CA199 and CA724 in GC group were significantly higher than those in control group (P < 0.05). With the increase of TNM stage, the serum CEA, CA199 and CA724 expression levels in GC patients increased significantly, and the differences between groups were statistically significant (P < 0.05). The positive rate of the CA724 single test was higher than that of CEA and CA199 single test (P < 0.05). The positive rate of the three combined tests was 95.40% (83/87), which was higher than that of CEA, CA199 and CA724 single tests. The difference was statistically significant (P < 0.05). The combined detection positive rates of CEA, CA199, and CA724 in stages I, II, III, and IV of GC were 89.66%, 93.10%, 98.85%, and 100.00% respectively, all of which were higher than the individual detection rates of CEA, CA199, and CA724. The differences were statistically significant (P < 0.05). There was no significant difference in serum CEA, CA199 and CA724 levels between GC patients with different genders, smoking history and alcohol history (P > 0.05). However, the serum CEA, CA199 and CA724 levels were significantly higher in GC patients aged ≥ 45 years, TNM stage III-IV, with lymph node metastasis and tumor diameter ≥ 5 cm than in GC patients aged < 45 years, TNM stage I-II, without lymph node metastasis and tumor diameter < 5 cm (P < 0.05). The expression levels of serum tumor markers CEA, CA199 and CA724 in patients with GC are high and rise with the increase of TNM stage. The levels of CEA, CA199 and CA724 are related to age, TNM stage, lymph node metastasis and tumor diameter. The combined detection of CEA, CA199 and CA724 is helpful to improve the diagnostic accuracy of GC with high clinical guidance value.

Plasma metabolome identifies potential biomarkers of gastric precancerous lesions and gastric cancer risk.

Currently, metabolic biomarkers with great practicability of gastric cancer (GC) and gastric precancerous lesions (GPL) are scarce. Thus, we are devoted to determining the plasma metabolic profiles of patients with GPL or GC and validate candidate biomarkers for disease diagnosis. In this hospital-based case-control study, 68 plasma samples from 27 non-atrophic gastritis (NAG, control), 31 GPL, and 10 GC patients were collected for targeted metabolomics analysis. Univariate and multivariate analyses were used for selecting the differential metabolites. A receiver operating characteristic curve combined with binary logistic regression analysis was performed to test the diagnostic performance of the differential metabolites. Dietary data were obtained using a semiquantitative food frequency questionnaire. Distinct metabolomic profiles were noted for NAG, GPL, and GC. Compared to the NAG patients, the levels of 5 metabolites in the GPL group and 4 metabolites in the GC group were found to significantly elevate. Compared with the model involving 9 traditional risk factors (AUC: 0.89, 95%CI: 0.78-1.00), Trimethylamine N-oxide, the most significant metabolite (P = 2.00 × 10-5, FDR = 0.003, FC > 2, VIP > 2), showed a good diagnostic performance for the patients with GC (AUC: 0.90, 95%CI: 0.78-1.00), and its diagnostic performance has been further improved with the integration of Rhamnose (AUC: 0.96, 95%CI: 0.89-1.00). In our study, 9 defined metabolites might serve as meaningful biomarkers for identifying the high-risk population of GPL and GC, possibly enhancing the prevention and control of GPL and GC.

Correlation of CTLA-4 polymorphism and the risk of gastric cancer in a Chinese Bai population.

Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) is involved in the regulation of immune responses mediated by T cells. This study aimed to explore the correlation between CTLA-4 gene polymorphisms and the risk of gastric cancer (GC) in the Bai minority population of southwestern China. A total of 422 GC patients and 397 healthy controls (HC) were included in this case-control study. Four single nucleotide polymorphism sites of CTLA-4 gene (rs231775, rs733618, rs16840252 and rs3087243) were selected and analysed. The results showed a significant difference in the rs733618 loci between GC and HC groups. The frequency of the rs733618 polymorphism 'TC' genotype was significantly lower in GC group compared to the HC group [odds ratio (OR), 95% confidence interval (CI): .47 (.35-.63), p<.001]. GC cases with dominant genetic model 'TC+CC' had a 47% reduced risk of GC [OR, 95%CI: .53 (.40-.71), p<.001]. Subgroup analyses revealed that the rs733618 'TC+CC' genotype was associated with a lower risk of GC in male patients [OR, 95%CI: .42 (.31-.58), p<.001], those aged ≤60 years old [OR, 95%CI: .27 (.18-.42), p<.001], non-drinkers [OR, 95%CI: .21 (.13-.33), p<.001], non-smokers [OR, 95%CI: .38 (.25-.57), p<.001] and individuals without Helicobacter pylori infection [OR, 95%CI: .16 (.10-.26), p<.001]. Further multivariated analyses indicated that individuals with the 'TC+CC' rs733618 genotype who were aged ≤60 years old [OR, 95%CI: .42 (.29-.83), p=.032] and had no H. pylori infection [OR, 95%CI: .35 (.28-.76), p=.018] were found to have a protective effect against GC. Additionally, soluble CTLA-4 were significantly lower in GC patients with 'TC' and 'TC+CC' genotypes (all p<.05). Our findings suggest that the rs733618 polymorphism of CTLA-4 gene may play a critical role in the prevention of GC.

Relationship between gastric xanthoma, gastric precancerous lesions, and gastric cancer: A retrospective study.

To evaluate the relationship between gastric cancer and its precancerous lesions and gastric xanthoma. Medical records of 47 736 patients who underwent gastroscopy in our center from January 2020 to December 2021 were reviewed. Patients' age, sex, endoscopic and histopathological findings, and the presence, number and location of gastric xanthoma were recorded. To investigate the detection rate of gastric xanthoma at different stages of gastric lesions, the participants were further divided into the chronic gastritis group (n = 42 758), the precancerous lesion group (n = 3672), and the gastric cancer group (n = 1306), respectively. The overall detection rate of gastric xanthoma was 2.85%, and it was most commonly observed in the gastric antrum (52.50%). In addition, gastric xanthoma was more common in men and more likely to be single lesion. It was most detected in the precancerous lesion group (8.39%), followed by the gastric cancer group (5.44%), and least in the chronic gastritis group (2.29%). Multivariate analysis showed that gastric xanthoma was closely related to precancerous lesions (odds ratio [OR] 3.197, 95% confidence interval [CI] 2.791-3.662, P < 0.001) and gastric cancer (OR 1.794, 95% CI 1.394-2.309, P < 0.001). Gastric xanthoma is closely related to gastric precancerous lesions and gastric cancer.

CircRNA circSLIT2 is anovel diagnostic and prognostic biomarker for gastric cancer.

Many diseases can mimic the symptoms of gastric cancer (GC). Therefore, misdiagnosis of GC is common. Our preliminary sequencing analysis revealed the altered expression of circSLIT2 in GC. In this study, we further explored the role of circSLIT2 in GC. The research subjects included GC patients, patients with irritable bowel syndrome (IBS), patients with gastric ulcer (GU), patients with gastric tuberculosis (GT), patients with Crohn's disease (CD), and healthy controls (HC). Accumulation of circSLIT2 RNA in both tissue and plasma samples was determined with RT-qPCR. The diagnostic and prognostic values of circSLIT2 for GC were explored by performing ROC and survival curve analysis. The χ2-test was applied for association analysis. Increased circSLIT2 RNA accumulation was observed in GC tissues compared to non-tumor tissues. Compared to the HC group, increased plasma circSLIT2 RNA accumulation was only observed in the GC group, but not in the IBS, GU, GT, and CD groups. Plasma circSLIT2 showed apositive correlation with circSLIT2 in GC tissues but not circSLIT2 in non-tumor tissues. Using increased plasma circSLIT2 as abiomarker, GC patients were effectively separated from other disease groups and the HC group. Survival curve analysis revealed that most patients who died during the 5‑year follow-up had high levels of circSLIT2 accumulation in GC tissues and plasma. CircSLIT2 in plasma and GC tissue was only closely associated with distant tumor metastases, but not other clinical factors. Increased circSLIT2 accumulation may serve as anovel diagnostic and prognostic biomarker for GC.