Gastric Cancer Screening Research Articles

Knowledge and practice of early gastric cancer screening among adults aged ≥ 45 years in China: a cross-sectional study

BackgroundAs the incidence of gastric cancer increases sharply in adults aged over 45 years, a better understanding of gastric cancer screening knowledge and practice is crucial to promote cancer-screening services. This study aimed to evaluate knowledge of early gastric cancer screening, adherence to screening, and perceived barriers hindering screening practices among adults aged ≥ 45 years in China.MethodsA multi-center, face-to-face, cross-sectional study was conducted in community sites in Shijiazhuang, China, through the distribution of structured questionnaires from August to September, 2022.ResultsOf the 1053 respondents, only 13.4% demonstrated a good understanding of early gastric cancer screening. While 64.0% knew that gastroscopy is the gold standard for screening (“how to screen”), only 19.9% were aware of the recommended starting age (“when to screen”). Moreover, less than half could correctly identify high-risk groups (“whom to screen”), with awareness ranging from 20.5% for those infected with H. pylori to 47.8% for those with gastric diseases. Independent factors related to higher screening knowledge included female sex (OR = 1.55, 95% CI = 1.01–2.38), higher education level (OR = 4.03, 95% CI = 2.68–6.06), being with a personal/family experience of gastric diseases (OR = 1.68, 95% CI = 1.12–2.52). In addition, only 23.4% of respondents underwent GC screening. The dominant barrier to early screening was the “absence of symptoms or signs”, followed by “fearing procedural discomfort”.ConclusionThis study highlights significant gaps in early gastric cancer screening knowledge and participation among middle-aged and elderly individuals in China. Addressing these gaps through culturally tailored health education campaigns is a critical strategy for increasing public awareness and participation.

Clinical application of oral contrast-enhanced ultrasound in evaluating the preoperative T staging of gastric cancer.

Oral contrast-enhanced ultrasound (OCEUS) is widely used in the noninvasive diagnosis and screening of gastric cancer (GC) in China. To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer. OCEUS was performed before the operation, and standard ultrasound images were retained. The depth of infiltration of GC (T-stage) was evaluated according to the American Joint Committee on Cancer 8th edition of the tumor-node-metastasis staging criteria. Finally, with postoperative pathological staging as the gold standard reference, the sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic value of OCEUS T staging were evaluated. OCEUS achieved diagnostic accuracy rates of 76.6% (T1a), 69.6% (T1b), 62.7% (T2), 60.8% (T3), 88.0% (T4a), and 88.7% (T4b), with an average of 75.5%. Ultrasonic T staging sensitivity exceeded 62%, aside from T1b at 40.3%, while specificity was over 91%, except for T3 with 83.5%. The Youden index was above 60%, with T1b and T2 being exceptions. OCEUS T staging corresponded closely with pathology in T4b (kappa > 0.75) and moderately in T1a, T1b, T2, T3, and T4a (kappa 0.40-0.75), registering a concordance rate exceeding 84%. OCEUS was effective, reliable, and accurate in diagnosing the preoperative T staging of GC. As a noninvasive diagnostic technique, OCEUS merits clinical popularization.

Health screening disparities in people living with HIV; A nationwide organized screening setting

BackgroundWe identified the uptake of people living with HIV (PLWH) using health-screening services and compared the screening rate with the general population, to identify factors associated with the use of screening services by PLWH. MethodsThis population-based study used data from the Korean National Health Insurance, a single mandatory health insurance system covering all residents. The uptake rates for screening for general health, gastric cancer, and colorectal cancer, which were provided by a national health screening program with free of charge or minimal cost in Korea from 2010–2020. Factors associated with general health, gastric cancer, and colorectal cancer screening were also explored. ResultsScreening uptake rates for general health, gastric cancer, and colorectal cancer in PLWH increased from 2010–2019 but decreased in 2020. The standardized screening ratio showed lower screening rates for general health, gastric cancer, and colorectal cancer in PLWH with 0.80 (95 % confidence interval (CI) = 0.77–0.83), 0.64 (95 % CI = 0.61–0.67), and 0.67 (95 % CI = 0.64–0.71) in 2019. Increased age, Charlson Comorbidity Index, and years since HIV diagnosis were associated with increased screening uptake in PLWH. Otherwise, PLWH recipients of medical aid programs received less for each screening compared to PLWH who paid insurance premiums higher than 50 %. An increased medication possession ratio of highly active antiretroviral therapy was associated with decreased general health and gastric cancer screening uptake but increased colorectal cancer screening uptake. ConclusionsSignificant disparities in health-screening uptake were observed in PLWH compared to the general population in a nationwide organized screening setting without cost barriers.

Microfluidic-SERS sensing system based on dual signal amplification and aptamer for gastric cancer detection.

Studies have found that matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) play an important role in tumorigenesis. In order to detect MMP-9 and IL-6 concentrations with high sensitivity and specificity, an efficient microfluidic-SERS sensing system was prepared based on surface-enhanced Raman scattering (SERS). The aptamer recognition-release mechanism and the dual signal amplification strategy were applied in the sensing system. The sensor system was developed using two kinds of nanomaterials with excellent SERS properties, namely gold-coated iron tetroxide particles (Fe3O4@AuNPs) and gold nanocages (AuNCs). In addition, Fe3O4@AuNPs also has magnetic adsorption properties. In the sensing system, single-stranded DNA1 (ssDNA1) and aptamer were modified on Fe3O4@AuNPs. Single-stranded DNA2 (ssDNA2) and Raman tags were modified on AuNCs. When the target was present, the aptamer bound to the target and detached from the Fe3O4@AuNPs, andssDNA2 bound to the exposed ssDNA1. At this time, the Fe3O4@AuNPs@AuNCs@SERS tag complex was formed, and the SERS signal was enhanced for the first time. Under the action of an external magnet on the microfluidic chip, the complex was magnetized and enriched. The SERS signal was enhanced for the second time. Due to the high affinity between the aptamer and the target object, the sensing system has a strong specificity. The double amplification of the SERS signal gave the system excellent sensitivity. The limit of detection (LOD) relative to MMP-9 and IL-6 were as low as 0.178pg/mL and 0.165pg/mL, respectively. The microfluidic-SERS sensing system has a feasible prospect in the early screening of gastric cancer.

Re-evaluation of the role of endoscopic submucosal dissection in the treatment of early gastric cancer based on additional gastrectomy results.

Endoscopic submucosal dissection (ESD) plays a pivotal role in treating early gastric cancer (EGC). Some patients require additional gastrectomy because of non-curative ESD. This study aimed to analyze the clinical factors associated with non-curative ESD and to re-evaluate the role of ESD according to its indication criteria. Altogether, 134 patients who had undergone additional gastrectomy with lymphadenectomy for non-curative ESD based on the pathological results of ESD specimens were included. Their data including pre-ESD diagnosis, reasons for requesting additional gastrectomy, and surgical outcomes were analyzed retrospectively. Of the 134 patients with EGC in the final pathology of ESD specimens, 56 underwent staging ESD for a diagnostic approach, of whom 28 were diagnosed with atypical glands and 28 with high-grade dysplasia (HGD) prior to ESD. The remaining 78 patients of the 134 were identified to have EGC and received ESD for therapy. Based on the pathological results of ESD specimens, additional gastrectomy was commissioned with non-curative ESD because of one or more causes such as deep submucosal invasion, lymphatic invasion, positive vertical margin, undifferentiated histology, positive lateral margin, and venous invasion. Regarding surgical specimens, 13 patients had lymph node metastasis (LNM) and 9 had local residual tumor; one of them had both LNM and a local residual tumor. In patients with atypical glands, 4 had LNM and 3 had a local residual tumor; one of them had both LNM and a local residual tumor, and then died of multiple organ metastasis. In patients with HGD, 4 had LNM and 1 had a local residual tumor. Additionally, 4 patients who were absolutely indicated for ESD had LNM, of whom 2 had atypical glands, and the other 2 had HGD. Similarly, in 6 patients with a local residual tumor absolutely indicated for ESD, 2 had atypical glands and 1 had HGD. Positive vertical margin, lymphatic invasion, and deep submucosal invasion were identified as independent risk factors for LNM. ESD may play diagnostic and therapeutic roles in determining the optimal treatment of EGC when the diagnosis is equivocal or insufficient in endoscopic assessments for gastric cancer screening.

Development and validation of a relatively accurate gastric cancer high-risk group screening scoring system in urban residents.

Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy. The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems. In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency. Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.

Public awareness of gastric cancer risk factors and screening behaviours in Shijiazhuang, China: A community-based survey.

Reducing exposure to risk factors and screening represent 2 major approaches to gastric cancer (GC) prevention, but public knowledge GC risk factors and screening behaviour remain unknown. We aimed to investigate public awareness of GC risk factors, adherence to screening, and barriers hindering screening practices in China. This community-based household survey was conducted within Shijiazhuang, China, and 1490 residents were recruited through a multistage stratified cluster random sampling approach. A self-administered questionnaire was completed which consisted of three sections: demographics, awareness of GC risk factors, and personal screening behaviours. Factors associated with knowledge of risk factors and screening behaviours were evaluated using binary logistic regression analysis. The mean risk factor awareness score of 12 (7, 15) revealed insufficient knowledge in 51.1% of participants. Dietary lifestyle factors were better understood than physical activity and weight-related factors. Marital status (OR 1.967; 95% CI 1.415 to 2.734), higher income (OR 1.197; 95% CI 1.010 to 1.418), and a history of upper gastrointestinal problems (OR 0.048; 95% CI 1.002 to 1.311) were associated with higher awareness. Merely 21.5% underwent GC screening, with higher rates linked to older age (OR 1.642; 95% CI 1.418 to 1.902), higher education (OR 1.398; 95% CI 1.176 to 1.662), a history of upper gastrointestinal problems (OR 3.842; 95% CI 2.833 to 5.209), and moderate (OR 2.077; 95% CI 1.352 to 3.191) and high (OR 2.529; 95% CI 1.311 to 4.878) perceived GC risk. Notably, participants commonly refused gastroscopy due to the absence of symptoms or signs. In Shijiazhuang, more than half of participants demonstrated inadequate knowledge of GC risk factors, and screening participation rates were remarkably low. This emphasizes the need for targeted interventions to enhance GC awareness and significantly improve screening rates.

S2350 Financial Practicality of Screening for Hereditary Diffuse Gastric Cancer in Patients With Lobular Breast Cancer

S2350 Financial Practicality of Screening for Hereditary Diffuse Gastric Cancer in Patients With Lobular Breast Cancer

Cost-Effectiveness of Serum Pepsinogen as a Gastric Cancer Targeted Screening Strategy in the United States

Background and AimsCurrent gastric cancer (GC) screening modalities are invasive and expensive. Noninvasive screening for GC precursors with serum pepsinogen (PG) may improve early detection and prevention. Test characteristics of PG based on US prospective data was recently reported and used to study the cost-effectiveness of PG screening versus no screening in the US. MethodsA patient-level state transition microsimulation of gastric adenocarcinoma analyzed noninvasive screening versus no screening in a hypothetical cohort of average risk US individuals. Primary outcomes included life expectancy, quality-adjusted life years (QALYs), total costs, and incremental cost-effectiveness ratios (ICERs). Secondary outcomes included total GC incidence and mortality. Base-case PG sensitivity and specificity were 34.1% and 94.7%, respectively, with a wide range of PG performance characteristics also examined. ResultsOne-time serum PG screening at age 40 was cost-effective compared to no screening with an ICER of $4,913.29 per QALY. PG screening resulted in 10.9% relative reduction in lifetime GC incidence and 10.8% relative decrease in cumulative GC mortality. Localized stage at diagnosis increased from 30.5% to 33.6% and metastatic stage decreased from 40.8% to 37.4%. Sensitivity analysis showed PG screening was most sensitive to endoscopy costs, chronic atrophic gastritis quality of life, and PG prevalence. PG screening remained cost-effective across a wide range of test values. ConclusionPG screening is a cost-effective strategy to improve GC mortality, however, mortality benefit will depend on the test characteristics of the biomarker. Future blood-based screening tests that have better performance characteristics could further improve GC prevention.

Fecal Immunochemical Test and Helicobacter pylori Stool Antigen Co-Testing: A Potential Approach for Gastric Cancer Screening.

Fecal Immunochemical Test and Helicobacter pylori Stool Antigen Co-Testing: A Potential Approach for Gastric Cancer Screening.

Ultrasensitive and multiplexed Gastric cancer biomarkers detection with an integrated electrochemical immunosensing platform

Developing immunosensing platforms capable of simultaneously detecting multiple cancer markers is crucial for clinical diagnosis and biomedical research. Here, we introduce a novel dual-mode electrochemical biosensing assay platform capable of detecting two gastric cancer biomarkers: pepsinogen I (PG I) and pepsinogen II (PG II). Methylene blue (MB) and Prussian blue (PB) were used as dual signal sources to label PG I and PG II, respectively. The platform integrates an ARM STM32F411 microcontroller and an AD5941 analog front-end, which not only facilitates cyclic voltammetry (CV) and differential pulse voltammetry (DPV) with efficacy comparable to commercial electrochemical workstations but also offers data collection and synchronous analysis capabilities, allowing simultaneous output of PG I and PGR (PG I/PG II) values. Equipped with an interactive screen for operational control and result display, the immunosensing platform provides linear detection ranges for PG I (5 pg/mL–100 ng/mL) and PG II (50 pg/mL–200 ng/mL), enabling rapid detection within 5 min. It demonstrates excellent sensitivity and selectivity when comparing serum samples from healthy individuals and gastric cancer patients. The dual-marker detection platform significantly enhances early diagnosis and screening of gastric cancer, offering substantial improvements over single-marker assays. Furthermore, this platform shows potential for detecting multiple biomarkers in various diseases, highlighting its utility for biomedical applications.

Molecular evolution of intestinal-type early gastric cancer according to Correa cascade.

Early screening is crucial for the prevention of intestinal-type gastric cancer. The objective of the current study was to ascertain molecular evolution of intestinal-type gastric cancer according to the Correa cascade for the precise gastric cancer screening. We collected sequential lesions of the Correa cascade in the formalin-fixed and paraffin-embedded endoscopic submucosal dissection-resected specimens from 14 Chinese patients by microdissection, and subsequently determined the profiles of somatic aberrations during gastric carcinogenesis using the whole exome sequencing, identifying multiple variants at different Correa stages. The results showed that TP53, PCLO, and PRKDC were the most frequently mutated genes in the early gastric cancer (EGC). A high frequency of TP53 alterations was found in low-grade intraepithelial neoplasia (LGIN), which further increased in high-grade intraepithelial neoplasia (HGIN) and EGC. Intestinal metaplasia (IM) had no significant correlation with EGC in terms of mutational spectra, whereas both LGIN and HGIN showed higher genomic similarities to EGC, compared with IM. Based on Jaccard similarity coefficients, three evolutionary models were further constructed, and most patients showed linear progression from LGIN to HGIN, ultimately resulting in EGC. The ECM-receptor interaction pathway was revealed to be involved in the linear evolution. Additionally, the retrospective validation study of 39 patients diagnosed with LGIN indicated that PRKDC mutations, in addition to TP53 mutations, may drive LGIN progression to HGIN or EGC. In conclusion, the current study unveils the genomic evolution across the Correa cascade of intestinal-type gastric cancer, elucidates the underlying molecular mechanisms of gastric carcinogenesis, and provides some evidence for potential personalized gastric cancer surveillance.

Confocal laser endomicroscopy for gastric neoplasm.

Confocal laser endomicroscopy (CLE) is a novel endoscopic modality that provides real-time histological information via high-resolution magnified view of the mucosa. CLE has a higher sensitivity, specificity, and diagnostic accuracy in detecting atrophic gastritis as compared to chromoendoscopy and narrow-band imaging. It can even predict low-grade and high-grade intraepithelial neoplasia by analyzing gastric pit patterns. CLE may have some advantages over the standard biopsy protocol, such as higher diagnostic yield and fewer biopsy requirements. Its diagnostic accuracy in detecting superficial gastric cancer is higher than that of white-light endoscopy. Inherent limitations, such as a narrow field of vision, can be surpassed by technological advancements and integration with other detection methods. Artificial intelligence holds promise in automated analysis of histopathological images. Thus, CLE can be helpful in screening for early gastric cancer and may help reduce the risk of complications from repeated biopsies, such as mucosal damage, bleeding, and infection.

Chicken swarm algorithm with deep convolutional neural network based tongue image analysis for gastric cancer classification

Tongue images (the size, shape, and colour of tongue and the thickness, colour, and moisture content of tongue coating), reflecting the medical condition of entire body based on the model of traditional Chinese medicine (TCM) are extremely utilized in China for millions of years. Gastric cancer (GC) is great lethal kind of cancer in countries and societies. The screening and analysis of GC yet depend on gastroscopy, however its application was significantly restricted due to its invasive, maximum rate and the requirement for expert endoscopists. Early recognition in GC patients and direct treatment contribute significantly to safety for health. Consequently, this study introduces a Chicken Swarm Algorithm with Deep learningbased Tongue Image Analysis for Gastric Cancer Classification (CSADL-TIAGCC) system. The projected CSADL-TIAGCC approach studies the input tongue images for the identification and classification of GC. To accomplish this, the CSADL-TIAGCC system uses improved U-Net segmentation approach. Besides, residual network (ResNet-34) model-based feature extractor is used. Furthermore, long short term memory (LSTM) approach was exploited for GC classification and its hyperparameters are selected by the CSA. The simulation outcome of the CSADL-TIAGCC algorithm was examined under tongue image database. The experimental outcomes illustrate the enhanced results of the CSADL-TIAGCC technique with respect of different evaluation measures.

HCMV detection in Asian gastric cancer RNA-seq data sets and clinical validation in Indian GC patients reveals the HCMV-GC specific gene signatures.

Gastric cancer (GC) prevalence is very high in the Asian population. Oncogenic viruses play a crucial role in the progression of different types of cancers. Through reanalysis of clinical RNA-seq data sets derived from Asian GC patients, this study identified the presence of human cytomegalovirus (HCMV) in Asian GC tumors, next to the well-studied association of EBV. Clinical recruitment of the Indian GC cohort and screening for HCMV presence identified a 14.28% occurrence, similar to that observed in the bioinformatics analysis. A combinatorial approach of rank-based meta-analysis and ranking of groups based on an expectation-maximization algorithm identified that the upregulated LINC02864 and MAGEA10 correlated with poor survival of GC patients and downregulated tumor suppressor genes enriching for gastric acid secretion pathway to be associated with HCMV-positive GC patients, revealing the progressive role of HCMV infection in GC. Genes that discriminate between different stages of GC were identified through feature selection implemented in a machine-learning approach. LTF and KLK10 expressions were found to be specifically dysregulated by HCMV and can also indicate the GC stages. The results of this study will guide future studies to identify the functional role of these genes in the HCMV-associated GC.IMPORTANCENearly 75% of gastric cancer (GC) cases reported globally are from the Asian population. Most existing public databases, such as TCGA, comprise only a fractional portion of data derived from Asian ancestry. This study identified EBV and human cytomegalovirus (HCMV)'s higher detection in GC patients. The presence and role of EBV associated with GC are well-known, and the observation of HCMV prompted us to validate the findings in a small cohort of 40 Indian GC patients. We observed a 14.28% occurrence of HCMV in the Indian cohort, similar to that observed from next-generation sequencing. A combinatorial approach of rank-based meta-analysis and ranking of groups based on an expectation-maximization algorithm identified that the upregulated LINC02864 and MAGEA10 correlated with poor survival of GC patients and downregulated tumor suppressor genes enriching for gastric acid secretion pathway to be associated with HCMV-positive GC patients, revealing the progressive role of HCMV infection in GC.

The spatiotemporal associations between esophageal and gastric cancers provide evidence for its joint endoscopic screening in China: a population-based study

BackgroundThe spatiotemporal epidemiological evidence supporting joint endoscopic screening for esophageal cancer (EC) and gastric cancer (GC) remains limited. This study aims to identify combined high-risk regions for EC and GC and determine optimal areas for joint and separate endoscopic screening.MethodsWe analyzed the association of incidence trends between EC and GC in cancer registry areas across China from 2006 to 2016 using spatiotemporal statistical methods. Based on these analyses, we divided different combined risk regions for EC and GC to implement joint endoscopic screening.ResultsFrom 2006 to 2016, national incidence trends for both EC and GC showed a decline, with an average annual percentage change of -3.15 (95% confidence interval [CI]: -5.33 to -0.92) for EC and -3.78 (95% CI: -4.98 to -2.56) for GC. A grey comprehensive correlation analysis revealed a strong temporal association between the incidence trends of EC and GC, with correlations of 79.00% (95% CI: 77.85 to 80.14) in males and 77.62% (95% CI: 76.50 to 78.73) in females. Geographic patterns of EC and GC varied, demonstrating both homogeneity and heterogeneity across different regions. The cancer registry areas were classified into seven distinct combined risk regions, with 33 areas identified as high-risk for both EC and GC, highlighting these regions as priorities for joint endoscopic screening.ConclusionThis study demonstrates a significant spatiotemporal association between EC and GC. The identified combined risk regions provide a valuable basis for optimizing joint endoscopic screening strategies for these cancers.

Gastric Cancer Screening: Intention to Adhere and Patients' Perspective.

Gastric cancer (GC) is the third cause of cancer mortality worldwide. A screening strategy that combines an upper gastrointestinal endoscopy (UGIE) with a screening colonoscopy may be cost-effective in intermediate-risk regions. This study aimed to evaluate the intention to adhere to combined endoscopic screening and assess knowledge of GC symptoms, risk factors, and barriers to screening. Cross-sectional study enrolling individuals eligible for CRC screening in northern Portugal, where a populational fecal occult blood test (FOBT) program is implemented. The validated PERCEPT-PREVENT tool was applied across three groups: (a) not yet invited to CRC screening, (b) FOBT-positive referred to colonoscopy, and (c) primary colonoscopy screening. A high acceptance rate was observed for combined endoscopic screening (94%; n = 264) [not yet invited to CRC screening 98% (n = 90) vs. FOBT-positive referred to colonoscopy 90% (n = 103) vs. primary colonoscopy 97% (n = 71); p = 0.017], with the vast majority reporting intention to adhere in the setting of full reimbursement (97%; n = 255). Most respondents were unaware of any possible GC symptom (76%; n = 213), risk factor (73%; n = 205), and UGIE-related complication (85%; n = 237). Regular follow-up with the primary care physician (Odds Ratio (OR) 27.59, 95% confidence interval (CI) 2.99-254.57), lower perceived negative health consequences of UGIE (OR 1.40, 95% CI 1.13-1.74), and lower perceived financial burden (OR 2.46, 95% CI 1.04-5.85) were the only factors independently associated with a higher intention to undergo combined screening. Willingness to undergo combined endoscopic screening was notably high and positively impacted by lower perceived barriers. Additional efforts should be undertaken to improve levels of digestive health literacy.

TRIP13 regulates progression of gastric cancer through stabilising the expression of DDX21

GC (Gastric cancer) is one of the most common malignant tumours, with over 95% of gastric cancer patients being adenocarcinoma and most gastric cancer patients having no apparent symptoms in the early stages. Finding biomarkers for early screening of gastric cancer and exploring new targets for gastric cancer treatment are urgent problems to be solved in the treatment of gastric cancer, with significant clinical outcomes for the survival rate of gastric cancer patients. The AAA+ family ATPase thyroid hormone receptor-interacting protein 13 (TRIP13) has been reported to play an essential role in developing various tumours. However, the biological function and molecular mechanism of TRIP13 in gastric cancer remain unclear. This study confirms that TRIP13 is highly expressed in gastric cancer tissue samples and that TRIP13 participates in the proliferation, migration, invasion in vitro, and tumourigenesis and metastasis in vivo of gastric cancer cells. Mechanistically, this study confirms that TRIP13 directly interacts with DDX21 and stabilises its expression by restraining its ubiquitination degradation, thereby promoting gastric cancer progression. Additionally, histone deacetylase 1 (HDAC1) is an upstream factor of TRIP13, which could target the TRIP13 promoter region to promote the proliferation, migration, and invasion of gastric cancer cells. These results indicate that TRIP13 serve is a promising biomarker for the treating of gastric cancer patients, and the HDAC1-TRIP13/DDX21 axis might provide a solid theoretical basis for clinical treatment of gastric cancer patients.

The diagnostic value of serum trefoil factor 3 and pepsinogen combination in chronic atrophic gastritis: a retrospective study based on a gastric cancer screening cohort in the community population

Background Chronic atrophic gastritis (CAG) is an important precursor of gastric cancer(GC), and there is currently a lack of reliable non-invasive diagnostic markers. This study aims to find a biomarker for non-invasive screening of CAG in the community. Methods A total of 540 individuals were enrolled (test set = 385, validation set = 155). ROC curve analysis was used to evaluate the diagnostic significance of serum Trefoil Factor 3 (TFF3) alone or in combination with pepsinogen (PG) for CAG in the test and validation set. Furthermore, the diagnostic value of TFF3 and PG in different Helicobacter pylori (H. pylori) infection states was studied. Results When compared with chronic superficial gastritis (CSG), the expression level of serum TFF3 in the CAG was higher (27 ng/ml vs 19.61, P < 0.001). ROC curve analysis found that the sensitivity, specificity, and area under the curve (AUC) of CAG diagnosis using serum TFF3 alone at the optimal cut-off value of 26.55 ng/ml were 0.529, 0.87, and 0.739, respectively. When TFF3 was combined with The Ratio of PGI to PGII (PGR), the AUC and specificity reached 0.755 and 0.825, respectively. TFF3 individual or combined with PGR had good predictive value, especially in the H. Pylori negative patients. Conclusion TFF3 combined with PGR can effectively predict CAG, especially in patients with H. pylori negative.

The road to a world-unified approach to the management of patients with gastric intestinal metaplasia: a review of current guidelines

ObjectiveDuring the last decade, the management of gastric intestinal metaplasia (GIM) has been addressed by several distinct international evidence-based guidelines. In this review, we aimed to synthesise these guidelines and...