• Title, Summary, Keyword: gastric precancerous lesions

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Does treatment of Helicobacter Pylori Infection Reduce Gastric Precancerous Lesions?

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Mojtahedi, Kourosh;Sokhanvar, Homayoon;Askari, Kourosh;Shafaeizadeh, Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1571-1574
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    • 2015
  • Background: Treatment of Helicobacter pylori (H. pylori) decreases the prevalence of gastric cancer, and may inhibit gastric precancerous lesions progression into gastric cancer. The aim of this study was to determine the effect of treatment on subsequent gastric precancerous lesion development. Materials and Methods: We prospectively studied 27 patients who had low grade dysplasia at the time of enrollment, in addition to dysplasia atrophic gastritis and intestinal metaplasia observed in all patients. All were prescribed quadruple therapy to treat H. Pylori infection for 10 days. Patients underwent endoscopy with biopsy at enrollment and then at follow up two years later. Biopsy samples included five biopsies from the antrum of lesser curvature, antrum of greater curvature, angularis, body of stomach and fundus. Results of these biopsies were compared before and after treatment. Results: Overall, the successful eradication rate after two years was 15/27 (55.6%). After antibiotic therapy, the number of patients with low grade dysplasia decreased significantly (p=0.03), also with reduction of the atrophic lesions (p=0.01), but not metaplasia. Conclusions: Treatment of H. pylori likely is an effective therapy in preventing the development of subsequent gastric premalignant lesions.

Screening of Precancerous Gastric Lesions by Serum Pepsinogen, Gastrin-17, Anti-Helicobacter Pylori and Anti-Caga Antibodies in Dyspeptic Patients over 50 years Old in Guilan Province, North of Iran

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Rajpout, Yaghoub;Hasandokht, Tolou
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7635-7638
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    • 2014
  • Background: The aim of this study was to investigate the value of serum gastric markers to differentiate between patients with precancerous lesions and nonatrophic chronic gastritis. Materials and Methods: Serum samples of 128 patients with dyspepsia who were candidates for endoscopic examination were tested for pepsinogen (PG I and PG II), PG I/II ratio, gastrin 17(G-17), anti-Helicobacter pylori (anti-H pylori ) and anti-CagA antibodies. Two sample t-tests, chi-square tests and Pearson's correlation analyses were used for analysis using SPSS (version 20). Results: PGI, PG I/II ratio values were decreased significantly in the precancerous lesion group (0.05, 0.001 respectively). The frequency of H pylori infection was significantly (p=0.03) different between the two groups ofthe study. Conclusions: We suggest PGI and the PG I/II ratio as valuable markers for screening of premalignant gastric lesions.

Classification and Clinical Implications of Precancerous Lesions in the Stomach (위에서 전암병변의 분류와 임상적 의의)

  • Kim, Kyoung-Mee
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.46-50
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    • 2009
  • During carcinogenesis, precancers (premalignant lesions) are the morphologically identifiable lesions that precede invasive cancers. In theory, the successful treatment of precancers would result in the eradication of most human cancers. Despite the importance of these lesions, there has been no effort to list and classify all of the precancers. In 2001, the NCI sponsored a workshop on the classification of precancers. When considering all the possible classes of precancers, it is worth noting that not all precancers are neoplastic. In fact, precancers need not progress to cancer, and precancerous lesions often have a high rate of regression. Thus, the following five classes were adopted: 1) acquired microscopic precancers; 2) acquired large lesions with microscopic atypia; 3) Precursor lesions occurring with inherited hyperplastic syndromes that progress to cancer; 4) acquired diffuse hyperplasias and diffuse metaplasias; and 5) currently unclassified entities. In this review paper, precancerous lesions of the stomach are classified and their clinical significance is described.

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Gastric Precancerous Lesions in First Degree Relatives of Patients with Known Gastric Cancer: a Cross-Sectional Prospective Study in Guilan Province, North of Iran

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Baghaei, Seyed Mohammad;Yousefi-Mashhoor, Mahmood;Naghipour, Mohammad Reza;Sanaei, Omid;Naghdipour, Misa;Shafighnia, Shora;Atrkar-Roushan, Zahra
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1779-1782
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    • 2012
  • Background & Objectives: In patients with gastric cancer, the most frequently reported family history of cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerous lesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with those of individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons more than 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmed adenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoing upper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. All subjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in the cancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001). Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group (P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia were shown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity. Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patients in Iran.

Esophageal/Gastric Cancer Screening in High-risk Populations in Henan Province, China

  • Lu, Yu-Fei;Liu, Zhi-Cai;Li, Zhong-Hong;Ma, Wen-Hao;Wang, Fu-Rang;Zhang, Ya-Bing;Lu, Jian-Bang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1419-1422
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    • 2014
  • Objective: To summarize the endoscopic screening findings in high-risk population of esophageal and gastric carcinoma and analyze influential factors related to screening. Methods: In seven selected cities and counties with high incidences of esophageal carcinoma, people at age of 40-69 were set as the target population. Those with gastroscopy contradictions were excluded, and all who were voluntary and willing to comply with the medical requirements were subjected to endoscopic screening and histological examination for esophageal, gastric cardia and gastric carcinoma in accordance with national technical manual for early detection and treatment of cancer. Results: In three years, 36,154 people were screened, and 16,847 (46.60%) cases were found to have precancerous lesions. A total of 875 cases were found to have cancers (2.42%), and among them 739 cases had early stage with an early diagnosis rate is 84.5%. Some 715 patients underwent prompt treatment and the success rate was 81.8%. Conclusions: In a high-risk population of esophageal and gastric carcinoma, it is feasible to implement early detection and treatment by endoscopic screening. Screening can identify potential invasive carcinoma, early stage carcinoma and precancerous lesions, improving efficacy through early detection and treatment. The exploratory analysis of related influential factors will help broad implementation of early detection and treatment for esophageal and gastric carcinoma.

Helicobacter pylori Eradication Reduces the Metachronous Recurrence of Gastric Neoplasms by Attenuating the Precancerous Process

  • Jung, Da Hyun;Kim, Jie-Hyun;Lee, Yong Chan;Lee, Sang Kil;Shin, Sung Kwan;Park, Jun Chul;Chung, Hyun Soo;Kim, Hyunki;Kim, Hoguen;Kim, Yong Hoon;Park, Jae Jun;Youn, Young Hoon;Park, Hyojin
    • Journal of Gastric Cancer
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    • v.15 no.4
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    • pp.246-255
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    • 2015
  • Purpose: The importance of Helicobacter pylori eradication after endoscopic resection (ER) of gastric neoplasms remains controversial. In this study, we clarified the importance of H. pylori eradication for metachronous lesions after ER. Materials and Methods: This study included 3,882 patients with gastric neoplasms who underwent ER. We included patients infected with H. pylori who received eradication therapy. Among them, 34 patients with metachronous lesions after ER and 102 age- and sex-matched patients (nonmetachronous group) were enrolled. Background mucosal pathologies such as atrophy and intestinal metaplasia (IM) were evaluated endoscopically. The expression levels of CDX1, CDX2, Sonic hedgehog (SHH), and SOX2 were evaluated based on H. pylori eradication and the development of metachronous lesions. Results: The eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.036). Open-type atrophy (P=0.003) and moderate-to-severe IM (P=0.001) occurred more frequently in the metachronous group. In patients with an initial diagnosis of dysplasia, the eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.002). In addition, open-type atrophy was more frequent in the metachronous group (P=0.047). In patients with an initial diagnosis of carcinoma, moderate-to-severe IM occurred more frequently in the metachronous group (P=0.003); however, the eradication failure rate was not significantly different between the two groups. SHH and SOX2 expression was increased, and CDX2 expression was decreased in the nonmetachronous group after eradication (P<0.05). Conclusions: Open-type atrophy, moderate-to-severe IM, and H. pylori eradication failure were significantly associated with metachronous lesions. However, eradication failure was significantly associated with dysplasia, but not carcinoma, in the metachronous group. Thus, H. pylori eradication may play an important role in preventing metachronous lesions after ER for precancerous lesions before carcinomatous transformation.

Microsatellite Instability of Nuclear and Mitochondrial DNAs in Gastric Carcinogenesis

  • Lee, Jae-Ho;Kim, Dae-Kwang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8027-8034
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    • 2014
  • Genetic instability contributes to the development and progression of gastric cancer, one of the leading causes of cancer death worldwide. Microsatellite instability (MSI) has been hypothesized to be involved in carcinogenesis, althgough its mechanisms and exact roles in gastric cancer remain largely unknown. Our aim was to identify associated clinicopathological characteristics and prognostic value of MSI in gastric cancer and precancerous lesions including gastritis, metaplasia, dysplasia, and adenoma. Because mitochondrial DNA has a different genetic system from nuclear DNA, the results of both nuclear MSI and mitochondrial MSI in gastric cancer were reviewed. This review provides evidence that genetic instability of nuclear and mitochondrial DNAs contributes to early stages of gastric carcinogenesis and suggests possible roles in predicting prognosis.

A Case of Gastric Adenoma in a Maltese Dog (말티즈 견에서 발생한 위 선종 증례)

  • Eom, Na-Young;Lee, Hee-Chun;Lee, Seung-Yong;Jang, Hyo-Mi;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.370-373
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    • 2015
  • A 10-year-old, intact female, Maltese dog was presented with a two weeks history of vomiting, anorexia and weight loss. Hematologic analysis revealed mild leukocytosis and increased liver enzyme. Gaseous dilation of small intestine and hyperechoic nodules of hepatic lobes were revealed on the imaging studies. Liver biopsy was performed through laparotomy and histopathologic results revealed liver cirrhosis with precancerous lesions. Two days later, endoscopy was performed and histopathologic results of the specimens taken by endoscopic biopsy showed gastric adenoma. The gastric surgery was not performed by the owner's request. The patient died after 60 days of diagnosis of gastric adenoma. This case describes clinical features, imaging studies, endoscopic features and histopathologic characteristics of gastric adenoma in a Maltese dog.

Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

  • Shafaghi, Afshin;Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Sharafkhah, Maryam;Mesbah, Alireza;Askari, Kurosh;Geranmayeh, Siamak;Mehrvarz, Alireza;Souti, Fatemeh;Sokhanvar, Homayoon;Fakhrieh, Saba;Aminian, Keyvan;Yousefi-Mashhour, Mahmud;Khosh-Sorur, Mahmud;Rasoulian, Javid
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3931-3936
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    • 2013
  • Background: Iran is a country with very high incidences of stomach cancer, especially in Northern parts. Here we assessed prognostic value of serum screening biomarkers among people >50 years old for early detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran. Methods: A cross-sectional population-based survey was conducted on 1,390 residents of Lashtenasha city with the mean age (SD) of 61.8 (9.02) years old (50.8% females) to assess the association of gastrin and the pepsinogen (PG) I/II ratio with premalignant gastric lesions. Blood samples were taken for CBC, blood group, and serologic exams (PGI, PGII, and gastrin 17) from each subject. Expert gastroenterologists performed upper GI endoscopy and ROC curves were generated to determine appropriate cutoff points. Results: Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose atrophy and intestinal metaplasia, a significantly higher AUC was observed for the PGI/PGII ratio (70 and 72%, respectively) compared to the PGI (56, 55%), PGII (63, 64%) and gastrin (59, 61%) (all p<0.001). Conclusions: Biomarker tests such as the PGI/II ratio can be used in the screening and diagnosis of subjects at high gastric cancer risk in our region.

Endoscopic Findings in a Mass Screening Program for Gastric Cancer in a High Risk Region - Guilan Province of Iran

  • Mansour-Ghanaei, Fariborz;Sokhanvar, Homayoon;Joukar, Farahnaz;Shafaghi, Afshin;Yousefi-Mashhour, Mahmud;Valeshabad, Ali Kord;Fakhrieh, Saba;Aminian, Keyvan;Ghorbani, Kambiz;Taherzadeh, Zahra;Sheykhian, Mohammad Reza;Rajpout, Yaghoub;Mehrvarz, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1407-1412
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    • 2012
  • Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.