T2067 Prospective Analysis of Metachronous Early Gastric Cancer in High Risk Patients After H. pylori Eradication

2008 ◽  
Vol 134 (4) ◽  
pp. A-612
Author(s):  
Akiko Shiotani ◽  
Noriya Uedo ◽  
Tomoari Kamada ◽  
Hiroyasu Iishi ◽  
Masaharu Tatsuta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Early Gastric Cancer ◽  
Prospective Analysis ◽  
High Risk Patients ◽  
Risk Patients ◽  
H Pylori

scholarly journals HELICOBACTER PYLORI CHRONIC GASTRITIS ON PATIENTS WITH PREMALIGNANT CONDITIONS: OLGA AND OLGIM EVALUATION AND SERUM BIOMARKERS PERFORMANCE

2021 ◽  
Vol 58 (1) ◽  
pp. 39-47
Author(s):  
Maria Clara Freitas COELHO ◽  
Henrique Gomes RIBEIRO ◽  
Celio Geraldo de Oliveira GOMES ◽  
Frederico Passos MARINHO ◽  
Alfredo J A BARBOSA ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Chronic Gastritis ◽  
Serum Biomarkers ◽  
Premalignant Lesions ◽  
High Risk Patients ◽  
Grading Systems ◽  
Risk Patients ◽  
H Pylori ◽  
Sensitivity Specificity

ABSTRACT BACKGROUND: H. pylori chronic atrophic gastritis is a premalignant lesion, and its staging, according to OLGA and OLGIM systems aims to identify patients at increased risk of developing gastric cancer and optimize their follow-up. GastroPanel®, serum biomarkers panel including pepsinogen I (PGI), pepsinogen II (PGII), Gastrin 17 (G17) and anti- H. pylori antibodies is a noninvasive test for adenocarcinoma risk assessment in chronic H. pylori gastritis patients. OBJECTIVE: Prospective study to evaluate the concordance between OLGA and OLGIM grading systems, as well as to evaluate GastroPanel´s performance in patients with premalignant lesions secondary to H. pylori chronic gastritis in Brazil. METHODS: Patients with H. pylori chronic gastritis with premalignant lesions confirmed by histology were recruited from the gastrointestinal clinic of a University Hospital. All participants underwent endoscopic examination with biopsies which were reported according to updated Sydney system and premalignant lesions grading systems (OLGA and OLGIM). Blood samples were collected for biomarkers serological analysis (GastroPanel®, Biohit, Helsinki, Finland). The cut off values used to define high risk patients were those recommended by the manufacturer: PGI ≤30 µm/L and PGI/PGII ≤3. RESULTS: 41 patients were recruited: 28 women, 13 men, mean age 67.3 (47-89, SD: 9.6) years. By OLGA system, were obtained: OLGA 0 (n=1), OLGA I (n=7), OLGA II (n=17), OLGA III (n=9), and OLGA IV (n=7). By OLGIM system, were obtained: OLGIM 0 (n=14), OLGIM I (n=5), OLGIM II (n=10), OLGIM III (n=10), and OLGIM IV (n=2). Regarding histological staging among patients staged as low risk (OLGA/OLGIM 0, I and II) and high risk (OLGA/OLGIM III and IV) for gastric cancer development, the concordance rate found between both classifications was 85.4%. Considering high risk patients, those patients thus included in at least one of the systems the final distribution of our sample considered 24 low-risk and 17 high-risk patients for the development of gastric cancer. To determine by GastroPanel® whether the patient would be at low or high risk of developing gastric cancer, PGI showed a sensitivity, specificity and accuracy of 0.47 (95%CI: 0.26-0.69), 0.67 (95%CI: 0.47-0.82), and 0.58 (95%CI: 0.43-0.72), respectively, while PGI/PGII showed sensitivity, specificity and accuracy of 0.06 (95%CI: 0.01-0.27), 0.83 (95%CI: 0.64-0.93) and 0.51 (95%CI: 0.36-0.66), respectively. CONCLUSION: The histological classifications OLGA and OLGIM presented a substantial concordance rate among themselves. Simultaneous use of both histological classification systems increased the identification’s rate of high-risk patients. Biomarker analysis was not effective to distinguish low to high risk patients in the studied population. Further studies are needed to validate its use in clinical practice in Brazil.

scholarly journals Accuracy of upper endoscopies with random biopsies to identify patients with gastric premalignant lesions who can safely be exempt from surveillance

2021 ◽  
Vol 24 (3) ◽  
pp. 680-690
Author(s):  
Michiel C. Mommersteeg ◽  
Stella A. V. Nieuwenburg ◽  
Wouter J. den Hollander ◽  
Lisanne Holster ◽  
Caroline M. den Hoed ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Low Risk ◽  
Premalignant Lesions ◽  
High Risk Patients ◽  
European Guidelines ◽  
Progression Of Disease ◽  
Risk Patients ◽  
Progression Risk

Abstract Introduction Guidelines recommend endoscopy with biopsies to stratify patients with gastric premalignant lesions (GPL) to high and low progression risk. High-risk patients are recommended to undergo surveillance. We aimed to assess the accuracy of guideline recommendations to identify low-risk patients, who can safely be discharged from surveillance. Methods This study includes patients with GPL. Patients underwent at least two endoscopies with an interval of 1–6 years. Patients were defined ‘low risk’ if they fulfilled requirements for discharge, and ‘high risk’ if they fulfilled requirements for surveillance, according to European guidelines (MAPS-2012, updated MAPS-2019, BSG). Patients defined ‘low risk’ with progression of disease during follow-up (FU) were considered ‘misclassified’ as low risk. Results 334 patients (median age 60 years IQR11; 48.7% male) were included and followed for a median of 48 months. At baseline, 181/334 (54%) patients were defined low risk. Of these, 32.6% were ‘misclassified’, showing progression of disease during FU. If MAPS-2019 were followed, 169/334 (51%) patients were defined low risk, of which 32.5% were ‘misclassified’. If BSG were followed, 174/334 (51%) patients were defined low risk, of which 32.2% were ‘misclassified’. Seven patients developed gastric cancer (GC) or dysplasia, four patients were ‘misclassified’ based on MAPS-2012 and three on MAPS-2019 and BSG. By performing one additional endoscopy 72.9% (95% CI 62.4–83.3) of high-risk patients and all patients who developed GC or dysplasia were identified. Conclusion One-third of patients that would have been discharged from GC surveillance, appeared to be ‘misclassified’ as low risk. One additional endoscopy will reduce this risk by 70%.

scholarly journals A Tumor Progression Related 7-Gene Signature Indicates Prognosis and Tumor Immune Characteristics of Gastric Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Fen Liu ◽  
Zongcheng Yang ◽  
Lixin Zheng ◽  
Wei Shao ◽  
Xiujie Cui ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Cancer Progression ◽  
Risk Score ◽  
Risk Model ◽  
Cox Regression ◽  
Hub Genes ◽  
Cox Regression Analysis ◽  
High Risk Patients ◽  
Risk Patients

BackgroundGastric cancer is a common gastrointestinal malignancy. Since it is often diagnosed in the advanced stage, its mortality rate is high. Traditional therapies (such as continuous chemotherapy) are not satisfactory for advanced gastric cancer, but immunotherapy has shown great therapeutic potential. Gastric cancer has high molecular and phenotypic heterogeneity. New strategies for accurate prognostic evaluation and patient selection for immunotherapy are urgently needed.MethodsWeighted gene coexpression network analysis (WGCNA) was used to identify hub genes related to gastric cancer progression. Based on the hub genes, the samples were divided into two subtypes by consensus clustering analysis. After obtaining the differentially expressed genes between the subtypes, a gastric cancer risk model was constructed through univariate Cox regression, least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analysis. The differences in prognosis, clinical features, tumor microenvironment (TME) components and immune characteristics were compared between subtypes and risk groups, and the connectivity map (CMap) database was applied to identify potential treatments for high-risk patients.ResultsWGCNA and screening revealed nine hub genes closely related to gastric cancer progression. Unsupervised clustering according to hub gene expression grouped gastric cancer patients into two subtypes related to disease progression, and these patients showed significant differences in prognoses, TME immune and stromal scores, and suppressive immune checkpoint expression. Based on the different expression patterns between the subtypes, we constructed a gastric cancer risk model and divided patients into a high-risk group and a low-risk group based on the risk score. High-risk patients had a poorer prognosis, higher TME immune/stromal scores, higher inhibitory immune checkpoint expression, and more immune characteristics suitable for immunotherapy. Multivariate Cox regression analysis including the age, stage and risk score indicated that the risk score can be used as an independent prognostic factor for gastric cancer. On the basis of the risk score, we constructed a nomogram that relatively accurately predicts gastric cancer patient prognoses and screened potential drugs for high-risk patients.ConclusionsOur results suggest that the 7-gene signature related to tumor progression could predict the clinical prognosis and tumor immune characteristics of gastric cancer.

Value of Gastric Juice Carcinoembryonic Antigen in Identifying High-Risk Patients for Gastric Cancer

Oncology ◽  
1988 ◽  
Vol 45 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Masaharu Tatsuta ◽  
Hiroyasu Iishi ◽  
Hisako Yamamura ◽  
Shigeru Okudo
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Carcinoembryonic Antigen ◽  
Gastric Juice ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals A SEER population analysis of stage IB resected gastric cancer: Who can benefit from adjuvant therapy?

2019 ◽  
Vol 5 (suppl) ◽  
pp. 122-122
Author(s):  
Yue Wang
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Clinical Decision Making ◽  
Family Income ◽  
Population Analysis ◽  
Low Risk ◽  
High Risk Patients ◽  
Stage Ib ◽  
Risk Patients

122 Background: The benefit of adjuvant therapy (AT) remains controversial in stage IB gastric cancer (GC). This study aimed to offer a reference for the rational indications of AT. Methods: We retrospectively included 1935 stage IB GC patients who experienced curative surgery from the SEER database between 2004 and 2015. These patients were allocated into two groups: Group AT and Group surgery alone (Group SA). Risk factors associated with AT were examined using univariate/multivariate analyses. A nomogram to project overall survival (OS) of AT was established and internally validated. Results: Five variables, which were significantly related with OS of AT, were incorporated in the nomogram. These variables were sex, age, examined lymph nodes, tumor site, and family income. The C-index of the model was 0.636 and the calibration curve showed that the anticipated values were in accordance with the actual values. The decision curve demonstrated that the optimal clinical impact was achieved when the threshold possibility was 0-47%. Then the entire cohort was separated into low-risk (≤107 points) as well as high-risk ( > 107 points) groups based on the projected 5-year OS. Group SA revealed a significantly poorer OS than Group AT for high-risk patients (P < 0.001); on the other hand, there was a comparable OS for low-risk patients (P = 0.067). Conclusions: We have developed an effective, intuitional and applied prognostic tool based on nomogram to clinical decision-making. For stage IB GC after surgical resection, AT was only recommended for high-risk patients. However, AT may be dispensable for low-risk patients.

Su1245 - SOS: Save Our Stomachs! Detailed Gastric Mapping Versus Standard Endoscopy as Surveillance for Familial Gastric Cancer in High Risk Patients

2018 ◽  
Vol 154 (6) ◽  
pp. S-516
Author(s):  
Bryan F. Curtin ◽  
Udo Rudloff ◽  
Jonathan M. Hernandez ◽  
Martha Quezado ◽  
Theo Heller ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Familial Gastric Cancer ◽  
High Risk Patients ◽  
Risk Patients ◽  
Mapping Versus ◽  
Gastric Mapping

Predictive Factors for Metachronous Gastric Cancer in High-Risk Patients after Successful Helicobacter pylori Eradication

Digestion ◽  
2008 ◽  
Vol 78 (2-3) ◽  
pp. 113-119 ◽  
Author(s):  
Akiko Shiotani ◽  
Noriya Uedo ◽  
Hiroyasu Iishi ◽  
Yamanaka Yoshiyuki ◽  
Manabu Ishii ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
High Risk ◽  
Predictive Factors ◽  
High Risk Patients ◽  
Risk Patients ◽  
Metachronous Gastric Cancer

scholarly journals Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging

Gut ◽  
2020 ◽  
Vol 70 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Naohiro Yoshida ◽  
Hisashi Doyama ◽  
Tomonori Yano ◽  
Takahiro Horimatsu ◽  
Noriya Uedo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Early Gastric Cancer ◽  
Early Detection ◽  
Second Generation ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Risk Patients ◽  
Randomised Controlled ◽  
Suspicious Lesions

ObjectiveEarly detection of gastric cancer has been the topic of major efforts in high prevalence areas. Whether advanced imaging methods, such as second-generation narrow band imaging (2G-NBI) can improve early detection, is unknown.DesignThis open-label, randomised, controlled tandem trial was conducted in 13 hospitals. Patients at increased risk for gastric cancer were randomly assigned to primary white light imaging (WLI) followed by secondary 2G-NBI (WLI group: n=2258) and primary 2G-NBI followed by secondary WLI (2G-NBI group: n=2265) performed by the same examiner. Suspected early gastric cancer (EGC) lesions in both groups were biopsied. Primary endpoint was the rate of EGC patients in the primary examination. The main secondary endpoint was the positive predictive value (PPV) for EGC in suspicious lesions detected (primary examination).ResultsEGCs were found in 44 (1.9%) and 53 (2.3%; p=0.412) patients in the WLI and 2G-NBI groups, respectively, during primary EGD. In a post hoc analysis, the overall rate of lesions detected at the second examination was 25% (n=36/145), with no significant differences between groups. PPV for EGC in suspicious lesions was 13.5% and 20.9% in the WLI (50/371 target lesions) and 2G-NBI groups (59/282 target lesions), respectively (p=0.015).ConclusionThe overall sensitivity of primary endoscopy for the detection of EGC in high-risk patients was only 75% and should be improved. 2G-NBI did not increase EGC detection rate over conventional WLI. The impact of a slightly better PPV of 2G-NBI has to be evaluated further.Trial registration numberUMIN000014503.

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