Variability in the Endoscopist Detection Rate of Gastric Premalignant Conditions And Its Correlation With the Rate Of Missed Gastric Cancer During A Routine Esophagogastroduodenoscopy

Background CDH1 pathogenic variants (PV) cause the majority of inherited diffuse-gastric cancer (DGC), but have low detection rates and vary geographically. This study examines hereditary causes of DGC in patients from Ontario, Canada. Methods Eligible DGC cases at the Zane Cohen Centre (ZCC) underwent multi-gene panel or CDH1 single-site testing if they met 2015 International Gastric Cancer Linkage Consortium (IGCLC) criteria, isolated DGC <50 or family history suggestive of an inherited cancer syndrome. A secondary aim was to review all CDH1 families at the ZCC to assess cancer penetrance. Results 85 DGC patients underwent CDH1 (n=43) or multi-gene panel testing (n=42), and 15 (17.6%) PV or likely PV were identified. CDH1 detection rate was 9.4% (n=8/85), and 11% (n=7/65) using IGCLC criteria. No CDH1 PV identified in isolated DGC <40, but one PV identified in isolated DGC<50. Multi-gene panel from 42 individuals identified 9 PV (21.4%) including CDH1, STK11, ATM, BRCA2, MLH1 and MSH2. Review of 81 CDH1 carriers revealed that 10% had DGC (median age:48, range:38-59), 41% were unaffected (median age:53, range:26-89). Three families had lobular-breast cancer (LBC) only. Non-DGC/LBC malignancies included colorectal, gynecological, kidney/bladder, prostate, testicular and ductal breast. Conclusions Low detection rate of CDH1 in Ontario DGC patients. No CDH1 PV found in isolated DGC <40, but identified in isolated DGC<50. Multi-gene panels are recommended for all DGC under age 50, and those meeting the IGCLC criteria, given overlapping phenotype with other hereditary conditions. HDGC phenotype is evolving with a spectrum of non-DGC/LBC cancers.

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Mo1345 Cooperation of Multi-Disciplinary Team in Early Gastric Cancer Diagnosis Improves the Detection Rate of Early Gastric Cancer

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.621 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB464

Author(s):

Lianjun Di ◽

Huichao Wu ◽

Rong Zhu ◽

Hongping Li ◽

Haibo Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Cancer Diagnosis ◽

Detection Rate ◽

Multi Disciplinary Team

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Multi-disciplinary team for early gastric cancer diagnosis improves the detection rate of early gastric cancer

BMC Gastroenterology ◽

10.1186/s12876-017-0711-9 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 8

Author(s):

Lianjun Di ◽

Huichao Wu ◽

Rong Zhu ◽

Youfeng Li ◽

Xinglong Wu ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Cancer Diagnosis ◽

Detection Rate ◽

Multi Disciplinary Team

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Combined use of methylated reprimo cell-free DNA and pepsinogens for noninvasive detection of early gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.27 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 27-27

Author(s):

Alejandra Alarcon ◽

Wilda Olivares ◽

Maria Jose Maturana ◽

Andres Rodriguez ◽

Oslando Padilla ◽

...

Keyword(s):

Gastric Cancer ◽

Sensitivity And Specificity ◽

Detection Rate ◽

Low Grade ◽

Cell Free Dna ◽

Predictive Values ◽

Non Invasive ◽

Free Dna ◽

Combined Use ◽

Potential Biomarker

27 Background: Gastric cancer (GC) has been described as a multistep cascade of precursor lesions such as non-atrophic chronic gastritis (NACG), multiphocal atrophic gastritis (MAG), intestinal metaplasia (IM), low grade dysplasia (LGD) and high grade dysplasia (HGD) leading to early stages of GC (EGC). Currently, no non-invasive biomarkers for this progression are clinically available. We have previously identified a potential biomarker based on methylated Reprimo (RPRM) cell-free DNA (cfDNA) (Clin Cancer Res 2008;14:6264-9). In a cross-sectional study of 1,076 patients, we showed a sensitivity of 70.8% (95% CI: 60.3 to 81.3) and specificity of 74.3% (95% CI: 71.5 to 77) for methylated RPRM cfDNA, to distinguish NACG+MAG+IM+LGD vs HGD+EGC+AGC (Digestive Disease Week 2014 #108). However, the crude detection rate of EGC was only 46.6%. Here, we aim to explore the role of the combined use of methylated RPRM cfDNA and well stablished atrophy biomarkers such as pepsinogens, for non-invasive detection of EGC. Methods: A case-control study was performed including 237 patients (NACG:40; MAG:94; IM:55; LGD:11; HGD:5: EGC:15; AGC:17) scheduled for upper gastrointestinal endoscopy (UGIE). A heparinized venous blood sample was collected and methylated RPRM cfDNA and Immunoassays for Pepsinogen I and II were performed. Positive value was considered if methylated RPRM cfDNA > 0 copies/mL and PG I/II ratio <3.0 were found. Results: Overall sensitivity and specificity for the combined use of methylated RPRM cfDNA and PGI/II to distinguish NACG+MAG+IM+LGD vs HGD+EGC+AGC was 67.5% (95% CI: 50.2% to 81.9%) and 63% (95% CI: 55.9% to 69.7%), respectively. Positive and negative predictive values were 25.2% (95% CI: 17% to 34.9%) and 91.3% (95% CI: 85.3% to 95.4%), respectively. Importantly, crude detection rate for EGC increased from 46.6% to 86.7%. Conclusions: The combined use of methylated RPRM cfDNA and PGI/II reached similar sensitivity and specificity compared to methylated RPRM cfDNA alone to distinguish NACG+MAG+IM+LGD vs HGD+EGC+AGC. However, combined use of methylated RPRM cfDNA and PGI/II significantly improved the detection rate of EGC, a lesion with a curability rate over 95%.

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Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15521 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15521-e15521

Author(s):

Carlos Castaneda Altamirano ◽

Carolina Belmar Lopez ◽

Miluska Castillo Garcia ◽

Jais Nieves ◽

Julio Polo ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Risk Factor ◽

Cancer Patients ◽

Detection Rate ◽

Virulence Genes ◽

Virulence Gene ◽

Gastric Cancer Patients ◽

Tumoral Area ◽

Common Infections

e15521 Background: Helicobacter pylori (HP) infection is one of the most common infections worldwide and is a risk factor for gastric cancer (GC) development. This study was conducted to determinate the prevalence rate of HP as well as presence of vacA and cagA in gastric cancer samples from Peruvian patients. Methods: GC samples were prospectively collected from patients who went to surgery between April 2015 and November 2016. Three types of gastric samples were obtained from each patient: tumoral area (T), proximal healthy (P) and distal healthy tissue (D) samples. HP status through H&E was analyzed by a pathologist. DNA was extracted from tissue, and detection of colonization (ureA and hspA) and virulence genes (vacA and cagA) of HP was performed through quantitative PCR (qPCR). Results: A total of 183 patients were studied with a mean age of 64 years and 51.9% were men. 52.2% had a primary from antrum, 47.8% was HG 3 and 60% were diffuse. Presence of HP through H&E was found in 58.4% (n=107/183). Positive HP cases through qPCR were determinate with positivity of at least one ureA/hspA gene and was found in 89.6% (n=164/183). HP detection rate and its concentration were higher in D (ureA: 62.8%, n=115, [703.58±245.47pg]; hspA: 73.8%, n=135, [42.77±10.17pg]) than P (ureA: 59.0%, n=108, [539.69±121.32pg]; hspA: 71.0%, n=130, [31.90±8.64pg]) and T (ureA: 49.7%, n=91, [296.32±164.98pg]; hspA: 70.5%, n=129, [4.6±1.33pg]) (p<.001). Antrum location was associated to higher level of hspA expression (p=0.047). Neither histology (p=0.45) nor HG (p=0.2) was associated to level of hspA expression. qPCR detected HP in 75% (n=57/76) of cases without evidence of HP by pathology evaluation (H&E) (ICC: 0.77 vs 0.58). cagA virulence gene was detected in 95.8% (n=159/166) while vacAm allele in 85.5% (n=142/166) and vacAs allele in 96.8% (n=160/166). vacA+cagA- combination was found in 0.6% (n=1/166), vacA+cagA+ cases in 95.8% (n=159/166) and vacA-cagA- cases in 3.6% (n=3/166). Conclusions: Our results show a significant presence of HP in Peruvian gastric cancer patients and combination of vacA+/-cagA+/- virulence genes had particular patterns.

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Highly Sensitive Gold Nanoparticle Polymerase Chain Reaction in the Detection of Anaplastic Lymphoma Kinase-Positive Gastric Cancer from a Biopsy Specimen

Nanoscience and Nanotechnology Letters ◽

10.1166/nnl.2020.3128 ◽

2020 ◽

Vol 12 (4) ◽

pp. 498-505

Author(s):

Dan Zhang ◽

Zhaoxi Lu ◽

Bing Sun

Keyword(s):

Gastric Cancer ◽

Polymerase Chain Reaction ◽

Detection Rate ◽

Target Gene ◽

Malignant Tumors ◽

Chain Reaction ◽

Nano Gold ◽

Biopsy Tissue ◽

Pcr Technology ◽

Polymerase Chain

Gastric cancer is a malignant tumor that is originated from the epithelia of the gastric mucosa. Although the gastroscopic biopsy of suspicious gastric areas can provide better early-warning opportunities for patients with malignant tumors that result in achieving early diagnosis and treatment, many malignant tumors are still excluded due to atypical histology, sampling errors, nonspecific antibodies, and other reasons, which pose a threat to the physical and mental health of patients. Therefore, more sensitive and specific detection methods of gastric cancer are needed to improve the screening efficiency of gastroscopic biopsy. The sensitivity of nano PCR was 10 times higher than that of conventional PCR. In comparison with the conventional RT-PCR method, nano PCR technology can amplify brighter bands and identify higher gene expression levels for ALK weak positive gastric cancer in IHC, and improve the detection rate of clinical specimens with lower ALK staining. Therefore, nano-gold polymerase chain reaction used gold nanoparticle (nano-gold PCR) has high sensitivity and positive detection rate for ALK-positive gastric cancer identified by gastroscopy. When a low concentration was observed for the amplified gene, especially when the biopsy tissue was too small to carry out IHC staining, the target gene could be amplified more effectively. Therefore, nano PCR technology is proposed to be widely used in target gene detection of biopsy tissue to achieve better tumor screening.

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