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Montalvan-Sanchez EE, Norwood DA, Dougherty M, Beas R, Guranizo-Ortiz M, Ramirez-Rojas M, Morgan DR, Imperiale TF. Colorectal Cancer Screening Programs in Latin America: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2354256. [PMID: 38300621 PMCID: PMC10835514 DOI: 10.1001/jamanetworkopen.2023.54256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Importance Colorectal cancer (CRC) is a leading cause of cancer-related mortality globally, with increasing incidence and mortality in Latin America. CRC screening programs can reduce disease burden, but information on screening programs in Latin America is limited. Objective To describe characteristics (eg, type of program, uptake, neoplastic yield) of CRC screening programs in Latin America. Data Sources PubMed, Ovid MEDLINE, EMBASE, Cochrane, PsycINFO, Web of Science Core Collection, LILACS, and SciELO were searched from inception to February 2023. Relevant references from bibliographies, conference proceedings, and gray literature were considered. The search strategy included English, Spanish, and Portuguese terms. Study Selection Included were studies of CRC screening programs in Latin America using fecal immunochemical test (FIT) or colonoscopy as the primary screening method. Four reviewers independently assessed study eligibility based on titles, with review of abstracts and full texts as needed. Data Extraction and Synthesis Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed for data abstraction and quality assessment. Descriptive information was extracted, and data were pooled using a random-effects model. Main outcomes and Measures Program performance indicators included rates of participation and FIT positivity, adenoma detection rate (ADR), advanced adenoma detection rate (AADR), CRC detection rate, and colonoscopy quality indicators. Results There were 17 studies included from upper middle-income and high-income countries in Latin America with a total of 123 929 participants. Thirteen studies used FIT as the initial screening method, whereas 4 used screening colonoscopy. The participation rate in FIT-based programs was 85.8% (95% CI, 78.5%-91.4%). FIT positivity rates were 15.2% (95% CI, 9.6%-21.8%) for the 50-ng/mL threshold and 9.7% (95% CI, 6.8%-13.0%) for the 100-ng/mL threshold. For FIT-based studies, the pooled ADR was 39.0% (95% CI, 29.3%-49.2%) and CRC detection rate was 4.9% (95% CI, 2.6%-7.9%); for screening colonoscopy-based studies, the pooled ADR was 19.9% (95% CI, 15.5%-24.8%) and CRC detection rate was 0.4% (95% CI, 0.1%-0.8%). Conclusions and Relevance This systematic review and meta-analysis suggests that CRC screening in upper middle-income countries in Latin America is feasible, detecting rates of neoplasia comparable with those of high-income regions. Population-based screening programs should be developed or enhanced in these settings. There is a knowledge gap regarding feasibility and yield of screening programs in lower middle-income countries.
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Affiliation(s)
| | - Dalton A. Norwood
- Division of Preventive Medicine, The University of Alabama at Birmingham, Birmingham
| | - Michael Dougherty
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill
- UNC Rex Digestive Healthcare, Raleigh, North Carolina
| | - Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | | | | | - Douglas R. Morgan
- Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham
| | - Thomas F. Imperiale
- Division of Gastroenterology and Hepatology, Indiana University, Indianapolis
- Regenstrief Institute, Indianapolis, Indiana
- The Indiana University Simon Cancer Center, Indianapolis
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2
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Rifkin SB, Miller AK, Montalvan-Sanchez EE, Norwood DA, Martinez E, Waterboer T, Beasley TM, Dominguez RL, Williams SM, Morgan DR. Wood cookstove use is associated with gastric cancer in Central America and mediated by host genetics. Sci Rep 2023; 13:16515. [PMID: 37783717 PMCID: PMC10545771 DOI: 10.1038/s41598-023-42973-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023] Open
Abstract
Biomass cookstove food preparation is linked to aero-digestive cancers, mediated by ingested and inhaled carcinogens (e.g., heterocyclic amines, and polycyclic aromatic hydrocarbons). We investigated the association between gastric adenocarcinoma, wood cookstove use, H. pylori CagA infection and risk modification by variants in genes that metabolize and affect the internal dose of carcinogens. We conducted a population-based, case-control study (814 incident cases, 1049 controls) in rural Honduras, a high-incidence region with a homogeneous diet and endemic H. pylori infection, primarily with the high-risk CagA genotype. We investigated factors including wood cookstove use, H. pylori CagA serostatus, and 15 variants from 7 metabolizing genes, and the interactions between wood stove use and the genetic variants. Male sex (OR 2.0, 1.6-2.6), age (OR 1.04, 1.03-1.05), wood cookstove use (OR 2.3, 1.6-3.3), and CagA serostatus (OR 3.5, 2.4-5.1) and two SNPs in CYP1B1 (rs1800440 and rs1056836) were independently associated with gastric cancer in multivariate analysis. In the final multivariate model, a highly significant interaction (OR 3.1, 1.2-7.8) was noted between wood cookstove use and the rs1800440 metabolizing genotype, highlighting an important gene-environment interaction. Lifetime wood cookstove use associates with gastric cancer risk in the high-incidence regions of Central America, and the association is dependent on the rs1800440 genotype in CYP1B1. H. pylori CagA infection, wood cookstove use and the rs1800440 genotype, all of which are highly prevalent, informs who is at greatest risk from biomass cookstove use.
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Affiliation(s)
- Samara B Rifkin
- Department of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Anna K Miller
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Eleazar E Montalvan-Sanchez
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dalton A Norwood
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
- Division of Preventive Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Mark Beasley
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Ricardo L Dominguez
- Hospital de Occidente, Ministry of Health, Santa Rosa de Copan, Copan, Honduras
| | - Scott M Williams
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
- Department of Population and Quantitative Health Sciences and Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Douglas R Morgan
- Medicine and Epidemiology, UAB Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.
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Norwood DA, Montalvan-Sanchez EE, Corral JE, Estévez-Ordoñez D, Paredes AA, Domínguez LB, Rodríguez AA, Bravo LE, Morgan DR, Domínguez RL. Western Honduras Copán Population-Based Cancer Registry: Initial Estimates and a Model for Rural Central America. JCO Glob Oncol 2021; 7:1694-1702. [PMID: 34914550 PMCID: PMC8691495 DOI: 10.1200/go.21.00273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/21/2021] [Accepted: 11/17/2021] [Indexed: 12/09/2022] Open
Abstract
PURPOSE Population-based cancer registries (PBCRs) are critical for national cancer control planning, yet few low- and middle-income countries (LMICs) have quality PBCRs. The Central America Four region represents the principal LMIC region in the Western hemisphere. We describe the establishment of a PBCR in rural Western Honduras with first estimates for the 2013-2017 period. METHODS The Western Honduras PBCR was established through a collaboration of academic institutions and the Honduras Ministry of Health for collection of incident cancer data from public and private health services. Data were recorded using the Research Electronic Data Capture (REDCap) web-based platform with data monitoring and quality checks. Crude and age-standardized rates (ASRs) were calculated at the regional level, following WHO methodology. RESULTS The web-based platform for data collection, available ancillary data services (eg, endoscopy), and technical support from international centers (United States and Colombia) were instrumental for quality control. Crude cancer incidence rates were 112.2, 69.8, and 154.6 per 100,000 habitants overall, males, and females, respectively (excluding nonmelanoma skin cancer). The adjusted ASRs were 84.2, 49.6, and 118.9 per 100,000 overall habitants, males, and females, respectively. The most common sites among men were stomach (ASR 26.0, 52.4%), colorectal (ASR 5.11, 10.15%), and prostate (ASR 2.7, 5.4%). The most common sites in women were cervix (ASR 34.2, 36.7%), breast (ASR 11.2, 12.3%), and stomach (ASR 10.8, 11.7%). CONCLUSION The Copán-PBCR represents a successful model to develop cancer monitoring in rural LMICs. Innovations included the use of the REDCap platform and leverage of Health Ministry resources. This provides the first PBCR data for Honduras and the Central America Four and confirms that infection-driven cancers, such as gastric and cervical, should be priority targets for cancer control initiatives.
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Affiliation(s)
- Dalton Argean Norwood
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
- Universidad Nacional Autónoma de Honduras, School of Medicine, Honduras
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| | - Eleazar Enrique Montalvan-Sanchez
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
- Indiana University, Department of Medicine, Indianapolis, IN
| | - Juan E. Corral
- Division of Gatroenterology and Hepatology, Presbyterian Healthcare Services, Albuquerque, New Mexico
| | | | - Andrea A. Paredes
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
- Universidad Nacional Autónoma de Honduras, School of Medicine, Honduras
| | - Lucia B. Domínguez
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
| | - Aida A. Rodríguez
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
- Universidad Nacional Autónoma de Honduras, School of Medicine, Honduras
| | - Luis E. Bravo
- IACR Regional Representative for Latin America, International Agency for Research on Cancer, Lyon, France
- Departamento de Patología, Universidad del Valle, Cali, Colombia
| | - Douglas R. Morgan
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL
- Division of Gastroenterology, Hepatology and Nutrition, The University of Alabama at Birmingham, Birmingham, AL
| | - Ricardo L. Domínguez
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copán, Honduras
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Ornithine decarboxylase (ODC1) gene variant (rs2302615) is associated with gastric cancer independently of Helicobacter pylori CagA serostatus. Oncogene 2021; 40:5963-5969. [PMID: 34376808 PMCID: PMC8692072 DOI: 10.1038/s41388-021-01981-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023]
Abstract
The primary cause of gastric cancer is chronic infection with Helicobacter pylori (H. pylori), particularly the high-risk genotype cagA, and risk modification by human genetic variants. We studied 94 variants in 54 genes for association with gastric cancer, including rs2302615 in ornithine decarboxylase (ODC1), which may affect response to chemoprevention with the ODC inhibitor, eflornithine (difluoromethylornithine; DFMO). Our population-based, case-control study included 1366 individuals (664 gastric cancer cases and 702 controls) from Western Honduras, a high incidence region of Latin America. CagA seropositivity was strongly associated with cancer (OR = 3.6; 95% CI: 2.6, 5.1). The ODC1 variant rs2302615 was associated with gastric cancer (OR = 1.36; p = 0.018) in a model adjusted for age, sex, and CagA serostatus. Two additional single nucleotide polymorphisms (SNPs) in CASP1 (rs530537) and TLR4 (rs1927914) genes were also associated with gastric cancer in univariate models as well as models adjusted for age, sex, and CagA serostatus. The ODC1 SNP association with gastric cancer was stronger in individuals who carried the TT genotype at the associating TLR4 polymorphism, rs1927914 (OR = 1.77; p = 1.85 × 10-3). In conclusion, the ODC1 variant, rs2302615, is associated with gastric cancer and supports chemoprevention trials with DFMO, particularly in individuals homozygous for the T allele at rs1927914.
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Estevez-Ordonez D, Montalvan-Sanchez EE, Wong RE, Montalvan-Sanchez DM, Rodriguez-Murillo AA, Dominguez RL, Morgan DR. Health Barriers and Patterns of Gastric Cancer Care in Rural Central American Resource-Limited Settings. JAMA Oncol 2019; 4:1131-1133. [PMID: 29978182 DOI: 10.1001/jamaoncol.2018.2570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | | | | | | | | | | | - Douglas R Morgan
- Vanderbilt Ingram Cancer Center, Nashville, Tennessee.,Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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6
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Dominguez RL, Cherry CB, Estevez-Ordonez D, Mera R, Escamilla V, Pawlita M, Waterboer T, Wilson KT, Peek RM, Tavera G, Williams SM, Gulley ML, Emch M, Morgan DR. Geospatial analyses identify regional hot spots of diffuse gastric cancer in rural Central America. BMC Cancer 2019; 19:545. [PMID: 31174492 PMCID: PMC6554991 DOI: 10.1186/s12885-019-5726-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/16/2019] [Indexed: 12/12/2022] Open
Abstract
Background Geospatial technology has facilitated the discovery of disease distributions and etiology and helped target prevention programs. Globally, gastric cancer is the leading infection-associated cancer, and third leading cause of cancer mortality worldwide, with marked geographic variation. Central and South America have a significant burden, particularly in the mountainous regions. In the context of an ongoing population-based case-control study in Central America, our aim was to examine the spatial epidemiology of gastric cancer subtypes and H. pylori virulence factors. Methods Patients diagnosed with gastric cancer from 2002 to 2013 in western Honduras were identified in the prospective gastric cancer registry at the principal district hospital. Diagnosis was based on endoscopy and confirmatory histopathology. Geospatial methods were applied using the ArcGIS v10.3.1 and SaTScan v9.4.2 platforms to examine regional distributions of the gastric cancer histologic subtypes (Lauren classification), and the H. pylori CagA virulence factor. Getis-Ord-Gi hot spot and Discrete Poisson SaTScan statistics, respectively, were used to explore spatial clustering at the village level (30–50 rural households), with standardization by each village’s population. H. pylori and CagA serologic status was determined using the novel H. pylori multiplex assay (DKFZ, Germany). Results Three hundred seventy-eight incident cases met the inclusion criteria (mean age 63.7, male 66.3%). Areas of higher gastric cancer incidence were identified. Significant spatial clustering of diffuse histology adenocarcinoma was revealed both by the Getis-Ord-GI* hot spot analysis (P-value < 0.0015; range 0.00003–0.0014; 99%CI), and by the SaTScan statistic (P-value < 0.006; range 0.0026–0.0054). The intestinal subtype was randomly distributed. H. pylori CagA had significant spatial clustering only in association with the diffuse histology cancer hot spot (Getis-Ord-Gi* P value ≤0.001; range 0.0001–0.0010; SaTScan statistic P value 0.0085). In the diffuse gastric cancer hot spot, the lowest age quartile range was 21–46 years, significantly lower than the intestinal cancers (P = 0.024). Conclusions Geospatial methods have identified a significant cluster of incident diffuse type adenocarcinoma cases in rural Central America, suggest of a germline genetic association. Further genomic and geospatial analyses to identify potential spatial patterns of genetic, bacterial, and environmental risk factors may be informative.
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Affiliation(s)
| | - Charlotte B Cherry
- Office of Public Health Informatics & Analytics, Tennessee Department of Public Health, Nashville, TN, USA
| | - Dago Estevez-Ordonez
- Vanderbilt Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, USA
| | - Robertino Mera
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, USA
| | - Veronica Escamilla
- Carolina Population Center, University of North Carolina, Chapel Hill, USA
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Keith T Wilson
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, USA
| | - Richard M Peek
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, USA
| | - Gloria Tavera
- Department of Population and Quantitative Health Sciences and Institute of Computational Biology, Case Western Reserve University, Cleveland, USA
| | - Scott M Williams
- Department of Population and Quantitative Health Sciences and Institute of Computational Biology, Case Western Reserve University, Cleveland, USA
| | - Margaret L Gulley
- Department of Pathology, University of North Carolina, Chapel Hill, USA
| | - Michael Emch
- Department of Geography, University of North Carolina, Chapel Hill, USA
| | - Douglas R Morgan
- Vanderbilt Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, USA. .,Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, USA. .,Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham (UAB), 1808 7th Avenue South, BDB 373, Birmingham, AL, 35233, USA.
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7
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Piñeros M, Frech S, Frazier L, Laversanne M, Barnoya J, Garrido C, Gharzouzi E, Chacón A, Fuentes Alabi S, Ruiz de Campos L, Figueroa J, Dominguez R, Rojas O, Pereira R, Rivera C, Morgan DR. Advancing Reliable Data for Cancer Control in the Central America Four Region. J Glob Oncol 2018; 4:1-11. [PMID: 30241165 PMCID: PMC6180802 DOI: 10.1200/jgo.2016.008227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.
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Affiliation(s)
- Marion Piñeros
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Silvina Frech
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Lindsay Frazier
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Mathieu Laversanne
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Joaquin Barnoya
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Claudia Garrido
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Eduardo Gharzouzi
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Andrea Chacón
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Soad Fuentes Alabi
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Lisseth Ruiz de Campos
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Jacqueline Figueroa
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Ricardo Dominguez
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Ofelia Rojas
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Rosario Pereira
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Carla Rivera
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Douglas R. Morgan
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
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8
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Kamdem J, Palmer D, Barrier C, Bardin R, Brown JA, Topazian M. Diagnostic yield of gastrointestinal endoscopy in North West Region Cameroon and trends in diagnosis over time. Pan Afr Med J 2018; 29:178. [PMID: 30050642 PMCID: PMC6057602 DOI: 10.11604/pamj.2018.29.178.10785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 02/28/2018] [Indexed: 12/11/2022] Open
Abstract
Introduction Gastrointestinal endoscopy is an important modality for diagnosis and treatment of gastrointestinal disease, but there are limited data regarding the diagnostic yield of endoscopy in Cameroon and changes in the prevalence of endoscopic findings over time. Our aims were to describe the diagnostic utility of esophagogastroduodenoscopy (EGD) and colonoscopy, the impact of periodic on-site mentorship on cecal intubation rate and changes in the prevalence of common upper gastrointestinal findings when compared to a similar report from our region published in 1990. Methods Retrospective review of all EGD and colonoscopy procedures performed during 2015 at a regional referral hospital in North West Region, Cameroon, with comparison to EGD findings reported by Dent and colleagues in 1990. During the year 3 endoscopists provided periodic colonoscopy mentorship. Results Among 1,371 EGDs, abnormalities were found in 59.7% and therapeutic interventions (most commonly esophageal stricture dilation or band ligation of varices) were performed in 137 (10%). When compared to 25 years previously, peptic ulcer disease was less common and esophagitis was more common (p < 0.0001; p < 0.0001). The prevalence of malignancy (2.2%) was similar. Among 380 colonoscopies diagnostic findings were seen in 60.5%, including colorectal malignancies in 5.8%. Cecal intubation rate improved from 32% to 89% during the one-year study period. Conclusion EGD and colonoscopy have a diagnostic yield of about 60% in symptomatic patients in North West Region, Cameroon. When compared to 1990 peptic ulcer disease was less common and esophagitis was more common. Periodic on-site mentorship was associated with improved physician performance of colonoscopy.
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9
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Ruíz-García E, Guadarrama-Orozco J, Vidal-Millán S, Lino-Silva LS, López-Camarillo C, Astudillo-de la Vega H. Gastric cancer in Latin America. Scand J Gastroenterol 2018; 53:124-129. [PMID: 29275643 DOI: 10.1080/00365521.2017.1417473] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Every year, cancer affects more than one million Latin Americans. The increasing incidence of cancer could be secondary to an aging population, westernization of life style, and urbanization. LA has among the highest incidence rates of gastric cancer, compared to other countries. In this review, different studies on gastric cancer and its relation with risks factors, such as infections, diet and life styles typical of LA, besides the different molecular alterations of that specific population (mainly at a genetic polymorphism level) are analyzed. An exhaustive research was made in PubMed, MEDLINE and Embase of the most relevant studies conducted in the last 27 years (1990-2017) in LA.
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Affiliation(s)
- Erika Ruíz-García
- a Laboratorio de Medicina Traslacional , Instituto Nacional de Cancerología , Ciudad de México , México.,b Departamento de Tumores Gastro-Intestinales , Instituto Nacional de Cancerología , Ciudad de México , México
| | - Jorge Guadarrama-Orozco
- a Laboratorio de Medicina Traslacional , Instituto Nacional de Cancerología , Ciudad de México , México
| | - Silvia Vidal-Millán
- c Laboratorio de Diagnóstico Molecular , Instituto Nacional de Cancerología , Ciudad de México , México
| | - Leonardo S Lino-Silva
- d Departamento de Patología , Instituto Nacional de Cancerología , Ciudad de México , México
| | - César López-Camarillo
- e Posgrado en Ciencias Genómicas , Universidad Autónoma de la Ciudad de México , Ciudad de México , México
| | - Horacio Astudillo-de la Vega
- f Laboratorio de Investigación Traslacional en Cáncer y Terapia Celular , Centro Médico Siglo XXI, IMSS , Ciudad de México , México
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10
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Sun X, Bi Y, Dong T, Min M, Shen W, Xu Y, Liu Y. Linked colour imaging benefits the endoscopic diagnosis of distal gastric diseases. Sci Rep 2017; 7:5638. [PMID: 28717210 PMCID: PMC5514041 DOI: 10.1038/s41598-017-05847-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 06/05/2017] [Indexed: 12/19/2022] Open
Abstract
Gastric diseases are common in China, and gastroduodenoscopy could provide accurate diagnoses. Our previous study verified that linked colour imaging (LCI) can improve endoscopic diagnostic accuracy. This study aimed for the first time to establish an LCI-based endoscopic model called colour-microstructure-vessel (CMV) criteria and validated its clinical feasibility for detecting distal gastric diseases manifested as red mucosal lesions under endoscopy in a cohort of 62 patients. Colour features were extracted from the endoscopic images and categorized into 3 types. Colour type 1 was a typical red; Colour type 2 was red ringed with purple and Colour type 3 was red with yellow in the centre and purple around the periphery, allowing for predicting chronic nonatrophic gastritis, chronic atrophic gastritis and gastric cancer. The sensitivity, specificity and Youden index of Colour type 3 with abnormal M or V for gastric cancer were 100.0%, 98.2% and 98.2%. The kappa values for intra-observer and inter-observer agreement for predicting the pathology were 0.834 and 0.791 for experienced endoscopists and 0.788 and 0.732 for endoscopy learners, and these values were comparable regardless of the experience of the endoscopists (P > 0.05). These findings support that the CMV criteria are a promising model for accurate endoscopic diagnosis.
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Affiliation(s)
- Xiaotian Sun
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China.,Department of Internal Medicine, Clinic of August First Film Studio, Beijing, 100161, China
| | - Yiliang Bi
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China
| | - Tenghui Dong
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China
| | - Min Min
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China
| | - Wei Shen
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China
| | - Yang Xu
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China
| | - Yan Liu
- Department of Gastroenterology, the 307 Hospital of Academy of Military Medical Science, Beijing, 100071, China.
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11
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Sanchez FA. Best Practices and Practical Nuances in the Treatment of Gastric Cancer in High-Risk Global Areas. Am Soc Clin Oncol Educ Book 2017; 37:258-260. [PMID: 28561673 DOI: 10.1200/edbk_175226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Gastric cancer is an aggressive disease that is very frequent in Latin America. The reasons for this increased incidence is not clear. Associated with the lack of minimum health care opportunities, lack of accurate statistics and reporting data beyond epidemiologic data, and raw nonreliable data, there is little known of the actual clinical course and treatment of these patients. Understanding epidemiologic data may allow us to encourage the adequate use and distribution of the meager resources that exist.
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12
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Montalván EE, Montalván DM, Urrutia SA, Rodríguez AA, Sandoval H, Sauceda PO, Rodríguez CE, Melgar AJ, Estévez D, Morgan DR, Torres KP, Domínguez RL. [Survival of Gastric Cancer in Western Honduras Pilot study: 2002-2012]. REVISTA MEDICA HONDURENA 2017; 85:6-10. [PMID: 35959361 PMCID: PMC9364809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Gastric cancer is the second leading cause of cancer death globally. In Honduras the incidence in the last decade was 39 and 21 per 100,000 inhabitants for men and women, respectively. In 2008 IARC (GLOBOCAN) placed Honduras as the country with the highest incidence of gastric cancer in Latin America. METHODS A retrospective cohort study of patients diagnosed with gastric cancer at the Hospital de Occidente between 2002-2012 was designed. A sample of 144 patients was selected from a total of 490 to obtain a confidence level of 95%. The data collection was obtained by verbal autopsy. Prognostic factors of survival were analyzed using Cox proportional hazards ratio models (CI: 95%). OUTCOMES The male/female ratio was 2.8:1. The mean age was 63.29 years. Overall five-year survival was 9.39%. Among patients receiving dual therapy (surgery and chemotherapy), a statistically significant increase in survival was found (10.42%, p=0.048). Between the proximal (28.95%) and distal (56.58%) locations also a statistically significant difference was observed (p=0.03). There was no statistically significant difference in the macroscopic (Borrmann) and microscopic findings (Lauren). DISSCUSION This study represents the first effort to estimate survival of gastric cancer in Honduras. Survival may be linked to the location of the primary lesion and the type of treatment. It is expected to develop studies with greater coverage, to answer these questions.
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Affiliation(s)
- Eleazar Enrique Montalván
- Departamento Medicina Interna, Servicio de Gastroenterología, Hospital de Occidente, Santa Rosa, Copán, Honduras
| | - Daniela María Montalván
- Departamento Medicina Interna, Servicio de Gastroenterología, Hospital de Occidente, Santa Rosa, Copán, Honduras
| | - Samuel Alejandro Urrutia
- Departamento Medicina Interna, Servicio de Gastroenterología, Hospital de Occidente, Santa Rosa, Copán, Honduras
| | - Aída Argentina Rodríguez
- Departamento Medicina Interna, Servicio de Gastroenterología, Hospital de Occidente, Santa Rosa, Copán, Honduras
| | - Héctor Sandoval
- Centro Universitario Regional de Occidente (CUROC), Santa Rosa, Copán, Honduras
| | - Pedro Odair Sauceda
- Centro Universitario Regional de Occidente (CUROC), Santa Rosa, Copán, Honduras
| | | | - Ana Julia Melgar
- Centro Universitario Regional de Occidente (CUROC), Santa Rosa, Copán, Honduras
| | - Dagoberto Estévez
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA 37232
| | - Douglas R Morgan
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA 37232
- Vanderbilt Institute for Global Health, Nashville, Tennessee, USA 37232
| | | | - Ricardo Leonel Domínguez
- Departamento Medicina Interna, Servicio de Gastroenterología, Hospital de Occidente, Santa Rosa, Copán, Honduras
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13
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Wang G, Romero-Gallo J, Benoit SL, Piazuelo MB, Dominguez RL, Morgan DR, Peek RM, Maier RJ. Hydrogen Metabolism in Helicobacter pylori Plays a Role in Gastric Carcinogenesis through Facilitating CagA Translocation. mBio 2016; 7:e01022-16. [PMID: 27531909 PMCID: PMC4992972 DOI: 10.1128/mbio.01022-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/15/2016] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED A known virulence factor of Helicobacter pylori that augments gastric cancer risk is the CagA cytotoxin. A carcinogenic derivative strain, 7.13, that has a greater ability to translocate CagA exhibits much higher hydrogenase activity than its parent noncarcinogenic strain, B128. A Δhyd mutant strain with deletion of hydrogenase genes was ineffective in CagA translocation into human gastric epithelial AGS cells, while no significant attenuation of cell adhesion was observed. The quinone reductase inhibitor 2-n-heptyl-4-hydroxyquinoline-N-oxide (HQNO) was used to specifically inhibit the H2-utilizing respiratory chain of outer membrane-permeabilized bacterial cells; that level of inhibitor also greatly attenuated CagA translocation into AGS cells, indicating the H2-generated transmembrane potential is a contributor to toxin translocation. The Δhyd strain showed a decreased frequency of DNA transformation, suggesting that H. pylori hydrogenase is also involved in energizing the DNA uptake apparatus. In a gerbil model of infection, the ability of the Δhyd strain to induce inflammation was significantly attenuated (at 12 weeks postinoculation), while all of the gerbils infected with the parent strain (7.13) exhibited a high level of inflammation. Gastric cancer developed in 50% of gerbils infected with the wild-type strain 7.13 but in none of the animals infected with the Δhyd strain. By examining the hydrogenase activities from well-defined clinical H. pylori isolates, we observed that strains isolated from cancer patients (n = 6) have a significantly higher hydrogenase (H2/O2) activity than the strains isolated from gastritis patients (n = 6), further supporting an association between H. pylori hydrogenase activity and gastric carcinogenesis in humans. IMPORTANCE Hydrogen-utilizing hydrogenases are known to be important for some respiratory pathogens to colonize hosts. Here a gastric cancer connection is made via a pathogen's (H. pylori) use of molecular hydrogen, a host microbiome-produced gas. Delivery of the known carcinogenic factor CagA into host cells is augmented by the H2-utilizing respiratory chain of the bacterium. The role of hydrogenase in carcinogenesis is demonstrated in an animal model, whereby inflammation markers and cancer development were attenuated in the hydrogenase-null strain. Hydrogenase activity comparisons of clinical strains of the pathogen also support a connection between hydrogen metabolism and gastric cancer risk. While molecular hydrogen use is acknowledged to be an alternative high-energy substrate for some pathogens, this work extends the roles of H2 oxidation to include transport of a carcinogenic toxin. The work provides a new avenue for exploratory treatment of some cancers via microflora alterations.
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Affiliation(s)
- Ge Wang
- Department of Microbiology, University of Georgia, Athens, Georgia, USA
| | - Judith Romero-Gallo
- Division of Gastroenterology, Department of Medicine, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Stéphane L Benoit
- Department of Microbiology, University of Georgia, Athens, Georgia, USA
| | - M Blanca Piazuelo
- Division of Gastroenterology, Department of Medicine, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Douglas R Morgan
- Division of Gastroenterology, Department of Medicine, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Richard M Peek
- Division of Gastroenterology, Department of Medicine, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee, USA Departments of Cancer Biology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Robert J Maier
- Department of Microbiology, University of Georgia, Athens, Georgia, USA
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14
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Corral JE, Delgado Hurtado JJ, Domínguez RL, Valdez de Cuéllar M, Balmore Cruz C, Morgan DR. The descriptive epidemiology of gastric cancer in Central America and comparison with United States Hispanic populations. J Gastrointest Cancer 2015; 46:21-8. [PMID: 25412859 DOI: 10.1007/s12029-014-9672-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The aims of this study were to delineate the epidemiology of gastric adenocarcinoma in Central America and contrast it with Hispanic-Latino populations in the USA. METHODS Published literature and Central America Ministry of Health databases were used as primary data sources, including national, population-based, and hospital-based registries. US data was obtained from the National Cancer Institute (NCI)-Epidemiology End Results Program (SEER) registry. Incident gastric adenocarcinoma cases were analyzed for available data between 1985 and 2011, including demographic variables and pathology information. RESULTS In Central America, 19,741 incident gastric adenocarcinomas were identified. Two thirds of the cases were male, 20.5 % were under age 55, and 58.5 %were from rural areas. In the SEER database (n = 7871), 57.8 % were male and 28.9 % were under age 55. Among the US Hispanics born in Central America with gastric cancer (n = 1210), 50.3 % of cases were male and 38.1 % were under age 55. Non-cardia gastric cancer was more common in Central America (83.3 %), among US Hispanics (80.2 %), and Hispanics born in Central America (86.3 %). Cancers of the antrum were more common in Central America (73.6 %), whereas cancers of the corpus were slightly more common among US Hispanics (54.0 %). Adenocarcinoma of the diffuse subtype was relatively common, both in Central America (35.7 %) and US Hispanics (69.5 %), although Lauren classification was reported in only 50 % of cases. CONCLUSIONS A significant burden of gastric adenocarcinoma is observed in Central America based upon limited available data. Differences are noted between Central America and US Hispanics. Strengthening population-based registries is needed for improved cancer control in Central America, which may have implications for the growing US Hispanic population.
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Affiliation(s)
- Juan E Corral
- Department of Medicine, University of Miami Miller School of Medicine and Jackson Memorial Hospital, 1611 NW 12th Avenue Central Building, Room 600D (R-60), Miami, FL, 33136, USA,
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Kayamba V, Sinkala E, Mwanamakondo S, Soko R, Kawimbe B, Amadi B, Zulu I, Nzaisenga JB, Banda T, Mumbwe C, Phiri E, Munkonge P, Kelly P. Trends in upper gastrointestinal diagnosis over four decades in Lusaka, Zambia: a retrospective analysis of endoscopic findings. BMC Gastroenterol 2015; 15:127. [PMID: 26444265 PMCID: PMC4596361 DOI: 10.1186/s12876-015-0353-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/22/2015] [Indexed: 12/15/2022] Open
Abstract
Background and aims There a shortage of robust information about profiles of gastrointestinal disease in sub-Saharan Africa. The endoscopy unit of the University Teaching Hospital in Lusaka has been running without interruption since 1977 and this 38-year record is largely intact. We report an analysis of endoscopic findings over this period. Methods Written endoscopy records from 29th September 1977 to 16th December 2014 were recovered, computerised, coded by two experienced endoscopists and analysed. Temporal trends were analysed using tables, graphs, and unconditional logistic regression, with age, sex of patient, decade, and endoscopist as independent variables to adjust for inter-observer variation. Results Sixteen thousand nine hundred fifty-three records were identified and analysed. Diagnosis of gastric ulcer rose by 22 %, and that of duodenal ulcer fell by 14 % per decade. Endoscopically diagnosed oesophageal cancer increased by 32 % per decade, but gastric cancer rose only in patients under 60 years of age (21 % per decade). Oesophageal varices were the commonest finding in patients presenting with haematemesis, increasing by 14 % per decade in that patient group. Two HIV-related diagnoses, oesophageal candidiasis and Kaposi’s sarcoma, rose from almost zero to very high levels in the 1990s but fell substantially after 2005 when anti-retroviral therapy became widely available. Conclusions This useful dataset suggests that there are important trends in some endoscopic findings over four decades. These trends are not explained by inter-observer variation. Reasons for the divergent trends in incidence of peptic ulceration and apparent trends in diagnosis of upper gastrointestinal cancers merit further exploration.
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Affiliation(s)
- Violet Kayamba
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Edford Sinkala
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Stayner Mwanamakondo
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Rose Soko
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia
| | | | - Beatrice Amadi
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Isaac Zulu
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | | | - Themba Banda
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Chipasha Mumbwe
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Evans Phiri
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Philip Munkonge
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
| | - Paul Kelly
- TROPGAN, Department of Medicine, University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, Lusaka, Zambia. .,Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, 4 Newark Street, London, E1 2AD, UK.
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Chaturvedi R, de Sablet T, Asim M, Piazuelo MB, Barry DP, Verriere TG, Sierra JC, Hardbower DM, Delgado AG, Schneider BG, Israel DA, Romero-Gallo J, Nagy TA, Morgan DR, Murray-Stewart T, Bravo LE, Peek RM, Fox JG, Woster PM, Casero RA, Correa P, Wilson KT. Increased Helicobacter pylori-associated gastric cancer risk in the Andean region of Colombia is mediated by spermine oxidase. Oncogene 2015; 34:3429-40. [PMID: 25174398 PMCID: PMC4345146 DOI: 10.1038/onc.2014.273] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 07/16/2014] [Accepted: 07/19/2014] [Indexed: 12/11/2022]
Abstract
Helicobacter pylori infection causes gastric cancer, the third leading cause of cancer death worldwide. More than half of the world's population is infected, making universal eradication impractical. Clinical trials suggest that antibiotic treatment only reduces gastric cancer risk in patients with non-atrophic gastritis (NAG), and is ineffective once preneoplastic lesions of multifocal atrophic gastritis (MAG) and intestinal metaplasia (IM) have occurred. Therefore, additional strategies for risk stratification and chemoprevention of gastric cancer are needed. We have implicated polyamines, generated by the rate-limiting enzyme ornithine decarboxylase (ODC), in gastric carcinogenesis. During H. pylori infection, the enzyme spermine oxidase (SMOX) is induced, which generates hydrogen peroxide from the catabolism of the polyamine spermine. Herein, we assessed the role of SMOX in the increased gastric cancer risk in Colombia associated with the Andean mountain region when compared with the low-risk region on the Pacific coast. When cocultured with gastric epithelial cells, clinical strains of H. pylori from the high-risk region induced more SMOX expression and oxidative DNA damage, and less apoptosis than low-risk strains. These findings were not attributable to differences in the cytotoxin-associated gene A oncoprotein. Gastric tissues from subjects from the high-risk region exhibited greater levels of SMOX and oxidative DNA damage by immunohistochemistry and flow cytometry, and this occurred in NAG, MAG and IM. In Mongolian gerbils, a prototype colonizing strain from the high-risk region induced more SMOX, DNA damage, dysplasia and adenocarcinoma than a colonizing strain from the low-risk region. Treatment of gerbils with either α-difluoromethylornithine, an inhibitor of ODC, or MDL 72527 (N(1),N(4)-Di(buta-2,3-dien-1-yl)butane-1,4-diamine dihydrochloride), an inhibitor of SMOX, reduced gastric dysplasia and carcinoma, as well as apoptosis-resistant cells with DNA damage. These data indicate that aberrant activation of polyamine-driven oxidative stress is a marker of gastric cancer risk and a target for chemoprevention.
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Affiliation(s)
- Rupesh Chaturvedi
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thibaut de Sablet
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mohammad Asim
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - M. Blanca Piazuelo
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel P. Barry
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas G. Verriere
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J. Carolina Sierra
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana M. Hardbower
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alberto G. Delgado
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Barbara G. Schneider
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dawn A. Israel
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Judith Romero-Gallo
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Toni A. Nagy
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas R. Morgan
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tracy Murray-Stewart
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Luis E. Bravo
- Department of Pathology, Universidad del Valle School of Medicine, Cali, Colombia
| | - Richard M. Peek
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G. Fox
- Division of Comparative Medicine, Massachusetts lnstitute of Technology, Cambridge, MA, USA
| | - Patrick M. Woster
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Robert A. Casero
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pelayo Correa
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Keith T. Wilson
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
- Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
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Correlation of serum levels of endostatin with tumor stage in gastric cancer: a systematic review and meta-analysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:623939. [PMID: 25685799 PMCID: PMC4313525 DOI: 10.1155/2015/623939] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/25/2014] [Accepted: 12/13/2014] [Indexed: 12/16/2022]
Abstract
Background. We performed a systematic review and meta-analysis to study the association between serum endostatin levels and gastric cancer (GC) progression. Method. We searched the MEDLINE, Science Citation Index, Cochrane Library, PubMed, Embase, Current Contents Index, and several Chinese databases for published studies relevant to our study topic. Carefully selected studies were pooled and SMD and its corresponding 95% CI were calculated. Version 12.0 STATA software was used for statistical analysis. Results. Serum endostatin levels were analyzed in 12 case-control studies (736 GC patients and 350 controls). Significant differences in serum endostatin levels were observed between GC patients and the healthy controls (SMD = 1.418, 95% CI = 1.079~1.757, P < 0.001). Importantly, significantly lower levels of serum endostatin were found in I-II grade patients compared to those with III-IV grade tumors (P < 0.001). Further, higher serum endostatin levels were observed in the LN invasion-positive GC subjects in comparison with LN invasion-negative subjects (P < 0.001). Conclusion. Patients with GC exhibited elevated levels of serum endostatin than controls and its level showed a statistical correlation with the more aggressive type of GC, exhibiting invasion and LN metastasis. Thus, serum levels of endostatin being a useful prognostic biomarker for GC patients warrants further investigation.
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Morgan DR, Torres J. The stratification of gastric cancer risk in Latin America. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2014; 78:125-6. [PMID: 24028814 DOI: 10.1016/j.rgmx.2013.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/05/2013] [Indexed: 11/26/2022]
Affiliation(s)
- D R Morgan
- Division of Gastroenterology, Vanderbilt University, Nashville, TN, USA.
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