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Díaz del Arco C, Ortega Medina L, Estrada Muñoz L, Molina Roldán E, García Gómez de las Heras S, Fernández Aceñero MJ. Impact of Age at Diagnosis on Clinicopathological Features, Prognosis, and Management of Gastric Cancer: A Retrospective Single-Center Experience from Spain. Cancers (Basel) 2023; 15:4241. [PMID: 37686517 PMCID: PMC10486869 DOI: 10.3390/cancers15174241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The impact of age on various aspects of gastric cancer (GC) remains controversial. Clarifying this issue can improve our understanding of the disease, refine risk stratification models, and aid in personalized therapeutic approaches. This study aimed to evaluate the influence of age at diagnosis on the clinicopathological features, prognosis, and management of a specific cohort of Spanish patients with resected GC. The study encompassed 315 patients treated at a single tertiary hospital in Spain, divided into two age-based subgroups: ≤65 years and >65 years. The mean and median ages at diagnosis were 72 and 76 years. Most tumors were diagnosed at pT3 stage (49.2%), and 59.6% of patients had lymph node metastases. 21.3% of cases were diagnosed with GC at age ≤ 65 years. Younger patients showed a significantly higher prevalence of flat, diffuse, high-grade tumors, signet-ring cells, perineural infiltration, D2 lymphadenectomies, and adjuvant therapy. They also exhibited a higher rate of recurrences, but had a significantly longer follow-up. Kaplan-Meier curves indicated no significant prognostic differences based on age. Finally, age did not independently predict overall survival or disease-free survival. Our results suggest that younger patients may require more aggressive treatment due to adverse clinicopathologic features, but the lack of prognostic differences among age groups in our cohort indicates the need for further investigation into the complex interplay between age, clinicopathologic factors, and long-term outcomes in GC.
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Affiliation(s)
- Cristina Díaz del Arco
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (L.O.M.); (M.J.F.A.)
- Department of Pathology, Hospital Clínico San Carlos, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Luis Ortega Medina
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (L.O.M.); (M.J.F.A.)
- Department of Pathology, Hospital Clínico San Carlos, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Lourdes Estrada Muñoz
- Department of Basic Medical Sciences, School of Medicine, Rey Juan Carlos University, Móstoles, 28933 Madrid, Spain; (L.E.M.); (S.G.G.d.l.H.)
- Department of Pathology, Rey Juan Carlos Hospital, Móstoles, 28933 Madrid, Spain
| | - Elena Molina Roldán
- Department of Pathology, Hospital Clínico San Carlos, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
- Biobank, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Soledad García Gómez de las Heras
- Department of Basic Medical Sciences, School of Medicine, Rey Juan Carlos University, Móstoles, 28933 Madrid, Spain; (L.E.M.); (S.G.G.d.l.H.)
| | - María Jesús Fernández Aceñero
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (L.O.M.); (M.J.F.A.)
- Department of Pathology, Hospital Clínico San Carlos, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
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Ai B, Mei Y, Liang D, Wang T, Cai H, Yu D. Uncovering the special microbiota associated with occurrence and progression of gastric cancer by using RNA-sequencing. Sci Rep 2023; 13:5722. [PMID: 37029259 PMCID: PMC10082026 DOI: 10.1038/s41598-023-32809-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
Gastric cancer (GC) has been identified as the third deadly cancer in the world. Accumulating researches suggest a potential role of microorganisms in tumorigenesis. However, the composition of microbiota in GC tissues is not clear and it changes throughout the different stages of GC remain mostly elusive. Our study integrated RNA-Seq data of 727 samples derived from gastric tissues across four datasets and revealed its microbial composition. In order to remove the false positive results, core taxa were defined and characterized. Based on it, we analyzed the influence of biological factors on its composition. The pan-microbiome of gastric tissues was estimated to be over than 1400 genera. Seventeen core genera were identified. Among them, Helicobacter, Lysobacter were significantly enriched in normal tissues, while Pseudomonas was enriched in tumor tissues. Interestingly, Acinetobacter, Pasteurella, Streptomyces, Chlamydia, and Lysobacter, showed a significant increase trend during tumor development and formed strong intra/inter-correlations among them or with other genera. Furthermore, we found that tumor stage played an important role in altering the microbial composition of GC tissues. This study provides support for the in-depth study of tumor microbiome, and the specific microbiome excavated provides a possibility for the subsequent identification of potential biomarkers for GC.
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Affiliation(s)
- Bin Ai
- Department of Precision Medicine, Translational Medicine Research Center, Naval Medical University, Shanghai, China
- Shanghai Key Laboratory of Cell Engineering, Shanghai, China
| | - Yue Mei
- Department of Precision Medicine, Translational Medicine Research Center, Naval Medical University, Shanghai, China
- Shanghai Key Laboratory of Cell Engineering, Shanghai, China
| | - Dong Liang
- Department of Precision Medicine, Translational Medicine Research Center, Naval Medical University, Shanghai, China
- Shanghai Key Laboratory of Cell Engineering, Shanghai, China
| | - Tengjiao Wang
- Department of Precision Medicine, Translational Medicine Research Center, Naval Medical University, Shanghai, China
- Shanghai Key Laboratory of Cell Engineering, Shanghai, China
| | - Hui Cai
- Department of Gastrointestinal Surgery, Changhai Hospital, Shanghai, China.
| | - Dong Yu
- Department of Precision Medicine, Translational Medicine Research Center, Naval Medical University, Shanghai, China.
- Shanghai Key Laboratory of Cell Engineering, Shanghai, China.
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Poniewierska-Baran A, Warias P, Zgutka K. Sirtuins (SIRTs) As a Novel Target in Gastric Cancer. Int J Mol Sci 2022; 23:ijms232315119. [PMID: 36499440 PMCID: PMC9737976 DOI: 10.3390/ijms232315119] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
Gastric cancer is a major health burden worldwide. Among all neoplasms, gastric cancer is the fifth most common and the third most deadly type of cancer. It is known that sirtuins (SIRTs), are NAD+-dependent histone deacetylases regulating important metabolic pathways. High expression of SIRTs in the human body can regulate metabolic processes; they prevent inflammation but also resist cell death and aging processes. The seven members of this family enzymes can also play a fundamental role in process of carcinogenesis by influencing cell viability, apoptosis and metastasis. This review collects and discusses the role of all seven sirtuins (SIRT1-SIRT7) in the pathogenesis of gastric cancer (GC).
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Affiliation(s)
- Agata Poniewierska-Baran
- Institute of Biology, University of Szczecin, Felczaka 3c, 71-412 Szczecin, Poland
- Correspondence:
| | - Paulina Warias
- Department of Physiology, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Katarzyna Zgutka
- Department of Physiology in Health Sciences, Faculty of Health Sciences, Pomeranian Medical University, Szczecin, Żołnierska 54, 70-210 Szczecin, Poland
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A Comparative Study of Spatial Distribution of Gastrointestinal Cancers in Poverty and Affluent Strata (Kermanshah Metropolis, Iran). J Gastrointest Cancer 2020; 50:838-847. [PMID: 30136201 DOI: 10.1007/s12029-018-0163-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The trend of cancers has witnessed a twofold rise in the last three decades, which is expected to be fivefold by 2030. On the other hand, gastrointestinal cancers have turned into one of the health issues in many societies. Given the presence of gastrointestinal cancer hot spots and evidence of health inequalities across Kermanshah Metropolis and the results of studies signaling the association between gastrointestinal cancers and socioeconomic status of individuals as well as evidence of unequal socioeconomic opportunities in this metropolis, the present study aimed to investigate the spatial distribution of gastrointestinal cancers in the poverty and affluent strata of Kermanshah Metropolis, Iran. MATERIALS AND METHODS In this descriptive-analytical study, the recorded data of patients, suffering from gastrointestinal cancers, in Kermanshah-based Pathology Centers and Vice Chancellery of Kermanshah University of Medical Sciences (2007-2012) were used. Moreover, to examine the status of gastrointestinal cancers in socioeconomic classes based on the census data collected during 2007-2012, 33 social, cultural, and structural indexes were extracted from the statistical blocks. Additionally, for data analysis and factor analysis, Kruskal-Wallis Test in the environment of SPSS and kernel density estimation (KDE) and Moran's I tests in the GIS environment were employed. FINDINGS The results of the present study revealed that the distribution of poverty (Z score = 48.916518, p value = 0.000000) and affluent strata (Z score = 14.345028, p value = 0.000000) followed clustered patterns (p < 0.01). Additionally, the results indicated that the spatial distribution pattern of the upper gastrointestinal cancer was clustered (Z score = 1.896996, p value = 0.007828), whereas the spatial distribution pattern of the lower gastrointestinal cancer was inclined to a randomized clustered pattern (Z score = 1.338121, p value = 0.000857) (p < 0.01). Finally, seven main hot spots were identified from the poverty stratum in Kermanshah, which perfectly overlapped the hot spots of upper gastrointestinal cancer. Similarly, four main hot spots were identified from the affluent stratum in Kermanshah, which overlapped the hot spots of lower gastrointestinal cancer. The results of the Kruskal-Wallis Test demonstrated that the poverty and affluent strata were significantly different from each other in terms of gastrointestinal cancer: upper gastrointestinal cancer (p < 0.05 and X2=10.064) and lower gastrointestinal cancer (p < 0.05 and X2=10.253). CONCLUSION The results of the present study showed that the ratio of patients with lower gastrointestinal cancers was higher than the incidence of upper gastrointestinal cancers over the 5-year period under study. Moreover, in Kermanshah Metropolis, there was a significant difference between the upper gastrointestinal cancer in the poverty stratum and the lower gastrointestinal cancer in the affluent stratum. Hence, it is suggested that GIS be applied as a tool for identifying the patterns of effective factors of this type of cancer in each social class, and it is recommended that some effective policies be presented and adopted by health managers according to the role and importance of socioeconomic, environmental, and nutritional factors in the poverty and affluent strata of society, and people at risk be equipped with preventive training programs in this respect.
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Morgan R, Cassidy M, DeGeus SWL, Tseng J, McAneny D, Sachs T. Presentation and Survival of Gastric Cancer Patients at an Urban Academic Safety-Net Hospital. J Gastrointest Surg 2019; 23:239-246. [PMID: 30097966 DOI: 10.1007/s11605-018-3898-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/23/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Gastric cancer is decreasing nationally but remains pervasive globally. We evaluated our experience with gastric cancer at a safety-net hospital with a substantial immigrant population. METHODS Demographics, pathology, and treatment were analyzed for gastric adenocarcinoma at our institution (2004-2017). Chi-square analyses were performed for dependence of staging on demographics. Survival was evaluated with Kaplan-Meier and Cox regression analyses. RESULTS We identified 249 patients (median age 65 years). Patients were predominantly born outside the USA or Canada (74.3%), non-white (70.7%), and federally insured (71.4%), and presented with late-stage disease (52.2%). Hispanic ethnicity, Central American birthplace, Medicaid insurance, and zip code poverty > 20% were associated with late-stage presentation (all p < 0.05). Univariate analyses showed decreased survival for patients with late-stage disease, highest zip code poverty, and age ≥ 65 (all p < 0.05). On multivariate analysis, survival was negatively associated with late-stage presentation (HR 4.45, p < 0.001), age ≥ 65 (1.80, p = 0.018), and H. pylori infection (2.02, p = 0.036). CONCLUSION Hispanic ethnicity, Central American birthplace, Medicaid insurance, and increased neighborhood poverty were associated with late-stage presentation of gastric cancer with poor outcomes. Further study of these populations may lead to screening protocols in order to increase earlier detection and improve survival.
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Affiliation(s)
- Ryan Morgan
- Department of Surgery, Boston Medical Center, Boston, MA, USA
| | - Michael Cassidy
- Department of Surgery, Boston Medical Center, Boston, MA, USA
| | | | - Jennifer Tseng
- Department of Surgery, Boston Medical Center, Boston, MA, USA
| | - David McAneny
- Department of Surgery, Boston Medical Center, Boston, MA, USA
| | - Teviah Sachs
- Department of Surgery, Boston Medical Center, Boston, MA, USA.
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The Association Between Index of Nutritional Quality (INQ) and Gastric Cancer and Evaluation of Nutrient Intakes of Gastric Cancer Patients: A Case-Control Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.9747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Karim S, Mirza Z, Naseer MI, Al-Qahtani MH, Ali A. Clinicopathological characteristics and chronology of p53 expression in the development of gastric cancer. Asian Pac J Cancer Prev 2014; 15:1375-9. [PMID: 24719956 DOI: 10.7314/apjcp.2014.15.3.1375] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS The present study was aimed to investigate the correlation between selected clinicopathological characteristics and p53 protein overexpression, in Indian gastric cancer patients. METHODOLOGY Here, we studied specimens from 103 patients with gastric carcinomas and cases were categorized by AJCC-TNM classification. The p53 expression was analyzed in all the specimens by immunohistochemistry (IHC) and was correlated with the clinicopathological characteristics of the patients as well as etiological factors for gastric cancer. The cases were considered p53 overexpressed if more than 25% of the tumor cells were found to be expressing this protein. RESULTS We found significant association of p53 overexpression with the gender (p = 0.004) and histology grades (p = 0.001). However, p53 overexpression was not found to be significantly associated with other clinicopathological characteristics like age, cell differentiation, stage and location and various etiological factors. CONCLUSIONS Our observation showed that IHC-based detection of altered expression of p53 protein in gastric carcinomas may play an important role for diagnosing the progression of gastric carcinoma, even in the early stages.
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