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Xiang Y, Wang Z, Ma Y, Yuan Y, Li W, Zhu Y, Ye Q, Wang Y, Yang J, Sun Q, Ding X, Longi F, Tang D, An F, Xu G. Established nomogram based on clinicopathological characteristics, lifestyle, and comorbidities risk factors for metachronous recurrence in curative endoscopic submucosal dissection. Therap Adv Gastroenterol 2025; 18:17562848251330973. [PMID: 40292089 PMCID: PMC12033642 DOI: 10.1177/17562848251330973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 03/11/2025] [Indexed: 04/30/2025] Open
Abstract
Background Metachronous gastric cancer (MGC) has gained increasing attention due to the preservation of the stomach during endoscopic resection for early gastric cancer (EGC). Objectives This study aims to investigate the risk factors associated with MGC in the postoperative surveillance of endoscopic submucosal dissection (ESD). Design A retrospective case-control study. Methods The retrospective study was conducted between January 1, 2014, and June 30, 2020, at the Affiliated Drum Tower Hospital of Nanjing University Medical School. Results Several independent risk factors for developing MGC were identified as smoking history (hazard ratio (HR) 2.39, 95% confidence interval (CI) 1.25-4.58), metabolic dysfunction-associated steatotic liver disease (MASLD; HR 2.44, 95% CI 1.23-4.87), cerebrovascular disease (CD; HR 2.55, 95% CI 1.09-5.99), multiple lesions (HR 2.06, 95% CI 1.17-3.63), Helicobacter pylori infection status (eradicated vs negative: HR 1.42, 95% CI 0.60-3.39; persistent vs negative: HR 5.47, 95% CI 2.13-14.03), and atrophic gastritis (AG; moderate vs mild: HR 4.44, 95% CI 1.36-14.53; severe vs mild: HR 7.30, 95% CI 2.11-25.22). The established nomogram based on these risk factors demonstrated high accuracy both in the training and test sets, with concordance indexes of 0.787, 0.762, and 0.845 for the training set, and 0.764, 0.824, and 0.788 for the test set at 2, 3, and 5 years, respectively. Conclusion The risk factors for developing MGC after curative ESD for EGC were identified as smoking history, MASLD, CD, multiple lesions, H. pylori infection status, and AG. To reduce the risk of MGC, a healthy lifestyle, regular H. pylori testing, and annual endoscopic screening are recommended.
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Affiliation(s)
- Ying Xiang
- Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Zhenyu Wang
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Yichun Ma
- Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Ying Yuan
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Wenying Li
- Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Yanmei Zhu
- Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Qiange Ye
- Nanjing Drum Tower Hospital, Clinical College of Jiangsu University, Nanjing, Jiangsu Province, China
| | - Yanan Wang
- Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Jinping Yang
- Oncology Department of Integrated Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qi Sun
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Xiwei Ding
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Faraz Longi
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dehua Tang
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Fangmei An
- Department of Gastroenterology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, Jiangsu Province 214023, China
| | - Guifang Xu
- Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
- Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
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Duan T, Chen X, Wu J, Li R, Guo H, Du J, Guo J. Serum carbohydrate antigen 72-4 concentrations decrease with age in females but not in males in Beijing, China. Ann Clin Biochem 2021; 58:556-562. [PMID: 34120477 DOI: 10.1177/00045632211026961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Carbohydrate antigen 72-4 (CA72-4) is widely used in the diagnosis and monitoring of many cancers. However, there are few studies on the differences of CA72-4 concentrations in terms of age and gender. METHODS A total of 10,957 healthy subjects were divided into two groups according to gender and three age groups. The serum CA72-4 were detected. Statistical analysis was performed by SPSS. RESULTS The CA72-4 concentration in female group was significantly higher than that in male group. The concentration of CA72-4 gradually decreased with age. Compared with the age >60 group, the CA72-4 concentrations were increased in the age 46-60 group and 16-45 group (P >0.05, respectively). To better observe the age difference, the age 16-45 and 46-60 groups were combined into the age 16-60 group. In comparison to the age >60 group, the CA72-4 concentration of age 16-60 group was significantly increased (P = 0.000). In the age >60 group, there was no difference between genders. Nevertheless, the difference between the sexes in the age 16-60 group was significant (P = 0.023). CONCLUSIONS The reference interval of CA72-4 for local healthy population was established. CA72-4 concentrations gradually decreased with the increase of age, and CA72-4 concentration in females aged 16-60 years (0-18.0 U/mL) was higher than in males (0-14.5 U/mL); however, there was no gender difference in the age group above 60 years old (0-14.5 U/mL). Moreover, in male CA72-4 there was no significant difference among all age groups, while the potential mechanism of female changes with age needs further study.
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Affiliation(s)
- Tongmei Duan
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Department of Clinical Laboratory, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xun Chen
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Wu
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ronghai Li
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Huijuan Guo
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Juan Du
- Clinical Laboratory Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Guo
- Department of Clinical Laboratory, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Deng W, Jin L, Zhuo H, Vasiliou V, Zhang Y. Alcohol consumption and risk of stomach cancer: A meta-analysis. Chem Biol Interact 2021; 336:109365. [PMID: 33412155 DOI: 10.1016/j.cbi.2021.109365] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 11/27/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
Stomach cancer is one of the most common cancers in the world. The relationship between alcohol consumption and the risk of stomach cancer remains unclear. Epidemiology studies investigating this relationship have shown inconsistent findings. A meta-analysis was performed to explore the association between alcohol consumption and increased stomach cancer risk. Eighty-one epidemiology studies, including 68 case-control studies and 13 cohort studies, were included in this study. A significant association was found between alcohol consumption and increased risk of stomach cancer (OR = 1.20, 95% CI 1.12-1.27). To explore the source of the significant heterogeneity (p < 0.05, I2 = 86%), analysis was stratified by study type (case-control study and cohort study), control type (hospital-based control and population-based control), gender (male, female, and mix), race (White and Asian), region (United States, Sweden, China, Japan), subsite of stomach cancer, and type of alcohol. The stratified analyses found that region and cancer subsite are major sources of the high heterogeneity. The inconsistent results in different regions and different subsites might be related to smoking rates, Helicobacter pylori infection, obesity, and potential genetic susceptibility. The positive association between drinking and increased risk of stomach cancer is consistent in stratified analyses. The dose-response analysis showed a clear trend that a higher daily intake of alcohol is associated with a higher risk of stomach cancer.
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Affiliation(s)
- Wenting Deng
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Lan Jin
- Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Haoran Zhuo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Vasilis Vasiliou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Cancer Center, New Haven, CT, USA
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Huang L, Chen L, Gui ZX, Liu S, Wei ZJ, Xu AM. Preventable lifestyle and eating habits associated with gastric adenocarcinoma: A case-control study. J Cancer 2020; 11:1231-1239. [PMID: 31956369 PMCID: PMC6959061 DOI: 10.7150/jca.39023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/14/2019] [Indexed: 01/19/2023] Open
Abstract
Background: Besides the well-established risk factors for gastric adenocarcinoma (GaC), many other etiological factors remain largely unexplored. This large comprehensive case-control study aimed to investigate the preventable lifestyle and eating habits associated with GaC. Methods: Consecutive patients with primary microscopically-confirmed GaC diagnosed in 2016-2018 were matched by sex, age, height, and socioeconomic status at a 1:1 ratio with healthy controls. Association of GaC versus control with investigated factors was assessed using the multivariable-adjusted conditional logistic regression for paired samples. Results: Together 302 GaC patients and 302 healthy controls were investigated. Participants receiving higher education and those eating majorly vegetables had less frequently GaC. The majorly frying cooking habit was associated with a higher incidence of GaC. People complaining about poor sleep quality had more often GaC. The more often one smoked, the more often he/she had GaC. A higher frequency for having pickled food was associated with more frequent GaC, while having more frequently vegetables/fruit, beans, or kelps was associated with less often GaC. A greater preference for sour or bitter taste was associated with less frequent GaC. The frequencies of thin liquid intake after meal, swallowing hot food without adequate cooling, doing other things while eating, eating overnight food, and eating midnight snack were all positively associated with GaC, while going to bed regularly was associated with less often GaC. Conclusions: Education level, sleep quality, smoking, the frequencies of use of several foods and seasonings, the preference for specific tastes, and various eating and living habits were associated with GaC. The findings offer important hints for further prospective investigations and for easy effective GaC-preventative strategy-making.
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Affiliation(s)
- Lei Huang
- Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - Lei Chen
- Second Clinical Medicine College of Anhui Medical University
| | - Zhong-Xuan Gui
- Second Clinical Medicine College of Anhui Medical University
| | - Shun Liu
- Second Clinical Medicine College of Anhui Medical University
| | - Zhi-Jian Wei
- Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
| | - A-Man Xu
- Department of General Surgery, the First Affiliated Hospital of Anhui Medical University
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Guo E, Wei H, Liao X, Xu Y, Li S, Zeng X. Prognostic value of alcohol dehydrogenase mRNA expression in gastric cancer. Oncol Lett 2018; 15:5505-5516. [PMID: 29552190 PMCID: PMC5840614 DOI: 10.3892/ol.2018.8007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 12/08/2017] [Indexed: 12/11/2022] Open
Abstract
Previous studies have reported that alcohol dehydrogenase (ADH) isoenzymes possess diagnostic value in gastric cancer (GC). However, the prognostic value of ADH isoenzymes in GC remains unclear. The aim of the present study was to identify the prognostic value of ADH genes in patients with GC. The prognostic value of ADH genes was investigated in patients with GC using the Kaplan-Meier plotter tool. Kaplan-Meier plots were used to assess the difference between groups of patients with GC with different prognoses. Hazard ratios (HR) and 95% confidence intervals (CI) were used to assess the relative risk of GC survival. Overall, 593 patients with GC and 7 ADH genes were included in the survival analysis. High expression of ADH 1A (class 1), α polypeptide (ADH1A; log-rank P=0.043; HR=0.79; 95% CI: 0.64–0.99), ADH 1B (class 1), β polypeptide (ADH1B; log-rank P=1.9×10−05; HR=0.65; 95% CI: 0.53–0.79) and ADH 5 (class III), χ polypeptide (ADH5; log-rank P=0.0011; HR=0.73; 95% CI: 0.6–0.88) resulted in a significantly decreased risk of mortality in all patients with GC compared with patients with low expression of those genes. Furthermore, protective effects may additionally be observed in patients with intestinal-type GC with high expression of ADH1B (log-rank P=0.031; HR=0.64; 95% CI: 0.43–0.96) and patients with diffuse-type GC with high expression of ADH1A (log-rank P=0.014; HR=0.51; 95% CI: 0.3–0.88), ADH1B (log-rank P=0.04; HR=0.53; 95% CI: 0.29–0.98), ADH 4 (class II), π polypeptide (log-rank P=0.033; HR=0.58; 95% CI: 0.35–0.96) and ADH 6 (class V) (log-rank P=0.037; HR=0.59; 95% CI: 0.35–0.97) resulting in a significantly decreased risk of mortality compared with patients with low expression of those genes. In contrast, patients with diffuse-type GC with high expression of ADH5 (log-rank P=0.044; HR=1.66; 95% CI: 1.01–2.74) were significantly correlated with a poor prognosis. The results of the present study suggest that ADH1A and ADH1B may be potential prognostic biomarkers of GC, whereas the prognostic value of other ADH genes requires further investigation.
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Affiliation(s)
- Erna Guo
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.,School of International Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Haotang Wei
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530031, P.R. China
| | - Xiwen Liao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Yang Xu
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Shu Li
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Xiaoyun Zeng
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
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Prognostic significance of cancer family history for patients with gastric cancer: a single center experience from China. Oncotarget 2018; 7:37305-37318. [PMID: 27127887 PMCID: PMC5095078 DOI: 10.18632/oncotarget.9032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 04/16/2016] [Indexed: 01/27/2023] Open
Abstract
Family history of cancer is a risk factor for gastric cancer. In this study, we investigated the prognoses of gastric cancer patients with family history of cancer. A total of 1805 gastric cancer patients who underwent curative gastrectomy from 2000 to 2008 were evaluated. The clinicopathologic parameters and prognoses of gastric cancer patients with a positive family history (PFH) of cancer were compared with those with a negative family history (NFH). Of 1805 patients, 382 (21.2%) patients had a positive family history of cancer. Positive family history of cancer correlated with younger age, more frequent alcohol and tobacco use, worse differentiation, smaller tumor size, and more frequent tumor location in the lower 1/3 of the stomach. The prognoses of patients with a positive family history of cancer were better than that of patients with a negative family history. Family history of cancer independently correlated with better prognosis after curative gastrectomy in gastric cancer patients.
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Lai HTM, Koriyama C, Tokudome S, Tran HH, Tran LT, Nandakumar A, Akiba S, Le NT. Waterpipe Tobacco Smoking and Gastric Cancer Risk among Vietnamese Men. PLoS One 2016; 11:e0165587. [PMID: 27802311 PMCID: PMC5089735 DOI: 10.1371/journal.pone.0165587] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 10/16/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The association of waterpipe tobacco (WPT) smoking with gastric cancer (GC) risk was suggested. METHODS A hospital-based case-control study was conducted to examine the association of WPT with GC risk among Vietnamese men, in Hanoi city, during the period of 2003-2011. Newly-diagnosed GC cases (n = 454) and control patients (n = 628) were matched by age (+/- 5 years) and the year of hospitalization. Information on smoking and alcohol drinking habits and diet including salty food intake and fruits/vegetables consumption were obtained by the interview. Maximum likelihood estimates of odds ratios (ORs) and corresponding 95% confidence intervals (Cis) were obtained using conditional logistic regression models. RESULTS The group with the highest consumption of citrus fruits showed a significantly low GC risk (OR = 0.6, 95%CI = 0.4-0.8, P for trend = 0.002). However, there was no association of raw vegetable consumption with GC risk. Referring to never smokers, GC risk was significantly higher in current WPT smokers (OR = 1.8, 95%CI = 1.3-2.4), and it was more evident in exclusively WPT smokers (OR = 2.7, 95%CI = 1.2-6.5). GC risk tended to be higher with daily frequency and longer duration of WPT smoking but these trends were not statistically significant (P for trend: 0.144 and 0.154, respectively). GC risk of those who started smoking WPT before the age of 25 was also significantly high (OR = 3.7, 95%CI = 1.2-11.3). Neither cigarette smoking nor alcohol drinking was related to GC risk. CONCLUSION The present findings revealed that WPT smoking was positively associated with GC risk in Vietnamese men.
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Affiliation(s)
- Hang Thi Minh Lai
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Hoc Hieu Tran
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam
| | - Long Thanh Tran
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Athira Nandakumar
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Suminori Akiba
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ngoan Tran Le
- Department of Occupational Health, Hanoi Medical University, Hanoi, Vietnam
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Yang K, Zhu H, Chen CC, Wen TF, Zhang WH, Liu K, Chen XZ, Guo DJ, Zhou ZG, Hu JK. Lessons Learned From a Case of Gastric Cancer After Liver Transplantation for Hepatocellular Carcinoma: A Case Report and Literatures Review. Medicine (Baltimore) 2016; 95:e2666. [PMID: 26886605 PMCID: PMC4998605 DOI: 10.1097/md.0000000000002666] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/29/2015] [Accepted: 01/04/2016] [Indexed: 02/05/2023] Open
Abstract
Nowadays, de novo malignancies have become an important cause of death after transplantation. According to the accumulation of cases with liver transplantation, the incidence of de novo gastric cancer is anticipated to increase among liver transplant recipients in the near future, especially in some East Asian countries where both liver diseases requiring liver transplantation and gastric cancer are major burdens. Unfortunately, there is limited information regarding the relationship between de novo gastric cancer and liver transplantation. Herein, we report a case of stage IIIc gastric cancer after liver transplantation for hepatocellular carcinoma, who was successfully treated by radical distal gastrectomy with D2 lymphadenectomy but died 15 months later due to tumor progression. Furthermore, we extract some lessons to learn from the case and review the literatures. The incidence of de novo gastric cancer following liver transplantations is increasing and higher than the general population. Doctors should be vigilant in early detection and control the risk factors causing de novo gastric cancer after liver transplantation. Curative gastrectomy with D2 lymphadenectomy is still the mainstay of treatment for such patients. Preoperative assessments, strict postoperative monitoring, and managements are mandatory. Limited chemotherapy could be given to the patients with high risk of recurrence. Close surveillance, early detection, and treatment of posttransplant cancers are extremely important and essential to improve the survival.
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Affiliation(s)
- Kun Yang
- From the Department of Gastrointestinal Surgery (KY, HZ, W-HZ, KL, X-ZC, D-JG, Z-GZ, J-KH); Laboratory of Gastric Cancer (KY, W-HZ, KL, X-ZC, D-JG, J-KH); Department of Nephrology (C-CC); and Department of Liver Surgery and Liver Transplantation Center (T-FW), West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Xiao H, Bian J, Zhang L, Wang Z, Ding A. Gastric cancer following a liver transplantation for glycogen storage disease type Ia (von Gierke disease): A case report. Oncol Lett 2014; 8:2803-2805. [PMID: 25364469 PMCID: PMC4214470 DOI: 10.3892/ol.2014.2599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/11/2014] [Indexed: 12/31/2022] Open
Abstract
Glycogen storage disease type Ia (GSD-Ia; also termed von Gierke disease) is an inherited metabolic disorder resulting from a glucose-6-phosphatase deficiency. Liver transplantation is considered to be the most effective treatment for GSD-Ia patients. In the present study, the case of a patient with GSD-Ia who received a liver transplantation at 17 years of age is presented. During the 12 years following transplantation, the patient’s quality of life markedly improved. However, recently, the patient was diagnosed with de novo gastric cancer following a biopsy. Thus, a total gastrectomy with lymph node dissection was performed and the tumor was histologically determined to be a poorly differentiated adenocarcinoma (histopathological stage, pT4N1M0). The patient recovered well and was discharged on postoperative day 10 without any complications. To the best of our knowledge, this is the first case of de novo gastric cancer in a patient with GSD-Ia to be reported.
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Affiliation(s)
- Hua Xiao
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Jianmin Bian
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Lei Zhang
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Zhaoming Wang
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
| | - Aixing Ding
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, P.R. China
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Dinis-Oliveira RJ, Magalhães T, Moreira R, Proença JB, Pontes H, Santos A, Duarte JA, Carvalho F. Clinical and forensic signs related to ethanol abuse: a mechanistic approach. Toxicol Mech Methods 2014; 24:81-110. [PMID: 24274640 DOI: 10.3109/15376516.2013.869782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
For good performance in clinical and forensic toxicology, it is important to be aware of the signs and symptoms related to xenobiotic exposure since they will assist clinicians to reach a useful and rapid diagnosis. This manuscript highlights and critically analyses clinical and forensic imaging related to ethanol abuse. Here, signs that may lead to suspected ethanol abuse, but that are not necessarily related to liver disease are thoroughly discussed regarding its underlying mechanisms. This includes flushing and disulfiram reactions, urticaria, palmar erythema, spider telangiectasias, porphyria cutanea tarda, "paper money skin", psoriasis, rhinophyma, Dupuytren's contracture, multiple symmetrical lipomatosis (lipomatosis Lanois-Bensaude, Madelung's disease), pancreatitis-related signs, black hairy tongue, gout, nail changes, fetal alcohol syndrome, seborrheic dermatitis, sialosis and cancer.
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Affiliation(s)
- Ricardo Jorge Dinis-Oliveira
- IINFACTS -- Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, Advanced Institute of Health Sciences - North, CESPU, CRL , Gandra , Portugal
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Time characteristics of the effect of alcohol cessation on the risk of stomach cancer--a meta-analysis. BMC Public Health 2013; 13:600. [PMID: 23786883 PMCID: PMC3695890 DOI: 10.1186/1471-2458-13-600] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 06/12/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In the Bagnardi et al. (2001) meta-analysis, it was found that alcohol consumption increases the risk of stomach cancer (OR = 1.32 for heavy drinkers). However, it is unknown if drinking cessation reverses this alcohol-elevated risk. METHODS A systematic literature review was performed to provide the information for a meta-analysis where the dose-risk trend was estimated for years since drinking cessation and the risk of stomach cancer. A random effect generalised least squares model for trend estimation was used, employing study characteristics to control for heterogeneity. RESULTS Nineteen observational studies were identified in the literature review, of which five studies quantified duration of cessation and risk of stomach cancer, giving a total of 1947 cancer cases. No significant effect of drinking cessation on the risk of stomach cancer could be found (OR = 0.99 CI: 0.97-1.02). CONCLUSIONS This result should be interpreted with caution due to the limited number of studies in this area. Recent findings suggest a link between heavy drinking and stomach cancer, especially gastric noncardia, but not for moderate drinking. Since all but one of the included studies in this meta-analysis failed to control for consumption level, the current study could not test if the risk decline following drinking cessation differs between moderate and high consumers.
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Everatt R, Tamosiunas A, Kuzmickiene I, Virviciute D, Radisauskas R, Reklaitiene R, Milinaviciene E. Alcohol consumption and risk of gastric cancer: a cohort study of men in Kaunas, Lithuania, with up to 30 years follow-up. BMC Cancer 2012; 12:475. [PMID: 23066954 PMCID: PMC3527179 DOI: 10.1186/1471-2407-12-475] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 10/10/2012] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Gastric cancer is the second most common cause of death from cancer in the world. Epidemiological findings on alcohol use in relation to gastric cancer remain controversial. The aim of this study was to examine the effect of alcohol consumption on the risk of gastric cancer. METHODS The association between alcohol intake and the risk of gastric cancer was examined in a population-based cohort of 7,150 men in Kaunas, Lithuania, who were enrolled during 1972-1974 or 1976-1980. After up to 30 years of follow-up, 185 gastric cancer cases were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). The attained age was used as a time-scale. RESULTS After adjustment for smoking, education level and body mass index, the HR of gastric cancer was 2.00 (95% CI: 1.04-3.82) for the highest alcohol consumption frequency (2-7 times per week) compared with occasional drinking (a few times per year) and 1.90 (95% CI: 1.13-3.18) for ≥ 100.0 g ethanol/week versus 0.1-9.9 g ethanol/week. A stronger effect of alcohol consumption on gastric cancer risk was observed during the second half of the study (1993-2008). In the analysis of gastric cancer risk by alcoholic beverage type, all beverages were included simultaneously in the model. The multivariate HR for men who consumed ≥ 0.5 litre of wine per occasion (compared with those who consumed <0.5 litre) was 2.95 (95% CI: 1.30-6.68). Higher consumption of beer or vodka was not statistically significantly associated with gastric cancer risk. After adjustment for smoking, education level, body mass index and ethanol, we found no excess risk of gastric cancer in association with total acetaldehyde intake. CONCLUSIONS This study supports a link between alcohol consumption (primarily from ethanol) and the development of gastric cancer in the Lithuanian population. Although an association with heavy wine consumption was observed, the effect of exposure to acetaldehyde on the development of gastric cancer in this cohort was not confirmed. Further research is needed to provide a more detailed evaluation of alcohol drinking and gastric cancer risk.
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Affiliation(s)
- Ruta Everatt
- Group of Epidemiology, Institute of Oncology, Vilnius University, Baublio 3B, LT-08406, Vilnius, Lithuania
| | - Abdonas Tamosiunas
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009, Kaunas, Lithuania
| | - Irena Kuzmickiene
- Group of Epidemiology, Institute of Oncology, Vilnius University, Baublio 3B, LT-08406, Vilnius, Lithuania
| | - Dalia Virviciute
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009, Kaunas, Lithuania
| | - Regina Reklaitiene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009, Kaunas, Lithuania
| | - Egle Milinaviciene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009, Kaunas, Lithuania
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Jensen K, Afroze S, Munshi MK, Guerrier M, Glaser SS. Mechanisms for nicotine in the development and progression of gastrointestinal cancers. TRANSLATIONAL GASTROINTESTINAL CANCER 2012; 1:81-87. [PMID: 22701817 PMCID: PMC3371638 DOI: 10.3978/j.issn.2224-4778.2011.12.01] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Long-term smoking is major risk factor for a variety of cancers, including those of the gastrointestinal (GI) tract. Historically, nicotine and its derivatives are well known for their role in addiction, and have more recently been documented for their carcinogenic role in a number of human cancers. The cellular and molecular pathways activated by nicotine mimic physiological and environmental carcinogenesis in cancers throughout the GI tract potentiating cancer growth and/or inducing the formation of cancer on their own. Thus, it is important to unlock the carcinogenic mechanisms induced by nicotine in these systems, and underscore nicotine's potential as an environmental hazard. This review outlines the specific pathways demonstrated to mediate nicotine's carcinogenic mechanism in the GI tract. The abundance of cell and animal evidence calls for increased epidemiologic and case-control evaluation of nicotine's role in cancer.
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Tramacere I, Negri E, Pelucchi C, Bagnardi V, Rota M, Scotti L, Islami F, Corrao G, La Vecchia C, Boffetta P. A meta-analysis on alcohol drinking and gastric cancer risk. Ann Oncol 2012; 23:28-36. [PMID: 21536659 DOI: 10.1093/annonc/mdr135] [Citation(s) in RCA: 211] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Whether an association between alcohol drinking and gastric cancer risk exists is an open question. In order to provide a definite quantification of the association between alcohol drinking and gastric cancer risk, we conducted a meta-analysis of available data. PATIENTS AND METHODS We carried out a PubMed search of articles published up to June 2010 and identified 44 case-control and 15 cohort studies, including a total of 34 557 gastric cancer cases. We derived meta-analytic estimates using random-effects models, taking into account correlation between estimates. We carried out a dose-risk analysis using nonlinear random-effects meta-regression models. RESULTS Compared with nondrinkers, the pooled relative risk (RR) was 1.07 [95% confidence interval (CI) 1.01-1.13] for alcohol drinkers and 1.20 (95% CI 1.01-1.44) for heavy alcohol drinkers (≥4 drinks per day). The pooled estimates were apparently higher for gastric noncardia (RR for heavy drinkers=1.17, 95% CI 0.78-1.75) than for gastric cardia (RR=0.99, 95% CI 0.67-1.47) adenocarcinoma. The dose-risk model estimated a RR of 0.95 (95% CI 0.91-0.99) for 10 g/day and 1.14 (95% CI 1.08-1.21) for 50 g/day. CONCLUSIONS This meta-analysis provides definite evidence of a lack of association between moderate alcohol drinking and gastric cancer risk. There was, however, a positive association with heavy alcohol drinking.
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Affiliation(s)
- I Tramacere
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan
| | - E Negri
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan
| | - C Pelucchi
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan.
| | - V Bagnardi
- Department of Statistics, University of Milano-Bicocca, Milan; Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan
| | - M Rota
- Department of Statistics, University of Milano-Bicocca, Milan; Department of Clinical Medicine and Prevention, Centre of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza, Italy
| | - L Scotti
- Department of Statistics, University of Milano-Bicocca, Milan
| | - F Islami
- International Agency for Research on Cancer, Lyon, France; Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - G Corrao
- Department of Statistics, University of Milano-Bicocca, Milan
| | - C La Vecchia
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan; Section of Medical Statistics, Department of Occupational Health, University of Milan, Milan, Italy
| | - P Boffetta
- International Prevention Research Institute, Lyon, France; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
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Li L, Ying XJ, Sun TT, Yi K, Tian HL, Sun R, Tian JH, Yang KH. Overview of methodological quality of systematic reviews about gastric cancer risk and protective factors. Asian Pac J Cancer Prev 2012; 13:2069-2079. [PMID: 22901173 DOI: 10.7314/apjcp.2012.13.5.2069] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study. METHODS Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches. RESULTS Beta- carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30 g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products). CONCLUSIONS The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.
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Affiliation(s)
- Lun Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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16
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Zhang MW, Jin MJ, Yu YX, Zhang SC, Liu B, Jiang X, Pan YF, Li QI, Ma SY, Chen K. Associations of lifestyle-related factors, hsa-miR-149 and hsa-miR-605 gene polymorphisms with gastrointestinal cancer risk. Mol Carcinog 2011; 51 Suppl 1:E21-31. [PMID: 21976437 DOI: 10.1002/mc.20863] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 09/02/2011] [Accepted: 09/09/2011] [Indexed: 12/23/2022]
Abstract
To explore the associations of SNPs within hsa-miR-605 (rs2043556) and hsa-miR-149 (rs2292832) and lifestyle-related factors with gastrointestinal cancer, a case-control study including 762 cases and 757 controls was conducted. Marginally significant associations were found both for hsa-miR-149 rs2292832 with gastric cancer risk (TC + CC vs. TT, OR = 0.68, 95% CI: 0.44-1.04) and for hsa-miR-605 rs2043556 with colorectal cancer risk (AG + GG vs. AA, OR = 0.70, 95% CI: 0.48-1.02) in males. Tea drinking showed a protective effect on gastric cancer risk (OR = 0.28, 95% CI: 0.13-0.60), while smoke inhalation increased the risk of gastric cancer (OR = 1.94, 95% CI: 1.08-3.47). Irritability was found to be a risk factor for both colorectal cancer (OR = 1.61, 95% CI: 1.02-2.53) and gastric cancer (OR = 1.96, 95% CI: 1.17-3.29). Among those that engaged in smoke inhalation, miR-149 CT/CC and miR-605 AG/GG genotype carriers had increased susceptibilities to colorectal cancer (OR = 1.90, 95% CI: 1.11-3.25) and gastric cancer (OR = 1.87, 95% CI: 1.03-3.42), respectively. Among the tea drinkers, there exists a marginally protective effect of miR-605 AG/GG genotypes on colorectal cancer incidence (OR = 0.71, 95% CI: 0.47-1.06) and a significantly protective effect of miR-149 CT/CC on gastric cancer incidence (OR = 0.47, 95% CI: 0.29-0.77). The SNPs of rs2292832 and rs2043556 might be able to modify the susceptibility to male gastric and colorectal cancers, respectively. Tea drinking is a protective factor, while smoke inhalation is a risk factor for gastric cancer, and they might have the potential to modify the associations between miR-149 and miR-605 polymorphisms with gastrointestinal cancer risk. In addition, irritability was shown to be a risk factor for both gastric and colorectal cancers.
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Affiliation(s)
- M W Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
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17
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Chang CC, Chen CC, Chiu HF, Yang CY. Higher parity associated with higher risk of death from gastric cancer. World J Gastroenterol 2011; 17:784-8. [PMID: 21390150 PMCID: PMC3042658 DOI: 10.3748/wjg.v17.i6.784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 12/27/2010] [Accepted: 01/04/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the association between parity and gastric cancer (the cases are almost all premenopausal women) risk in a cohort of young parous women.
METHODS: The study cohort consisted of all women with a record of a first and singleton childbirth in the Birth Register between 1978 and 1987. We tracked each woman from the time of her first childbirth to December 31, 2008. Their vital status was ascertained by linking records to the computerized mortality database. Cox proportional hazard regression models were used to estimate hazard ratios of death from gastric cancer associated with parity.
RESULTS: There were 1090 gastric cancer deaths (85.87% of them were premenopausal) during 33 686 828 person-years of follow-up. The mortality rate of gastric cancer was 3.24 cases per 100 000 person-years. A trend of increasing risk of gastric cancer was seen with increasing parity. The adjusted hazard ratio was 1.24 [confidence interval (95% CI): 1.02-1.50] for women who had borne two to three children, and 1.32 (95% CI: 1.01-1.72) for women with four or more births, when compared with women who had given birth to only one child.
CONCLUSION: These results suggest that higher parity may increase the risk of death from gastric cancer among premenopausal women.
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18
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Pourfarzi F, Whelan A, Kaldor J, Malekzadeh R. The role of diet and other environmental factors in the causation of gastric cancer in Iran--a population based study. Int J Cancer 2009; 125:1953-1960. [PMID: 19569234 DOI: 10.1002/ijc.24499] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. The rates of GC reported from Ardabil Province, Iran, are among the highest in the world. To investigate risk factors for GC in Ardabil, we undertook a population-based case-control study. The study aimed to recruit all Ardabil residents newly diagnosed with GC in the time period of 2004-2005, and 2 controls per case. Participants were interviewed using a structured questionnaire. Ten milliliters of blood was collected for blood grouping and investigating the presence of IgG antibodies against Helicobacter pylori. During the study period, 217 people with GC and 394 controls were recruited. In multivariate analysis, diet and Helicobacter pylori infection (OR = 2.41; 95% CI: 1.35-4.32) were found to be the factors that were most strongly related to GC. High intake of Allium vegetables (OR = 0.35) and fruit, especially citrus fruit (OR = 0.31) and consumption of fresh fish (OR = 0.37) were significantly protective. On the other hand, consumption of red meat (OR = 3.40) and dairy products (OR = 2.28) were positively associated with the risk of GC. People who had a preference for higher salt intake (OR = 3.10) and drinking strong and hot tea (OR = 2.64 and 2.85, respectively) were at higher risk. In conclusion, Helicobacter pylori infection as measured by serum IgG as well as the consumption of red meat and dairy products increases the risk of GC in Ardabil, while the intake of fresh fruit and fresh fish decrease the risk.
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Affiliation(s)
- Farhad Pourfarzi
- Division of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran.
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19
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Lunet N, Valbuena C, Vieira AL, Lopes C, Lopes C, David L, Carneiro F, Barros H. Fruit and vegetable consumption and gastric cancer by location and histological type: case-control and meta-analysis. Eur J Cancer Prev 2007; 16:312-27. [PMID: 17554204 DOI: 10.1097/01.cej.0000236255.95769.22] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The available information favours a greater impact of environmental exposures on intestinal type gastric cancer, and risk factors for the cardia and distal stomach cancers also appear to be different. We aimed to estimate the association between fruit and vegetable intake and gastric cancer, by location and histological type. We performed a population-based case-control study and a meta-analysis of studies addressing this issue. Incident cases (n=305) were identified in two large teaching hospitals (Porto, Portugal), and controls were randomly sampled among city dwellers (n=1129). Published studies were searched through PubMed, and effects were combined with random effects meta-analysis. In our case-control study, the odds ratio (OR) for the comparison of the highest vs. lowest tertile of fruit consumption was 0.47 [95% confidence interval (CI): 0.21-1.05] for cardia, 0.53 (95% CI: 0.35-0.80) for non-cardia cancer, 0.36 (95% CI: 0.20-0.62) for intestinal, and 1.00 (95% CI: 0.53-1.90) for the diffuse histological type. For vegetables, the corresponding OR was 0.59 (95% CI: 0.26-1.35), 0.85 (95% CI: 0.58-1.26), 0.95 (95% CI: 0.57-1.57), and 0.60 (95% CI: 0.32-1.14). In meta-analysis, considering fruit consumption (highest vs. lowest category), the combined OR was 0.58 (95% CI: 0.38-0.89) for cardia, 0.61 (95% CI: 0.44-0.84) for non-cardia, 0.49 (95% CI: 0.33-0.72) for intestinal type, and 0.82 (95% CI: 0.57-1.20) for diffuse type. Vegetables also decreased the risk of cardia (OR=0.63, 95% CI: 0.50-0.79), non-cardia (OR=0.75, 95% CI: 0.59-0.95), intestinal (OR=0.61, 95% CI: 0.44-0.86), and diffuse type (OR=0.67, 95% CI: 0.44-1.01). Fruit or vegetable intake was associated with a decreased risk of gastric cancer regardless of the anatomical location and the histological type, although dietary intake had a more clear-cut protective effect on intestinal type cancers.
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Affiliation(s)
- Nuno Lunet
- Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
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20
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Larsson SC, Giovannucci E, Wolk A. Alcoholic beverage consumption and gastric cancer risk: a prospective population-based study in women. Int J Cancer 2007; 120:373-7. [PMID: 17066442 DOI: 10.1002/ijc.22204] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The association between alcohol consumption and risk of gastric cancer remains controversial. Moreover, prospective data on the role of alcoholic beverage type are sparse. We prospectively investigated the association between total alcohol (ethanol) intake as well as specific alcoholic beverages and risk of gastric cancer in the Swedish Mammography Cohort, a population-based cohort of 61,433 women. Alcohol intake and other dietary exposures were assessed at baseline (1987-1990) and again in 1997 using a food-frequency questionnaire. Incident gastric cancer cases were ascertained through the Swedish Cancer Register. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 966,807 person-years of follow-up, through June 2005, 160 incident cases of gastric cancer occurred. Total alcohol intake was not significantly associated with risk of gastric cancer. Compared with nondrinkers, the multivariate HR of gastric cancer for women with an alcohol intake of 40 g or more per week was 1.33 (95% CI, 0.79-2.25). Consumption of medium-strong/strong beer was associated with a statistically significant increased risk of gastric cancer; the multivariate HR for women who consumed more than one serving of medium-strong/strong beer per week (median, 2.5 drinks/week) was 2.09 (95% CI, 1.11-3.93; p-trend = 0.02) compared with no consumption. Consumption of light beer, wine, and hard liquor was not significantly associated with gastric cancer risk. Our findings suggest that constituents of beer other than alcohol may be associated with an increased risk of gastric cancer.
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Affiliation(s)
- Susanna C Larsson
- Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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21
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Sul J, Yu GP, Lu QY, Lu ML, Setiawan VW, Wang MR, Guo CH, Yu SZ, Mu L, Cai L, Kurtz RC, Zhang ZF. P53 Codon 72 polymorphisms: a case-control study of gastric cancer and potential interactions. Cancer Lett 2005; 238:210-23. [PMID: 16111803 PMCID: PMC4165492 DOI: 10.1016/j.canlet.2005.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2004] [Revised: 07/06/2005] [Accepted: 07/08/2005] [Indexed: 12/14/2022]
Abstract
P53 codon 72 polymorphisms have been reported to be associated with cancers of the lung, esophagus and cervix. However, there have been no reports on the interaction of select risk factors and p53 codon 72 polymorphisms in gastric cancer susceptibility. 155 gastric cancer cases and 134 cancer-free controls were enrolled at the Memorial Sloan Kettering Cancer Center (MSKCC) from November 1992 to November 1994. The crude odds ratio (OR1) associated with the (Pro/Pro) polymorphism and the risk of gastric cancer was 1.27 (0.70-2.33). Adjusting for age, sex, race and education (OR2) and further adjusting for BMI, calories, sodium, smoking, vitamin C, fiber, alcohol, fat, and H. pylori status (OR3) did not yield significant results. Significant joint effects were associated with high fat consumption (OR1=2.61 (95% CI:1.13-6.06); OR2=2.85 (95% CI:1.14-7.15) for total cancers and for proximal tumors (OR1=2.56 (95%CI:1.00-6.54)). The low vitamin C intake/high-risk polymorphism group (Pro/Pro) had an OR1 of 4.82 (95% CI: 1.72-13.45) and the OR2 was 6.19 (95% CI: 2.08-18.40) for distal tumors. The point estimates were increased for interaction odds ratios but not statistically significant (OR1=4.25 (95% CI: 0.66-27.50); OR2=4.73 (95% CI: 0.67-33.43); OR3=5.55 (95% CI: 0.66-46.47)). Further studies specifically looking at proximal and distal tumors are required to confirm any potential interaction between the p53 codon 72 polymorphisms and environmental risk, in particular low dietary vitamin C and high fat consumption.
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Affiliation(s)
- James Sul
- Clinical Instructor, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 44-138 CHS, Los Angeles, CA 90095-1684, USA.
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22
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Shin VY, Cho CH. Nicotine and gastric cancer. Alcohol 2005; 35:259-64. [PMID: 16054988 DOI: 10.1016/j.alcohol.2005.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2005] [Revised: 04/12/2005] [Accepted: 04/14/2005] [Indexed: 02/04/2023]
Abstract
About 60 components in cigarette smoke are considered to be carcinogens, namely polycyclic aromatic hydrocarbons, nitrosamines, aromatic amine, trace metals, as well as nicotine. Nicotine is considered to be one of the active components in cigarette smoke, and its association with tumorigenesis is enigmatic. Nonsteroidal antiinflammatory drugs are widely accepted as antitumor agents to treat patients with cancer by inhibiting cyclooxygenase-2 activity. Stimulation of tumor growth by nicotine involves different processes of cell proliferation and angiogenesis. Study results, with the use of animal xenograft models and cell culture systems, show that nicotine stimulates the progression of tumor growth, through a cyclooxygenase-2-dependent pathway. On the basis of these findings, nicotine seems to be a potent mitogenic agent in modulating tumor cell proliferation, and selective cyclooxygenase-2 inhibitors are promising antitumor agents for gastric cancer in smokers.
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Affiliation(s)
- Vivian Y Shin
- Centre of Infection and Immunology and Department of Pharmacology, Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, China
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23
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Koizumi Y, Tsubono Y, Nakaya N, Kuriyama S, Shibuya D, Matsuoka H, Tsuji I. Cigarette smoking and the risk of gastric cancer: a pooled analysis of two prospective studies in Japan. Int J Cancer 2004; 112:1049-55. [PMID: 15386347 DOI: 10.1002/ijc.20518] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To examine the association between cigarette smoking and the risk of gastric cancer, we conducted a pooled analysis of 2 population-based prospective cohort studies in rural northern Japan. Cohort 1 included 9,980 men (>or=40 years old) and Cohort 2 included 19,412 men (40-64 years old). The subjects completed a self-administered questionnaire on cigarette smoking and other health habits. We identified 228 cases of gastric cancer among Cohort 1 subjects (9 years of follow-up with 74,073 person-years) and 223 among Cohort 2 subjects (7 years of follow-up with 141,675 person-years). From each cohort, we computed the relative risk (RR) and 95% confidence interval (CI) of gastric cancer associated with smoking using a Cox regression analysis and pooled these estimates to obtain summary measures. The pooled multivariate RRs (95% CIs) for current smokers and past smokers compared to subjects who had never smoked were 1.84 (1.39-2.43) and 1.77 (1.29-2.43), respectively. The higher number of cigarettes smoked per day among current smokers was associated with a linear increase in risk (trend p < 0.05). The significant increase in risk for past smokers remained for up to 14 years after cessation. An increased risk was noted for cancer of the antrum but not for cardia or body lesions. The risk was increased for both differentiated and nondifferentiated histologic subtypes. Our findings support the hypothesis that cigarette smoking is a risk factor for gastric cancer.
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Affiliation(s)
- Yayoi Koizumi
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Chen MJ, Wu DC, Ko YC, Chiou YY. Personal history and family history as a predictor of gastric cardiac adenocarcinoma risk: a case-control study in Taiwan. Am J Gastroenterol 2004; 99:1250-7. [PMID: 15233662 DOI: 10.1111/j.1572-0241.2004.30872.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To clarify the risk of gastric cardiac adenocarcinoma for patients with a personal and/or family history of gastrointestinal diseases. METHODS The present study was a hospital-based case-control study conducted from 1992 to 1997 in Kaohsiung, Taiwan, consisting of 176 cases and 579 controls matched by age, sex, and time of hospitalization. With informed oral consent, each subject completed a structured questionnaire during hospitalization regarding sociodemographic status, lifestyle, and health history. RESULTS The response rate was 98%. Adjusting for age, sex, years of schooling, socioeconomic status, body mass index (BMI), and smoking. Multivariate logistic regression models indicated a reduced effect for patients with a personal history of duodenal ulcer (DU) (odds ratio (OR) = 0.8, 95% confidence interval (CI) 0.5-0.9). No association was observed between the risk of gastric cardiac cancer and other forms of gastric disease. Furthermore, we also demonstrated that individuals with a family history of gastric cancer had a higher risk than those who lacked a family history (OR = 2.5, 95% CI 1.3-4.8). CONCLUSIONS Our findings provide further evidence that individuals with DU history are less likely to have gastric cardiac cancer, and we infer that Helicobacter pylori (H. pylori) infection (85-95% DU patients infected with H. pylori) alone may not be sufficient to cause gastric cardiac adenocarcinoma. In addition, this study also suggests that a positive family history of gastric cancer may predict an increased risk for the disease.
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Affiliation(s)
- Mei-Ju Chen
- Department of Nursing, Chung Hwa Institute of Technology, Tainan County, Taiwan
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25
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Wu MT, Chen MC, Wu DC. Influences of lifestyle habits and p53 codon 72 and p21 codon 31 polymorphisms on gastric cancer risk in Taiwan. Cancer Lett 2004; 205:61-8. [PMID: 15036662 DOI: 10.1016/j.canlet.2003.11.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2003] [Revised: 11/18/2003] [Accepted: 11/19/2003] [Indexed: 12/19/2022]
Abstract
Influences of lifestyle habits and p53 codon 72 and p21 codon 31 polymorphisms on the risk for developing primary gastric cancer were examined in 89 gastric adenocarcinoma cases (51 males, 38 females) and 192 controls (106 males, 86 females) in a hospital-based, case-control study in Taiwan. In the final regression model, Helicobacter pylori infection and substance use (cigarette smoking, areca chewing) were significant predictors of risk for developing gastric cancer. Compared with subjects negative for H. pylori infection, positive subjects were 3.65-fold (95% CI = 2.07-6.42) more likely to develop gastric cancer. Compared with non-smokers or non-chewers, subjects with more than a 15 pack-year history or more than a 498 betel-year history (about 20 betel quids/day for 25 years) were 2.27- and 4.86-fold more at risk (95% CI = 1.06-4.84 and 1.20-19.74), respectively. Frequencies of arg/arg, arg/pro and pro/pro in p53 were 11 (12.4%), 53 (59.5%) and 25 (28.1%) in carcinoma cases and 40 (20.8%), 95 (49.5%) and 57 (29.7%) in control cases, respectively. Frequencies of arg/arg, ser/arg and ser/ser in p21 were 26 (29.2%), 36 (40.5%) and 27 (30.3%) in carcinoma cases and 49 (25.5%), 94 (49.0%) and 49 (25.5%) in control cases, respectively. Neither p53, nor p21 polymorphisms were significantly different in cases and controls ( P = 0.16 and P = 0.41, respectively). Results remained insignificant after dichotomizing with respect to cigarette smoking, areca chewing and H. pylori infection. In summary, our data indicate that in Taiwan, H. pylori infection, smoking and areca chewing are significant risk predictors for developing gastric cancer. p53 codon 72 and p21 codon 31 genotypes did not modify these risks.
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Affiliation(s)
- Ming-Tsang Wu
- Department of Occupational Medicine, Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
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26
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Matsumura S, Oue N, Kitadai Y, Chayama K, Yoshida K, Yamaguchi Y, Toge T, Imai K, Nakachi K, Yasui W. A single nucleotide polymorphism in the MMP-1 promoter is correlated with histological differentiation of gastric cancer. J Cancer Res Clin Oncol 2004; 130:259-65. [PMID: 14986114 DOI: 10.1007/s00432-004-0543-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2003] [Accepted: 12/28/2003] [Indexed: 12/29/2022]
Abstract
PURPOSE Matrix metalloproteinase-1 (MMP-1) plays a key role in cancer invasion and metastasis by degradation of extracellular matrix (ECM) and basement membrane barriers. The 1G/2G single nucleotide polymorphism (SNP) in the MMP-1 promoter at position -1607 bp has been reported to affect the transcriptional activity. In the light of these findings, we investigated whether this SNP in the MMP-1 promoter is associated with the development, differentiation, and progression of gastric cancer. METHODS The 215 gastric cancer patients and 166 controls were used in this study. The SNP of the MMP-1 promoter was analyzed by PCR-RFLP and sequencing. The genotype frequency was compared between cases and controls, and the association with clinicopathological parameters among cases was studied. RESULTS The frequency of 1G/2G genotypes in gastric cancer patients was similar to those in controls (p=0.57). The degree of tumor invasion, the presence of lymph node metastasis, and clinical stage showed no significant association with the SNP. On the other hand, we found a significant association with histological differentiation and gender among gastric cancer patients (p<0.05, respectively). CONCLUSIONS The presence of 2G allele in the MMP-1 promoter did not enhance the risk of gastric cancer; however, it may be involved in differentiation of gastric cancer.
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Affiliation(s)
- Shunji Matsumura
- Department of Molecular Pathology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
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27
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Fiotti N, Altamura N, Cappelli C, Schillan M, Guarnieri G, Giansante C. Long Term Prognosis in Patients with Peripheral Arterial Disease Treated with Antiplatelet Agents. Eur J Vasc Endovasc Surg 2003; 26:374-80. [PMID: 14511998 DOI: 10.1016/s1078-5884(03)00318-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the fatal and non-fatal cardiovascular event rate in patients with intermittent claudication treated with antiplatelet agents. METHODS AND DESIGN Patients with PAD-II stage Fontaine (n=223) and sex and age matched controls (n=446) were followed up from 1974 to 1998. All patients were treated with antiplatelet agents (aspirin, 325 mg once daily or ticlopidine, 250 mg twice daily) and for risk factors, if present. The end points were death for any cause (vascular event, cancer, and others) and non-fatal vascular events (myocardial infarction, ischemic/hemorrhagic stroke, and leg amputation). RESULTS PAD patients had a significantly higher mortality rate than controls (3.99 vs. 2.53 deaths for 100 patients per year, respectively), cancer (mostly lung, stomach and colon) and vascular mortality accounted for such difference. The incidence of non-fatal vascular events was three times higher in patients than in controls (1.7 vs. 0.56, 100 patients per year, respectively, p<0.05) even considering amputation separately (0.28 vs. 0.00, 100 patients per year, p<0.05). No difference between patients treated with aspirin or ticlopidine could be found in both end points. CONCLUSIONS Vascular mortality and morbidity, despite the use of antiplatelet agents, are still higher than sex and age matched controls; however, the commonest cause of death is cancer.
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Affiliation(s)
- N Fiotti
- Unit of Internal Medicine, Department of Clinical, Morphological, and Technological Sciences, University of Trieste, Trieste, Italy
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28
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Welin M, Holmgren NMA, Nilsson P, Enroth H. Statistical model of the interactions between Helicobacter pylori infection and gastric cancer development. Helicobacter 2003; 8:72-8. [PMID: 12603619 DOI: 10.1046/j.1523-5378.2003.00110.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The bacterium Helicobacter pylori is associated with a number of gastrointestinal diseases, such as gastric ulcer, duodenal ulcer and gastric cancer. Several histological changes may be observed during the course of infection; some may influence the progression towards cancer. The aim of this study was to build a statistical model to discover direct interactions between H. pylori and different precancerous changes of the gastric mucosa, and in what order and to what degree those may influence the development of the intestinal type of gastric cancer. METHODS To find direct and indirect interactions between H. pylori and different histological variables, log-linear analyses were used on a case-control study. To generate mathematically and biologically relevant statistical models, a designed algorithm and observed frequency tables were used. RESULTS The results show that patients with H. pylori infection need to present with proliferation and intestinal metaplasia to develop gastric cancer of the intestinal type. Proliferation and intestinal metaplasia interacted with the variables atrophy and foveolar hyperplasia. Intestinal metaplasia was the only variable with direct interaction with gastric cancer. Gender had no effect on the variables examined. CONCLUSION The direct interactions observed in the final statistical model between H. pylori, changes of the mucosa and gastric cancer strengthens and supports previous theories about the progression towards gastric cancer. The results suggest that gastric cancer of the intestinal type may develop from H. pylori infection, proliferation and intestinal metaplasia, while atrophy and foveolar hyperplasia interplay with the other histological variables in the disease process.
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Affiliation(s)
- Martin Welin
- Department of Natural Science, University of Skövde, Sweden
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29
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Kikuchi S, Nakajima T, Kobayashi O, Yamazaki T, Kikuichi M, Mori K, Oura S, Watanabe H, Nagawa H, Otani R, Okamoto N, Kurosawa M, Anzai H, Konishi T, Futagawa S, Mizobuchi N, Kobori O, Kaise R, Inaba Y, Wada O. U-shaped effect of drinking and linear effect of smoking on risk for stomach cancer in Japan. Jpn J Cancer Res 2002; 93:953-9. [PMID: 12359047 PMCID: PMC5927125 DOI: 10.1111/j.1349-7006.2002.tb02470.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
A case-control study was conducted to evaluate the relationship between smoking or drinking doses and risk for stomach cancer, and to clarify whether the relationship is dose-dependent or U-shaped. Smoking dose was categorized as 0, 1 - 399, 400 - 799, or 800 + cigarette-years, and drinking dose as 0, occasional/0.1 - 134.9, 135 - 1349.9, or 1350 + alcohol-years (ml of pure alcohol intake per day multiplied by years of drinking). Helicobacter pylori status was determined by serology for adjustment. Using logistic regression, the adjusted effects of smoking and drinking doses on risk for stomach cancer were calculated for both genders. Among male subjects, the odds ratios (95% confidence intervals (CIs)) were 1.29 (0.76, 2.18) for 1 - 399, 1.71 (1.05, 2.80) for 400 - 799 and 2.46 (1.49, 4.07) for 800 + cigarette-years compared with never-smokers, and 1.89 (0.97, 3.69) for never-drinkers, 2.82 (1.63, 4.86) for 135 - 1349.9 and 2.84 (1.97, 4.83) for 1350.0 +, compared with occasional/0.1 - 134.9 alcohol-years. Among female subjects, they were 0.44 (0.20, 1.00) for 1 - 399 and 2.471 (0.91, 6.68) for 400 + cigarette-years compared with never-smokers, and 1.54 (0.90, 2.63) for never-drinkers and 1.39 (0.66, 2.93) for 135.0 + alcohol-years. Smoking seems to exert a linear effect and drinking, a J- or U-shaped effect on risk for stomach cancer, although there might be a dip of risk in light smokers among female subjects.
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Affiliation(s)
- Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, Japan.
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30
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Hiyama T, Tanaka S, Kitadai Y, Ito M, Sumii M, Yoshihara M, Shimamoto F, Haruma K, Chayama K. p53 Codon 72 polymorphism in gastric cancer susceptibility in patients with Helicobacter pylori-associated chronic gastritis. Int J Cancer 2002; 100:304-308. [PMID: 12115545 DOI: 10.1002/ijc.10483] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
p53 codon 72, which produces variant proteins with an arginine (Arg) or proline (Pro), has been reported to be associated with cancers of the lung, esophagus and cervix. However, there have been no reports on the p53 codon 72 polymorphism in gastric cancer susceptibility in patients with Helicobacter pylori-associated chronic gastritis (H. pylori-CG). We, therefore, examined the polymorphism in 117 gastric cancer patients (72 intestinal type and 45 diffuse type) with H. pylori-CG and 116 H. pylori-CG patients without gastric cancer as controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was performed to analyze the p53 codon 72 polymorphism. The crude genotypic frequencies in the gastric cancer patients were similar to those of the controls. However, when gastric cancers were classified by histologic subtype, the Pro/Pro was more frequent in the patients with diffuse type gastric cancer than in the controls (22.2% of cases vs. 12.1% of controls). The Pro/Pro genotype was associated with a 2.98-fold higher risk of diffuse-type cancer compared to the Arg/Arg genotype (95% confidence interval [CI] 1.07-8.32, p = 0.038). These results suggest that the Pro/Pro genotype at p53 codon 72 contributes to susceptibility for diffuse-type gastric cancer in patients with H. pylori-CG. The p53 codon 72 polymorphism may serve as the genetic marker for the risk assessment of the diffuse-type gastric cancer development in patients with H. pylori-CG.
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Affiliation(s)
- Toru Hiyama
- First Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan
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31
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Brenner H, Arndt V, Bode G, Stegmaier C, Ziegler H, Stümer T. Risk of gastric cancer among smokers infected with Helicobacter pylori. Int J Cancer 2002; 98:446-9. [PMID: 11920598 DOI: 10.1002/ijc.10201] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Infection with the gastric bacterium Helicobacter pylori (in particular infection with CagA-positive strains) and smoking have been identified as risk factors for the development of gastric cancer. Both risk factors are typically acquired early in life and prevail over decades if not for life. We assessed the individual and joint impact of both risk factors on gastric cancer risk in a population-based case-control study from Germany including 71 patients with histologically verified gastric cancer and 363 patients with colorectal cancer who served as controls. Information on smoking and potential confounding factors was collected by standardized interviews. H. pylori infection was measured serologically by immunoglobulin G antibody titers against H. pylori. In addition, antibodies against the CagA antigen were determined by Western blot. Twenty-seven percent of cases compared with 15% of controls were smokers, and 43% of cases compared with 23% of controls were infected with CagA-positive H. pylori strains. After control for potential confounders, the relative risk of gastric cancer was 2.6 (95% CI 1.2-5.7) for nonsmoking subjects with CagA-positive H. pylori infections and 7.2 (95% CI 2.2-23.6) for smoking subjects with CagA-positive H. pylori infections compared with subjects without these risk factors. The corresponding relative risks for noncardia gastric cancer were 6.1 ( 95% CI 2.3-16.5) and 16.6 (95% CI 4.3-64.2). We conclude that smoking subjects with CagA-positive H. pylori infections have a strongly increased risk of gastric cancer and may be an important group for targeting efforts of prevention and early detection.
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Affiliation(s)
- Hermann Brenner
- Department of Epidemiology, German Centre for Research on Ageing, Heidelberg, Germany.
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