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Zullo A, De Francesco V, Amato A, Bergna I, Bendia E, Giorgini G, Buscarini E, Manfredi G, Cadoni S, Cannizzaro R, Realdon S, Ciuffi M, Ignomirelli O, Da Massa Carrara P, Finucci G, Di Somma A, Frandina C, Loria M, Galeazzi F, Ferrara F, Gemme C, Bertetti NS, Gentili F, Lotito A, Germanà B, Russo N, Grande G, Conigliaro R, Cravero F, Venezia G, Marmo R, Senneca P, Milano A, Efthymakis K, Monica F, Montalto P, Lombardi M, Morelli O, Castellani D, Nigro D, Festa R, Peralta S, Grasso M, Privitera A, Distefano ME, Scaccianoce G, Loiacono M, Segato S, Balzarini M, Usai Satta P, Lai M, Manta R. Upper Gastrointestinal Endoscopy Quality in Italy: A Nationwide Study. J Gastrointestin Liver Dis 2023; 32:433-437. [PMID: 38147598 DOI: 10.15403/jgld-5059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/02/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND AND AIMS International guidelines advise improving esophagogastroduodenoscopy (EGD) quality in Western countries, where gastric cancer is still diagnosed in advanced stages. This nationwide study investigated some indicators for the quality of EGD performed in endoscopic centers in Italy. METHODS Clinical, endoscopic, and procedural data of consecutive EGDs performed in one month in the participating centers were reviewed and collected in a specific database. Some quality indicators before and during endoscopic procedures were evaluated. RESULTS A total of 3,219 EGDs performed by 172 endoscopists in 28 centers were reviewed. Data found that some relevant information (family history for GI cancer, smoking habit, use of proton pump inhibitors) were not collected before endoscopy in 58.5-80.7% of patients. Pre-endoscopic preparation for gastric cleaning was routinely performed in only 2 (7.1%) centers. Regarding the procedure, sedation was not performed in 17.6% of patients, and virtual chromoendoscopy was frequently (>75%) used in only one (3.6%) center. An adequate sampling of the gastric mucosa (i.e., antral and gastric body specimens) was heterogeneously performed, and it was routinely performed only by 23% of endoscopists, and in 14.3% centers. CONCLUSIONS Our analysis showed that the quality of EGD performed in clinical practice in Italy deserves to be urgently improved in different aspects.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology and Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italia.
| | | | - Arnaldo Amato
- Gastroenterology Unit, A. Manzoni Hospital, Lecco, Italy..
| | - Irene Bergna
- Gastroenterology Unit, A. Manzoni Hospital, Lecco, Italy..
| | | | | | | | - Guido Manfredi
- Gastroenterology and Endoscopy Unit, Maggiore Hospital, Crema (CR), Italy..
| | - Sergio Cadoni
- Gastroenterology Unit, CTO Hospital, Iglesias, Italy..
| | - Renato Cannizzaro
- Experimental Oncological Gastroenterology Unit, CRO Hospital, Aviano (PN), Italy..
| | - Stefano Realdon
- Experimental Oncological Gastroenterology Unit, CRO Hospital, Aviano (PN), Italy..
| | - Mario Ciuffi
- Endoscopy Unit, IRCCS CROB Hospital, Rionero in Vulture (PZ), Italy..
| | | | | | - Giovanni Finucci
- Gastroenterology Unit, ASL Toscana Nord-Ovest, San Luca Hospital, Lucca, Italy.
| | | | - Chiara Frandina
- Gastroenterology Unit, S. Giovanni di Dio Hospital, Crotone, Italy.
| | | | | | | | - Carlo Gemme
- Gastroenterology Unit, SS. Antonio, Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Noemi Sara Bertetti
- Gastroenterology Unit, SS. Antonio, Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | | | - Antonio Lotito
- Gastroenterology Unit, Santa Maria Hospital, Terni, Italy.
| | | | - Nunzia Russo
- Gastroenterology and Endoscopy Unit, San Martino Hospital, Belluno, Italy.
| | - Giuseppe Grande
- Gastroenterology Unit, Civile Baggiovara Hospital, Modena, Italy.
| | - Rita Conigliaro
- Gastroenterology Unit, Civile Baggiovara Hospital, Modena, Italy.
| | - Federico Cravero
- Gastroenterology Unit, Santa Croce e Carle Hospital, Cuneo, Italy.
| | - Giovanna Venezia
- Gastroenterology Unit, Santa Croce e Carle Hospital, Cuneo, Italy.
| | - Riccardo Marmo
- Gastroenterology Unit, L. Curto Hospital, Polla (SA), Italy.
| | - Piera Senneca
- Gastroenterology Unit, L. Curto Hospital, Polla (SA), Italy.
| | - Angelo Milano
- Gastroenterology and Endoscopy Unit, SS. Annunziata Hospital, Hospital, Chieti, Italy.
| | | | - Fabio Monica
- Gastroenterology Unit, San Giovanni di Dio Hospital, Gorizia; Gastroenterology and Endoscopy Unit, Cattinara Hospital, Trieste, Italy..
| | - Paolo Montalto
- Gastroenterology Unit, ASL Toscana Centro, Pistoia, Italy.
| | - Mario Lombardi
- Gastroenterology Unit, ASL Toscana Centro, Pistoia, Italy.
| | - Olivia Morelli
- Gastroenterology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy.
| | - Danilo Castellani
- Gastroenterology Unit, Santa Maria della Misericordia Hospital, Perugia, Italy.
| | - Daniela Nigro
- Gastroenterology Unit, San Carlo Hospital, Melfi (PZ), Italy.
| | - Roberto Festa
- Gastroenterology Unit, San Carlo Hospital, Melfi (PZ), Italy.
| | - Sergio Peralta
- Gastroenterology Unit, AOU Policlinico Hospital, Palermo, Italy.
| | - Maria Grasso
- Gastroenterology Unit, AOU Policlinico Hospital, Palermo, Italy.
| | | | | | | | | | - Sergio Segato
- Gastroenterology Unit, ASST dei Sette Laghi Hospital, Varese, Italy.
| | - Marco Balzarini
- Gastroenterology Unit, ASST dei Sette Laghi Hospital, Varese, Italy.
| | | | | | - Raffaele Manta
- Gastroenterology Unit, ASL Toscana Nord-Ovest, San Luca Hospital, Lucca, Italy.
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Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, Buscarini E, Ciuffi M, Ignomirelli O, Farinati F, Savarino E, Pallini P, Milan L, Conigliaro R, Grande G, Cannizzaro R, Maiero S, Pisani A, Marangi S, Manta R, Morelli O, Peralta S, La Mantia A, Buonocore MR, Khalaf K, Hassan C, Monica F. Real-time determination of gastric juice pH with EndoFaster® for atrophic gastritis assessment. Dig Liver Dis 2022; 54:1646-1648. [PMID: 35794064 DOI: 10.1016/j.dld.2022.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In patients with atrophic gastritis involving gastric body mucosa the pH value of gastric juice is distinctly increased, so that pH assessment would allow predict this precancerous lesion. We tested whether EndoFaster® - a device allowing real-time pH measure and H. pylori diagnosis - may optimize the need of taking gastric biopsies. METHODS In this prospective, multicentre study, the accuracy of EndoFaster® for ruling out gastric atrophy involving corporal mucosa was assessed. Real-time pH and ammonium determination was performed by aspirating 3-6 ml gastric juice during endoscopy. Histology performed on 5 standard gastric biopsies was used as gold standard. RESULTS A total of 1008 consecutive patients were observed in 12 centres. At histology, gastric body mucosa atrophy/metaplasia was detected in 65 (6.4%) cases, and a pH value >4.5 in the gastric juice was observed in 150 patients. The values of EndoFaster® performance in predicting the presence of atrophic gastritis were as follow: 51% sensitivity, 84% specificity, 18% PPV, 96% NPV, and 82% accuracy. The NPV value was not distinctly affected by neither ongoing proton pump inhibitor therapy nor H. pylori infection. By considering also data of ammonium concentrations, the values of EndoFaster® in detecting extensive atrophy on gastric mucosa were 74% sensitivity, 84% specificity, 24% PPV, 98% NPV, and 83% accuracy. CONCLUSION The very high NPV of EndoFaster® might allow to safely rule out presence of atrophic gastritis, reducing the need of taking gastric biopsies in unselected patients managed in clinical practice.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, Gastroenterologia ed Endoscopia Digestiva, 'Nuovo Regina Margherita' Hospital, Via Emilio Morosini, 30, Rome 00153 , Italy.
| | - Bastianello Germanà
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno, Italy
| | - Ermenegildo Galliani
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno, Italy
| | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit, Santa Chiara' Hospital, Trento, Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Santa Chiara' Hospital, Trento, Italy
| | - Guido Manfredi
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema, Italy
| | - Elisabetta Buscarini
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema, Italy
| | - Mario Ciuffi
- Endoscopy Unit, IRCCS CROB, Rionero in Vulture, Italy
| | | | - Fabio Farinati
- Gastroenterology Unit, University of Padua, Padua, Italy
| | | | - Paolo Pallini
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza, Italy
| | - Luisa Milan
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza, Italy
| | - Rita Conigliaro
- Gastroenterology Unit, 'Ospedale Civile Baggiovara', Modena, Italy
| | - Giuseppe Grande
- Gastroenterology Unit, 'Ospedale Civile Baggiovara', Modena, Italy
| | | | - Stefania Maiero
- Experimental Oncological Gastroenterology Unit, CRO, Aviano, Italy
| | - Antonio Pisani
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte, Italy
| | - Stefania Marangi
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte, Italy
| | - Raffaele Manta
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia, Italy
| | - Olivia Morelli
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia, Italy
| | - Sergio Peralta
- Gastroenterology Unit, 'AOU Policlinico', Palermo, Italy
| | | | | | - Kareem Khalaf
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Cesare Hassan
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Fabio Monica
- Gastroenterology and Digestive Endoscopy, 'Cattinara' Academic Hospital, Trieste, Italy
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Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, Buscarini E, Ciuffi M, Ignomirelli O, Farinati F, Savarino E, Pallini P, Milan L, Conigliaro R, Grande G, Cannizzaro R, Maiero S, Pisani A, Marangi S, Manta R, Morelli O, Peralta S, Mantia AL, Rossano Buonocore M, Monica F. Real-time gastric juice analysis with EndoFaster for H. pylori diagnosis: a large, multicentre study. Eur J Gastroenterol Hepatol 2022; 34:1121-1124. [PMID: 36170680 DOI: 10.1097/meg.0000000000002429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Helicobacter pylori infection is the main cause of the most frequent gastroduodenal diseases. Because its prevalence is decreasing in developed countries, gastric biopsies are negative in several patients. By measuring ammonium in the gastric juice, EndoFaster allows to exclude H. pylori infection during endoscopy. This study aimed to assess the accuracy of device versions working with either 6 ml or 3 ml of gastric juice. STUDY DESIGN This prospective study involved 12 endoscopic units. During endoscopy, EndoFaster testing was performed and standard five gastric biopsies were taken. The accuracy was calculated by considering histological assessment as the gold standard for H. pylori diagnosis. RESULTS Gastric juice analysis was attempted in 1279 patients, but it failed in 131 (15.5%) and in 10 (2.3%), with the 6 ml and the 3 ml device, respectively (P < 0.001). Overall, EndoFaster detected H. pylori infection with an 86.3% sensitivity, 83.3% specificity, 52.7% positive predictive value, 96.6% negative predictive value and 83.8% accuracy. The performance was not affected either by ongoing proton pump inhibitor therapy or a previous H. pylori eradication. No significant difference in accuracy emerged between the two versions of the device. CONCLUSION The novel version of the EndoFaster device operating with 3 ml gastric juice may be performed in virtually all patients, and it allows excluding H. pylori infection with a very high accuracy. Gastric biopsies can be avoided in a definite portion of cases without endoscopic lesions or other clinical indications.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, 'Nuovo Regina Margherita' Hospital, Rome
| | - Bastianello Germanà
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno
| | | | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit,' Santa Chiara' Hospital, Trento
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit,' Santa Chiara' Hospital, Trento
| | - Guido Manfredi
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema
| | | | | | | | | | | | - Paolo Pallini
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza
| | - Luisa Milan
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza
| | | | | | | | | | - Antonio Pisani
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte
| | - Stefania Marangi
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte
| | - Raffaele Manta
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia
| | - Olivia Morelli
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia
| | | | | | | | - Fabio Monica
- Gastroenterology and Digestive Endoscopy, 'Cattinara' Academic Hospital, Trieste, Italy
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Laurino S, Mazzone P, Ruggieri V, Zoppoli P, Calice G, Lapenta A, Ciuffi M, Ignomirelli O, Vita G, Sgambato A, Russi S, Falco G. Cationic Channel TRPV2 Overexpression Promotes Resistance to Cisplatin-Induced Apoptosis in Gastric Cancer Cells. Front Pharmacol 2021; 12:746628. [PMID: 34671260 PMCID: PMC8521017 DOI: 10.3389/fphar.2021.746628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 01/30/2023] Open
Abstract
Gastric cancer (GC) is characterized by poor efficacy and modest clinical impact of current therapies, in which apoptosis evasion is relevant. Intracellular calcium homeostasis dysregulation is associated with apoptosis escaping, and aberrant expression of calcium regulator genes could promote GC drug resistance. Since we previously found a prognostic value for TRPV2 calcium channel expression in GC, we aimed to characterize the role of TRPV2 in cisplatin resistance. Using the TCGA-STAD dataset, we performed a differential gene expression analysis between GC samples in upper and lower tertiles of TRPV2 expression, and then through a gene set analysis, we highlighted the enriched ontology and canonical pathways. We used qRT-PCR to assess TRPV2 expression in three GC cell lines and flow cytometry to evaluate cisplatin-induced cell death rates. Calcium green-1-AM assay was used to estimate differences in intracellular Ca2+ concentrations after inhibition of TRPV2. We engineered AGS cell line to overexpress TRPV2 and used confocal microscopy to quantify its overexpression and localization and flow cytometry to evaluate their sensitivity to cisplatin. Consistent with our hypothesis, among enriched gene sets, we found a significant number of those involved in the regulation of apoptosis. Subsequently, we found an inverse correlation between TRPV2 expression and sensitivity to cisplatin in GC cell lines. Moreover, we demonstrated that inhibition of TRPV2 activity by tranilast blocks the efflux of Ca2+ ions and, in combination with cisplatin, induced a significant increase of apoptotic cells (p = 0.004). We also demonstrated that TRPV2 exogenous expression confers a drug-resistant phenotype, and that tranilast is able to revert this phenotype, restoring cisplatin sensitivity. Our findings consistently suggested that TRPV2 could be a potential target for overcoming cisplatin resistance by promoting apoptosis. Notably, our data are a prerequisite for the potential reposition of tranilast to the treatment of GC patients and anticipate the in vivo evaluation.
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Affiliation(s)
- Simona Laurino
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Pellegrino Mazzone
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Vitalba Ruggieri
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.,UOC Clinical Pathology, Altamura Hospital, Altamura, Italy
| | - Pietro Zoppoli
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Giovanni Calice
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Antonella Lapenta
- Trial Office, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Mario Ciuffi
- Endoscopy Unit, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Orazio Ignomirelli
- Endoscopy Unit, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Giulia Vita
- Pathology Unit, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Alessandro Sgambato
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Sabino Russi
- Laboratory of Preclinical and Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Geppino Falco
- Biogem Scarl, Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy.,Department of Biology, University of Naples Federico II, Naples, Italy
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5
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Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, D'Onofrio V, Iaquinto G, Conio M. Dietary Habits and Risk of Esophagitis and Barrett's Esophagus: A Multicenter Italian Case-Control Study. Dig Dis Sci 2021; 66:3448-3460. [PMID: 33073332 DOI: 10.1007/s10620-020-06658-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Barrett's esophagus (BE) and esophagitis share potentially modifiable risk factors such as obesity, smoking, and alcohol. The role of diet on BE and esophagitis is still debated. AIMS The objective of this study was to examine the association between some dietary habits and the risk of BE and esophagitis in Italy. METHODS A multicenter case-control study involving 1285 individuals was carried out in 12 areas. Patients with a new diagnosis of BE (320) or esophagitis (359) and a group of endoscopic controls (606) were included. Information on personal history and dietary habits was collected using a structured questionnaire. RESULTS No clear monotonic significant dose-response relationship was found for most of the considered food items. Nevertheless, the most extreme consumption category of red meat, cold cuts, dairy products, and fried foods showed esophagitis risk excesses varying from 19 to 49%. A higher fat rich diet seemed to increase risk by 49% for BE and 94% for esophagitis. A downward tendency in esophagitis (- 27%) and BE risk (- 20%) was found associated with higher frequency of fresh fruit intake. In addition, a statistically significant twofold increased risk for both BE and esophagitis was found for subjects eating late evening snacks more than once every three days in comparison with the lowest intake category (no consumption). CONCLUSIONS BE and esophagitis patients appeared to be more likely than controls to follow a diet rich in fats and poor in fruit and vegetables. Late evening snacks were found to be associated with both disorders.
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Affiliation(s)
- Rosa Angela Filiberti
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy.
| | - Vincenzo Fontana
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy
| | - Antonella De Ceglie
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Sabrina Blanchi
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Teresa Lacchin
- Policlinico San Giorgio, Gastroenterology, Pordenone, Italy
| | - Marina De Matthaeis
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Orazio Ignomirelli
- IRCCS CROB, Digestive Endoscopy, Strada Provinciale di Piano del Conte, 85028, Rionero in Vulture, PZ, Italy
| | - Roberta Cappiello
- Gastroenterology, S. Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy
| | - Alessandra Rosa
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy
| | - Vittorio D'Onofrio
- Gastroenterology and Digestive Endoscopy, S. G. Moscati Hospital, Contrada Amoretta, 83100, Avellino, Italy
| | - Gaetano Iaquinto
- Divisione di Gastroenterologia, Clinica Santa Rita, Via Appia, 83042, Atripalda, AV, Italy
| | - Massimo Conio
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
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Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, Foti M, Laterza F, D'Onofrio V, Iaquinto G, Conio M. Association between coffee or tea drinking and Barrett's esophagus or esophagitis: an Italian study. Eur J Clin Nutr 2017; 71:980-986. [PMID: 28488688 DOI: 10.1038/ejcn.2017.64] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 02/01/2017] [Accepted: 04/07/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Only a few papers have treated of the relationship between Barrett's esophagus (BE) or erosive esophagitis (E) and coffee or tea intake. We evaluated the role of these beverages in BE and E occurrence. SUBJECTS/METHODS Patients with BE (339), E (462) and controls (619) were recruited. Data on coffee and tea and other individual characteristics were collected using a structured questionnaire. RESULTS BE risk was higher in former coffee drinkers, irrespective of levels of exposure (cup per day; ⩽1: OR=3.76, 95% CI 1.33-10.6; >1: OR=3.79, 95% CI 1.31-11.0; test for linear trend (TLT) P=0.006) and was higher with duration (>30 years: OR=4.18, 95% CI 1.43-12.3; TLT P=0.004) and for late quitters, respectively (⩽3 years from cessation: OR=5.95, 95% CI 2.19-16.2; TLT P<0.001). The risk of BE was also higher in subjects who started drinking coffee later (age >18 years: OR=6.10, 95% CI 2.15-17.3). No association was found in current drinkers, but for an increased risk of E in light drinkers (<1 cup per day OR =1.85, 95% CI 1.00-3.43).A discernible risk reduction of E (about 20%, not significant) and BE (about 30%, P<0.05) was observed in tea drinkers. CONCLUSIONS Our data were suggestive of a reduced risk of BE and E with tea intake. An adverse effect of coffee was found among BE patients who had stopped drinking coffee. Coffee or tea intakes could be indicative of other lifestyle habits with protective or adverse impact on esophageal mucosa.
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Affiliation(s)
- R A Filiberti
- Clinical Epidemiology, IRCCS AOU San Martino- IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - V Fontana
- Clinical Epidemiology, IRCCS AOU San Martino- IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - A De Ceglie
- Gastroenterology, General Hospital, Sanremo, Imperia, Italy
| | - S Blanchi
- Gastroenterology, General Hospital, Sanremo, Imperia, Italy
| | - E Grossi
- Medical Department, Bracco Spa, Milan, Italy
| | - D Della Casa
- Digestive Endoscopic Surgery, Spedali Civili di Brescia, Brescia, Italy
| | - T Lacchin
- Endoscopy, Policlinico San Giorgio, Pordenone, Italy
| | - M De Matthaeis
- Gastroenterology and Digestive Endoscopy, Ospedale di Lavagna, Lavagna, Italy
| | - O Ignomirelli
- Endoscopy, IRCCS, Rionero in Vulture, Potenza, Italy
| | - R Cappiello
- Gastroenterology, S. Maria degli Angeli Hospital, Pordenone, Italy
| | - A Rosa
- Clinical Epidemiology, IRCCS AOU San Martino- IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - M Foti
- Gastroenterology, LARC private Clinic, Torino, Italy
| | - F Laterza
- Internal Medicine and Gastroenterology, University &Foundation, Chieti, Italy
| | - V D'Onofrio
- Gastroenterology and Digestive Endoscopy, S. G. Moscati Hospital, Avellino, Italy
| | - G Iaquinto
- Gastroenterology and Digestive Endoscopy, S. G. Moscati Hospital, Avellino, Italy
| | - M Conio
- Gastroenterology, General Hospital, Sanremo, Imperia, Italy
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7
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Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, Foti M, Laterza F, D'Onofrio V, Iaquinto G, Conio M. Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study. Br J Nutr 2017; 117:1151-1161. [PMID: 28478792 DOI: 10.1017/s0007114517000940] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.
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Affiliation(s)
- Rosa A Filiberti
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Vincenzo Fontana
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Antonella De Ceglie
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
| | - Sabrina Blanchi
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
| | - Enzo Grossi
- 3Medical Department,Bracco Spa,Via E Folli 50,20134 Milan,Italy
| | - Domenico Della Casa
- 4Digestive Endoscopic Surgery,Spedali Civili di Brescia,Piazzale Spedali Civili 1,25123 Brescia,Italy
| | - Teresa Lacchin
- 5Endoscopy,Policlinico San Giorgio,Via Gemelli 10,33170 Pordenone,Italy
| | - Marina De Matthaeis
- 6Gastroenterology and Digestive Endoscopy,Ospedale di Lavagna,ASL 4 Chiavarese,Via Don Bobbio 25,16033 Lavagna,Italy
| | - Orazio Ignomirelli
- 7Endoscopy,IIRCCS,Centro di Riferimento Oncologico di Basilicata,Via Padre Pio 1,85028 Rionero in Vulture,Potenza,Italy
| | - Roberta Cappiello
- 8Gastroenterology,S. Maria degli Angeli Hospital,Via Piave 54,33170 Pordenone,Italy
| | - Alessandra Rosa
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Monica Foti
- 9Gastroenterology,LARC Private Clinic,Cso Venezia 10,10155 Torino,Italy
| | - Francesco Laterza
- 10Department of Internal Medicine,Unit of Endoscopy and Gastroenterology,University Hospital SS.Annunziata, G.D'Annunzio University,Via dei Vestini,66100 Chieti,Italy
| | - Vittorio D'Onofrio
- 11Gastroenterology and Digestive Endoscopy,S. G. Moscati Hospital,Via San Giuseppe Moscati,83100 Avellino,Italy
| | - Gaetano Iaquinto
- 11Gastroenterology and Digestive Endoscopy,S. G. Moscati Hospital,Via San Giuseppe Moscati,83100 Avellino,Italy
| | - Massimo Conio
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
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Filiberti R, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Foti M, Laterza F, Annese V, Iaquinto G, Conio M. Smoking as an independent determinant of Barrett's esophagus and, to a lesser degree, of reflux esophagitis. Cancer Causes Control 2015; 26:419-29. [PMID: 25555994 DOI: 10.1007/s10552-014-0518-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/19/2014] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the role of smoking in Barrett's esophagus (BE) and erosive esophagitis (E) compared to endoscopic controls with no BE or E. Smoking is considered a cause of both BE and E, but results on this topic are quite controversial. METHODS Patients with BE (339), E (462) and controls (619: 280 with GERD (gastroesophageal reflux disease)-negative and 339 with GERD-positive anamnesis) were recruited in 12 Italian endoscopy units. Data were obtained from structured questionnaires. RESULTS Among former smokers, a remarkable upward linear trend was found in BE for all smoking-related predictors. In particular, having smoked for more than 32 years increased the risk more than two times (OR 2.44, 95 % CL 1.33-4.45). When the analysis was performed in the subgroup of subjects with GERD-negative anamnesis, the risk of late quitters (<9 years) passed from OR 2.11 (95 % CL 1.19-3.72) to OR 4.42 (95 % CL 1.52-12.8). A noticeably positive dose-response relationship with duration was seen also among current smokers. As regards E, no straightforward evidence of association was detected, but for an increased risk of late quitters (OR 1.84, 95 % CL 1.14-2.98) in former smokers and for early age at starting (OR 3.63, 95 % CL 1.19-11.1) in GERD-negative current smokers. CONCLUSIONS Smoking seems to be an independent determinant of BE and, to a lesser degree, of E. The elevation in risk is independent from GERD and is already present in light cigarette smokers. Smoking cessation may reduce, but not remove this risk.
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Affiliation(s)
- Rosa Filiberti
- Clinical Epidemiology, IRCCS AOU San Martino- IST-Istituto Nazionale per la Ricerca sul Cancro, Largo R. Benzi, 10, 16132, Genoa, Italy,
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Bochicchio A, Tartarone A, Ignomirelli O, Latorre G, Cangiano R, Gallucci G, Coccaro M, Feudale E, Aieta M. Anal metastasis from breast cancer: a case report and review of the literature. Future Oncol 2012; 8:333-6. [PMID: 22409468 DOI: 10.2217/fon.12.9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Breast cancer usually metastasizes towards the lymph nodes, lung, bone, liver or brain; metastatic gastrointestinal involvement is rare and anal metastases are extremely rare. Necroscopic studies report a 6-18% incidence of extra-hepatic gastrointestinal metastases, and the most frequent sites of the GI tract involved are the stomach and the small intestine. We report a case with anal metastasis from breast cancer and a review of the associated literature.
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Affiliation(s)
- Annamaria Bochicchio
- Department of Onco-Hematology, Centro di Riferimento Oncologico della Basilicata IRCCS, Via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
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De Ceglie A, Filiberti R, Blanchi S, Fontana V, Fisher DA, Grossi E, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Casa DD, Foti M, Laterza F, Rosati R, Annese V, Iaquinto G, Conio M. History of cancer in first degree relatives of Barrett's esophagus patients: a case-control study. Clin Res Hepatol Gastroenterol 2011; 35:831-8. [PMID: 21924696 DOI: 10.1016/j.clinre.2011.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/26/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Familial clusters of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) have been reported. This study evaluates the history of cancer in BE patients families. METHODS In two years, patients with BE (272), esophagitis (456) and controls (517) were recruited in 12 Italian Endoscopy Units. Cancer family history in first-degree (FD) relatives was determined by a questionnaire. RESULTS Approximately 53% of BE, 51% of esophagitis, and 48% of controls had at least one relative affected by any type of malignancy. Probands with at least one esophageal or gastric (E/G) cancer-affected relative showed a BE risk which was at least eighty-five percent higher than that of probands without affected relatives. The relative risk of BE was 4.18, 95% CL=0.76-23.04 if a FD relative had early (mean age ≤ 50 years) onset E/G cancer compared to late onset E/G cancer. CONCLUSION In this sample there was no evidence that a family history of cancer was associated with the diagnosis of BE. An intriguing result was the association between the occurrence of E/G cancers at earlier ages (< 50 years) among BE relatives with respect the control group. This could suggest a genetic contribution in onset of these tumors, but the sample was too small to demonstrate a significant association. Further exploration of family history of E/G cancer and a diagnosis of BE in larger samples is warranted.
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Affiliation(s)
- Antonella De Ceglie
- Unit of Digestive Endoscopy, Cancer Institute Giovanni Paolo II, Bari, Italy
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La Torre G, Cianci P, Mancino G, Verrusio C, Guarino G, Puppio B, Ignomirelli O, Feudale E. [Neuroendocrine tumors. A rare case of duodenal carcinoids]. Chir Ital 2006; 58:531-7. [PMID: 16999160 DOI: pmid/16999160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The authors report their experience with a case of double duodenum carcinoid tumors occurring in a 59-year-old female patient. She presented with a one-year history of frequent abdominal painful episodes, associated with dyspepsia, emesis, pyrosis, eructation, skin flushing and easy strain. The laboratory examinations point out high hematic values of serotonin and gastrin, with a raising of urinary 5-HIAA. Preoperative endoscopic examinations showed the presence of 2 little sessile polypoid growths, placed in the duodenal bulb, one of this interested muscular tunic. The patient underwent Billroth I resection and was discharged on postoperative day 8. The authors after a little dissertation on that topic, go on to examine the current diagnostic and therapeutic possibilities. They confirm the elective role of surgical treatment of these rare tumors.
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Affiliation(s)
- Giuseppe La Torre
- UO di Chirurgia Oncologica, Centro di Riferimento Oncologico di Basilicata, Ospedale Oncologico Regionale, Rionero in Vulture, Potenza
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Tartarone A, Romano G, Iodice G, Di Renzo N, Ignomirelli O. Response to de Gramont regimen in small cell lung cancer: a case report. Lung Cancer 2004; 43:375-6. [PMID: 15165102 DOI: 10.1016/j.lungcan.2003.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2003] [Indexed: 10/26/2022]
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Abstract
We reviewed our results of using stents for palliation of cancer of the lower third of the esophagus and gastric cardia. During a 14-year period, 76 patients with either lower third esophageal cancer (n = 43) or cancer of the gastric cardia (n = 33) received stents for palliation of malignant dysphagia. Successful endoscopic placement was initially achieved in all patients, with 71 patients available for follow-up. Of these, 40 (56%) were subsequently able to eat solid or semi-solid food, 25 (35%) could swallow only liquids, and 6 (8%) were unimproved. The combined early and late complication rate totalled 22%. Early complications included perforation (n = 3) and stent migration (n = 4); late complications consisted of dislodgment (n = 6), obstruction by tumor (n = 2), and severe esophagitis (n = 1). There were no procedure-related deaths, but survival at 1 year was estimated to be only 1.5%, with a median survival of 2.5 months after stent insertion. The endoscopic placement of prosthetic stents for cancer of the distal esophagus and gastric cardia entails a higher complication rate, less successful palliation, and shorter survival time compared to similar treatment for more proximal esophageal cancer.
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Affiliation(s)
- P Spinelli
- Department of Diagnostic and Surgical Endoscopy, Istituto Nazionale Tumori, Milan, Italy
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