Esophageal cancer is one of the most unknown and deadliest cancers worldwide,mainly because of its extremely aggressive nature and poor survival rate.Esophageal cancer is the 6th leading cause of death from cancer and...Esophageal cancer is one of the most unknown and deadliest cancers worldwide,mainly because of its extremely aggressive nature and poor survival rate.Esophageal cancer is the 6th leading cause of death from cancer and the 8th most common cancer in the world.The 5-year survival is around 15%-25%.There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide.There are areas of high incidence of squamous cell carcinoma(some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas.In Europe and United States the predominant histologic subtype is adenocarcinoma.The role of early diagnosis of adenocarcinoma in Barrett's esophagus remains controversial.The differences in the therapeutic management of early esophageal carcinoma(high-grade dysplasia,T1 a,T1 b,N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage.In areas where the incidence is high(China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus.展开更多
Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics a...Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review 展开更多
AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was con...AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.RESULTS: For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P < 0.001), and the proportions of OLGIM stages III-IV cases were 42.3% and 19.9%, respectively (P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA (OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages III-IV (OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages III-IV (P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA (75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages III-IV (OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).CONCLUSION: OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.展开更多
文摘Esophageal cancer is one of the most unknown and deadliest cancers worldwide,mainly because of its extremely aggressive nature and poor survival rate.Esophageal cancer is the 6th leading cause of death from cancer and the 8th most common cancer in the world.The 5-year survival is around 15%-25%.There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide.There are areas of high incidence of squamous cell carcinoma(some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas.In Europe and United States the predominant histologic subtype is adenocarcinoma.The role of early diagnosis of adenocarcinoma in Barrett's esophagus remains controversial.The differences in the therapeutic management of early esophageal carcinoma(high-grade dysplasia,T1 a,T1 b,N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage.In areas where the incidence is high(China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus.
基金This study was supported by Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2018PT32014)Chinese Academy of Medical Science Innovation Fund for Medical Science(2017-I2M-1-001).
文摘Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review
文摘AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.RESULTS: For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P < 0.001), and the proportions of OLGIM stages III-IV cases were 42.3% and 19.9%, respectively (P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA (OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages III-IV (OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages III-IV (P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA (75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages III-IV (OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).CONCLUSION: OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.
