BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,...BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,has been shown to significantly improve clinical symptoms in patients with CAG,as demonstrated by a multicenter cohort study(overall effective rate:82.5%,P<0.01).However,the unclear molecular mechanisms and therapeutic targets of AWD limit its international acceptance.AIM To investigate the therapeutic mechanisms of AWD against CAG from an integrated perspective.METHODS In this study,N-methyl-N’-nitro-N-nitrosoguanidine was used to establish a CAG rat model.Serum-derived constituents transferred from AWD were first identified using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.The concentrations of inflammatory cytokines in serum samples were determined by enzyme-linked immunosorbent assay.Moreover,gastric mucosal tissues were analyzed by quantitative realtime polymerase chain reaction to measure messenger RNA(mRNA)levels of the NLRP3 inflammasome.Western blotting was used to detect the protein expression of NLRP3,caspase-1,and interleukin(IL)-1β.To elucidate the regulatory mechanisms underlying AWD treatment,structural alterations of the gut microbiota(GM)and associated metabolites were analyzed using integrated high-throughput sequencing(16S rRNA)and liquid chromatography-mass spectrometry based untargeted metabolomics.This comprehensive approach systematically clarified AWD’s multi-target therapeutic mechanisms against CAG.RESULTS AWD notably reduced serum levels of pro-inflammatory cytokines,such as IL-1β,IL-18,tumor necrosis factor-α,and lipopolysaccharide,demonstrating significant statistical differences(all P<0.01).Additionally,AWD substantially inhibited NLRP3 mRNA expression in gastric mucosal tissue(P<0.01)and concurrently decreased the protein abundance of NLRP3,IL-1β,and caspase-1(all P<0.01),thereby suppressing inflammasome signaling activation.GM analysis indicated that AWD intervention significantly increased the relative abundance of beneficial bacteria.Associated microbial metabolites likely inhibited the NLRP3 inflammasome pathway by modulating immune cell function.Non-targeted metabolomics further indicated that AWD exerted anti-inflammatory effects by regulating critical metabolic pathways,including the Kaposi’s sarcoma-associated herpesvirus infection pathway,autophagy processes,and glycosylphosphatidylinositol-anchor biosynthesis.CONCLUSION AWD alleviates the pathological progression of CAG through multi-target synergistic mechanisms.On one hand,AWD directly suppresses gastric mucosal inflammation by inhibiting NLRP3 inflammasome activation.On the other hand,AWD remodels intestinal microbiota-metabolite homeostasis,enhances intestinal barrier function,and regulates mucosal immune responses.展开更多
Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling res...Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling results in mucosal impairment and the initiation of cancer.Banxia Xiexin Decoction(BXD),a well-known formula in traditional Chinese medicine(TCM),shows promise in treating gastric disorders,but its mechanisms in gastric restoration remain unclear.Methods:Using MNNG-induced CAG and PLGC rat models,BXD was administered for 12 weeks.Gastric mucosal pathology was assessed via hematoxylin-eosin staining.Proliferation(Ki-67)and angiogenesis(VEGFA)markers were evaluated by immunohistochemistry.Network pharmacology identified BXD’s targets and pathways.Notch pathway components(Notch1,Jagged1,Dll4,Hes1)were analyzed via qPCR,Western blot,and immunohistochemistry.Results:BXD significantly ameliorated mucosal atrophy,glandular structural disorder,and dysplasia in CAG and PLGC rats.Network pharmacology revealed 323 overlapping targets between BXD and PLGC,with Notch signaling as a central pathway.BXD downregulated Notch1,Jagged1,Dll4,and Hes1 expression at transcriptional and protein levels,suppressed Ki-67(proliferation)and VEGFA(angiogenesis)overexpression,and restored gastric mucosal integrity.Conclusion:BXD inhibits Notch signaling,reduces aberrant proliferation and angiogenesis,and interrupts Correa’s gastric carcinogenesis cascade.This study provides mechanistic evidence supporting BXD as a TCM-based intervention for gastric precancerous lesions.展开更多
Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a mor...Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.展开更多
Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the ...Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.展开更多
Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly div...Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.展开更多
This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiatio...This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.展开更多
AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiv...AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.展开更多
Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been...Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been found that traditional Chinese medicine(TCM)exerts therapeutic effects on CAG through various signaling pathways.This article systematically reviews and summarizes the literature on TCM treatment of CAG,elaborating on the etiology and pathogenesis of CAG,new ideas from different physicians in treating CAG,and the effects of different TCM monomers and compound prescriptions on signaling pathways such as PI3K-AKT and JAK1/STAT3 to provide a reference for subsequent research on CAG.展开更多
OBJECTIVE:To explore the mechanism of Tonglaga-5(通拉嘎-5,TLG-5)for the treatment of chronic atrophic gastritis(CAG),based on network pharmacology and metabolomics.METHODS:Forty-eight male Sprague-Dawley rats were ran...OBJECTIVE:To explore the mechanism of Tonglaga-5(通拉嘎-5,TLG-5)for the treatment of chronic atrophic gastritis(CAG),based on network pharmacology and metabolomics.METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into six groups(n=8):control group;model group;teprenone group,and low-,median-,and high-dose TLG-5 groups.The enzyme linked immunosorbent assay(ELISA)was used to measure the expression of pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ)and gastrin-17(G-17)in the serum.Hematoxylin and eosin staining were performed to observe the pathological condition.And the network pharmacology was employed to identify the targets and signaling pathways of TLG-5 affecting CAG.Then,the metabolomics approach was applied to explore the specific metabolites and metabolic pathways.Finally,validation was performed using the“metabolite-gene”interaction network,molecular docking and quantitative real-time polymerase chain reaction(q PCR).RESULTS:High-dose TLG-5 significantly improved the expression of PGⅠ,PGR(PGⅠ/PGⅡ)and G-17(P<0.05)and inhibited the expression of phosphoinositide-3-kinase regulatory subunit 2,AKT serine/threonine kinase(AKT),hypoxia-inducible factor 1-alpha(HIF-1α)(P<0.05).Further,high-dose TLG-5 reduced the number of glands was reduced,and fibrosis with oedema and ecchymosis appeared at the base.Overlapping TLG-5 and CAG gene targets produced 270 interactive targets.The results of gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses suggested that TLG-5 could affect CAG through the predominantly cancer and inflammation-related pathways.Pyrimidine metabolism was identified as a significantly differential pathway in the mechanism of TLG-5 for treating CAG.CONCLUSIONS:TLG-5 exerts a therapeutic effect on CAG by regulatingβ-alanine metabolism,pyrimidine metabolism pathways,and inhibiting the PI3K-AKT signaling pathway and HIF-1 signaling pathways.展开更多
Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures ...Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.展开更多
BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastri...BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.展开更多
AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study...AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P＜0.01). However, the grade of IM increased in H pylori -infected group (P＜0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.展开更多
BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastr...BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.展开更多
AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic...AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic gastritis (SCAG) and intestinal metaplasia (IM). METHODS: A total of 372 cases were selected from a cohort study in Linqu County, a high risk area for gastric cancer (GC) in northern China. To obtain a sufficient group size, patients with normal or superficial gastritis were included. Based on an average follow-up period of 56 mo, the 372 cases were divided into no progres-sion group (no histological progression from normal or superficial gastritis, n = 137), group Ⅰ (progressed from normal or superficial gastritis to SCAG, n = 134) and group Ⅱ (progressed from normal or superficial gastritis to IM, n = 101). IL-8 , MIF gene polymorphisms were detected by polymerase chain reaction-based denaturing high-performance liquid chromatography analysis and DNA sequencing. RESULTS: An increased risk of SCAG was found in subjects with IL-8-251 AA genotype [odds ratio (OR) = 2.62, 95% CI: 1.23-5.72] or IL-8-251 A allele carriers (AA + AT) (OR = 1.81, 95% CI: 1.06-3.09). An elevated risk of IM was found in subjects with IL-8-251 AT genotype (OR = 2.27, 95% CI: 1.25-4.14) or IL-8-251 A allele carriers (OR = 2.07, 95% CI: 1.16-3.69). An increased risk of SCAG was found in subjects with MIF-173 GC genotype (OR = 2.36, 95% CI: 1.38-4.02) or MIF-173 C allele carriers (GC + CC) (OR = 2.07, 95% CI: 1.21-3.55). An elevated risk of IM was found in subjects with MIF-173 CC genotype (OR = 2.27, 95% CI: 1.16-4.46) or MIF-173 C allele carriers (OR = 3.84, 95% CI: 1.58-9.34). The risk of SCAG and IM was more evident in subjects carrying IL-8-251 A allele (OR = 6.70, 95% CI: 1.29-9.78) or MIF-173 C allele (OR = 6.54, 95% CI: 2.97-14.20) and positive for H. pylori infection. CONCLUSION: IL-8-251 and MIF-173 gene polymorphisms are significantly associated with the risk of SCAG and IM in a population with a high risk of GC in Linqu County, Shandong Province, China.展开更多
AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control...AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG)model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24J/cm2doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter,the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope.RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P＜0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P＜0.01), the gastric mucosal inflammation cells were decreased (P＜0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal.CONCLUSION: 3.36J/cm2 dose of He-Ne laser has a significant effect on CAG in rats.展开更多
BACKGROUND The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention,and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying p...BACKGROUND The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention,and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying pathological diagnosis,which is of great significance for the treatment of precision gastric diseases,the improvement of the early diagnosis rate of gastric cancer,and the reduction of missed diagnosis rate and misdiagnosis rate.AIM To perform a histopathological classification and follow-up analysis of chronic atrophic gastritis(CAG).METHODS A total of 2248 CAG tissue samples were collected,and data of their clinical characteristics were also gathered.Based on these samples,the expression levels of Mucin 1(MUC1),MUC2,MUC5AC,and MUC6 in CAG tissue were tested by immunohistochemical assay.Moreover,we followed these patients for up to four years.The difference between different stages of gastroscopic biopsy was observed.RESULTS Through observation,it is believed that CAG should be divided into four types,simple type,hyperplasia type,intestinal metaplasia(IM)type,and intraepithelial neoplasia(IEN)type.Simple CAG accounted for 9.1%(205/2248),which was more common in elderly people over 60 years old.The main change was that the lamina propria glands were reduced in size and number.Hyperplastic CAG accounted for 29.1%(654/2248),mostly occurring between 40 and 60 years old.The main change was that the lamina propria glands were atrophy accompanied by glandular hyperplasia and slight expansion of the glands.IM CAG accounted for 50.4%(1132/2248),most of which increased with age,and were more common in those over 50 years.The atrophy of the lamina propria glands was accompanied by significant IM,and the mucus containing sialic acid or sulfate was distinguished according to the nature of the mucus.The IEN type CAG accounted for 11.4%(257/2248),which developed from the previous types,with severe gland atrophy and reduced mucus secretion,and is an important precancerous lesion.CONCLUSION The histological typing of CAG is convenient to understand the property of lesion,determine the follow-up time,and guide the clinical treatment.展开更多
BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was ...BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly inferior to the Updated Kimura-Takemoto classification for morphological verification of atrophic gastritis.展开更多
Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods...Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods： Rats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis （CAG） models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin （H-E） and alcian blue （A-B） stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer （μm） and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope （SEM）. The levels of PGE2, EGF （epiderminal growth factor） and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR （EGF receptor）, C-erbB-2, p53, p6 and bcl-2 in gastric tissue. Results： Under SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower （P〈0.05）. Compared with normal level of （0.61±0.28） μg/L, EGF in CAG （2.24±0.83） μg/L was significantly higher （P〈0.05）. The levels of PGEz and gastrin in serum were significantly lower in CAG rats than that in normal rats （P〈0.05）. Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group （P〈0.05）. Imrauno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p 16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue, bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue. Conclusion： The pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.展开更多
BACKGROUND Gastric cancer(GC)is one of the most frequently diagnosed tumor globally.In most cases,GC develops in a stepwise manner from chronic gastritis or atrophic gastritis(AG)to cancer.One of the major issues in c...BACKGROUND Gastric cancer(GC)is one of the most frequently diagnosed tumor globally.In most cases,GC develops in a stepwise manner from chronic gastritis or atrophic gastritis(AG)to cancer.One of the major issues in clinical settings of GC is diagnosis at advanced disease stages resulting in poor prognosis.Micro RNAs(mi RNAs)are small noncoding molecules that play an essential role in a variety of fundamental biological processes.However,clinical potential of mi RNA profiling in the gastric cancerogenesis,especially in premalignant GC cases,remains unclear.AIM To evaluate the AG and GC tissue mi RNomes and identify specific mi RNAs’potential for clinical applications(e.g.,non-invasive diagnostics).METHODS Study included a total of 125 subjects:Controls(CON),AG,and GC patients.All study subjects were recruited at the Departments of Surgery or Gastroenterology,Hospital of Lithuanian University of Health Sciences and divided into the profiling(n=60)and validation(n=65)cohorts.Total RNA isolated from tissue samples was used for preparation of small RNA sequencing libraries and profiled using next-generation sequencing(NGS).Based on NGS data,deregulated mi RNAs hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p were analyzed in plasma samples of independent cohort consisting of CON,AG,and GC patients.Expression level of hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p was determined using the quantitative real-time polymerase chain reaction and 2-ΔΔCt method.RESULTS Results of tissue analysis revealed 20 differentially expressed mi RNAs in AG group compared to CON group,129 deregulated mi RNAs in GC compared to CON,and 99 altered mi RNAs comparing GC and AG groups.Only 2 mi RNAs(hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p)were identified to be step-wise deregulated in healthy-premalignant-malignant sequence.Area under the curve(AUC)-receiver operating characteristic analysis revealed that expression level of hsa-mi R-196 a-5 p is significant for discrimination of CON vs AG,CON vs GC and AG vs GC and resulted in AUCs:88.0%,93.1%and 66.3%,respectively.Comparing results in tissue and plasma samples,hsa-mi R-129-1-3 p was significantly down-regulated in GC compared to AG(P=0.0021 and P=0.024,tissue and plasma,respectively).Moreover,analysis revealed that hsa-mi R-215-3 p/5 p and hsa-mi R-934 were significantly deregulated in GC based on Helicobacter pylori(H.pylori)infection status[log2 fold change(FC)=-4.52,P-adjusted=0.02;log2 FC=-4.00,P-adjusted=0.02;log2 FC=6.09,P-adjusted=0.02,respectively].CONCLUSION Comprehensive mi RNome study provides evidence for gradual deregulation of hsa-mi R-196 a-5 p and hsa-mi R-129-1-3 p in gastric carcinogenesis and found hsami R-215-3 p/5 p and hsa-mi R-934 to be significantly deregulated in H.pylori carrying GC patients.展开更多
基金Supported by the National Natural Science Foundation of China,No.81860843Guangxi Administration of Traditional Chinese Medicine Project,No.GZSY23-36 and No.GXZYA20240150。
文摘BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,has been shown to significantly improve clinical symptoms in patients with CAG,as demonstrated by a multicenter cohort study(overall effective rate:82.5%,P<0.01).However,the unclear molecular mechanisms and therapeutic targets of AWD limit its international acceptance.AIM To investigate the therapeutic mechanisms of AWD against CAG from an integrated perspective.METHODS In this study,N-methyl-N’-nitro-N-nitrosoguanidine was used to establish a CAG rat model.Serum-derived constituents transferred from AWD were first identified using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.The concentrations of inflammatory cytokines in serum samples were determined by enzyme-linked immunosorbent assay.Moreover,gastric mucosal tissues were analyzed by quantitative realtime polymerase chain reaction to measure messenger RNA(mRNA)levels of the NLRP3 inflammasome.Western blotting was used to detect the protein expression of NLRP3,caspase-1,and interleukin(IL)-1β.To elucidate the regulatory mechanisms underlying AWD treatment,structural alterations of the gut microbiota(GM)and associated metabolites were analyzed using integrated high-throughput sequencing(16S rRNA)and liquid chromatography-mass spectrometry based untargeted metabolomics.This comprehensive approach systematically clarified AWD’s multi-target therapeutic mechanisms against CAG.RESULTS AWD notably reduced serum levels of pro-inflammatory cytokines,such as IL-1β,IL-18,tumor necrosis factor-α,and lipopolysaccharide,demonstrating significant statistical differences(all P<0.01).Additionally,AWD substantially inhibited NLRP3 mRNA expression in gastric mucosal tissue(P<0.01)and concurrently decreased the protein abundance of NLRP3,IL-1β,and caspase-1(all P<0.01),thereby suppressing inflammasome signaling activation.GM analysis indicated that AWD intervention significantly increased the relative abundance of beneficial bacteria.Associated microbial metabolites likely inhibited the NLRP3 inflammasome pathway by modulating immune cell function.Non-targeted metabolomics further indicated that AWD exerted anti-inflammatory effects by regulating critical metabolic pathways,including the Kaposi’s sarcoma-associated herpesvirus infection pathway,autophagy processes,and glycosylphosphatidylinositol-anchor biosynthesis.CONCLUSION AWD alleviates the pathological progression of CAG through multi-target synergistic mechanisms.On one hand,AWD directly suppresses gastric mucosal inflammation by inhibiting NLRP3 inflammasome activation.On the other hand,AWD remodels intestinal microbiota-metabolite homeostasis,enhances intestinal barrier function,and regulates mucosal immune responses.
基金supported by the National Natural Science Foundation of China(Grant No.82274442)the Key Research Project in Traditional Chinese Medicine of Tianjin Municipal Health Commission(Grant No.202007)the Integrated Traditional Chinese and Western Medicine Research Project of Tianjin Municipal Health Commission(Grant No.2023134).
文摘Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling results in mucosal impairment and the initiation of cancer.Banxia Xiexin Decoction(BXD),a well-known formula in traditional Chinese medicine(TCM),shows promise in treating gastric disorders,but its mechanisms in gastric restoration remain unclear.Methods:Using MNNG-induced CAG and PLGC rat models,BXD was administered for 12 weeks.Gastric mucosal pathology was assessed via hematoxylin-eosin staining.Proliferation(Ki-67)and angiogenesis(VEGFA)markers were evaluated by immunohistochemistry.Network pharmacology identified BXD’s targets and pathways.Notch pathway components(Notch1,Jagged1,Dll4,Hes1)were analyzed via qPCR,Western blot,and immunohistochemistry.Results:BXD significantly ameliorated mucosal atrophy,glandular structural disorder,and dysplasia in CAG and PLGC rats.Network pharmacology revealed 323 overlapping targets between BXD and PLGC,with Notch signaling as a central pathway.BXD downregulated Notch1,Jagged1,Dll4,and Hes1 expression at transcriptional and protein levels,suppressed Ki-67(proliferation)and VEGFA(angiogenesis)overexpression,and restored gastric mucosal integrity.Conclusion:BXD inhibits Notch signaling,reduces aberrant proliferation and angiogenesis,and interrupts Correa’s gastric carcinogenesis cascade.This study provides mechanistic evidence supporting BXD as a TCM-based intervention for gastric precancerous lesions.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
基金Supported by National Traditional Chinese Medicine Advantageous Specialty Project of National Administration of Traditional Chinese MedicineShuguang Hospital Siming Foundation Research Special Project,No.SGKJ-202304.
文摘Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.
文摘Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.
基金Inner Mongolia Autonomous Region Education Science“14th Five-Year Plan”Project(Project No.NGJGH2023467)Inner Mongolia Medical University Higher Education Teaching Reform Research Project(Project No.NYJXGG2022054)。
文摘Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.
基金supported by the Zhejiang Science and Technology Program of TCM(No.2025ZF017)the Clinical Young-Talent Trainning Project in TCM under the Young Eagle Program of the China Association of Chinese Medicine(No.CYJH2024048).
文摘This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.
文摘AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.
基金supported by the Youth Medical Science and Technology Talent Special Research Project of Xinjiang Uygur Autonomous Region Health Commission(WJWY-202440).
文摘Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been found that traditional Chinese medicine(TCM)exerts therapeutic effects on CAG through various signaling pathways.This article systematically reviews and summarizes the literature on TCM treatment of CAG,elaborating on the etiology and pathogenesis of CAG,new ideas from different physicians in treating CAG,and the effects of different TCM monomers and compound prescriptions on signaling pathways such as PI3K-AKT and JAK1/STAT3 to provide a reference for subsequent research on CAG.
基金the National Natural Science Foundation of China:New Quality Control Model of Mongolian Medicine Tonglaga-5“Qingzhuo Shenghua”Based on“Stomach Blood Bone Correlation Tracking”(No.82160745)Grassland Talent Rolling Support Program([2023]3)+1 种基金Key Projects of Inner Mongolia Medical University:Research on the Mechanism of Mongolian Prescription Tonglaga-5 in Treating Chronic Atrophic Gastritis based on Multiomics Integration(No.YKD2024ZD001)Scientific Research Projects of the Inner Mongolia Autonomous Region Collaborative Innovation Centre of Mongolian Medicine:Preparation and Pharmacological Study of Mongolian Medicine Tonglaga-5 Transdermal Patch(No.MYYXTPY202313)。
文摘OBJECTIVE:To explore the mechanism of Tonglaga-5(通拉嘎-5,TLG-5)for the treatment of chronic atrophic gastritis(CAG),based on network pharmacology and metabolomics.METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into six groups(n=8):control group;model group;teprenone group,and low-,median-,and high-dose TLG-5 groups.The enzyme linked immunosorbent assay(ELISA)was used to measure the expression of pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ)and gastrin-17(G-17)in the serum.Hematoxylin and eosin staining were performed to observe the pathological condition.And the network pharmacology was employed to identify the targets and signaling pathways of TLG-5 affecting CAG.Then,the metabolomics approach was applied to explore the specific metabolites and metabolic pathways.Finally,validation was performed using the“metabolite-gene”interaction network,molecular docking and quantitative real-time polymerase chain reaction(q PCR).RESULTS:High-dose TLG-5 significantly improved the expression of PGⅠ,PGR(PGⅠ/PGⅡ)and G-17(P<0.05)and inhibited the expression of phosphoinositide-3-kinase regulatory subunit 2,AKT serine/threonine kinase(AKT),hypoxia-inducible factor 1-alpha(HIF-1α)(P<0.05).Further,high-dose TLG-5 reduced the number of glands was reduced,and fibrosis with oedema and ecchymosis appeared at the base.Overlapping TLG-5 and CAG gene targets produced 270 interactive targets.The results of gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses suggested that TLG-5 could affect CAG through the predominantly cancer and inflammation-related pathways.Pyrimidine metabolism was identified as a significantly differential pathway in the mechanism of TLG-5 for treating CAG.CONCLUSIONS:TLG-5 exerts a therapeutic effect on CAG by regulatingβ-alanine metabolism,pyrimidine metabolism pathways,and inhibiting the PI3K-AKT signaling pathway and HIF-1 signaling pathways.
文摘Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.
文摘BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.
基金Supported by the Scientific Research Fund of the Health Bureau of Zhejiang Province, No. 2001QN012
文摘AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P＜0.01). However, the grade of IM increased in H pylori -infected group (P＜0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.
文摘BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.
基金Supported by The Grants from Beijing Municipal Science Foundationthe Key Technology Research and Development Program, No. 2002BA711A06+1 种基金the National 973 Project, No.1998051203863 Project, No. 2006A402
文摘AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic gastritis (SCAG) and intestinal metaplasia (IM). METHODS: A total of 372 cases were selected from a cohort study in Linqu County, a high risk area for gastric cancer (GC) in northern China. To obtain a sufficient group size, patients with normal or superficial gastritis were included. Based on an average follow-up period of 56 mo, the 372 cases were divided into no progres-sion group (no histological progression from normal or superficial gastritis, n = 137), group Ⅰ (progressed from normal or superficial gastritis to SCAG, n = 134) and group Ⅱ (progressed from normal or superficial gastritis to IM, n = 101). IL-8 , MIF gene polymorphisms were detected by polymerase chain reaction-based denaturing high-performance liquid chromatography analysis and DNA sequencing. RESULTS: An increased risk of SCAG was found in subjects with IL-8-251 AA genotype [odds ratio (OR) = 2.62, 95% CI: 1.23-5.72] or IL-8-251 A allele carriers (AA + AT) (OR = 1.81, 95% CI: 1.06-3.09). An elevated risk of IM was found in subjects with IL-8-251 AT genotype (OR = 2.27, 95% CI: 1.25-4.14) or IL-8-251 A allele carriers (OR = 2.07, 95% CI: 1.16-3.69). An increased risk of SCAG was found in subjects with MIF-173 GC genotype (OR = 2.36, 95% CI: 1.38-4.02) or MIF-173 C allele carriers (GC + CC) (OR = 2.07, 95% CI: 1.21-3.55). An elevated risk of IM was found in subjects with MIF-173 CC genotype (OR = 2.27, 95% CI: 1.16-4.46) or MIF-173 C allele carriers (OR = 3.84, 95% CI: 1.58-9.34). The risk of SCAG and IM was more evident in subjects carrying IL-8-251 A allele (OR = 6.70, 95% CI: 1.29-9.78) or MIF-173 C allele (OR = 6.54, 95% CI: 2.97-14.20) and positive for H. pylori infection. CONCLUSION: IL-8-251 and MIF-173 gene polymorphisms are significantly associated with the risk of SCAG and IM in a population with a high risk of GC in Linqu County, Shandong Province, China.
基金Supported by the Natural Science Foundation of Hebei Province, No. 301427
文摘AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG)model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24J/cm2doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter,the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope.RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P＜0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P＜0.01), the gastric mucosal inflammation cells were decreased (P＜0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal.CONCLUSION: 3.36J/cm2 dose of He-Ne laser has a significant effect on CAG in rats.
文摘BACKGROUND The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention,and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying pathological diagnosis,which is of great significance for the treatment of precision gastric diseases,the improvement of the early diagnosis rate of gastric cancer,and the reduction of missed diagnosis rate and misdiagnosis rate.AIM To perform a histopathological classification and follow-up analysis of chronic atrophic gastritis(CAG).METHODS A total of 2248 CAG tissue samples were collected,and data of their clinical characteristics were also gathered.Based on these samples,the expression levels of Mucin 1(MUC1),MUC2,MUC5AC,and MUC6 in CAG tissue were tested by immunohistochemical assay.Moreover,we followed these patients for up to four years.The difference between different stages of gastroscopic biopsy was observed.RESULTS Through observation,it is believed that CAG should be divided into four types,simple type,hyperplasia type,intestinal metaplasia(IM)type,and intraepithelial neoplasia(IEN)type.Simple CAG accounted for 9.1%(205/2248),which was more common in elderly people over 60 years old.The main change was that the lamina propria glands were reduced in size and number.Hyperplastic CAG accounted for 29.1%(654/2248),mostly occurring between 40 and 60 years old.The main change was that the lamina propria glands were atrophy accompanied by glandular hyperplasia and slight expansion of the glands.IM CAG accounted for 50.4%(1132/2248),most of which increased with age,and were more common in those over 50 years.The atrophy of the lamina propria glands was accompanied by significant IM,and the mucus containing sialic acid or sulfate was distinguished according to the nature of the mucus.The IEN type CAG accounted for 11.4%(257/2248),which developed from the previous types,with severe gland atrophy and reduced mucus secretion,and is an important precancerous lesion.CONCLUSION The histological typing of CAG is convenient to understand the property of lesion,determine the follow-up time,and guide the clinical treatment.
文摘BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly inferior to the Updated Kimura-Takemoto classification for morphological verification of atrophic gastritis.
基金Project (No. 011103018) supported by the Science and TechnologyPlan of Zhejiang Province, China
文摘Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods： Rats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis （CAG） models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin （H-E） and alcian blue （A-B） stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer （μm） and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope （SEM）. The levels of PGE2, EGF （epiderminal growth factor） and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR （EGF receptor）, C-erbB-2, p53, p6 and bcl-2 in gastric tissue. Results： Under SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower （P〈0.05）. Compared with normal level of （0.61±0.28） μg/L, EGF in CAG （2.24±0.83） μg/L was significantly higher （P〈0.05）. The levels of PGEz and gastrin in serum were significantly lower in CAG rats than that in normal rats （P〈0.05）. Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group （P〈0.05）. Imrauno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p 16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue, bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue. Conclusion： The pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.
基金Supported by the MULTIOMICS project that has received funding from European Social Fund(No.09.3.3-LMT-K-712-01-0130)under grant agreement with the Research Council of Lithuania(LMTLT)。
文摘BACKGROUND Gastric cancer(GC)is one of the most frequently diagnosed tumor globally.In most cases,GC develops in a stepwise manner from chronic gastritis or atrophic gastritis(AG)to cancer.One of the major issues in clinical settings of GC is diagnosis at advanced disease stages resulting in poor prognosis.Micro RNAs(mi RNAs)are small noncoding molecules that play an essential role in a variety of fundamental biological processes.However,clinical potential of mi RNA profiling in the gastric cancerogenesis,especially in premalignant GC cases,remains unclear.AIM To evaluate the AG and GC tissue mi RNomes and identify specific mi RNAs’potential for clinical applications(e.g.,non-invasive diagnostics).METHODS Study included a total of 125 subjects:Controls(CON),AG,and GC patients.All study subjects were recruited at the Departments of Surgery or Gastroenterology,Hospital of Lithuanian University of Health Sciences and divided into the profiling(n=60)and validation(n=65)cohorts.Total RNA isolated from tissue samples was used for preparation of small RNA sequencing libraries and profiled using next-generation sequencing(NGS).Based on NGS data,deregulated mi RNAs hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p were analyzed in plasma samples of independent cohort consisting of CON,AG,and GC patients.Expression level of hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p was determined using the quantitative real-time polymerase chain reaction and 2-ΔΔCt method.RESULTS Results of tissue analysis revealed 20 differentially expressed mi RNAs in AG group compared to CON group,129 deregulated mi RNAs in GC compared to CON,and 99 altered mi RNAs comparing GC and AG groups.Only 2 mi RNAs(hsa-mi R-129-1-3 p and hsa-mi R-196 a-5 p)were identified to be step-wise deregulated in healthy-premalignant-malignant sequence.Area under the curve(AUC)-receiver operating characteristic analysis revealed that expression level of hsa-mi R-196 a-5 p is significant for discrimination of CON vs AG,CON vs GC and AG vs GC and resulted in AUCs:88.0%,93.1%and 66.3%,respectively.Comparing results in tissue and plasma samples,hsa-mi R-129-1-3 p was significantly down-regulated in GC compared to AG(P=0.0021 and P=0.024,tissue and plasma,respectively).Moreover,analysis revealed that hsa-mi R-215-3 p/5 p and hsa-mi R-934 were significantly deregulated in GC based on Helicobacter pylori(H.pylori)infection status[log2 fold change(FC)=-4.52,P-adjusted=0.02;log2 FC=-4.00,P-adjusted=0.02;log2 FC=6.09,P-adjusted=0.02,respectively].CONCLUSION Comprehensive mi RNome study provides evidence for gradual deregulation of hsa-mi R-196 a-5 p and hsa-mi R-129-1-3 p in gastric carcinogenesis and found hsami R-215-3 p/5 p and hsa-mi R-934 to be significantly deregulated in H.pylori carrying GC patients.
