Preventive effects of etodolac,a selective cyclooxygenase‐2 inhibitor,on cancer development in extensive metaplastic gastritis,a Helicobacter pylori‐negative precancerous lesion

The present study investigated the preventive effects of etodolac, a selective cyclo‐oxygenase (COX)‐2 inhibitor, on metachronous cancer development after endoscopic resection of early gastric cancer. Among 267 early gastric cancer patients who underwent endoscopic resection, 47 patients with extensive metaplastic gastritis were selected based on endoscopic findings and our previously described criteria of serum pepsinogen (PG) test‐positive and Helicobacter pylori antibody‐negative conditions. Nonrandomized etodolac treatment (300 mg/day) was administered to 26 patients (Group A), while the remaining 21 patients were untreated (Group B). No significant differences in age, sex distribution, lifestyle factors or extent of metaplastic gastritis at baseline were identified between groups. Patients were followed for metachronous cancer development with endoscopy every 6–12 months for up to 5 years. Mean (standard deviation) follow‐up period was 4.2 (0.9) years. In Group B, 5 cancers developed (incidence rate = 6,266/100,000 person‐years), significantly more than the 1 cancer in Group A (incidence rate = 898/100,000 person‐years; p < 0.05). Long‐term etodolac treatment did not influence the extent of metaplastic gastritis as revealed by endoscopic findings or by serum PG levels, but effectively reduced metachronous cancer development in patients with extensive metaplastic gastritis. These results strongly suggest that chemoprevention of cancer in the metaplastic stomach is possible by controlling COX‐2 expression.     

Determining Gastric Cancer-Related Risk Factors in Mongolian Population Using ABC(D) Method: A Matched Case-Control Study

Objective: We aimed to identify gastric cancer-related risk factors and evaluate the efficacy of screening ABC(D) method in determining high risk  gastric cancer individuals in Mongolian population. Methods: A total of 240 participants (120 gastric cancer patients and 120 healthy individuals) were included in this study. Data were collecting using a structured questionnaire consisting of 56 questions covering 5 categories. Serum Helicobacter pylori IgG (H. pylori IgG), pepsinogen I (PGI), and pepsinogen II (PGII) were tested in one third of all the participants (40 gastric cancer patients and 40 controls).  PGI, PGII, and H. pylori IgG levels were measured using GastroPanel enzyme-linked immunosorbent assay kit (Biohit, Helsinki, Finland). Results: Habits of having leftover meals (OR 2.22, 95%CI 1.27-3.86, p<0.01), daily consumption of tea with salt (OR 1.97, 95%CI 1.18-3.30, p<0.01), smoking on an empty stomach (OR 2.44, 95%CI 1.11-5.37, p<0.05), daily consumption of vegetables (OR 0.45, 95%CI 0.27-0.76, p<0.01), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p<0.05), family history of gastric cancer (parents OR 2.88, 95%CI 1.07-7.78, p<0.05, siblings (OR 3.09, 95%CI 1.09-8.81, p<0.05), and history of gastric diseases (OR 3.65, 95%CI 2.10-6.35, p<0.0001) were identified as protective factors. A low PGI level (<35.25ng/ml) and low PGI/II ratio (<4) were associated with gastric cancer risk. According to ABC(D) method, groups C and D had higher proportion of gastric cancer cases than group A and B (group C, OR 7.50, 95%CI 1.20-47.05, p<0.05; group D, OR 8.3, 95%CI 1.33-51.26, p<0.05). Conclusion: Our findings suggested that gastric cancer risk was more closely related to eating habits, smoking, family history, and precancerous lesions. ABC(D) method seems to be a plausible alternative or supplementary method for stratifying patients at high risk of gastric cancer in this country.     

Association of Helicobacter pylori infection with chronic atrophic gastritis: Meta-analyses according to type of disease definition

Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG). A large variety of definitions of CAG have been used in epidemiologic studies in the past. The aim of this work was to systematically review and summarize estimates of the association between H. pylori infection and CAG according to the various definitions of CAG. Articles on the association between H. pylori infection and CAG published until July 2007 were identified. Separate meta-analyses were carried out for studies defining CAG based on gastroscopy with biopsy, serum pepsinogen I (PG I) only, the pepsinogen I/pepsinogen II ratio (PG I/PG II ratio) only, or a combination of PG I and the PG I/PG II ratio. Numbers of identified studies and summary odds ratios (OR) (95% confidence intervals) were as follows: gastroscopy with biopsy: n = 34, OR = 6.4 (4.0-10.1); PG I only: n = 13, OR = 0.9 (0.7-1.2); PG I/PG II ratio: n = 8, OR = 7.2 (3.1-16.8); combination of PG I and the PG I/PG II ratio: n = 20, OR = 5.7 (4.4-7.5). Studies with CAG definitions based on gastroscopy with biopsy or the PG I/PG II ratio (alone or in combination with PG I) yield similarly strong associations of H. pylori with CAG. The association is missed entirely in studies where CAG is defined by PG I only.     

幽门螺杆菌及胃蛋白酶原、胃泌素17水平在胃癌前病变诊断中的应用价值

目的 探讨幽门螺杆菌(H.pylori)与胃蛋白酶原(PG)、胃泌素17(G17)与胃癌前病变的相关性.方法选取在我院行胃镜检查的患者856例,其中471例病理检出癌前病变的患者为病例组,385例未检出癌前病变的患者为对照组.病例组按病理诊断结果分为慢性萎缩性胃炎(CAG)组157例,肠化(IM)组153例,低级别上皮...     

胃复康加味方治疗隆起糜烂性胃炎（脾虚气滞型）患者的临床疗效观察

【目的】探讨胃复康加味方治疗隆起糜烂性胃炎(脾虚气滞型)患者的临床疗效及对血清胃泌素17(G-17)和胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及其比值(PGR)的影响。【方法】将62例隆起糜烂性胃炎(脾虚气滞型)患者随机分为治疗组32例和对照组30例。2组患者均给予幽门螺杆菌(Hp)阳性者标准抗Hp四联治疗,在此基础上,对照组给予抑制胃酸分泌、促进胃动力等常规对症治疗,治疗组给予中药胃复康加味方治疗,1个月为1个疗程,连续治疗2个疗程。观察2组患者治疗前后Hp阳性率和病理组织改善情况以及血清PGⅠ、PGⅡ、PGR、G-17水平的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗2个疗程后,治疗组的总有效率为90.63%(29/32),对照组为73.33%(22/30),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的Hp阳性率均较治疗前降低(P<0.05),且治疗组的Hp阳性率明显低于对照组,差异有统计学意义(P<0.05)。(3)治疗后,治疗组的腺体萎缩、肠上皮化生和异型增生等均较治疗前改善(P<0.05),而对照组均无...     

Microarray analysis of gastric mucosa among children with Helicobacter pylori infection

Background: Although initial infection with Helicobacter pylori may occur before 5 years of age, the pediatric mucosal immune response against H. pylori is not clear. The aim of the present study was to evaluate immune responses in the H. pylori‐infected gastric mucosa of children using microarray and real‐time polymerase chain reaction (PCR) analysis of pediatric gastric samples. Methods: Gastric samples were obtained from 12 patients undergoing routine endoscopy of chronic abdominal complaints. Six patients (three boys, three girls) aged 10.1–14.6 years had evidence of H. pylori infection, and the remaining six (three boys, three girls) aged 10.3–15.5 years had no evidence of infection and presented no histological changes associated with gastritis. Microarray and real‐time PCR analyses were performed, and the changes in gene expression‐related immune response were also analyzed. Results: Using microarray analysis, the total number of significantly upregulated and downregulated genes (fold change >5, P < 0.01) was 21 in the antrum and 16 in the corpus when comparing patients with or without infection. Using real‐time PCR, the expression of lipocalin‐2 (Lcn2), C‐C motif chemokine ligand (CCL) 18, C‐X‐C motif chemokine ligand (CXCL) 9 and CXCL11 was upregulated, while the expression of pepsinogen (PG) I and PGII was downregulated when comparing patients with or without infection. Conclusions: Lcn2, CCL18, CXCL9, CXCL11, PGI and PGII play important roles in childhood H. pylori infection.     

胃蛋白酶原及其亚群对胃癌早期诊断及预后判断的意义

目的探讨血清胃蛋白酶原(PG)及其亚群(PGⅠ、PGⅡ)与胃癌病人早期诊断及术后复发的关系。方法采用放射免疫分析法测定胃癌病人及正常对照组血清PGⅠ、PGⅡ含量,并对两者联合检测进行综合评价。结果胃癌病人血清PGⅠ含量及PGⅠ/PGⅡ比值明显低于正常对照组,早期胃癌即表现有显著性差异,而进展期胃癌则下降更显著(t′=11.84~14.95,t=15.82~40.27,P<0.01)。胃癌病人根治性手术后血清PGⅠ及PGⅡ的含量明显下降,根治性全胃切除术后病人血清胃蛋白酶原含量很低,胃癌复发后PGⅠ及PGⅡ均明显升高(t′=4.60~15.51,t=4.72,P<0.01)。结论监测PGⅠ及PGⅠ/PGⅡ比值变化对早期胃癌筛选有一定意义,可用于胃癌术后复发的监测。     

康复护理加用药饼灸对慢性萎缩性胃炎患者血清胃蛋白酶原及胃泌素的影响探究

目的探究康复护理加用药饼灸对慢性萎缩性胃炎(CAG)患者血清胃蛋白酶原及胃泌素(GS)的影响。方法 120例慢性萎缩性胃炎患者,随机分为实验组及对照组,每组60例。对照组患者在康复护理基础上加用常规药物治疗,实验组患者在康复护理基础上联合药饼灸治疗。比较两组患者治疗前后症状评分、血清胃蛋白酶原及胃泌素水平。结果治疗后,实验组患者症状评分为(2.32±0.28)分,显著低于对照组的(4.98±0.32)分,差异具有统计学意义(P<0.05)。治疗前,两组患者血清胃蛋白酶Ⅰ(PGⅠ)、胃蛋白酶Ⅱ(PGⅡ)及胃泌素水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的血清胃蛋白酶Ⅰ及胃泌素水平均明显高于本组治疗前,且实验组显著高于对照组,差异均具有统计学意义(P<0.05)。但两组患者治疗前后血清胃蛋白酶Ⅱ水平比较,差异无统计学意义(P>0.05)。结论康复护理加用药饼灸可有效改善慢性萎缩性胃炎患者的临床症状,同时使患者血清胃蛋白酶原及胃泌素表达升高,可调控疾病的发生发展,对临床治疗起到了一定的指导意义。     

Conformational change that accompanies pepsinogen activation observed in real time by fluorescence energy transfer

Pig pepsinogen has been reacted with N-carboxymethylisatoic anhydride to form N-carboxymethyl-anthraniloyl-(CMA-) pepsinogen, derivatized at Lys_p18 Lys _p23, Lys_p27, Lys_p30, and Lys₃₂₀. Conformational change associated with activation was detected by following energy transfer from tryptophan residues of the pepsin moiety, excited at 295 nm, to CMA groups, monitored by emission above 415 nm. Efficiency of this energy transfer is a measure of conformational change. For this zymogen derivative the change in efficiency occurs with a first order rate constant of 0.041 s^-1 at pH 2.4, 22°, which equals the rate at which, following acidification, alkali-stable potential activity becomes alkali-labile. For the native zymogen the rate of this conversion had been shown to be identical to the rate of cleavage of the scissile bond of pepsinogen. Therefore, the correspondence in this derivative of the rates of conversion to alkali lability and change in energy transfer demonstrates that a conformational change accompanies the peptide bond cleavage of activation.     

半夏泻心汤与三联疗法对慢性萎缩性胃炎患者的效果观察

目的 探讨半夏泻心汤与三联疗法对慢性萎缩性胃炎患者的效果观察。方法 将104例慢性萎缩性胃炎患者随机分为观察组(53例)和对照组(51例),两组患者均给予三联疗法,观察组加用半夏泻心汤治疗。评价两组患者中医症候积分、血清学指标、临床疗效和不良反应。结果 两组患者治疗后胃脘胀满、胃脘疼痛、反酸嗳气以及胃灼烧心等中医症候积分均较治疗前有明显改善,并且观察组患者胃脘胀满、胃脘疼痛、反酸嗳气以及胃灼热评分与对照组比较,观察组上述各中医证候评分低于对照组(t分别为7.447、8.116、8.507和9.743,P均＜0.001),两组之间的比较差异均具有统计学意义,;两组患者治疗后血清胃泌素17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)和表皮生长因子(EGF)等指标均较治疗前有明显改善,并且观察组患者血清G-17和PGⅠ水平高于对照组(t分别为12.193、7.848,P均＜0.001),观察组EGFEGF水平低于对照组(t=6.729,P＜0.001);观察组患者治疗总有效率(92.45%)高于对照组(78.43%),差异有统计学意义(t=4.140,P=0.042);观察组不良反应发生率(9.43%)与对照组(5.88%)的差异没有统计学意义(χ2=0.097,P=0.755)。结论 半夏泻心汤与三联疗法联合应用可有效减轻慢性萎缩性胃炎患者的临床症状,并促进血清G-17、PGⅠ以及EGF等指标的改善,提高疾病疗效,临床安全性较好。