-
Medicina (Kaunas, Lithuania) Oct 2020Calcifying fibrous tumor (CFT) in the stomach is extremely rare and is easily misdiagnosed as a gastrointestinal stromal tumor (GIST). This study aims to determine the... (Review)
Review
Calcifying fibrous tumor (CFT) in the stomach is extremely rare and is easily misdiagnosed as a gastrointestinal stromal tumor (GIST). This study aims to determine the best method to differentiate between gastric CFT and GIST after a systemic review and meta-analysis. A systematic search of articles using electronic databases (MEDLINE, EMBASE, and LILACS) was conducted and resulted in 162 articles with 272 CFT cases published from January 1988 to September 2019. Of these cases, 272 patients, 60 patients with gastric CFT (32 men and 28 women, mean age 49.2 years) were analyzed. The mean tumor size was 2.4 cm in patients with gastric CFT. Both endoscopic ultrasound (EUS) and computed tomography (CT) findings revealed well-defined (100% vs. 77.8%), heterogeneous (100% vs. 77.8%), iso-hypoechoic (71.4% vs. 33.3%), and calcified (85.7% vs. 77.8%) lesions, respectively. The majority of patients (53.3%) were symptomatic, with the most common symptom being abdominal discomfort (55.6%). None of the patients with gastric CFT showed recurrence after treatment, and most patients received nonendoscopic treatment (56%, = 28/50). Both age and tumor size were statistically significant in patients with gastric CFT than GIST (49.2 vs. 65.0 years and 2.4 vs. 6.0 cm; both < 0.001). The ratio of children among patients with CFT (5%) and GIST (0.05%) was also significantly different ( = 0.037). The calcification rates of gastric CFT had significantly higher calcification rates than GIST on images of EUS and CT (85.7% vs. 3.6% and 77.8% vs. 3.6%; both < 0.001). Compared with patients with GIST, patients with gastric CFT were younger, had smaller tumor size, and were symptomatic. Furthermore, gastric CFT was well-defined, heterogeneous in the third layer, and had high calcification rates on the images.
Topics: Child; Diagnostic Errors; Female; Gastrointestinal Stromal Tumors; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Fibrous Tissue; Retrospective Studies; Stomach; Stomach Neoplasms
PubMed: 33066662
DOI: 10.3390/medicina56100541 -
Frontiers in Cellular and Infection... 2021In recent years, increasing studies have been conducted on the mechanism of gut microbiota in neuropsychiatric diseases and non-neuropsychiatric diseases. The academic... (Review)
Review
In recent years, increasing studies have been conducted on the mechanism of gut microbiota in neuropsychiatric diseases and non-neuropsychiatric diseases. The academic community has also recognized the existence of the microbiota-gut-brain axis. Chronic pain has always been an urgent difficulty for human beings, which often causes anxiety, depression, and other mental symptoms, seriously affecting people's quality of life. Hyperalgesia is one of the main adverse reactions of chronic pain. The mechanism of gut microbiota in hyperalgesia has been extensively studied, providing a new target for pain treatment. Enterochromaffin cells, as the chief sentinel for sensing gut microbiota and its metabolites, can play an important role in the interaction between the gut microbiota and hyperalgesia through paracrine or neural pathways. Therefore, this systematic review describes the role of gut microbiota in the pathological mechanism of hyperalgesia, learns about the role of enterochromaffin cell receptors and secretions in hyperalgesia, and provides a new strategy for pain treatment by targeting enterochromaffin cells through restoring disturbed gut microbiota or supplementing probiotics.
Topics: Brain; Enterochromaffin Cells; Gastrointestinal Microbiome; Humans; Hyperalgesia; Probiotics; Quality of Life
PubMed: 34722345
DOI: 10.3389/fcimb.2021.760076 -
European Journal of Cancer Prevention :... May 2021Gastric cancer (GC) is the fifth diagnosed cancer worldwide and the third leading cause of death for cancer. Recent reports suggest that metabolic syndrome (MetS) has a... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Gastric cancer (GC) is the fifth diagnosed cancer worldwide and the third leading cause of death for cancer. Recent reports suggest that metabolic syndrome (MetS) has a role in etiology, progression or prognosis on GC. The aim of this study is to systematically review the evidence on the association between MetS and GC risk and prognosis.
METHODS
Literature search was performed using the electronic databases Pubmed, Web of Knowledge, Embase and Cinahl Complete until December 2019. Cohort and case-control studies were included. Study-specific association measures were pooled using a random-effect model.
RESULTS
A total of 14 studies included in the qualitative synthesis of which nine were meta-analyzed. The majority were cohort studies (92%) and set in Asia (57%). The pooled analysis reported no association between MetS and GC risk [hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.92-1.18; I2 = 74.2%, P < 0.001], however when the analysis was stratified according to the geographic area and sex, Western women with MetS had an increased risk of GC (HR 1.24, 95% CI 1.05-1.47; I2 = 4.6%, P = 0.351). We did not observe an increased risk of unfavorable prognosis for individuals with MetS (HR 1.23, 95% CI 0.25-6.08).
CONCLUSION
This systematic review and meta-analysis suggests that GC risk might be associated with MetS in women although larger studies are needed. Preventing and treating MetS, however, might have overall beneficial effect on several noncommunicable diseases and in this sense should be pursued.
Topics: Asia; Case-Control Studies; Female; Humans; Metabolic Syndrome; Prognosis; Stomach Neoplasms
PubMed: 32694278
DOI: 10.1097/CEJ.0000000000000618 -
The Cochrane Database of Systematic... Jan 2015Enteral nutrition by feeding tube is a common and efficient method of providing nutritional support to prevent malnutrition in hospitalised patients who have adequate... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Enteral nutrition by feeding tube is a common and efficient method of providing nutritional support to prevent malnutrition in hospitalised patients who have adequate gastrointestinal function but who are unable to eat. Gastric feeding may be associated with higher rates of food aspiration and pneumonia than post-pyloric naso-enteral tubes. Thus, enteral feeding tubes are placed directly into the small intestine rather than the stomach, and the use of metoclopramide, a prokinetic agent, has been recommended to achieve post-pyloric placement, but its efficacy is controversial. Moreover, metoclopramide may include adverse reactions, which with high doses or prolonged use may be serious and irreversible.
OBJECTIVES
To determine the effect of intravenous metoclopramide on post-pyloric placement of the naso-enteral tube in adults.
SEARCH METHODS
Trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 10) which includes the CUGPD group's specialised register of trials, MEDLINE (1996 to 21 October 2014), EMBASE (1988 to 21 October 2014), LILACS (2005 to 21 October 2014) We did not confine our search to English language publications. Searches in all databases were updated originally in January 2005, then in November 2008 and again in October 2014. No new studies were found in 2008 or in 2014.
SELECTION CRITERIA
We selected randomised controlled trials of adults needing enteral nutrition, who received intravenous or intramuscular metoclopramide to aid placement of transpyloric naso-enteral feeding tubes, compared to placebo or no intervention.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by The Cochrane Collaboration. All analyses were performed according to the intention-to-treat method. We present risk ratios (RR) with 95% confidence intervals (CI).
MAIN RESULTS
Four studies, with a total of 204 participants were included and analysed. The trials compared metoclopramide with placebo (two trials) or with no intervention (two trials). Metoclopramide was investigated at doses of 10 mg (two trials) and 20 mg (two trials). There was no statistically significant difference between metoclopramide versus placebo or no intervention administered to promote tube placement (RR 0.82, 95% CI 0.61 to 1.10). Metoclopramide at doses of 10 mg (RR 0.82, 95% CI 0.60 to 1.11) and 20 mg (RR 0.62, 95% CI 0.15 to 2.62) were equally ineffective in facilitating post-pyloric intubation when compared with placebo or no intervention.
AUTHORS' CONCLUSIONS
In this review, we found only four studies that fitted our inclusion criteria. These were small, underpowered studies, in which metoclopramide was given at doses of 10 mg and 20 mg. Our analysis showed that metoclopramide did not assist post-pyloric placement of naso-enteral feeding tubes.Ideally randomised clinical trials should be performed that have a significant sample size, administering metoclopramide against control, however, given the lack of efficacy revealed by this review it is unlikely that further studies will be performed.
Topics: Antiemetics; Duodenum; Enteral Nutrition; Gastric Emptying; Humans; Injections, Intravenous; Intubation, Gastrointestinal; Jejunum; Metoclopramide; Pylorus; Randomized Controlled Trials as Topic
PubMed: 25564770
DOI: 10.1002/14651858.CD003353.pub2 -
Journal of Gastrointestinal Cancer Mar 2021Gastric schwannomas (GSs) are rare mesenchymal neoplasms of the gastrointestinal tract. Diagnosis is often achieved postoperatively, based on pathology reports of... (Comparative Study)
Comparative Study
PURPOSE
Gastric schwannomas (GSs) are rare mesenchymal neoplasms of the gastrointestinal tract. Diagnosis is often achieved postoperatively, based on pathology reports of retrieved specimens. The aim of the present study is to follow up all patients with gastric schwannoma (Gs) undergoing endoscopic, partial, or more extended surgery and to evaluate the appearance of local or distant recurrence.
METHODS
A PubMed, Cochrane, and Embase systematic review of the literature has been performed. Original papers, review articles, and case reports published between 1988 and 2019 were considered eligible. All the studies who met the inclusion criteria were analyzed. Statistical analysis of data has been performed using GraphPad Prism 7 software.
RESULTS
Three hundred twenty-eight articles were found, and a total of 102 were included and analyzed in depth. Fifty-three papers reported the follow-up information, ranging from 1 to 417 months across different studies. Among them, 31 patients underwent endoscopic removal of the gastric lesions; 140 patients underwent local surgery, including wedge resection or partial gastrectomy; and 148 patients underwent subtotal or total gastrectomy. The median follow-up was of 27-38-33 months, respectively. No recurrence or distant metastasis was detected in the endoscopy group. Among local surgery group, liver metastasis was reported in one case; in extended surgery group, one patient died for multiple liver metastases.
CONCLUSIONS
Local or more extended surgery involved a larger cohort of patients and reported satisfactory long-term results compared with endoscopy group. Surgery in absence of a definite preoperative diagnosis is considered the gold standard treatment for resectable Gs.
Topics: Follow-Up Studies; Gastrectomy; Gastroscopy; Humans; Incidental Findings; Liver Neoplasms; Neoplasm Recurrence, Local; Neurilemmoma; Stomach; Stomach Neoplasms; Treatment Outcome
PubMed: 32964322
DOI: 10.1007/s12029-020-00456-2 -
Journal of Digestive Diseases Jan 2022We aimed to describe the pattern and time trends of survival from stomach cancer worldwide from population-based cancer registers. (Review)
Review
OBJECTIVES
We aimed to describe the pattern and time trends of survival from stomach cancer worldwide from population-based cancer registers.
METHODS
A systematic search of PubMed, Web of Science, EMBASE, SEER and SinoMed for articles published up to 31 December 2020 was conducted. All eligible survival analyses of stomach cancer were collected and evaluated by countries or regions, periods, sex and age groups.
RESULTS
Our review included 76 articles on stomach cancer survival rates and found that these rates had improved globally with time, although this increase was unremarkable. The highest 5-year survival rate of 72.1% was observed in Japan (2004-2007). The 5-year relative and net survival, rates were relatively high in Korea and Japan, while they were fairly poor in Africa and India. Sex-specific survival rates were higher in women than in men in America, Europe and Oceania, whereas they were relatively low in Asia. The poorest age-specific 5-year relative and net survival rates were observed in patients aged over 75 years.
CONCLUSIONS
Over the past decades, patient prognosis of stomach cancer has gradually improved worldwide and survival rates in developed regions were higher than those in developing regions. White men and Asian women had a poorer survival than white women and Asian men. Younger patients had better survival rates than those aged over 75 years globally.
Topics: Aged; Child, Preschool; Female; Humans; Incidence; India; Male; Registries; Stomach Neoplasms; Survival Analysis; Survival Rate
PubMed: 34821032
DOI: 10.1111/1751-2980.13070 -
British Journal of Sports Medicine Feb 2015Studies evaluating the relationship of physical activity and stomach cancer risk have yielded inconsistent and largely inconclusive results. We therefore conducted a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Studies evaluating the relationship of physical activity and stomach cancer risk have yielded inconsistent and largely inconclusive results. We therefore conducted a systematic review and meta-analysis of observational studies that assessed the relationship between physical activity and risk of gastric cancer.
METHODS
Following a standard protocol, we searched medical literature databases (PubMed, EMBASE, CINAHL, PsycINFO and Google Scholar) from inception to July 2012, and conducted a random effects meta-analysis.
RESULTS
Seven prospective cohorts and four case-control studies of physical activity and gastric cancer risk, with 1,535,006 people and 7944 cases of gastric cancer were included. We found a modest protective association between sufficient physical activity and gastric cancer risk (relative risk: 0.81 (95% CI 0.69 to 0.96); I(2)=68.5%) in the prospective studies and (relative risk: 0.78 (95% CI 0.66 to 0.91); I(2)=0%) in case-control studies. The association appeared weaker in smokers than in non-smokers (p heterogeneity=0.035). The association may also be weaker for gastric cardia cancer relative to the distal non-cardia subtypes. Physical activity type (recreational or occupational), intake of alcohol, total energy intake, consumption of fruits and vegetables and infection with Helicobacter pylori had no influence on the association. The effect measure from cohort studies (relative risk: 0.82 (95% CI 0.70 to 0.97); I(2)=61.7%) and case-control studies (relative risk: 0.83 (95% CI 0.66 to 1.04); I(2)=49.8%) did not differ materially at higher physical activity levels.
CONCLUSIONS
We conclude that a regular physical activity may be protective against stomach cancer risk.
Topics: Cardia; Epidemiologic Studies; Exercise; Female; Humans; Male; Middle Aged; Observational Studies as Topic; Publication Bias; Risk Factors; Sex Factors; Smoking; Stomach Neoplasms
PubMed: 24434186
DOI: 10.1136/bjsports-2013-092778 -
Helicobacter Jun 2018Helicobacter pylori is a recognized cause of stomach cancer, but only a fraction of infected subjects develop cancer. This systematic review 1, summarizes the prevalence... (Review)
Review
The epidemiology of Helicobacter pylori infection in Europe and the impact of lifestyle on its natural evolution toward stomach cancer after infection: A systematic review.
BACKGROUND
Helicobacter pylori is a recognized cause of stomach cancer, but only a fraction of infected subjects develop cancer. This systematic review 1, summarizes the prevalence of infection with this bacterium in Europe; and 2, reviews the possible impact of particular lifestyles in progression from infection to stomach cancer.
MATERIALS AND METHODS
A systematic literature search was conducted in two databases by two independent investigators. Studies describing prevalence of infection among European healthy adult populations and worldwide studies analyzing the impact of lifestyle factors in association with H. pylori on stomach cancer risk were included.
RESULTS
Variable H. pylori infection prevalence was observed depending on region and study period. The lowest infection prevalences were found in Northern Europe, while the highest were in Eastern and Southern Europe, up to 84% in Portugal and Poland. Studies on smoking, salt, and meat consumption demonstrated increased risks of developing stomach cancer among H. pylori-infected individuals, while studies relating the intake of fruit, vegetables, and vitamins demonstrated decreased risks, but the levels of significance differed importantly between studies. No significant interaction could be found for alcohol consumption or physical activity.
CONCLUSIONS
Recent data showed remaining high H. pylori infection rates in several European regions. This systematic review suggests that a number of correctable lifestyle factors could impact the disease progression toward H. pylori-associated stomach cancer. However, additional research is required to determine the potential role of targeted interventions in reducing stomach cancer development after H. pylori infection.
Topics: Europe; Helicobacter Infections; Helicobacter pylori; Humans; Life Style; Prevalence; Risk Factors; Stomach Neoplasms; Time Factors
PubMed: 29635869
DOI: 10.1111/hel.12483 -
World Journal of Gastroenterology Feb 2017To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen... (Review)
Review
AIM
To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).
METHODS
Systematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation.
RESULTS
Six achalasia studies ( = 154), 3 GERD ( = 52), and 5 studies including healthy controls ( = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm/mmHg prior to treatment that increased to ≥ 3.4 mm/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm/mmHg) following fundoplication.
CONCLUSION
FLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed.
Topics: Diagnostic Imaging; Esophageal Achalasia; Esophagogastric Junction; Esophagoscopy; Esophagus; Fundoplication; Gastroesophageal Reflux; Healthy Volunteers; Humans; Male; Manometry; Treatment Outcome
PubMed: 28275309
DOI: 10.3748/wjg.v23.i7.1289 -
Journal of Cancer Research and Clinical... Jul 2024To conduct a systematic review and meta-analysis of case-control and cohort human studies evaluating metabolite markers identified using high-throughput metabolomics... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To conduct a systematic review and meta-analysis of case-control and cohort human studies evaluating metabolite markers identified using high-throughput metabolomics techniques on esophageal cancer (EC), cancer of the gastroesophageal junction (GEJ), and gastric cancer (GC) in blood and tissue.
BACKGROUND
Upper gastrointestinal cancers (UGC), predominantly EC, GEJ, and GC, are malignant tumour types with high morbidity and mortality rates. Numerous studies have focused on metabolomic profiling of UGC in recent years. In this systematic review and meta-analysis, we have provided a collective summary of previous findings on metabolites and metabolomic profiling associated with EC, GEJ and GC.
METHODS
Following the PRISMA procedure, a systematic search of four databases (Embase, PubMed, MEDLINE, and Web of Science) for molecular epidemiologic studies on the metabolomic profiles of EC, GEJ and GC was conducted and registered at PROSPERO (CRD42023486631). The Newcastle-Ottawa Scale (NOS) was used to benchmark the risk of bias for case-controlled and cohort studies. QUADOMICS, an adaptation of the QUADAS-2 (Quality Assessment of Diagnostic Accuracy) tool, was used to rate diagnostic accuracy studies. Original articles comparing metabolite patterns between patients with and without UGC were included. Two investigators independently completed title and abstract screening, data extraction, and quality evaluation. Meta-analysis was conducted whenever possible. We used a random effects model to investigate the association between metabolite levels and UGC.
RESULTS
A total of 66 original studies involving 7267 patients that met the required criteria were included for review. 169 metabolites were differentially distributed in patients with UGC compared to healthy patients among 44 GC, 9 GEJ, and 25 EC studies including metabolites involved in glycolysis, anaerobic respiration, tricarboxylic acid cycle, and lipid metabolism. Phosphatidylcholines, eicosanoids, and adenosine triphosphate were among the most frequently reported lipids and metabolites of cellular respiration, while BCAA, lysine, and asparagine were among the most commonly reported amino acids. Previously identified lipid metabolites included saturated and unsaturated free fatty acids and ketones. However, the key findings across studies have been inconsistent, possibly due to limited sample sizes and the majority being hospital-based case-control analyses lacking an independent replication group.
CONCLUSION
Thus far, metabolomic studies have provided new opportunities for screening, etiological factors, and biomarkers for UGC, supporting the potential of applying metabolomic profiling in early cancer diagnosis. According to the results of our meta-analysis especially BCAA and TMAO as well as certain phosphatidylcholines should be implicated into the diagnostic procedure of patients with UGC. We envision that metabolomics will significantly enhance our understanding of the carcinogenesis and progression process of UGC and may eventually facilitate precise oncological and patient-tailored management of UGC.
Topics: Humans; Metabolomics; Esophageal Neoplasms; Stomach Neoplasms; Biomarkers, Tumor; Gastrointestinal Neoplasms; Metabolome; Case-Control Studies; Esophagogastric Junction
PubMed: 38951269
DOI: 10.1007/s00432-024-05857-5