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Alimentary Pharmacology & Therapeutics Mar 2020Helicobacter pylori is the most infamous constituent of the gastric microbiota and its presence is the strongest risk factor for gastric cancer and other gastroduodenal...
BACKGROUND
Helicobacter pylori is the most infamous constituent of the gastric microbiota and its presence is the strongest risk factor for gastric cancer and other gastroduodenal diseases. Although historically the healthy stomach was considered a sterile organ, we now know it is colonised with a complex microbiota. However, its role in health and disease is not well understood.
AIM
To systematically explore the literature on the gastric microbiota in health and disease as well as the gut microbiota after bariatric surgery.
METHODS
A systematic search of online bibliographic databases MEDLINE/EMBASE was performed between 1966 and February 2019 with screening in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomised controlled trials, cohort studies and observational studies were included if they reported next-generation sequencing derived microbiota analysis on gastric aspirate/tissue or stool samples (bariatric surgical outcomes).
RESULTS
Sixty-five papers were eligible for inclusion. With the exception of H pylori-induced conditions, overarching gastric microbiota signatures of health or disease could not be determined. Gastric carcinogenesis induces a progressively altered microbiota with an enrichment of oral and intestinal taxa as well as significant changes in host gastric mucin expression. Proton pump inhibitors usage increases gastric microbiota richness. Bariatric surgery is associated with an increase in potentially pathogenic proteobacterial species in patient stool samples.
CONCLUSION
While H pylori remains the single most important risk factor for gastric disease, its capacity to shape the collective gastric microbiota remains to be fully elucidated. Further studies are needed to explore the intricate host/microbial and microbial/microbial interplay.
Topics: Cohort Studies; DNA, Bacterial; Gastric Mucosa; Gastrointestinal Diseases; Gastrointestinal Microbiome; Health; Helicobacter Infections; Helicobacter pylori; High-Throughput Nucleotide Sequencing; Humans; Proton Pump Inhibitors; Risk Factors; Sequence Analysis, DNA; Stomach Neoplasms
PubMed: 32056247
DOI: 10.1111/apt.15650 -
International Journal of Gynecological... Dec 2023To investigate the prognostic value of cancer antigen 125 (CA125) related variables on progression free survival and overall survival in primary and recurrent ovarian... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the prognostic value of cancer antigen 125 (CA125) related variables on progression free survival and overall survival in primary and recurrent ovarian cancers.
METHOD
A comprehensive review of the Medline, Embase, and Cochrane Library databases was conducted to identify relevant literature on survival outcomes according to the ELIMination Rate Constant K (KELIM), Gynecologic Cancer InterGroup (GCIG) CA125 response criteria, CA125 half-life, and CA125 nadir levels during first line or later line chemotherapy. The search included articles published before February 2023. Cut-off values determining the favorable/unfavorable score of each study were extracted, and pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed using a random effects model to identify the relationship between survival outcomes of the favorable/unfavorable groups, which was determined by an individual model using CA125 kinetics.
RESULTS
A total of 27 studies with 14 444 patients with epithelial ovarian cancer were included in this meta-analysis. In primary ovarian cancer, a favorable KELIM score, determined by individual modeled cut-off values, was associated with a significant progression free survival (HR 0.53, 95% CI 0.45 to 0.62) and overall survival (HR 0.51, 95% CI 0.43 to 0.62) benefit in the primary setting. The favorable KELIM scored group also correlated with a better progression free survival (HR 0.54, 95% CI 0.47 to 0.62) in relapsed disease. We failed to demonstrate a better prognostic value of the GCIG response criteria and the CA125 half-life for progression free survival and overall survival.
CONCLUSION
Novel chemotherapy response scores, such as KELIM, may be more clinically relevant than other prognostic models using CA125 kinetics, being directly associated with a more favorable survival in both the primary and relapsed setting in patients with epithelial ovarian cancer.
STUDY REGISTRATION
The systemic review and meta-analysis were registered in PROSPERO (CRD42023385512).
Topics: Humans; Female; Carcinoma, Ovarian Epithelial; Prognosis; Ovarian Neoplasms; Half-Life; CA-125 Antigen; Neoplasm Recurrence, Local
PubMed: 37949486
DOI: 10.1136/ijgc-2023-004825 -
Gynecologic Oncology Jun 2012In order to provide an updated quantification of the association between alcohol drinking and epithelial ovarian cancer risk, we conducted a meta-analysis of published... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
In order to provide an updated quantification of the association between alcohol drinking and epithelial ovarian cancer risk, we conducted a meta-analysis of published observational studies.
METHODS
Using PubMed, we performed a literature search of all case-control and cohort studies published as original articles in English up to September 2011. We included 27 observational studies, of which 23 were case-control studies, 3 cohort studies and one pooled analysis of prospective cohort studies, including a total of 16,554 epithelial ovarian cancer cases. We derived pooled meta-analytic estimates using random-effects models.
RESULTS
The pooled relative risk (RR) for any alcohol drinking compared with non/occasional drinking was 1.00 [95% confidence interval (CI), 0.95-1.05]. The RRs were 0.97 (95% CI, 0.92-1.02), 1.03 (95% CI, 0.96-1.11) and 1.09 (95% CI, 0.80-1.50) for light (≤ 1 drink/day), moderate (>1 to <3 drinks) and heavy drinking (≥ 3 drinks/day), respectively. In particular, the pooled RR for invasive epithelial ovarian cancers was 1.00 (95% CI, 0.95-1.06), while for borderline cancers was 0.96 (95% CI, 0.74-1.26). Stratified analyses across cancer histotypes revealed a modest protective effect of alcohol on endometrioid epithelial ovarian tumors (RR=0.82, 95% CI, 0.70-0.96), while no association was found for serous (RR=1.00, 95% CI, 0.84-1.19), mucinous (RR=0.91, 95% CI, 0.78-1.08) and clear cell (RR=0.93, 95% CI, 0.76-1.14) cancers. There was no evidence of publication bias.
CONCLUSIONS
This comprehensive meta-analysis provided no evidence of a material association between alcohol drinking and epithelial ovarian cancer risk.
Topics: Alcohol Drinking; Carcinoma, Ovarian Epithelial; Case-Control Studies; Cohort Studies; Female; Humans; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Risk Factors
PubMed: 22449732
DOI: 10.1016/j.ygyno.2012.03.031 -
Journal of Obstetrics and Gynaecology... Nov 2022Serous ovarian cancer is the most common subtype of epithelial ovarian carcinoma-the most prevalent type of ovarian cancer. High-grade serous ovarian carcinoma (HGSOC)... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Serous ovarian cancer is the most common subtype of epithelial ovarian carcinoma-the most prevalent type of ovarian cancer. High-grade serous ovarian carcinoma (HGSOC) is thought to arise from the distal fallopian tube, with a precursor lesion known as serous tubal intraepithelial carcinoma (STIC). STICs are found in the final pathology of a salpingectomy specimen in 10%-20% of women with a BRCA gene mutation and 1%-7% of women without a mutation. However, there is currently no official guideline and a paucity of data on the management of STICs.
DATA SOURCES
We performed a systematic review following PRISMA guidelines. Five databases were searched for relevant studies on STICs.
STUDY SELECTION
Two independent reviewers performed the abstract and full-text screening and data extraction, with conflicts resolved through discussion with the third reviewer. The risk of bias of each study was assessed using the Newcastle-Ottawa scale.
DATA EXTRACTION AND SYNTHESIS
Fourteen articles were included. Ninety-nine patients who were diagnosed with STIC and subsequently followed for a mean period of 55.5 months were included in this analysis. Eighty-three patients (83.9%) were BRCA mutation carriers. After the diagnosis of isolated STIC, 7 patients (7.3%) received chemotherapy and 25 (26%) underwent surgical staging. Three of the 25 patients were diagnosed with HGSOC based on the staging surgery. Nine patients were later diagnosed with HGSOC during follow-up, with an average duration of follow-up of 58.5 months between the diagnosis of STIC and the diagnosis of HGSOC.
CONCLUSION
Based on our review of the literature, there is a 10.7% risk of having concurrent HGSOC at the time of STIC diagnosis, and the risk of developing a subsequent HGSOC is 14.5%. BRCA mutation status should be determined in cases of isolated STIC, as 83.9% of patients included in this study were found to carry BRCA mutations. We believe it is necessary to further investigate the role of surgical staging following the diagnosis of STIC.
Topics: Humans; Female; Carcinoma in Situ; Fallopian Tube Neoplasms; Cystadenocarcinoma, Serous; Salpingectomy; Ovarian Neoplasms; Adenocarcinoma in Situ
PubMed: 36099965
DOI: 10.1016/j.jogc.2022.08.018 -
Clinica Chimica Acta; International... Apr 2021Endometrial cancer, one of the most frequent pelvic gynecologic cancer worldwide, currently has no biomarker used to assess it in daily practice. Nonetheless, human...
INTRODUCTION
Endometrial cancer, one of the most frequent pelvic gynecologic cancer worldwide, currently has no biomarker used to assess it in daily practice. Nonetheless, human epididymis 4 (HE4) appears to offer the best prospects, alone or combined with CA125. This study sought to systematically review the work on HE4 from the first publications in 2008 until now.
MATERIAL AND METHODS
Two independent reviewers searched the PubMed database with the terms "HE4″, "endometrial cancer", "endometrial carcinoma", and HE4 or human epididymis protein 4. Only original clinical research articles and meta-analyses, published in English, were included, with literature reviews and case reports excluded.
RESULTS
Studies were organized into 3 categories: diagnosis, prognosis, and recurrence/survival. Overall we identified 117 articles dealing with HE4 and endometrial cancer and selected 52 relevant texts: 46 articles, 6 meta-analyses. The sensitivity of HE4 for the diagnosis of endometrial cancer varied from 44.2% to 91% and its specificity from 65.5 to 100%, versus 24.1 to 71.5% and from 65.6 to 100% for CA125. Two meta-analyses of their combination produced areas under the curve (AUC): 0.83 and 0.86. Two available algorithms - the REM (risk of endometrial malignancy) and REM-B (risk of endometrial malignancy associated with BMI) scores - require more study. HE4 is also strongly associated with prognostic factors such as myometrial invasion, tumor grade, FIGO stage, and lymph node involvement. It also predicts recurrence and can serve as a monitoring tool, as reported by a 2018 meta-analysis with a hazard ratio of 2.15 (P < 0.001).
CONCLUSION
HE4, alone or associated with CA125, appears to be an important tool in the management of endometrial cancer, initially for diagnosis, but for assessing prognosis and survival. Other prospective and multicenter studies are necessary to confirm these hopes and be able to recommend the use of HE4 in regular practice.
Topics: Biomarkers, Tumor; CA-125 Antigen; Endometrial Neoplasms; Female; Humans; Neoplasm Recurrence, Local; Ovarian Neoplasms; Prospective Studies; Proteins
PubMed: 33388311
DOI: 10.1016/j.cca.2020.12.029 -
Annals of Surgical Oncology Aug 2014The aim of this study was to summarize the current literature comparing the surgical outcomes of invasive intraductal papillary mucinous neoplasms (IPMN(INV)) and... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis comparing the surgical outcomes of invasive intraductal papillary mucinous neoplasms and conventional pancreatic ductal adenocarcinoma.
OBJECTIVE
The aim of this study was to summarize the current literature comparing the surgical outcomes of invasive intraductal papillary mucinous neoplasms (IPMN(INV)) and conventional pancreatic ductal adenocarcinomas (PDAC) in order to determine the differences in disease characteristics and prognosis.
METHODS
Systematic review of the literature yielded 12 comparative studies reporting the clinicopathological characteristics and overall survival (OS) of 1,450 patients with IPMN(INV) with 19,304 patients with conventional PDAC.
RESULTS
IPMN(INV) had a significantly lower likelihood of tumors extending beyond the pancreas [27.6 vs. 94.3 %; T4 vs. T1: odds ratio (OR) 0.111, 95 % confidence intervals (CI) 0.057-0.214], nodal metastasis (45.4 vs. 62.9 %: OR 0.507, 95 % CI 0.347-0.741), positive margin (14.2 vs. 28.3 %; OR 0.438, 95 % CI 0.322-0.596), perineural invasion (49.2 vs. 76.5 %; OR 0.304, 95 % CI 0.106-0.877) and vascular invasion (25.2 vs. 45.7 % OR 0.417, 95 % CI 0.177-0.980) when compared with PDAC. The 5-year OS of IPMN(INV) was significantly better than PDAC [31.4 vs. 12.4 %: hazard ratio (HR) 0.659, 95 % CI 0.574-0.756]. The tubular subtype had a poorer 5-year OS and demonstrated significantly more aggressive features such as nodal metastases, vascular invasion, and perineural invasion compared with the colloid subtype.
CONCLUSION
IPMN(INV) were significantly more likely to present at an earlier stage and were less likely to demonstrate nodal involvement, perineural invasion and vascular invasion. When controlled for stage, IPMN(INV) had an improved OS when compared with PDAC in the early stages.
Topics: Adenocarcinoma, Mucinous; Carcinoma, Pancreatic Ductal; Carcinoma, Papillary; Humans; Neoplasm Invasiveness; Neoplasm Staging; Pancreatic Neoplasms; Prognosis
PubMed: 24687151
DOI: 10.1245/s10434-014-3639-0 -
Cancer Metastasis Reviews Jun 2019Overexpression of mucin glycoproteins has been demonstrated in many epithelial-derived cancers. The significance of this overexpression remains uncertain. The aim of...
Overexpression of mucin glycoproteins has been demonstrated in many epithelial-derived cancers. The significance of this overexpression remains uncertain. The aim of this paper was to define the association of mucin glycoproteins with apoptosis, cell growth, invasion, migration, adhesion, and clonogenicity in vitro as well as tumor growth, tumorigenicity, and metastasis in vivo in epithelial-derived cancers by performing a systematic review of all published data. A systematic review of PubMed, Embase, and the Cochrane Central Register of Controlled Trials was performed to identify all papers that evaluated the association between mucin glycoproteins with apoptosis, cell growth, invasion, migration, adhesion, and clonogenicity in vitro as well as tumor growth, tumorigenicity, and metastasis in vivo in epithelial-derived cancers. PRISMA guidelines were adhered to. Results of individual studies were extracted and pooled together based on the organ in which the cancer was derived from. The initial search revealed 2031 papers, of which 90 were deemed eligible for inclusion in the study. The studies included details on MUC1, MUC2, MUC4, MUC5AC, MUC5B, MUC13, and MUC16. The majority of studies evaluated MUC1. MUC1 overexpression was consistently associated with resistance to apoptosis and resistance to chemotherapy. There was also evidence that overexpression of MUC2, MUC4, MUC5AC, MUC5B, MUC13, and MUC16 conferred resistance to apoptosis in epithelial-derived cancers. The overexpression of mucin glycoproteins is associated with resistance to apoptosis in numerous epithelial cancers. They cause resistance through diverse signaling pathways. Targeting the expression of mucin glycoproteins represents a potential therapeutic target in the treatment of epithelial-derived cancers.
Topics: Animals; Apoptosis; Cell Movement; Cell Proliferation; Drug Resistance, Neoplasm; Humans; Mucins; Neoplasm Invasiveness; Neoplasms; Signal Transduction
PubMed: 30680581
DOI: 10.1007/s10555-019-09781-w -
Journal of the College of Physicians... Nov 2017The prognostic implication of acellular mucin pools (AMP) in rectal cancer is controversial. There is no Level-I evidence regarding their prognostic impact. This... (Meta-Analysis)
Meta-Analysis Review
Prognostic Role of Acellular Mucin Pools in Patients with Rectal Cancer after Pathological Complete Response to Preoperative Chemoradiation: Systematic Review and Meta-Analysis.
The prognostic implication of acellular mucin pools (AMP) in rectal cancer is controversial. There is no Level-I evidence regarding their prognostic impact. This systematic review was performed to determine the impact of AMPon survival in patients with rectal cancer, who demonstrate pathological complete response (PCR) to preoperative chemoradiation (CRT). Asystematic literature review was performed by searching MEDLINE and EMBASE database. For overall survival, the overall random effect model favored mucin negative tumors (HR=2, 95% CI=0.8-4.8) with heterogeneity (I-squared=0, p=0.6). However, the pooled analysis was not significant due to small sample. For disease-free survival, four studies showed HR >1; however, the pooled random effect model indicated little difference in risk (HR=1.06, 95% CI=0.4-2.4) with heterogeneity (I-squared=49.5%, p=0.07). No definite prognostic role of AMPin rectal cancer patients with PCR was found. These results, however, should be interpreted with caution.
Topics: Carcinoma; Chemoradiotherapy; Humans; Mucins; Preoperative Care; Prognosis; Rectal Neoplasms; Survival Rate
PubMed: 29132485
DOI: No ID Found -
Gynecologic Oncology Sep 2013We performed a systematic review and meta-analysis to quantify risks and benefits of screening asymptomatic women for ovarian cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We performed a systematic review and meta-analysis to quantify risks and benefits of screening asymptomatic women for ovarian cancer.
METHODS
We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL, without language restrictions, from January 1, 1979 to February 5, 2012. Eligible studies randomly assigned asymptomatic women to screening or usual care. Two reviewers independently screened studies for eligibility, extracted data using a standardized, piloted extraction form, and assessed bias and strength of inference for each outcome using the GRADE framework. Chance-corrected agreement was calculated at each step, and disagreements were resolved through consensus.
RESULTS
Ten randomized trials proved eligible. Screening did not reduce all-cause mortality (relative risk (RR)=1.0, 95% confidence interval (CI) 0.96-1.06), ovarian cancer specific mortality (RR=1.08, 95% CI 0.84-1.38), or risk of diagnosis at an advanced stage (RR of diagnosis at FIGO stages III-IV=0.86, 95% CI 0.68-1.11). Transvaginal ultrasound resulted in a mean of 38 surgeries per ovarian cancer detected (95% CI 15.7-178.1) while screening with CA-125 led to 4 surgeries per ovarian cancer detected (95% CI 2.7-4.5). Surgery was associated with severe complications in 6% of women (95% CI 1%-11%). Quality of life was not affected by screening; however, women with false-positive results had increased cancer-specific distress compared to those with normal results (odds ratio (OR)=2.22, 95% CI 1.23-3.99).
CONCLUSIONS
Screening asymptomatic women for ovarian cancer does not reduce mortality or diagnosis at an advanced stage and is associated with unnecessary surgery.
Topics: Asymptomatic Diseases; CA-125 Antigen; Confidence Intervals; Early Detection of Cancer; False Positive Reactions; Female; Humans; Ovarian Neoplasms; Quality of Life; Risk; Risk Assessment; Ultrasonography
PubMed: 23822892
DOI: 10.1016/j.ygyno.2013.06.029 -
Cancers Oct 2023Conflicting results about the prognostic relevance of signet ring cell histology in gastric cancer have been reported. We aimed to perform a meta-analysis focusing on... (Review)
Review
BACKGROUND
Conflicting results about the prognostic relevance of signet ring cell histology in gastric cancer have been reported. We aimed to perform a meta-analysis focusing on the clinicopathological features and prognosis of this subgroup of cancer compared with other histologies.
METHODS
A systematic literature search in the PubMed database was conducted, including all publications up to 1 October 2021. A meta-analysis comparing the results of the studies was performed.
RESULTS
A total of 2062 studies referring to gastric cancer with signet ring cell histology were identified, of which 262 studies reported on its relationship with clinical information. Of these, 74 were suitable to be included in the meta-analysis. A slightly lower risk of developing nodal metastases in signet ring cell tumours compared to other histotypes was found (especially to undifferentiated/poorly differentiated/mucinous and mixed histotypes); the lower risk was more evident in early and slightly increased in advanced gastric cancer. Survival tended to be better in early stage signet ring cell cancer compared to other histotypes; no differences were shown in advanced stages, and survival was poorer in metastatic patients. In the subgroup analysis, survival in signet ring cell cancer was slightly worse compared to non-signet ring cell cancer and differentiated/well-to-moderately differentiated adenocarcinoma.
CONCLUSIONS
Most of the conflicting results in signet ring cell gastric cancer literature could be derived from the lack of standardisation in their classification and the comparison with the different subtypes of gastric cancer. There is a critical need to strive for a standardised classification system for gastric cancer, fostering clarity and coherence in the forthcoming research and clinical applications.
PubMed: 37958365
DOI: 10.3390/cancers15215191