Histopathological evaluation of gastric mucosal environments in peptic ulcer using the endoscopic 5-point gastric biopsy method.

Although a strong association has been established between chronic Helicobacter pylori infection and peptic ulcers, the role of H. pylori is not necessarily causative because there are many patients infected with H. pylori who do not develop peptic ulcer. Therefore, we studied the relationship between the gastric mucosal environment and the development of peptic ulcers. We examined 165 endoscopic biopsy specimens from the gastric mucosa of 33 patients with peptic ulcers using the 5-point gastric biopsy method. The follow-up biopsies done within 3 weeks were well correlated with the first biopsy samples. We also reviewed the clinicohistopathological findings of 2250 endoscopic biopsy specimens from 450 patients with active gastric and/or duodenal ulcers. Over 90% of the patients with duodenal ulcer, with or without gastric ulcer, had no fundic gland atrophy, and a high incidence of intestinal metaplasia and pyloric mucosal atrophy was found in the patients with gastric ulcer. These findings suggest that patients with concomitant active gastric and duodenal ulcers exhibit severe atrophic changes in the antral mucosa but not in the fundic mucosa.</p

Single Nucleotide Polymorphisms Associated with Risk of Adverse Skin Reactions to Radiation in Patients Undergoing Breast-conserving Therapy: Single-institution Analysis

Purpose/Objective(s)In a previous study involving 9 institutions, 8 single nucleotide polymorphism (SNP) markers in 6 loci of genome were found to be associated with risks of early adverse skin reaction to radiation following breast-conserving surgery. In the present study, the SNPs for these loci were reanalyzed in patients, including new cases, treated and followed at a single institution with a uniform policy, in order to confirm the significance of previously reported polymorphisms. Association with adverse skin reaction within 6 months after radiation was also analyzed. An area under a receiver operating characteristic curve (AUC-ROC) analysis was newly applied in this study.\nMaterials/MethodsWith informed consent, DNA samples from 115 patients undergoing prophylactic radiation after breast-conserving surgery were obtained for SNP analysis. All patients received 50 Gy in 2-Gy daily fractions by tangential irradiation with or without an electron boost of 10 Gy in 5 fractions. Using the National Cancer Institute-Common Toxicity Criteria scoring system version 2, the patients were grouped according to adverse skin reactions within 3 months after starting radiotherapy (grade &#8804; 1, n = 74; grade = 2, n = 41) as well as those within 6 months (grade 0, n = 61; grade 1, n = 52). Eight SNPs from the 6 loci were analyzed for assessment of associations between groups. A risk score of a patient was calculated according to a total number of risk genotype(s) (an increased risk genotype = 1 and a reduced risk genotype = -1). The sensitivity and specificity of the markers were evaluated using an AUC-ROC analysis.\nResultsEach genotype of the PTTG1 rs3811999 CC, the RAD9A rs917570 CC, and the RAD9A rs2286620 TT showed association with an increased risk (P = 0.024, 0.040, and 0.017, respectively), while the REV3L rs190246 GG/GT and rs240962 GG/GT genotypes were associated with a reduced risk of adverse skin reaction within 3 months (P = 0.0059 and 0.049, respectively). After applying Bonferroni correction, only the rs190246 GG/GT genotype was considered to remain statistically significant (Pcorrected = 0.047). When combined effects of the 3 increased-risk genotypes and the 2 reduced-risk genotypes were examined by the AUC-ROC method, the AUC value of the model reached 0.72. No association was observed between the analyzed SNPs and adverse skin reaction within 6 months.\nConclusionsThis single-institution analysis confirmed the significance of combined effects of the SNPs on PTTG1, RAD9A, and REV3L genes in determining early adverse skin reaction. These SNPs were, however, not associated with reaction within 6 months, suggesting that they are not related to recovery of skin damage between 3 and 6 months after radiation

Single Nucleotide Polymorphisms Associated with Risk of Adverse Skin Reactions to Radiation in Patients Undergoing Breast-conserving Therapy: Single-institution Analysis

Abstract category: TR-11 Translational research- biomarkersASTRO\u27s 53th Annual Meetin

Clinical outcomes of stereotactic body radiotherapy for stage I non-small cell lung cancer using different doses depending on tumor size

Abstract Background The treatment schedules for stereotactic body radiotherapy (SBRT) for lung cancer vary from institution to institution. Several reports have indicated that stage IB patients had worse outcomes than stage IA patients when the same dose was used. We evaluated the clinical outcomes of SBRT for stage I non-small cell lung cancer (NSCLC) treated with different doses depending on tumor diameter. Methods Between February 2004 and November 2008, 124 patients with stage I NSCLC underwent SBRT. Total doses of 44, 48, and 52 Gy were administered for tumors with a longest diameter of less than 1.5 cm, 1.5-3 cm, and larger than 3 cm, respectively. All doses were given in 4 fractions. Results For all 124 patients, overall survival was 71%, cause-specific survival was 87%, progression-free survival was 60%, and local control was 80%, at 3 years. The 3-year overall survival was 79% for 85 stage IA patients treated with 48 Gy and 56% for 37 stage IB patients treated with 52 Gy (p = 0.05). At 3 years, cause-specific survival was 91% for the former group and 79% for the latter (p = 0.18), and progression-free survival was 62% versus 54% (p = 0.30). The 3-year local control rate was 81% versus 74% (p = 0.35). The cumulative incidence of grade 2 or 3 radiation pneumonitis was 11% in stage IA patients and 30% in stage IB patients (p = 0.02). Conclusions There was no difference in local control between stage IA and IB tumors despite the difference in tumor size. The benefit of increasing the SBRT dose for larger tumors should be investigated further.</p

Rationale, Design, and Feasibility of a Prospective Multicenter Registry Study of Anthracycline-Induced Cardiotoxicity (AIC Registry)

As the number of cancer survivors increases, cardiac management in anthracycline-treated patients has become more important. We planned to conduct a prospective multicenter registry study for comprehensive echocardiographic and biomarker data collection and an evaluation of the current practice in terms of diagnosis and management of anthracycline-induced cardiotoxicity (AIC registry). To examine the feasibility of this registry study, we analyzed the 1-year follow-up data of 97 patients registered during the first year of this registry. The AIC registry was launched in July 2016. Data on echocardiographic parameters (e.g., two-and three-dimensional [(2- and 3-D) left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS)) and biomarkers (e.g., troponin T and brain natriuretic peptide) were collected before anthracycline treatment, every 3 months during the first year after starting anthracycline, and every 6 months during the second year. Eighty-three patients (86%) completed a 1-year follow-up. The measurable rates of 2D LVEF, 3D LVEF, and GLS on each visit were nearly optimal (100%, 86–93%, and 84–94%, respectively). During the 1-year follow-up, 5 patients (6.0%) developed cardiotoxicity (a reduction in LVEF ≥ 10 percentage points from baseline and &lt;55%). The AIC registry study is feasible and will be the first study to collect sizable echocardiographic and biomarker data on cardiotoxicity in Japanese patients treated with anthracycline in a real-world setting