Emerging blood-based biomarkers for detection of gastric cancer

Publisher Copyright: © 2015 Baishideng Publishing Group Inc. All rights reserved.Early detection and efficient monitoring of tumor dynamics are prerequisites for reducing disease burden and mortality, and for improving the management of patients with gastric cancer (GC). Blood-based biomarker assays for the detection of early-stage GC could be of great relevance both for population-wide or risk groupbased screening programs, while circulating biomarkers that reflect the genetic make-up and dynamics of the tumor would allow monitoring of treatment efficacy, predict recurrences and assess the genetic heterogeneity of the tumor. Recent research to identify blood-based biomarkers of GC has resulted in the identification of a wide variety of cancer-associated molecules, including various proteins, autoantibodies against tumor associated antigens, cell-free DNA fragments, mRNAs and various non-coding RNAs, circulating tumor cells and cancer-derived extracellular vesicles. Each type of these biomarkers provides different information on the disease status, has different advantages and disadvantages, and distinct clinical usefulness. In the current review, we summarize the recent developments in blood-based GC biomarker discovery, discuss the origin of various types of biomarkers and their clinical usefulness and the technological challenges in the development of biomarker assays for clinical use.publishersversionPeer reviewe

Non-invasive diagnosis of gastroesophageal reflux disease using gastrin- and pepsinogen-based tests

Gastrin-17 (G-17), pepsinogen-1 (Pg1) and pepsinogen-2 (Pg2) reflect the functional state of gas-tric mucosa and are used for non-invasive diagnosis and screening of atrophic gastritis. The aimof the study was to clarify if erosive reflux disease (ERD) or non-ERD (NERD) can be distin-guished from other dyspeptic conditions in patients, in a non-invasive manner using specificbiomarkers. Levels of G-17, Pg1, and Pg2 were measured in 141 ERD patients (median age 48years, males — 68), 122 NERD patients (median age 45 years, males — 32) and 410 control pa-tients (median age 50 years, males — 97). Levels of biomarkers in ERD and NERD groups werecompared to controls. Median levels of G-17 (1.94 vs 2.92 pmol/L, p = 0.036) and Pg2 (6.70 vs7.79 μg/l,p= 0.046) were lower in the ERD group compared to control patients; no differencewith respect to the control was found for the NERD group. After exclusion of the patients havingat least one potential condition that might modify the levels of the biomarkers (gastric mucosa at-rophy, Helicobacter pylori colonisation), no difference in levels of biomarkers was observed withrespect to the control for both the ERD and NERD groups. G-17, Pg1, and Pg2 based tests can-not be used to distinguish ERD or NERD from other dyspeptic conditions in patients.publishersversionPeer reviewe

The Role of an Artificial Intelligence Method of Improving the Diagnosis of Neoplasms by Colonoscopy

Funding Information: The project is funded by the European Regional Development Fund (ERDF) 1.1.1.1. project “Practical Studies”, 4th phase, project ID Nr. 1.1.1.1/20/A/035. Publisher Copyright: © 2023 by the authors.BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Colonoscopy is the gold standard examination that reduces the morbidity and mortality of CRC. Artificial intelligence (AI) could be useful in reducing the errors of the specialist and in drawing attention to the suspicious area. METHODS: A prospective single-center randomized controlled study was conducted in an outpatient endoscopy unit with the aim of evaluating the usefulness of AI-assisted colonoscopy in PDR and ADR during the day time. It is important to understand how already available CADe systems improve the detection of polyps and adenomas in order to make a decision about their routine use in practice. In the period from October 2021 to February 2022, 400 examinations (patients) were included in the study. One hundred and ninety-four patients were examined using the ENDO-AID CADe artificial intelligence device (study group), and 206 patients were examined without the artificial intelligence (control group). RESULTS: None of the analyzed indicators (PDR and ADR during morning and afternoon colonoscopies) showed differences between the study and control groups. There was an increase in PDR during afternoon colonoscopies, as well as ADR during morning and afternoon colonoscopies. CONCLUSIONS: Based on our results, the use of AI systems in colonoscopies is recommended, especially in circumstances of an increase of examinations. Additional studies with larger groups of patients at night are needed to confirm the already available data.publishersversionPeer reviewe

Comparison of nice classification for optical diagnosis of colorectal polyps and morphology of removed lesions depending on localisation in colon

Publisher Copyright: © 2022 Ilona Vilkoite et al., published by Sciendo.The narrow-band imaging (NBI) International Colorectal Endoscopic (NICE) classification is based on narrow-band pictures of colon polyps viewed through a narrow-band spectrum. The categorisation utilises staining, surface structure, and vascular patterns to differentiate between hyperplastic and adenomatous colon polyps. It is known that accuracy of the NICE classification for colorectal polyps varies depending on the localisation in the colon.The aim of this study was to compare the diagnostic accuracy of the NICE classification and the gold standard - morphological analysis for the determination of the type of colorectal lesions depending on localisation in colon. A prospective study was performed in an outpatient clinic. 1214 colonoscopies were performed by two expert endoscopists and 475 polyps were found in 291 patients. The overall diagnostic accuracy of the NICE classification was 80.3%. Optical verification was better in ascending colon - 93.9%, followed by sigmoid colon - 82.1%. Inferior results were found for the descending colon - 64.0%. The results of this study showed that the NICE classification could be a helpful instrument in daily practice for the ascending and sigmoid colon. For better results, proper training should be considered. The NICE system could have a role in the replacement of morphological analysis if appropriate results of verification could be achieved.publishersversionPeer reviewe

Modular Point-of-Care Breath Analyzer and Shape Taxonomy-Based Machine Learning for Gastric Cancer Detection

Funding Information: The development of the analysis approach and its evaluation and analysis were supported by a postdoctoral grant within the Activity 1.1.1.2 “Post-doctoral Research Aid” co-funded by the European Regional Development Fund (postdoctoral project numbers: 1.1.1.2/VIAA/2/18/270 and 1.1.1.2/VIAA/3/19/495). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Background: Gastric cancer is one of the deadliest malignant diseases, and the non-invasive screening and diagnostics options for it are limited. In this article, we present a multi-modular device for breath analysis coupled with a machine learning approach for the detection of cancer-specific breath from the shapes of sensor response curves (taxonomies of clusters). Methods: We analyzed the breaths of 54 gastric cancer patients and 85 control group participants. The analysis was carried out using a breath analyzer with gold nanoparticle and metal oxide sensors. The response of the sensors was analyzed on the basis of the curve shapes and other features commonly used for comparison. These features were then used to train machine learning models using Naïve Bayes classifiers, Support Vector Machines and Random Forests. Results: The accuracy of the trained models reached 77.8% (sensitivity: up to 66.54%; specificity: up to 92.39%). The use of the proposed shape-based features improved the accuracy in most cases, especially the overall accuracy and sensitivity. Conclusions: The results show that this point-of-care breath analyzer and data analysis approach constitute a promising combination for the detection of gastric cancer-specific breath. The cluster taxonomy-based sensor reaction curve representation improved the results, and could be used in other similar applications.publishersversionPeer reviewe

The diagnostic value of anti-parietal cell and intrinsic factor antibodies, pepsinogens, and gastrin-17 in corpus-restricted atrophic gastritis

Raksta tekstā kļuda: afilācijai "Digestive Diseases Centre GASTRO Ltd", norādīta atrašanas vieta: Hong Kong, ChinapublishersversionPeer reviewe

Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study

Introduction-Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods-Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results-Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4-31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33-45% while specificity decreased (range: 61.1-62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions-Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage

Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection?

Funding Information: Acknowledgments: The study was funded in part by the Fundamental and Applied Research Project Program in Latvia, project No. lzp-2018/1-0135 “Research on implementation of a set of measures for prevention of gastric cancer mortality by eradication H. pylori and timely recognition of precancerous lesions”. We acknowledge the entire GISTAR study team as well as the infrastructure provided by the Digestive Diseases Centre GASTRO for endoscopy and the Academic Histology Laboratory for pathology infrastructures. Our acknowledgements also to Biohit Oyj, Finland, for their support with laboratory reagents. Funding Information: Funding: The work is funded by ERDF (European Regional Development Fund) within the frame-work of 2nd part of measure 1.1.1.1. ‘Practical Studies’, project ID Nr. 1.1.1.1/18/A/184. Funding Information: The work is funded by ERDF (European Regional Development Fund) within the framework of 2nd part of measure 1.1.1.1. ?Practical Studies?, project ID Nr. 1.1.1.1/18/A/184. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Background. Discrepancies between histology and serology results for Helicobacter pylori detection could be caused by a variety of factors, including a biopsy sampling error, expertise of the pathologist, natural loss of infection due to advanced atrophy, or a false-positive serology in the case of a previous infection, since antibodies may be present in blood following recovery from the infection. Aims. To identify true H. pylori-positive individuals in discrepant cases by serology and histology using real time polymerase chain reaction (RT-PCR) as a gold standard. Methods. Study subjects with discrepant histology and serology results were selected from the GISTAR pilot study data base in Latvia. Subjects having received previous H. pylori eradication therapy or reporting use of proton pump inhibitors, antibacterial medications, or bismuth containing drugs one month prior to upper endoscopy were excluded. We compared the discrepant cases to the corresponding results of RT-PCR performed on gastric biopsies. Results. In total, 97 individuals with discrepant results were identified: 81 subjects were serology-positive/histology-negative, while 16 were serologynegative/histology-positive. Among the serology-positive/histology-negative cases, 64/81 (79.0%) were false-positives by serology and, for the majority, inflammation was absent in all biopsies, while, in the serology-negative/histology-positive group, only 6.2% were proven false-positives by histology. Conclusions. Among this high H. pylori prevalent, middle-aged population, the majority of discrepant cases between serology and histology were due to false positive-serology, rather than false-negative histology. This confirms the available evidence that the choice of treatment should not be based solely on the serological results, but also after excluding previous, self-reported eradication therapy.publishersversionPeer reviewe

Biopsy Sampling in Upper Gastrointestinal Endoscopy : A Survey from 10 Tertiary Referral Centres across Europe

Funding Information: A. Link reports grants from European Commission “Eu-ropäischer Fond für regionale Entwicklung” (EFRE), outside the submitted work. In Lithuania the work was partly supported by Lithuanian Research Council Grant no APP-2/2016. In Latvia, the methodological support was made available from the project lzp-2018/1-0135. This work was also supported by the NIHR Oxford Biomedical Research Centre (The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care). In Barcelona, we thank the CERCA Programme/Generalitat de Catalunya for the support. Publisher Copyright: © 2020 The Author(s) Published by S. Karger AG, Basel.Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.publishersversionPeer reviewe