Helicobacter pylori infection altered gastric microbiota in patients with chronic gastritis

ObjectiveThe present study aims to investigate the effect of Helicobacter pylori (Hp) infection on gastric mucosal microbiota in patients with chronic gastritis.MethodsHere recruited a population of 193 patients with both chronic gastritis and positive rapid urease, including 124 patients with chronic atrophic gastritis (CAG) and 69 patients with chronic non-atrophic gastritis (nCAG). Immunoblotting was used to detect four serum Hp antibodies (UreA, UreB, VacA and CagA) to determine the types of virulent Hp-I and avirulent Hp-II infections. Gastric microbiota was profiled by 16S rRNA gene V3-V4 region, and R software was used to present the relationship between the microbial characteristics and the type of Hp infection.ResultsIn the stomach of patients with Hp-positive gastritis, the dominant gastric bacterial genera included Ralstonia (23.94%), Helicobacter (20.28%), Pseudonocardia (9.99%), Mesorhizobium (9.21%), Bradyrhizobium (5.05%), and Labrys (4.75%). The proportion of Hp-I infection was significantly higher in CAG patients (91.1%) than in nCAG patients (71.0%) (P < 0.001). The gastric microbiota richness index (observed OTUs, Chao) was significantly lower in CAG patients than in nCAG patients (P <0.05). Compared with avirulent Hp-II infection, virulent Hp-I infection significantly decreased the Shannon index in CAG patients (P <0.05). In nCAG patients, Hp-I infected patients had lower abundances of several dominant gastric bacteria (Aliidiomarina, Reyranella, Halomonas, Pseudomonas, Acidovorax) than Hp-II infected patients. Meanwhile, in CAG patients, Hp-I infected patients occupied lower abundances of several dominant oral bacteria (Neisseria, Staphylococcus and Haemophilus) than Hp-II infected patients. In addition, bile reflux significantly promoted the colonization of dominant oral microbiota (Veillonella, Prevotella 7 and Rothia) in the stomach of CAG patients. There was no significant symbiotic relationship between Helicobacter bacteria and non-Helicobacter bacteria in the stomach of nCAG patients, while Helicobacter bacteria distinctly linked with the non-Helicobacter bacteria (Pseudolabrys, Ralstonia, Bradyrhizobium, Mesorhizobium and Variovorax) in CAG patients.ConclusionsVirulent Hp infection alters the gastric microbiota, reduces microbial diversity, and enhances the symbiotic relationship between the Helicobacter bacteria and non-Helicobacter bacteria in patients with chronic gastritis. The data provides new evidence for treating Hp infection by improving the gastric microbiota

Time Trends of Gastrointestinal Cancers Incidence and Mortality in Yangzhong From 1991 to 2015: An Updated Age-Period-Cohort Analysis

Background: Gastrointestinal (GI) cancers are the common cause of morbidity and mortality in China which seriously threaten people's health and lives. The aim of this study was to describe the temporal trend in the epidemiology of GI cancers from 1991 to 2015, with an emphasis on the effects of age, period and cohort in Yangzhong City, Jiangsu province, a high-risk area of GI cancers in China.Methods: Our study extracted cases of gastric cancer, esophageal cancer and colorectal cancer diagnosed from 1991 to 2015 from Yangzhong Cancer Registry. Age-standardized rates (ASRs) were calculated and joinpoint regression was used to compute the estimated annual percent changes. Age-period-cohort (APC) model was performed to investigate the independent effects of age, calendar period, and birth cohort.Results: Between 1991 and 2015, 18,006 new cases and 10,262 deaths were registered with GI cancers in Yangzhong. The age-standardized incidence rates (ASIRs) of gastric cancer decreased in both sexes during the study period. And the incidence rates of esophageal cancer stabilized at first then continued to decline, the turning point was in 2005 for men and 2001 for women. Changes in the mortality rates of gastric cancer and esophageal cancer showed significant declined trends around 2000–2010 in both genders. The incidence rates of colorectal cancer increased steadily during the entire study period, and the increase was more pronounced in the mortality rates of men. The results of APC analysis suggest that general decreases in incidence and mortality of esophageal cancer and gastric cancer might be caused by the downward trend of the period and cohort effects, while the increases in colorectal cancer might be caused by the uptrend of the period effects.Conclusions: The incidence and mortality rates of esophageal and gastric cancers showed a downward trend and colorectal cancer was on the rise as a whole in Yangzhong City. The different burden of gastrointestinal cancer indicating heterogeneous risk factors exist and may have contributed to these temporal variations

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013.

OBJECTIVE:To describe the long-term trends of the incidence, mortality and survival of upper digestive tract cancers in a high-risk area of China. METHODS:We extracted esophageal and gastric cancer cases diagnosed from 1991 to 2013 through the Yangzhong Cancer Registry and calculated the crude and age-standardized incidence and mortality rates. Cancer trends were calculated using the Joinpoint Regression Program and were reported using the annual percentage change (APC). The cancer-specific survival rates were evaluated and compared between groups using the Kaplan-Meier method and log-rank test. RESULTS:The age-standardized incidence rate of esophageal cancer declined from 107.06 per 100,000 person-years (male: 118.05 per 100,000 person-years; female: 97.42 per 100,000 person-years) in 1991 to 37.04 per 100,000 person-years (male: 46.43 per 100,000 person-years; female: 27.26 per 100,000 person-years) in 2013, with an APC of -2.5% (95% confidence interval (CI): -3.4%, -1.5%) for males and -4.9% (95% CI:-5.8%, -3.9%) for females. The age-standardized incidence rate of gastric cancer was 165.11 per 100,000 person-years (male: 225.39 per 100,000 person-years; female: 113.34 per 100,000 person-years) in 1991 and 53.46 per 100,000 person-years (male: 76.51 per 100,000 person-years; female: 32.43 per 100,000 person-years) in 2013, with the APC of -3.6% (95% CI: -4.5%, -2.7%) for males and -4.8% (95% CI: -5.7%, -3.9%) for females. The median survival time was 3.0 years for patients with esophageal or gastric cancer. Cancer cases detected after 2004 had a better prognosis. CONCLUSIONS:The age-standardized incidence rates of both esophageal and gastric cancer continuously decreased since 1991 through 2013, whereas the mortality rate remained stable before 2004 and significantly declined following the massive endoscopic screening program initiated in 2004. The survival probability of patients with esophageal and gastric cancer has improved obviously in recent decades

Prognosis significance of HER-2/neu overexpression/amplification in Chinese patients with curatively resected gastric cancer after the ToGA clinical trial

Abstract Background HER-2/neu-targeted therapy has been successfully used in advanced gastric cancer, but the role of HER-2/neu in the prognosis of gastric cancer is not yet clear. In this study, we investigated the correlation between HER-2/neu expression and amplification as well as their association with clinic outcomes in patients with curatively resected gastric cancer. Methods We constructed tissue microarray blocks containing >70% of gastric cancer tissue and matched adjacent normal gastric tissue for 227 patients. Expression of the HER-2/neu protein in these specimens was analyzed using immunohistochemical staining. Amplification of HER-2/neu was also analyzed for the same samples using fluorescence in situ hybridization. Data on clinicopathological features and relevant prognostic factors in these patients were analyzed. Results Of the 227 gastric cancer samples, 11.89% were positive for HER-2/neu overexpression/amplification under the new scoring system. HER-2/neu overexpression/amplification was closely correlated to the Lauren type, degree of differentiation, tumor size and lymph node metastasis. HER-2/neu overexpression/amplification predicted poor survival in univariate analysis but not in a Cox proportional hazards model. Conclusion HER-2/neu overexpression/amplification was not an independent predictor for survival in patients with curatively resected gastric cancer.</p

Joinpoint analysis of esophageal and gastric cancers in Yangzhong, 1991–2013.

<p>Joinpoint analysis of esophageal and gastric cancers in Yangzhong, 1991–2013.</p

Incidence rate of esophageal and gastric cancer in Yangzhong, 1991–2013.

<p>Incidence rate of esophageal and gastric cancer in Yangzhong, 1991–2013.</p

Age-specific incidence rates of esophageal and gastric cancer in Yangzhong.

<p>A: esophageal cancer; B: gastric cancer.</p

Survival curves of upper digestive tract cancer before and after 2004.

<p>Survival curves of upper digestive tract cancer before and after 2004.</p

Mortality rate of esophageal and gastric cancers in Yangzhong, 1991–2013.

<p>Mortality rate of esophageal and gastric cancers in Yangzhong, 1991–2013.</p

Age-adjusted mortality rates of esophageal and gastric cancers in Yangzhong.

<p>A: esophageal cancer; B: gastric cancer.</p