Clinical and Translational Gastroenterology最新文献

{"title":"Impact of Treatment Adjustment on the Endoscopic Prognosis of Postoperative Anastomotic Lesions in Patients With Crohn's Disease.","authors":"Linlin Yin, Chenliang Ding, Yi Li, Lei Cao, Hongfei Tu, Yue Zhu, Luxuan Tan, Bin Zhang, Jianfeng Gong","doi":"10.14309/ctg.0000000000000859","DOIUrl":"10.14309/ctg.0000000000000859","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic ulcers are common after ileocolonic resection in patients with Crohn's disease (CD). However, the endoscopic prognosis of isolated anastomotic lesions after treatment adjustment remains unclear.</p><p><strong>Methods: </strong>We retrospectively included CD patients with anastomotic lesions who were referred to our center for ileocolonoscopy between 2020 and 2024. We conducted an initial evaluation of the impact of treatment adjustment on the endoscopic prognosis of anastomotic lesions. In addition, we analyzed the association between different adjustment strategies and endoscopic outcome.</p><p><strong>Results: </strong>In total, 199 eligible CD patients with anastomotic lesions were included in our study. Treatment adjustment promoted mucosal healing (multivariable Cox hazard ratio [HR]: 2.376, 1.400-4.032, P = 0.001) and endoscopic improvement (multivariable Cox HR: 2.373, 1.596-3.530, P < 0.001). We also found that the endoscopic ulcer improvement of biologics to biologics switching was superior to that of nontreatment adjustment (Cox HR: 2.055, 1.212-3.482, P = 0.007). Cox regression analyses further confirmed that nonbiologics to biologics switching was associated with better endoscopic mucosal healing (Cox HR: 2.751, 1.494-5.063, P = 0.001) and ulcer improvement (Cox HR: 2.154, 1.322-3.509, P = 0.002). Regarding patients with insufficient trough levels of biologics, biologic optimization significantly improved endoscopic mucosal healing (Cox HR: 2.854, 1.345-6.053, P = 0.006) and endoscopic ulcer improvement (Cox HR: 2.344, 1.288-4.265, P = 0.005).</p><p><strong>Discussion: </strong>Treatment adjustment contributed to the improvement of endoscopic prognosis in anastomotic lesions patients. Different adjustment strategies (biologics to biologics switching, nonbiologics to biologics switching, biologic optimization) similarly resulted in better endoscopic outcome.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00859"},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Suggestions for Improving Study Design and Incorporating Virological Markers in HBV Functional Cure Research.","authors":"Chaoting Yang, Huaguo Shao, Jinsong Huang","doi":"10.14309/ctg.0000000000000847","DOIUrl":"10.14309/ctg.0000000000000847","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00847"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Tumor Regression Grading on the Prognosis of Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Ruchen Wu, Shuying Lin, Junze Chen, Gang Wang, Lulu Han","doi":"10.14309/ctg.0000000000000860","DOIUrl":"10.14309/ctg.0000000000000860","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor regression grade (TRG) after neoadjuvant chemotherapy is recognized as a significant and favorable prognostic indicator in various cancer types. However, this relationship remains less defined and has not been systematically investigated in locally advanced gastric cancer (LAGC). To address this gap, we conducted a meta-analysis aimed at assessing the prognostic influence of tumor regression after preoperative therapy on disease-free survival (DFS) and overall survival (OS) among patients with LAGC.</p><p><strong>Methods: </strong>A systematic search was conducted across the following databases: PubMed, Web of Science, Embase, Cochrane, WF, CNKI, SinoMed, and VIP. The primary outcomes included DFS and OS, estimated using hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Subsequently, either the fixed-effects model or the random-effects model was used to compute HR and 95% CI based on the results of heterogeneity analysis.</p><p><strong>Results: </strong>A total of 11 studies, comprising 2,733 patients, were included in the final analysis. The results indicated that a lower TRG was associated with prolonged DFS (HR 0.53, 95% CI 0.32-0.88) and prolonged OS (HR 0.59, 95% CI 0.39-0.87) in patients with LAGC who received neoadjuvant chemotherapy. Sensitivity analysis demonstrated that no single study significantly influenced the results for both DFS and OS. Publication bias was identified in the meta-analysis for OS, whereas no publication bias was detected in the meta-analysis for DFS.</p><p><strong>Discussion: </strong>A lower TRG score is associated with improved DFS and OS in patients with LAGC receiving neoadjuvant chemotherapy.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00860"},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downregulated Expression of Serum Exosome-Derived miR-375-3p Alleviates Interface Hepatitis and Promotes Fibrosis Regression in Patients With Chronic Hepatitis B.","authors":"Ran Xu, Sihao Wang, Quanwei He, Wei Han, Shujuan Gong, Liping Yan, Jiagan Huang, Xiaoyan Zhan, Zhaofang Bai, Jiangtao Liu, Yan Chen, Yongping Yang","doi":"10.14309/ctg.0000000000000850","DOIUrl":"10.14309/ctg.0000000000000850","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic liver inflammation leads to fibrosis, cirrhosis, and hepatocellular carcinoma. Serum alanine aminotransferase is the most widely used indicator of liver inflammatory injury, but it does not accurately reflect the extent of chronic liver inflammation. The role of exosomes in chronic liver inflammation and fibrosis has gained significant interest. The aim of this study was to investigate the association between serum exosome-derived miRNAs and chronic liver inflammation injury in chronic hepatitis B (CHB) patients with significant fibrosis, and to evaluate their potential clinical value.</p><p><strong>Methods: </strong>Using serum samples collected from healthy adults and patients with paired histological CHB and significant fibrosis. Transcriptome analysis was conducted to identify dysregulated exosome-derived miRNAs associated with chronic liver inflammation. These were validated by lipopolysaccharide/D-galactosamine-induced acute liver injury in mice and CCl 4 -induced cirrhosis in rat models, and 80 CHB patients with paired histological after a 72-week treatment.</p><p><strong>Results: </strong>Exosome-derived miR-375-3p was positively associated with interface hepatitis, as determined by transcriptomic screening. Its upregulation was associated with severe interface hepatitis in the mouse and rat models. In the validation cohort, a high proportion of patients in the high-expression group demonstrated severe interface hepatitis (85%, P = 0.022), whereas the low-expression group showed a higher proportion of interface hepatitis improvement (80%, P = 0.002) and regression of fibrosis (70%, P < 0.001).</p><p><strong>Discussion: </strong>The expression level of serum exosome-derived miR-375-3p was positively associated with interface hepatitis and is independently associated with the prognosis of interface hepatitis and fibrosis in patients with CHB and significant fibrosis.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00850"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Prior Bariatric Surgery Predispose to Acetaminophen-Related Acute Liver Failure?","authors":"Shannan R Tujios, Isabel Wees, Ahmad Anouti, Michelle Gottfried, Jaime Almandoz, Valerie Durkalski, Jody A Rule, Robert J Fontana, William M Lee","doi":"10.14309/ctg.0000000000000852","DOIUrl":"10.14309/ctg.0000000000000852","url":null,"abstract":"<p><strong>Introduction: </strong>Prior small studies have suggested that patients with prior metabolic and bariatric surgery (MBS) may have increased susceptibility to acetaminophen (APAP)-related acute liver failure/acute liver injury (ALF/ALI). The aim of this study was to compare the presentation, etiology, and outcome of adult ALI/ALF patients who were enrolled in a prospective registry study with prior bariatric surgery to those without.</p><p><strong>Methods: </strong>Among 3,364 ALF/ALI patients in the Acute Liver Failure Study Group registry enrolled between January 1998 and August 2019, 85 (2.3%) reported prior MBS. On review, 6 cases were deemed not ALF and excluded from the analysis.</p><p><strong>Results: </strong>Among the 79 MBS ALF/ALI patients, 95% were female and 86% were White. Etiology included APAP-related ALF/ALI in 78.5% of the MBS group vs 49.3% in the non-MBS group ( P < 0.001). The proportion of patients with MBS increased from 1.6% (1998-2008) to 3.4% in the later years (2009-2019) ( P < 0.001). There were proportionately more unintentional overdoses in the MBS cohort (71% vs 52%, P < 0.001) with smaller median total APAP dose ingestion (6,500 mg vs 12,000 mg, P = 0.009). Although MBS patients had more severe encephalopathy at presentation, overall, 21-day and transplant-free survival between the groups were similar.</p><p><strong>Discussion: </strong>ALF/ALI is more frequent in MBS patients than in the general population. APAP toxicity is the most common cause in MBS patients but not the only diagnosis observed. MBS may predispose to severe unintentional APAP liver injury at lower doses. Both MBS patients and providers should be aware regarding this potential risk of increased susceptibility to APAP hepatotoxicity.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00852"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Survey Shows a Dilemma Toward Spontaneous Bacterial Peritonitis Prophylaxis Among US-Based Hepatology Professionals.","authors":"Deborah DiazGranados, Jacqueline G O'Leary, Madhumita Yamuzala, Shari Rogal, Jasmohan S Bajaj","doi":"10.14309/ctg.0000000000000858","DOIUrl":"10.14309/ctg.0000000000000858","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous bacterial peritonitis prophylaxis (SBPPr)-related practices are evolving, with recent studies showing almost half of potential subjects not being initiated on it. Determine practice dilemmas regarding SBPPr among US-based hepatology providers.</p><p><strong>Methods: </strong>A questionnaire regarding primary and secondary SBPPr using quantitative and qualitative (open-ended) approaches was sent to US-based hepatology providers electronically.</p><p><strong>Results: </strong>A total of 113 clinicians (86% physicians, 73% academic centers) responded. 54% started Primary and 72% secondary SBPPr in 50% of eligible patients. However, the issues related to antimicrobial resistance and ineffectiveness lead to SBPPr usage variations and restrictions on a patient-specific basis. Most respondents (>70%) would withdraw/not initiate SBPPr with data regarding ineffectiveness and harms. Open-ended answers showed that most believed newer trials to reduce reliance on weaker older evidence are needed.</p><p><strong>Discussion: </strong>A survey of US-based hepatologists demonstrates a major dilemma between usual care of initiating SBPPr versus not initiating/withdrawing SBPPr that needs newer randomized trials.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00858"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification for Malignant Potential of Intraductal Papillary Mucinous Neoplasms Using the Apolipoprotein-A2 Isoforms Blood Test.","authors":"Yuta Hasegawa, Norio Itokawa, Ayumi Kashiro, Michika Kitamura, Kengo Nagashima, Kenta Suzuki, Tetsuyuki Higashi, Kaori Shioda-Koyano, Hiroki Ono, Tadamichi Kawano, Yuji Yoshida, Tomomi Okubo, Taeang Arai, Korenobu Hayama, Keiko Kaneko, Masanori Atsukawa, Keiko Takeuchi, Seiji Futagami, Katsuhiko Iwakiri, Kazufumi Honda","doi":"10.14309/ctg.0000000000000856","DOIUrl":"10.14309/ctg.0000000000000856","url":null,"abstract":"<p><strong>Introduction: </strong>High-risk stigmata (HRS) and worrisome features (WFs) are imaging findings that reflect malignant potential of intraductal papillary mucinous neoplasms (IPMNs). The aim of this study was to determine the potential utility of stratifying malignant potential of IPMNs using apolipoprotein-A2 isoforms (apoA2-i) as a blood biomarker.</p><p><strong>Methods: </strong>A total of 212 patients with IPMNs diagnosed by either magnetic resonance cholangiopancreatography or contrast-enhanced computed tomography, and endoscopic ultrasound were retrospectively enrolled. ApoA2-i and CA19-9 of all patients and 295 healthy individuals were measured. The distributions of apoA2-i and CA19-9 were analyzed in association with the malignant potential evaluated by imaging.</p><p><strong>Results: </strong>In 212 patients with IPMN, 17 had HRS (HRS group), 70 had WFs (WF group), and 125 had no endoscopic ultrasound findings of HRS or WFs (non-WF group). The median of the apoA2-i Index in the HRS, WF, non-WF, and healthy groups were 57.7, 72.4, 87.5, and 87.9 μg/mL, respectively, with significantly lower levels in the HRS and WF groups ( P < 0.001). By contrast, CA19-9 showed no significant difference among the 4 groups. The area under the curve of the apoA2-i Index to differentiate patients in the HRS and WF groups from the non-WF group was significantly higher than that of the CA19-9 (0.676 vs 0.554, P = 0.029).</p><p><strong>Discussion: </strong>The diagnostic performance of apoA2-i for detecting IPMN with malignant potential was superior to that of CA19-9. The apoA2-i Index could serve as a useful biomarker for risk stratification and surveillance of IPMNs.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00856"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L1 Capsid Protein Expression in HPV-Positive Barrett Metaplasia-Dysplasia-Adenocarcinoma Lesions.","authors":"Divya I Vythilingam, Shweta Dutta Gautam, Leonardo D Santos, Wei Xuan, Mohammad Rabiei, Shanmugarajah Rajendra","doi":"10.14309/ctg.0000000000000853","DOIUrl":"10.14309/ctg.0000000000000853","url":null,"abstract":"<p><strong>Introduction: </strong>Human papillomavirus (HPV) has been associated with a subset of Barrett dysplasia and esophageal adenocarcinoma (EAC). The HPV L1 capsid protein has been closely linked to disease regression and is a prognostic factor in HPV-driven cancers of the cervix and anus.</p><p><strong>Methods: </strong>Thus, we investigated L1 protein expression in HPV-positive patients representing the esophageal squamous-Barrett metaplasia-dysplasia-adenocarcinoma sequence. L1 protein immunohistochemical staining was correlated with p16 overexpression and E6/E7 mRNA in situ hybridization.</p><p><strong>Results: </strong>Of 116 HPV DNA-positive patients ([age range: 19-90, mean [SD], 63.2 [13.5], 88 men and 28 women), 73 (62.9%) were genotype 16, 37 (31.9%) genotype 18, and 6 (5.2%) were genotype 6. L1 staining was identified in 64 individuals: 84.9% (28/33) controls, 94.1% (16/17) Barrett's esophagus, 50% (7/14) low-grade dysplasia, (8/21) 38.1% high-grade dysplasia, and 16.1% (5/31) EAC (adjusted P < 0.0001). Conversely, p16 was present in 9.1% (3/33) of controls, 17.7% (3/17) Barrett's esophagus, 57.1% (8/14) low-grade dysplasia, 61.9% (13/21) high-grade dysplasia, and 64.5% (20/31) of EAC patients ( P < 0.0001). Corresponding figures for E6/E7 mRNA positivity was 6.1% (2/33), 23.5% (4/17), 28.6% (4/14), 38.1% (8/21), and 45.2% (14/31), respectively ( P = 0.008). Expression of HPV-L1 and p16 or L1 and E6/E7 mRNA was largely mutually exclusive.</p><p><strong>Discussion: </strong>HPV L1 capsid expression is incrementally lost with increasing esophageal disease severity as in viral-driven anal and cervical lesions. Utility of L1 alone or in combination with p16 and or E6/E7 mRNA in stratifying HPV-positive patients for treatment should be explored in a prospective longitudinal investigation.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00853"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fecal Mycobiome in Chronic Pancreatitis Is Characterized by an Increase in Candida species and Nakaseomyces.","authors":"Przemyslaw M Podgorny, Stefan Weiss, Corinna Bang, Malte Rühlemann, Mats L Wiese, Henry Völzke, Andre Franke, Sebastian Zeissig, Matthias Sendler, Ali A Aghdassi, Markus M Lerch, Frank U Weiss, Fabian Frost","doi":"10.14309/ctg.0000000000000855","DOIUrl":"10.14309/ctg.0000000000000855","url":null,"abstract":"<p><strong>Introduction: </strong>The exocrine pancreas is an important determinant of the intestinal microbiome composition and stability. Although chronic pancreatitis (CP) is known to severely affect the bacterial community, its impact on the intestinal mycobiome is currently unknown.</p><p><strong>Methods: </strong>A total of 93 patients with clinical and imaging evidence of CP were prospectively recruited and compared with 2 equally sized matched control cohorts. One control group was matched for age, sex, body mass index, and smoking (Con-1), and the other additionally for exocrine pancreatic function (stool elastase) and diabetes (Con-2). Fecal samples were collected from all 279 individuals to determine the fecal mycobiome by internal transcribed spacer 2 sequencing.</p><p><strong>Results: </strong>In CP patients, fungal reads were increased (3.7-fold and 2.0-fold) as compared with Con-1 and Con-2. In comparison with Con-1, CP patients demonstrated higher total abundance of Candida (4.5-fold, q = 0.009) and higher mean relative abundance (11.4% vs 1.0%, q = 0.014) and presence (25.8% vs 9.7%, q = 0.025) of Nakaseomyces . In contrast to Con-2, CP patients showed higher Candida total abundance (1.9-fold, P = 0.016) which was, however, not significant after correction for multiple testing ( q = 0.056).</p><p><strong>Discussion: </strong>Not only the microbiome but also the mycobiome in CP patients is characterized by distinct changes, with higher abundances of Candida or Nakaseomyces . Exocrine pancreatic dysfunction in CP patients likely contributes to this observation. This may result in increased rates of fungal infections, chronic inflammation, and could be contributing to the development of pancreatic cancer.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00855"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Rates of Early Gastric Cancer in the Urban and Rural Medical Centers of Hangzhou, China.","authors":"Lu Sun, Qingfeng Yang, Bin Lyu, Yanjie Shen, Yeqi He, Yi Zhang, Liang Han","doi":"10.14309/ctg.0000000000000851","DOIUrl":"10.14309/ctg.0000000000000851","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare gastric cancer (GC) and early GC (EGC) diagnosis rates between urban and rural and to investigate potential reasons for the increased GC morbidity in rural areas.</p><p><strong>Methods: </strong>Patients who underwent endoscopy at rural and urban medical centers from 2019 to 2024 were included. We analyzed differences in patients' pre-endoscopic chief complaints and endoscopic diagnoses across the 2 areas.</p><p><strong>Results: </strong>Thirty-two thousand six hundred thirteen patients from rural medical centers and 70,195 patients from urban centers were included. Significant differences in endoscopic diagnoses were found between the groups, with the EGC diagnosis rate being significantly lower in rural areas than in urban (10.19% vs. 27.19%). Rural patients were more likely to undergo endoscopy for abdominal pain, reflux, abdominal fullness, and melena (relative risk [RR] = 1.340, 1.431, 1.106, and 1.231, respectively). Fewer rural patients underwent endoscopy because of laboratory abnormality, including Helicobacter pylori infection, elevated tumor markers, positive fecal occult blood tests, and anemia (RR = 0.591, 0.295, 0.251, and 0.400, respectively). In addition, rural patients were significantly less likely to undergo endoscopy owing to health screening or surveillance for chronic atrophic gastritis (RR = 0.362 and 0.527, respectively).</p><p><strong>Discussion: </strong>The diagnosis rate of EGC is significantly lower in rural than in urban. Rural patients are more likely to seek endoscopy because they are symptomatic and are less likely to undergo endoscopy for health screening, surveillance for chronic atrophic gastritis, or laboratory abnormality. Enhanced health education and awareness programs in rural areas are needed to encourage proactive endoscopic screening and surveillance.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00851"},"PeriodicalIF":3.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}