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ObjectiveTo date, there are no predictive biomarkers to guide selection of patients with gastric cancer (GC) who benefit from paclitaxel. Stomach cancer Adjuvant Multi-Institutional group Trial (SAMIT) was a 2×2 factorial randomised phase III study in which patients with GC were randomised to Pac-S-1 (paclitaxel +S-1), Pac-UFT (paclitaxel +UFT), S-1 alone or UFT alone after curative surgery.DesignThe primary objective of this study was to identify a gene signature that predicts survival benefit from paclitaxel chemotherapy in GC patients. SAMIT GC samples were profiled using a customised 476 gene NanoString panel. A random forest machine-learning model was applied on the NanoString profiles to develop a gene signature. An independent cohort of metastatic patients with GC treated with paclitaxel and ramucirumab (Pac-Ram) served as an external validation cohort.ResultsFrom the SAMIT trial 499 samples were analysed in this study. From the Pac-S-1 training cohort, the random forest model generated a 19-gene signature assigning patients to two groups: Pac-Sensitive and Pac-Resistant. In the Pac-UFT validation cohort, Pac-Sensitive patients exhibited a significant improvement in disease free survival (DFS): 3-year DFS 66% vs 40% (HR 0.44, p=0.0029). There was no survival difference between Pac-Sensitive and Pac-Resistant in the UFT or S-1 alone arms, test of interaction pConclusionUsing machine-learning techniques on one of the largest GC trials (SAMIT), we identify a gene signature representing the first predictive biomarker for paclitaxel benefit.Trial registration numberUMIN Clinical Trials Registry: C000000082 (SAMIT); ClinicalTrials.gov identifier, 02628951 (South Korean trial)

BACKGROUND The association of meat consumption with gastric cancer is inconclusive. OBJECTIVE We examined the association of meat consumption with gastric cancer risk among Japanese males and females. METHODS This cohort study included 42,328 male and 48,176 female participants of the Japan Public Health Center-based Prospective Study, who were aged 45 to 74 y at recruitment. Dietary intake data were collected from January 1, 1995 to December 31, 1999 using a validated food frequency questionnaire. HRs and 95% CIs for gastric cancer were estimated using Cox proportional hazards regression models. RESULTS During a mean follow-up of 15 y, 1868 male and 833 female incident gastric cancer cases were identified. Intake of total and subtypes of meat was not associated with total gastric cancer. However, higher chicken consumption was associated with reduced distal gastric cancer risk in females (HR for quintile 5 vs. quintile 1, 0.75 (95% CI 0.56, 0.99), P trend = 0.027], with a similar but non-significant risk reduction among females with Helicobacter pylori [HR 0.59 (95% CI 0.29, 1.20), P trend = 0.06] in subgroup analysis. CONCLUSIONS Meat consumption was not associated with total gastric cancer risk.

Background: The prevalence of Helicobacter pylori–negative gastric cancer (HpNGC) can be as low as 1%, when infection is assessed using more sensitive tests or considering the presence of gastric atrophy. HpNGC may share a high-risk profile contributing to the occurrence of cancer in the absence of infection. We estimated the proportion of HpNGC, using different criteria to define infection status, and compared HpNGC and positive cases regarding gastric cancer risk factors. Methods: Cases from 12 studies from the Stomach cancer Pooling (StoP) Project providing data on H. pylori infection status determined by serologic test were included. HpNGC was reclassified as positive (eight studies) when cases presented CagA markers (four studies), gastric atrophy (six studies), or advanced stage at diagnosis (three studies), and were compared with positive cases. A two-stage approach (random-effects models) was used to pool study-specific prevalence and adjusted odds ratios (OR). Results: Among non-cardia cases, the pooled prevalence of HpNGC was 22.4% (n = 166/853) and decreased to 7.0% (n = 55) when considering CagA status; estimates for all criteria were 21.8% (n = 276/1,325) and 6.6% (n = 97), respectively. HpNGC had a family history of gastric cancer more often [OR = 2.18; 95% confidence interval (CI), 1.03–4.61] and were current smokers (OR = 2.16; 95% CI, 0.52–9.02). Conclusion: This study found a low prevalence of HpNGC, who are more likely to have a family history of gastric cancer in first-degree relatives. Impact: Our results support that H. pylori infection is present in most non-cardia gastric cancers, and suggest that HpNGC may have distinct patterns of exposure to other risk factors.

Background: Stomach cancer is the fifth most common malignancy. In 2012, 952,000 cancers were diagnosed worldwide, which led to 723,000 deaths. Elderly men are the most frequently observed category of gastric cancer patients, mostly affecting the antrum. The objective of this study was to analyze the association of age with sex, tumor sites, types of surgical intervention, and diagnosed anatomical pathologies in cases of gastric cancer. Methods: This cross-sectional descriptive study analyzed the associations between age, sex, tumor sites, types of surgical intervention, and diagnosed anatomical pathologies among the total gastric cancer incidences during medical treatments from January 2016 to May 2019. The study samples were collected from the total gastric cancer respondents who met the inclusion criteria during medical treatments within the study period. Results: Gastric cancer was most frequently observed among females (56%) and those aged 50–70 years old (47%). Most respondents had advanced stages of gastric cancer at first enrollment at our institution. The most frequently found tumor site was the corpus (43%). The most frequently performed type of surgical intervention was jejunostomy feeding (26%), and the most frequently diagnosed anatomical pathology was adenocarcinoma with poorly differentiation (39%). Overall, age had statistically significant correlations with sex (p 50 years old), gastric cancer was more prevalent in women than men, and the gastric tumor tended to be more distal. Non-cardia gastric cancers were more prevalent than cardia gastric cancers.

The association between alcohol intake and stomach cancer risk remains controversial. We undertook a pooled analysis of data from six large‐scale Japanese cohort studies with 256 478 participants on this topic. Alcohol intake as ethanol was estimated using a validated questionnaire. The participants were followed for incidence of stomach cancer. We calculated study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) for stomach cancer according to alcohol intake using a Cox regression model. Summary HRs were estimated by pooling the study‐specific HRs using a random‐effects model. During 4 265 551 person‐years of follow‐up, 8586 stomach cancer cases were identified. In men, the multivariate‐adjusted HRs (95% CIs) of stomach cancer were 1.00 (0.87‐1.15) for occasional drinkers, and 1.00 (0.91‐1.11) for, Alcohol intake increased stomach cancer risk in men, and heavy drinkers showed a greater point estimate of risk for proximal cancer than for distal cancer.

Background Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse. Objectives We investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk. Methods Participants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Cox models were used to estimate HRs and 95% CIs for unrestrained eating (eating anything at any time, no concern with figure change, or both) and risk of digestive system cancers. Results During follow-up, 2064 digestive system cancer cases were documented among 70,450 eligible participants in analyses of eating anything at any time, In total, 2081 digestive system cancer cases were documented among 72,468 eligible participants in analyses of no concern with figure change. In fully adjusted analyses, women with the behavior of eating anything at any time had a higher risk of overall digestive system cancer (HR: 1.22; 95% CI: 1.10, 1.35), overall gastrointestinal tract cancer ((HR: 1.33; 95% CI: 1.18, 1.50), buccal cavity and pharynx cancer (HR: 1.50; 95% CI: 1.02, 2.21), esophageal cancer (HR: 1.62; 95% CI: 1.01, 2.62), small intestine cancer (HR: 1.92; 95% CI: 1.02,3. 59), and colorectal cancer (HR: 1.20; 95% CI: 1.04, 1.38), and a non-statistically significant increased risk of stomach cancer (HR: 1.54; 95% CI: 0.96,2.48), compared with women without this behavior. No statistically significant association was observed for pancreatic cancer and liver and gallbladder cancer. The combined effect of eating anything at any time and having no concern with figure change was associated with a significantly increased risk of overall digestive system cancer (HR: 1.27; 95% CI: 1.10, 1.46), overall gastrointestinal tract cancer (HR: 1.45; 95% CI: 1.23, 1.71), and colorectal cancer (HR: 1.34; 95% CI: 1.11, 1.63), compared with women exhibiting the opposite. Conclusions Unrestrained eating behavior was independently associated with increased risk of gastrointestinal tract cancers. The potential importance of unrestrained eating behavior modification in preventing gastrointestinal tract cancers should be noted.

In the Kharkov regional oncological dispensary for 7 years and 5 months (1953-1960) 1034 patients with stomach cancer were hospitalized. 632 patients were operated on. Radical operations were performed in 445 patients, of which combined (with resection of adjacent organs, germinated by the tumor) 72 (17% of all resections).

I take a short period of time, about one and a half years, during which 24 patients with stomach cancer have passed through our clinic.

Background The long‐term trend in cancer death in a rapidly developing country provides information for cancer prophylaxis. Here, we aimed to identify the trends in cancer mortality in China during the 2004‐2018 period. Methods Using raw data from the national mortality surveillance system of China, we assessed the mortalities of all cancer and site‐specific cancers during the 2004‐2018 period. The participants were divided into three age groups: ≥65 years, 40‐64 years, and ≤39 years. Changing trends in cancer death by gender, residency, and tumor location were estimated using fitting joinpoint models to log‐transformed crude mortality rates (CMRs) and age‐standardized mortality rates (ASMRs). Results Cancer death accounted for 24% of all‐cause of death in China during 2014‐2018. The CMR of all cancer was 150.0 per 100,000 persons. Cancer was the leading cause of death in the population, This 15‐year longitudinal study described cancer burden of a rapid changing country with significant regional and urban‐rural disparities, which is important in evaluating the effect of population ageing, risk factor exposure, and public health efforts on cancer mortality. Lung and liver cancers were the 1st leading cause of immature death in women and men, respectively. Lung, colorectal, and pancreatic cancers kept increasing in rural areas. These findings are references for policy making to control cancer.

Purpose There has been an increase in the incidence of signet ring cell cancer (SRCC) of the stomach and gastro-esophageal junction (GEJ). The multistage carcinogenesis involving genetic and epigenetic aberrations may have a major role in the increasing incidence of SRCC. Although there are numerous studies on the prognostic value of SRCC, they are markedly inconsistent in their results, making it impossible to draw any meaningful conclusions. We aimed to examine the available evidences on molecular alterations and stage-stratified treatment approaches in SRCC of the stomach and GEJ. Methods A systematic search was carried out in PubMed. Studies available in English related to SRCC of stomach and gastro-esophageal junction were identified and evaluated. Results This study reviewed the current evidence and provided an insight into the molecular alterations, stage-stratified treatment approaches, and future challenges in the management of SRCC of the stomach and GEJ. Specific therapeutic strategies and personalized multimodal treatment have been recommended based on the tumor characteristics of SRCC. Conclusion Multistage carcinogenesis involving genetic and epigenetic aberrations in SRCC is interlinked with stage-dependent prognosis. Specific therapeutic strategy and personalized multimodal treatment should be followed based on the tumor characteristics of SRCC. Endoscopic resection, radical surgery, and perioperative chemotherapy should be offered in carefully selected patients based on stage and prognostic stratification. Future studies in genetic and molecular analysis, histopathological classification, and options of multimodality treatment will improve the prognosis and oncological outcomes in SRCC of gastric and GEJ.

Objective:The aim of study was to determine factors connected with neuropsychiatric symptoms and anxiety in patients with terminal stomach cancer.Methods:We analysed retrospectively 134 terminal stomach cancer patients admitted to Palliative Care Unit.Results:Patients with anxiety had a greater chance for emergency admission, higher Numerical Rating Scale result, occurrence of cachexia and neuropsychiatric symptoms, longer duration of treatment, higher albumin concentration and lower glucose concentration.Patients with neuropsychiatric symptoms had greater chance for emergency admission, higher Performance Status scale note, occurrence of dyselectrolytemia, lower albumin concentration. Patients with those symptoms had more than 7 times greater chance for death.Conclusion:It is important to know factors connected with neuropsychiatric symptoms and anxiety because thanks to that we could avoid those dangerous clinical symptoms.

Актуальность. Коморбидная патология остается распространенной, но недостаточно изученной проблемой. В настоящее время частота и характер соединенной патологии у больных с хроническим метапластическим атрофическим гастритом (ХМАГ) окончательно не выяснены, как и роль щитовидной железы (ЩЖ) в этиопатогенезе данного заболевания. Цель: оценить состояние коморбидности у больных с ХМАГ и изучить частоту и характер структурных изменений ЩЖ у данной категории больных, исследовать литературные данные по этой проблеме. Материалы и методы. В обследование включен 41 больной с ХМАГ в возрасте (60,1 ± 2,4) года, среди которых было 29 женщин и 12 мужчин. Больным проводилась гастроскопия (с NBI-режимом и забором биопсийного материала), ультразвуковое исследование ЩЖ, анкетирование с помощью Сumulative Illness Rating Scale (CIRS), а также по историям болезни изучались коморбидные заболевания желудочно-кишечного тракта (ЖКТ). Результаты. У 82,9 % больных с ХМАГ выявлены ультразвуковые диффузные изменения ЩЖ, причем у 48,8 % обследованных они выявлялись впервые, а у 37,8 % пациентов данные изменения сочетались с наличием узлов в ЩЖ. К тому же у 9,8 % больных выявлены ультразвуковые признаки аутоиммунного тиреоидита. У 97,6 % пациентов с ХМАГ наблюдалась полиморбидная патология, причем у 92,7 % больных — со стороны 3 систем и больше и только у 4,9 % — со стороны 2 систем. Установлена положительная корреляционная связь между возрастом больных и суммарным количеством баллов, набранных с помощью опросника коморбидности CIRS (r = 0,412, p = 0,04). По данным СIRS, наиболее часто у пациентов с ХМАГ сочеталась патология верхнего и нижнего отделов ЖКТ (97,7 и 53,7 % соответственно), патология костно-мышечного аппарата и кожных покровов (68,3 %), патология глаз, ушей, горла, носа и гортани (56,1 %), сосудистая патология (56,1 %), заболевания сердца (51,2 %) и эндокринно-метаболическая патология (34,1 %). Выводы. У 82,9 % больных с ХМАГ выявлены ультразвуковые структурные изменения ЩЖ. Перспективным направлением дальнейшего исследования, на наш взгляд, было бы изучение аутоиммунных процессов в желудке и ЩЖ (установление возможных взаимосвязей между аутоиммунным тиреоидитом и аутоиммунным гастритом), а также особенностей течения данных коморбидных заболеваний. Необходимо уделить внимание ХМАГ не только как заболеванию, которое является фактором риска развития рака желудка, но и как возможному маркеру наличия сопутствующей патологии щитовидной железы.

Background A population-based cancer screening program in rural China, targeting three types of cancer that are most prevalent in these areas, including esophageal, stomach, and liver cancer was awarded by the government in China since 2007. A two-step design with cancer risk assessment based on questionnaire interview and HBsAg test strip and subsequent clinical intervention for high-risk populations was adopted with free of charge at the local hospitals designated in the program. The participate rate including high-risk rates and screening rates was important to find appropriate strategies to improve the overall awareness of the program. Methods Data from the cancer screening program between 2010 and 2016 were used to calculate higher rate (high-risk population/ participants recruited) and screening rate (participants received screening/ high-risk population). Results From 2010 to 2016, 1,637,429 residents were recruited in the program and filled the questionnaires, 350,646 (21.4%) for esophagus cancer, 273,715 (16.7%) for stomach cancer and 1,013,068 (61.9%) for liver cancer. 471,974 participants were assessed as high-risk population including 114,786 (24.3%) high risk for esophagus cancer, 161,809 (34.3%) high risk for stomach cancer and 195,379 (41.4%) high risk for liver cancer, respectively. 249,185 (52.8%) participants who were assessed as high risk received clinical screening. There were 64,710 (26.0%) for esophagus cancer screening, 71,365 (28.6%) for stomach cancer screening and 113,110 (45.4%) for liver cancer screening, respectively. Conclusion Our findings will provide important references for designing effective population-based screening strategies to enhance the screening acceptance by health action plan in the future.

Background/aim Primary hyperparathyroidism (PHPT) is a disease that is diagnosed more frequently and generally in the asymptomatic period, with widely available biochemical tests. Evidence suggesting an association between PHPT and malignancy risk is increasing. Clarification of this association will be useful in PHPT for malignancy screening and management of patients with PHPT. In this study, we aimed to investigate the frequency of cancer in PHPT patients. Materials and methods A total of 775 PHPT patients were included in the retrospective study. Demographic, clinical and laboratory data of the patients were evaluated retrospectively. Results Malignancy was detected in 128 (16.50%) of 775 PHPT patients (female/male: 625/150). The mean age at diagnosis of PHPT was 57.99 ± 10.86 years, and the mean age at diagnosis of malignancy was 57.46 ± 11.17 years. Of the 128 patients with malignancy, 53 (41.40%) were diagnosed in the same year as PHPT. In terms of malignancy types, 51 (6.50%) of 775 PHPT patients had thyroid cancer. Thyroid cancer was followed by breast cancer (2.30%) and stomach cancer (1%) in order of frequency. Conclusion We think that PHPT patients should be examined more carefully in terms of cancer risk, especially thyroid cancer. More comprehensive studies are needed to clarify the relationship between PHPT and cancer.

Giriş Amaç: Kanser hastalarının preoperatif en sık görülen klinik problemlerinden biri preoperatif anemidir. Preoperatif aneminin en sık görüldüğü kanser türlerinden biri mide kanseridir. Fakat, mide kanserinin anemi ile ilişkisi net değildir. Bu çalışmanın amacı mide kanserli hastaların bağımsız prognostik risk faktör olan patolojik evrelerinin ve tümör boyutlarının ameliyat öncesi hemoglobin değerleriyle karşılaştırarak preoperatif anemi ile tümör boyutu ve tümör evresi arasındaki ilişkiyi incelemek ve prognostik belirteçleri zayıf olan mide kanseri için preoperatif aneminin prognostik değerini araştırmaktır. Materyal ve Metod : XX üniversitesi XX bölümünde 1 ocak 2017 ile 1 aralık 2019 yılları arasında mide kanseri dolayısıyla küratif D2 gastrektomi ve Ro rezeksiyon uygulanmış hastaların klinikopatolojik ve demografik özellikleri retrospektif olarak incelendi. Bulgular : Toplam 85 hasta incelendi. Hastaların 66 (%77,6)’sı erkek 19 (%22,4)’u kadındı. Hastaların yaş ortalaması 68,1(41-87) idi. 55(%64,7) hastaya total gastrektomi 30 (%35,2) hastaya subtotal gastrektomi uygulandı. Hastaların tümü adenokarsinom tanılı idi. Hastaların 48(%56,5)’i evre 3, 29(%34,1)’u evre 2, 8(%9,4)’i evre 1 idi. 51(%60) hastanın tümör boyutu büyük 34(%40) hastanın küçüktü.51(%60) hastanın anemisi vardı. Sonuç : Preoperatif anemisi bulunan mide kanserli hastaların tümör boyutları daha büyük ve ileri evre tümörlerdir. Mide kanserli hastaların tedavisi planlanırken preoperatif anemisi bulunan hastaların tümör özelliklerinin daha agresif olabileceği gözardı edilmememidir.

AIM: to evaluate the genetic and clinical characteristics of Russian patients with Lynch syndrome.PATIENTS AND METHODS: in the period from 2012 to 2019, patients with suspected Lynch syndrome were studied, according to the selection recommendations (Amsterdam II and original criteria). All patients underwent a microsatellite instability test in the tumor, and if it was detected, for germline mutations in the genes of MMR system. All patients underwent standard clinical procedures (colonoscopy, gastroscopy, CT, MRI, etc.).RESULTS: Lynch syndrome was genetically confirmed in 60 unrelated patients (included 30 women and 30 men, ranging in age from 24 to 68 years). Germline mutations were found in the following genes: MLH1 — 30, MSH2 — 26, MSH6 — 2, PMS1 — 1, PMS2 — 1. For the first time in the world, 12 novel mutations have been described. Clinical features of Russian patients with Lynch syndrome include: the early average age of development of the first cancer — 39.0 years; frequent 45% localization in the left colon; high (55%) incidence of poorly differentiated adenocarcinomas. A total of 234 tumors were diagnosed in Russian patients with Lynch syndrome and their relatives. It is also important to note that the stomach cancer is the third most common cancer after colon cancer.CONCLUSION: Russian patients with Lynch syndrome showed clinical and genetic and features, that distinguish them from European and North American population and should be taken into account when treating.

Progress in cancer epidemiology and prevention has been a key determinant of the fall in cancer mortality in Europe. Using mortality and population figures from the WHO and Eurostat databases, we estimated the number of averted cancer deaths in the EU27 over the period 1989-2021, for both sexes, for all cancers, and nine major cancer sites. We also computed the avoided deaths for all cancers in five major European countries and the UK. We estimated a total of 4 958 000 (3 339 000 men and 1 619 000 women) avoided deaths for all neoplasms over the period 1989-2021 and 348 000 (246 000 men and 102 000 women) in 2021 alone in the EU27. For both sexes, we estimated 1 679 000 avoided deaths for stomach cancer, 747 000 for colorectum, 227 000 for bladder, 102 000 for leukemias. Avoided deaths for lung cancer accounted for 1 156 000 in men, while no reduction was estimated for women. For breast and uterine cancer, avoided deaths were about 300 000, for ovary 105 000 and for prostate 352 000. In the UK, a total of 1 061 000 (721 000 men and 340 000 women) deaths was avoided. Elimination of tobacco may avoid a further 20% of cancer mortality by 2050. Control of alcohol, overweight and obesity, and occupational and environmental carcinogens may avoid an additional 10% of cancer deaths. A similar reduction may be due to optimal adoption of cervical, colorectal, breast, and probably, lung and prostate cancer screening. Thus, primary and secondary cancer prevention can avoid an additional third of cancer deaths in Europe up to 2050.

Summary. Objective. Improvement of results of treatment of patients with stomach cancer complicated with acute gastric bleeding. Materials and methods. It was shown the analysis of results of surgical treatment of 252 patients with stomach cancer complicated with acute gastric bleeding, which got the hospital treatment at GI “V. T. Zaycev Institute of General and Urgent Surgery of NAMS of Ukraine“ from 2010 till 2019, aged 29 till 76. All patients randomly divided on 2 groups: the group of control — 129 patients (got the hospital treatment from 2010 till 2014), and the basic group — 123 patients (from 2015 till 2019). Results. The common surgical tactics and operations were used at the group of control. The two-staged active-idividualized surgical tactic was used at the basic group. Radical surgery was performed in 120 (47.6%) cases; in 132 (52,4%) cases – palliative and symptomatic(the 121(48,0%) cases of it was major abdominal surgery). Postoperative complications occurred in 79 patients (31.1%) and postoperative mortality in 7.9% (20 patients) cases. Conclusion. There is the rational of using the two-staged surgical tactic with wide using of minimally invasive procedure for the treatment of patients with stomach cancer complicated with acute gastric bleeding. Using of this tactic leads to increasing of quantity of radical operations from 38(29,2%) at the group of control till 82(72,8%) at the basic group and leads to decreasing post-operative deaths from 8,5 % till 7,2 % respectively.

Background. Stomach cancer (SC) is the 6th most common neoplasm among cancers (1 033 701 cases; 5.7%) and the 3rd most deadly cancer worldwide for men and women (782 685 deaths, 8.2%). SC therapy is a complex treatment associated with surgery, adjuvant chemotherapy, targeted therapy and immunotherapy with checkpoint inhibitors, nowadays. Despite the fact that the SC understanding has significantly increased within recent years, the prognosis still remains poor. In addition, very often the patients with the same stage of SC according to the international TNM classification of malignant tumors have different overall survival. Therefore, in order to improve survival rates, is necessary to understand the mechanisms of disease progression and to find new effective predictive factors. Besides many SC predictive factors, such as clinical and morphological characteristics (Lauren histologic type of tumor, degree of differentiation), biomarkers, deficient mismatch repair (dMMR), we have also revealed the positive correlation between the degree of tumor infiltration of tumor-infiltrating lymphocytes (TILs), especially with the spatial location of cell types (intratumoral or stromal cells), and the survival indicators of the patients with malignant neoplasms, recently. Moreover, TILs are the most significant predictive factors in patient survival rates than the TNM classification. At the same time, TILs predictive role in SC is still not clearly defined. Thus, the understanding of the degree of tumor infiltration of TILs depending on the spatial location would allow to determine the predictive significance, as well as to determine the direction of the immune reactions generating in patients with SC at the tissue level, depending on the risk and probability of progression. Aim. To study the predictive significance of intratumoral and stromal CD4+TILs, CD8+TILs and CD4+/CD8+TILs in patients with gastric adenocarcinoma. Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 patients with stages I–III, 20 patients with stage IV) received surgical/combined treatment or independent chemotherapy, respectively, at the Blokhin National Medical Research Center of Oncology. The histological material was carried out before the treatment. Intratumoral (iTILs) and stromal (sTILs) values of CD4+TILs, CD8+TILs, CD4/CD8+TILs and the predictive significance in respect of overall survival and progression-free survival (PFS) were studied. Results. During the observation period (16.4±6.2 months) CD4+/CD8+iTILs were factors of poor prognosis concerning PFS in patients of the first group (p=0.035; odds ratio – OR 3.264, 95% confidence interval – CI). We also identified the statistically significant decrease in CD4+iTILs, CD8+iTILs, CD4+/CD8+iTILs and the absence of CD4+sTILs, CD8+sTILs, CD4+/CD8+sTILs in patients with metastatic SC (р=0.0003; р=0.000004; р=0.00001). Conclusion. The results show the positive predictive significance of CD4+sTILs, CD8+sTILs, CD4+/CD8+sTILs. At the same time, the increase of CD4+/CD8+iTILs reduces the PFS in patients with early and locally advanced SC.

Purpose: Until 2016, there was no oncologist in Togo. This study reviewed the first four years of activities in the practice of clinical oncology in the country to provide the cancer profile, the treatment, and outcomes of patients.Methods: We performed a retrospective descriptive study of patients diagnosed with cancer seen in oncology in Togo from March 2016 to March 2020. Data on presentation, staging, treatment, and outcomes were reviewed. Statistics were computed using SPSS.Results: A total of 897 patients were included. There were 625 women (69.7%) and 272 men (30.3%). The mean age at diagnosis was 53.48 years for men and 52.39 for women and more than half of patients were under 60 years. A cancer diagnosis was histologically confirmed in 81.2% of patients. For both sexes, breast cancer was the commonest followed by cervix cancer, colorectal cancer, prostate, and stomach cancer. In men, prostate cancer ranked first followed respectively by gastric cancer and colorectal cancer. The most common cancer in women was breast cancer followed by cervix cancer. Majority of patients (60%) presented at a late stage. 531 patients (59.2%) received at least one cancer therapy modality but more than half of treated patients did not complete their treatment. After fifty-eight months of follow-up, only 132 patients (14.7%) in the all-study population are alive. Conclusion: This study describes the epidemiology and oncologic treatment in Togolese patients. Breast and Prostate are the leading cancer diagnoses in our population. Most patients presented at an advanced stage and the treatment was palliative in a majority of patients. There is an urgent need for early detection of cancer in Togo.

The review includes 70 articles, most of which have been published for the last 5 years. The aim of the review : explore the modern possibilities and prospects of early diagnosis of stomach cancer. In 2018 in Russia, the mortality rate within one year after the diagnosis was 47.4%. Leading experts in luminal endoscopy from Japan, where more than 60% cases of stomach cancer are detected at an early stage, recommend using advanced endoscopic equipment for routine diagnostics, which allows enlarging the image, examining the capillaries of the mucosa and taking series of pictures. Artificial intelligence improves accuracy. Gastroscopic study with artificial intelligence compensates errors and limited capabilities of people, and provides greater accuracy. However, this technology is expensive, and esophagogastroduodenoscopy itself is an invasive method and can be used only in a clinical setting. In patients with a detectable lesion, a biopsy should be performed. It is important to obtain a sufficient amount of tissue when collecting material, however, many patients take anticoagulants, and thus sampling of numerous fragments can lead to bleeding. Given the limitations of esophagogastroduodenoscopy with biopsy and the fact that only 12.4% cases of stomach cancer in 2018 in Russia identified on the stage I, the searching of effective diagnostic tools is still relevant. MicroRNAs have been in the «cancer research arena» for over 10 years and are considered biomarkers that can help to differentiate between the patients with normal range, dysplasia and those with cancer. MicroRNA regulates all vital processes of a cell, moreover, they are stable and easily extracted from various biological materials, including tissues, blood, feces, saliva, ascitic fluid and even paraffin blocks. And although microRNAs are only entering clinical practice, the results obtained are encouraging.

Dispepsia merupakan penyakit sindrom gejala yang ditandai dengan rasa nyeri atau tidak nyaman pada bagian atas atau ulu hati. Dispepsia organik antara lain karena terjadinya gangguan di saluran cerna atau di sekitar saluran cerna, seperti pankreas, kandung empedu dan lain-lain. Tujuan penelitian ini adalah untuk mengetahui definisi, penyebab, klasifikasi, dan terapi sindrom dispepsia. Metode yang digunakan dalam pembuatan review artikel ini adalah pengumpulan literature dari sumber jurnal yang ada yang berkaitan dengan dyspepsia secara umum yang bersumber dari google, google scholar, dan e-book dengan menggunakan kata kunci “dyspepsia”, “klasifikasi dyspepsia”, “penyebab dyspepsia”, dan “terapi dyspepsia” dalam pencarian literatur. Didapatkan hasil ispepsia organik terjadi karena adanya kelainan organik. Pada dispepsia organik terlihat kelainan yang nyata terlihat pada endoskopi terhadap organ saluran pencernaan seperti ulkus peptik atau yang dikenal dengan tukak peptik, gastritis, stomach cancer, gastro esophageal reflux disease (GERD), hiperasiditas. Kesimpulan yang didapatkan adalah dalam penyembuhannya penyakit dispepsia bisa ditangani dengan terapi farmakologi yang meliputi penggunaan obat-obatan seperti; antasida, antikolinergik, antagonis H2 dan lainnya. Selain itu penyakit dispepsiajuga bisa ditangani dengan terapi non farmakologi yang meliputi menjaga pola makan, mengurangi stress dan lainnya.

Background: Dietary supplements (DS) use is known to be common among cancer survivors. However, detailed information on the factors influencing DS use seems insufficient, including cancer-related and psychological factors.Methods: Study subjects were 1,852 Korean adult cancer survivors recruited from cancer survivor clinic of two university-affiliated hospitals. Data were collected retrospectively through review of medical records and self-administered questionnaires. Psychological factors were assessed using Hospital Anxiety and Depression Scale (HADS) and Fear of Cancer Recurrence Inventory-Short Form. Factors associated the DS use were evaluated by multiple logistic regression analysis after adjusting for covariates.Results: The prevalence of long-term DS use was 15.7% in overall (17.5% in female and 11.6% in male). Female survivors were 3.14 times (95% confidence interval [CI], 1.89–5.22) more likely to use DS than male. In male cancer survivors, ever-smoking and previous radiotherapy were positively associated with DS use. In females, breast cancer survivors were 0.32 times less likely to use DS compared with stomach cancer survivors, and survivors with family history of cancer were 1.39 times more likely to use DS than those without. After adjusting for sociodemographic, clinical, and lifestyle factors, survivors with anxiety (HADS ≥8) used DS 1.38 times (95% CI, 1.01–1.91) more frequently, compared with those without anxiety.Conclusion: Diverse factors such as female sex, cancer treatment modality, smoking history, family history and anxiety status were associated with DS use in Korean cancer survivors. Targeted strategies with consideration of these factors are needed for counseling DS use for cancer survivors.

BACKGROUND: Every year 1.5 million women in the world are diagnosed with breast cancer (BC). In 2018, more than 260,000 new cases of cancer and more than 40,000 deaths due to this disease were detected. At the same time, in Kazakhstan, an intensive indicator of the incidences of BC in 2018 amounted to 25.3% per population of 100 thousand people (2017–24.5%) with a growth rate of 3.1%, which in absolute numbers are 4,648 new cases per year. In terms of mortality, BC ranks third after lung and stomach cancer (6.8%). AIM: This necessitates a detailed study of the molecular mechanisms that underlie the development and progression of BC. One of the mechanisms of carcinogenesis is oxidative stress (OS). An increase in malondialdehyde (MDA) levels was detected in the early stages of cancer. It was suggested that MDA, due to its high cytotoxicity, acts as a promoter of the tumor and cocarcinogen agent. METHODS: Therefore, violation of the parameters of OS in BC is in no doubt. However, according to the literature data analysis, these results are ambiguous and contradictory. There are no studies on a comprehensive assessment of the oxidative destruction of lipids, proteins, and nucleic acids in BC. CONCLUSION: The nature and direction of changes in various components of OS in patients with BC have not been adequately studied, which is necessary for a correct assessment of the involvement of OS in the mechanism of the pathological process and determination of a sensitive marker of the risk of BC or its progression.

Background To reduce out‐of‐pocket costs, the Korean government expanded health insurance reimbursement in anti‐cancer drugs for cancer patients in 2013. Our objective was to examine the impact of the benefit coverage expansion policy on healthcare utilization and overall survival (OS) among patients with six types of solid cancer after the policy of expanding health insurance coverage. Methods This study analyzed a before‐and‐after retrospective cohort of patients newly diagnosed with six types of solid cancer (stomach cancer, colorectal cancer, lung cancer, liver cancer, breast cancer, and prostate cancer) from January 1, 2009 to December 31, 2015 in Korea. The intervention was the expansion of reimbursement in 2013. Multivariate Cox proportional hazards regression was used to estimate the policy effect. Results In total, 142,579 before and 147,760 patients after the benefit expansion, and after matched by age, gender, and stage, 132,440 before and 132,440 patients after policy were included in the analysis. Almost total medical expenditure increased for five types of cancer increased. The expansion of health insurance reimbursement was associated with significantly lower overall mortality compared with pre‐policy mortality for all six cancer sites. Conclusion The policy of expanding health insurance reimbursement might have been associated with a significant increase in survival among cancer patients by ensuring access to health care and medicine. Although the reimbursement expansion timing differs for each cancer, it is believed that eliminating delayed treatment might rather lead to reduce medical expenses and improve health outcomes., Comparison of 3‐year survival before and after expansion of health insurance coverage

This study was conducted to investigate the association between trace elements including cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), iron (Fe), lead (Pb), nickel (Ni), selenium (Se), zinc (Zn), and arsenic (As) in gastrointestinal cancer tissue and non-cancerous tissue (suspected gastrointestinal cancer) in Eastern Iran. The samples of 63 gastrointestinal cancers (stomach (n = 20), esophageal (n = 19), and colorectal (n = 24) along with 63 controls in South Khorasan Province, Iran, were collected and analyzed using ICP-MS (Agilent 7900). Our results indicated that the concentrations of Co (1.3 ± 0.8, 1.3 ± 0.8 μg kg-1), Cr (8.1 ± 7.3, 11.0 ± 14.8 μg kg-1), Ni (29.0 ± 20.1, 39.5 ± 30.2 μg kg-1), Pb (6.9 ± 4.0, 6.1 ± 4.6 μg kg-1), and Zn (867.6 ± 159.1, 935.6 ± 196.2 μg kg-1) were significantly higher among esophagus and colon cancer cases than controls (p < 0.05). Similarly, stomach cancer cases showed higher Co, Cr, Ni, Se, and Zn and lower Cu concentrations than their controls (p < 0.05). Moreover, the Spearman correlation between metals revealed a mostly low to moderate correlation between metals. Our finding illustrated that the significant risk differences of Cr, Ni, Pb, Se, and Zn metals on esophagus cancer when considered the single predictor unadjusted for other metals and covariates RD (95% CI) - Cr: -0.274 (-0.463, -0.086), Ni: -0.288 (-0.457, -0.118), Pb: -0.171 (-0.463, -0.086), Se: -0.243 (-0.434, -0.051), and Zn: -0.094 (-0.143, -0.045) respectively. This study suggests that the trace element's exposure may be associated with gastrointestinal cancer risk. Additional studies are needed to elucidate the mechanisms underlying trace element carcinogenesis further.

Purposes The spread of coronavirus disease 2019 (COVID-19) has affected socioeconomic and healthcare systems in many countries. Accordingly, many individuals may have canceled their annual health-check programs, including esophagogastroduodenoscopy, which would have resulted in lower numbers of newly diagnosed patients with gastric cancer in comparison to other times. Methods Questionnaires were distributed to 62 hospitals every week from May 2020 to August 2020 (total 744) through mailing lists of the Stomach Cancer Study Group of the Japan Clinical Oncology Group. The number of patients with gastric cancer and hospital systems during the COVID-19 pandemic were surveyed. Results In total, 74% (551 out of 744) of the questionnaires were answered and analyzed. In early May, approximately 50% of hospitals had to restrict surgical slots due to the COVID-19 pandemic. However, they gradually loosened the restrictions thereafter. The number of gastrectomies was

Background: Helicobacter pylori (H. pylori) is a worldwide gastrointestinal infection. It is a common risk factor for peptic ulcer disease (PUD), chronic gastritis, and stomach cancer. In patients with cirrhosis, there is a significant association between H. pylori infection and severity of gastropathy due to portal hypertension, chronic stomach upset, frequent upper gastrointestinal bleeding as well as hepatic encephalopathy. Objective: To assess the rate and risk factors of recurrence of H. pylori infection in Egyptian patients with liver cirrhosis after successful eradication therapy. Patients and methods: This study included 500 liver cirrhosis patients who were tested for H. pylori infection. Patients with positive H. pylori infection received proton pump inhibitors (PPI)-based treatment regimen. Successful eradication therapy was assessed 4-8 weeks and repeated over one year after end of treatment using urea breath test (UBT) and stool antigen test (SAT). Results: The prevalence of H. pylori infection in cirrhotic patients was 58%. There were significantly higher serum levels of ammonia and C-reactive protein (CRP) in H. pylori positive patients as well as significantly more gastritis in endoscopy findings in comparison with H. pylori-negative patients. H. pylori recurrence after successful eradication therapy was observed in 22.1% patients of H. pylori-positive cirrhotic patients. Multivariate analysis showed that higher serum ammonia level & receiving multiple treatment courses to achieve H. pylori eradication were independent risk factors for H. pylori recurrence in cirrhotic patients. Conclusion: H. pylori infection is prevalent in liver cirrhosis patients with a significant recurrence rate after eradication therapy. High serum ammonia and the need for multiple treatment courses are risk factors for recurrence.

The detection of tumor-like formations in the area of the uterine appendages during dispensary observation in patients who have undergone treatment for malignant neoplasms of the gastrointestinal tract often suggests metastatic lesions of the ovaries (Krukenberg metastasis). It is very important to collect anamnestic data, namely the fact of hereditary burden. It is recognized that one of the main indications for molecular genetic testing for the detection of mutations in the BRCA1, BRCA2 genes is hereditary burden, that is, the presence of a family history of cancer. Oncological burden of personal history, implying the development of polyneoplasias, is less often taken into account by oncologists, although it is one of the most important characteristics of hereditary ovarian cancer. Most often, with BRCA-associated ovarian cancer, breast cancer, pancreatic cancer occurs in the patient herself (polyneoplasia) or in close female and male relatives. The risk of developing stomach cancer is extremely low in patients with mutations in the BRCA1 genes. Stomach cancer is characterized by mutations in other genes. The article presents a rare case of multiple primary metachronous gastric cancer and BRCA1-associated ovarian cancer. In a patient who underwent radical treatment for stomach cancer, after 3 years, a relapse in the region of the esophageal-gastric anastomosis was revealed. Regarding the recurrence, extirpation of the gastric transplant with esophagogastroanastomosis with one-stage reconstruction – colon plastic surgery was performed in a planned manner. 10 years after the second operation, the patient was diagnosed with ovarian cancer. Taking into account the obtained postoperative historesponse for the ovary (serous adenocarcinoma), aggravated family and personal history, the patient underwent a molecular genetic study in order to identify germline mutations in the BRCA1 and BRCA2 genes by the polymerase chain reaction method. For the detection of mutations, a standard diagnostic panel was used, which makes it possible to analyze the mutations most common in the Russian Federation. According to the results of the study, the patient was found to have a 5382insC mutation in the BRCA1 gene. The patient is a candidate for PARP inhibitors, which are widely used as maintenance therapy not only for hereditary ovarian cancer, but also have found application in the treatment of patients with identified somatic mutations in the BRCA1 and BRCA2 genes, which will increase life expectancy and improve treatment results.

A incidência de câncer em todo o Brasil expressa o quadro sanitário no qual se encontra o país, o que requer um sistema um sistema de saúde capaz de interferir positivamente em tais situações. Foram analisadas as taxas de incidência de câncer de pulmão, traqueia, brônquios, esófago, estômago, cólon, reto, anus, próstata, lábio, cavidade oral, melanoma maligno da pele e outras neoplasias malignas de pele verificando a tendência nas regiões brasileiras, e a relação com as políticas públicas existentes neste período. Estudo transversal retrospectivo com dados obtidos no DATASUS e do Instituto Nacional do Câncer (INCA). Observa-se diferentes padrões de incidência dos principais tipos de cânceres entre as regiões brasileiras, com as maiores taxas para o câncer de próstata, de mama, de pele e cólon, reto e ânus, que permaneceram em ascensão no período analisado. O câncer de pulmão, brônquio e traqueia tem apresentado tendência de estabilidade e no de estômago, houve redução para o sexo masculino na região sudeste. Assim, são reconhecidos limites no processo de controle do câncer, mas também êxitos, o que condiz com bons resultados das políticas de saúde implementadas, em especial, as relacionadas às ações da atenção básica.

AIM: The purpose of the study is to investigate the occurrence of the main forms of chronic gastritis, metaplastic and dysplastic changes in the gastric mucosa, the degree of their severity, and to assess their potential risk for the development of gastric cancer. MATERIALS AND METHODS: The study involved 2982 patients who underwent esophagogastroduodenoscopy with a standard biopsy of the gastric mucosa for morphological assessment and bacterioscopy. If autoimmune gastritis was suspected, an additional serological diagnosis was performed. When detecting intestinal metaplasia of the gastric mucosa as well as neoplastic changes according to the histological report, the description of this report was analyzed in order to identify possible equivalents in the macroscopic description of the mucous membrane. RESULTS: Out of 2982 histological studies of gastric mucosa biopsies, 1273 cases (42.7%) were found to contain H. pylori contamination. In 726 cases (24.3%), intestinal metaplasia. 66 biopsies (2.21%) showed the presence of low-grade intraepithelial neoplasia of the mucosa, 2 biopsies showed indeterminate neoplasia and 4 biopsies showed high-grade neoplasia. In 3 out of the total number of the samples, intravascular gastric adenocarcinoma was detected. In 168 cases (5.6%), gastritis was detected with predominant inflammation of the fundal region characteristic of autoimmune gastritis. In 286 biopsies (10.6%), inflammatory and/or atrophic changes and/or metaplastic changes were preserved, which, as a rule, did not have high activity and pronounced inflammation. In the remaining 1279 cases (42.9%), there was no significant inflammation or atrophic changes. The analysis of endoscopic findings showed that the detectability of intestinal metaplasia of the gastric mucosa without a biopsy study was 13.3%. DISCUSSION OF THE RESULTS: According to the results of the conducted research and analysis, it can be stated that at present, the correct diagnosis of chronic gastritis with the establishment of the etiological factor, prognosis and risks of stomach cancer development is practically not feasible within the modern health care system. This not only deprives a doctor of the opportunity to make a correct diagnosis and prescribe adequate treatment to a patient, but also makes almost all cascades of carcinogenesis, including early cancer, invisible.

Background The efficacy of endoscopic ultrasound (EUS) for determining the T category of gastric cancer is variable. The aim of this study was to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition. Methods A retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were retrospectively analyzed. Differences between the 6th and 7th/8th edition T staging systems for preoperative EUS evaluation were compared. Results The accuracy of EUS T staging was 72.4% for the 7th/8th edition and 78.4% for the 6th edition. T3 stage accuracy was significantly worse when the T3 group status was changed. The tumor location, echoendoscope type, and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found that an indistinctly visible muscularis propria (MP) or with obvious thickening was considered an indicator of lesions involved in the MP with a sensitivity of 81.3%; an MP completely disappeared and accompanied with a serosal layer intact may be a marker that the lesion invaded to the subserosa. We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%. Conclusions The increased complexity of the 7th/8th edition T staging system is accompanied by worsening of the predictive accuracy for EUS as compared to the 6th edition. Furthermore, the tumor location, echoendoscope type, histological type, and EUS image features for each tumor T stage should warrant attention.

Relevance. An important issue is predicting the development of complications after surgery for gastric cancer. The most formidable is the failure of the sutures of gastroenteroanastomosis, which in most cases leads to mortality. Therefore, it is important to search for factors and markers to predict the development of these complications. One of the main markers that need to be studied are factors and markers of inflammation. Objective: to determine of pathophysiological regularities in the development of gastroenteroanastomoses leakage in patients who operated for stomach cancer depends on cryoglobulin level. Materials and methods. An analysis was carried out without a median result in the treatment of 50 patients, which were promptly operated for stomach cancer with distal subtotal resection of the stomach with the formation of gastroenteroanastomosis from 2013 to 2017. The determination of the blood counts was performed according to the method of A.E. Kalovidoris with modifications. An assessment was made of the number of T-lymphocytes (CD3), and the middle target - T-cytotoxic lymphocytes (CD8), as well as CD4 and CD16 in patients with stomach cancer in the postoperative period. Results. 6 patients, on the background have had gastroenteroanastomoses leakage. Dynamic monitoring of blood cryoglobulinemia throughout the entire period of surgery in patients with cancer of the gaster, revealing the inadequacy of the concentration of the cryoglobulins. In the peripheral blood of patients, the CD3 + number is significantly reduced (66.2 ± 0.5%, p

Gastric cancer is endemic in the so-called stomach cancer region comprising Rwanda, Burundi, South Western Uganda, and eastern Kivu province of Democratic Republic of Congo, but its outcomes in that region are under investigated. The purpose of this study was to describe the short-term outcomes (in-hospital mortality rate, length of hospital stay, 3-, 6-, 12-, and 24-month survival rates) in patients treated for gastric cancer in Rwanda. We retrospectively reviewed the data collected from records of patients who consulted Kigali University Teaching Hospital (CHUK) over a period of 10 years from September 2007 to August 2016. We followed patients before and after discharge for survival data. Baseline demographic data studied using descriptive statistics, whereas Kaplan-Meier model and univariate Cox regression were used for survival analysis. Among 199 patients enrolled in this study, 92 (46%) were males and 107 (54%) females. The age was ranging between 24 and 93 years with a mean age of 55.4. The mean symptom duration was 15 months. Many patients had advanced disease, 62.3% with distant metastases on presentation. Treatment with curative intent was offered for only 19.9% of patients. The in-hospital mortality rate was 13.3%. The 3-, 6-, 12-, and 24-month survival rate was 52%, 40.5%, 28%, and 23.4%, respectively. The overall survival rate was 7 months. Rwanda records a high number of delayed consultations and advanced disease at the time of presentation in patients with gastric cancer. This cancer is associated with poor outcomes as evidenced by high hospital mortality rates and short post discharge survival.

Stomach cancer is one of the most common tumors of the gastrointestinal tract. In Russia, stomach cancer is ranked fourth in incidence among malignancies and gives ground for lung, breast and colon cancers. Although the success of PD-1/PD-L1 inhibitors application in clinical practice has been proven in cases of many forms of malignancies, the advantages of application of these types of drugs in cases of stomach cancer has not yet been determined. The purpose of this review is to analyze modern studies concerning the clinical significance of PD-1 and PD-L1 expression in stomach tumors and to find the prospects of immunotherapy these tumors. The large number of studies are currently being described, concerning the analysis of the expression of PD-1, PD-L1 levels in tumor cells and soluble forms of these proteins sPD-1 and sPD-L1 in the serum in patients with stomach cancer. However, their clinical significance is unclear, and in many cases the predictive role of PD-L1 expression for the efficacy of immunotherapy is not yet clearly defined. Further accumulation of knowledge in this area can help to improve the efficacy of existing immunotherapy methods and to develop new predictive criteria.

Secondary use of medical big data is becoming increasingly popular in healthcare services and clinical research in the medical industry. Cancer recurrence is a common phenomenon of cancer patients after treatment (recovery period). Studying the time and influencing factors of cancer recurrence can provide effective clinical intervention means, which is the gospel of cancer patients. In this article, a sample of 50 000 cases of seven cancer patients, including liver cancer, lung cancer, kidney cancer, breast cancer, uterine cancer, stomach cancer, and bowel cancer, was collected. A twin support regression vector machine (TSVR) algorithm based on dependent nearest neighbor (DNN) weighting is proposed, the eplion-TSVR model is improved by DNN-weighted algorithm with local information mining function, and the solution of the improved model is derived. It is proposed to use the cuckoo algorithm to determine the optimal parameters of DNN to determine the optimal dependency region domain. In this article, the improved TSVR algorithm is used to establish a cancer recurrence prediction model. The prediction accuracy of the model for various cancers can reach more than 91%, which is significantly higher than that of convolutional neural network and e-TSVR models.

Li‐Fraumeni syndrome (LFS) is a hereditary cancer predisposition syndrome, and the majority of patients with LFS have been identified with germline variants in the p53 tumor suppressor (TP53) gene. In the past three decades, considerable case reports of TP53 germline variants have been published in Japan. To the best of our knowledge, there have been no large‐scale studies of Japanese patients with LFS. In this study, we aimed to identify Japanese patients with TP53 germline variants and to reveal the characteristics of LFS in Japan. We collected reported cases by reviewing the medical literature and cases diagnosed at the institutions of the authors. We identified 68 individuals from 48 families with TP53 germline pathogenic or likely pathogenic variants. Of the 48 families, 35 (72.9%) had missense variants, most of which were located within the DNA‐binding loop. A total of 128 tumors were identified in the 68 affected individuals. The 128 tumor sites were as follows: breast, 25; bones, 16; brain, 12; hematological, 11; soft tissues, 10; stomach, 10; lung, 10; colorectum, 10; adrenal gland, 9; liver, 4; and others, 11. Unique phenotype patterns of LFS were shown in Japan in comparison with those in a large national LFS cohort study in France. Above all, a higher frequency of patients with stomach cancer was observed in Japanese TP53 germline variant carriers. These results may provide useful information for the clinical management of LFS in Japan., Comparing this study in Japan with a large national Li‐Fraumeni syndrome cohort study in France, the unique phenotype patterns of Li‐Fraumeni syndrome was shown in Japan. Especially, the higher frequency of patients with stomach cancer in Japanese TP53 germline variants carriers was shown.

Background While double primary cancers are common in breast cancer patients, co-existence of primary gastric cancer and gastric metastases of breast cancer is exceedingly rare. Case presentation A 51-year-old woman receiving chemotherapy for breast cancer presented with melena and presyncope. A circumferential thickening of the pylorus and small submucosal tumor-like lesions in the gastric fundus and corpus were confirmed on endoscopy. Immunohistochemistry of biopsies revealed that the former was composed of poorly differentiated gastric cancer cells, while the latter were breast cancer metastases. Distal gastrectomy was performed. Pathological evaluation of the resected specimen revealed gastric adenocarcinoma in the pyloric lesion and breast countless cancer metastases throughout the remainder of the stomach, with positive margins. One lymph node had evidence of both stomach cancer and breast cancer metastases, forming a collision tumor. Despite a successful surgery, the patient died 6 months later due to progression of breast cancer. Conclusion We report a case of synchronous primary gastric adenocarcinoma and gastric metastases of breast cancer. Inter-disciplinary collaboration is crucial in determining the optimal treatment in double cancers.

ntroduction. Gastric cancer remains one of the most common malignant neoplasms. In the world, including Russia, high incidence rates and low efficacy rates of long-term treatment outcomes remain. The use of neoadjuvant therapy is now increasingly seen as a standard therapy approach for locally advanced gastric cancer and cardioesophageal junction. Materials and methods. This work presents the results of treatment using a new method – combined treatment of locally advanced stomach cancer (neoadjuvant chemoradiotherapy in the regime of accelerated hyperfraction with daily dose splitting up to SOD 46 Gy against the background of modified polychemotherapy according to the Xelox scheme). The structure of the development of locoregional relapses and metastases, the indicators of overall and relapse-free survival, depending on various clinical and morphological factors, were described. In total, the results were analyzed in 43 patients diagnosed with gastric cancer. Results and discussion. At the time of this analysis, 22 patients died, 21 patients continued to be observed or were lost from the observation. Life expectancy ranged from 6.1 to 122 months. According to the multivariate analysis, two factors were identified that have a statistically significant independent effect on overall survival: the macroscopic type of growth according to Borrmann (P≤0.009) and the degree of therapeutic pathomorphism (P≤0.015). In 3 cases, a complete therapeutic tumor pathomorphism was registered. Patients continue observation for up to 6 years. Local recurrence was not detected in any case. Regional recurrence was detected and morphologically confirmed in one patient. Peritoneal metastases, the development of which more often occurred in the case of low-grade forms of gastric cancer, were observed in 12 cases. Conclusion. All in all, the annual survival rate was 80.5 ± 6.2%, three-year 55.5 ± 7.8%, and five-year 45.0 ± 7.9%. The results show that combined treatment of locally advanced gastric cancer, using a new technique of neoadjuvant chemoradiotherapy, contributes to an increase in overall and relapse-free survival.

Background HLX02 is an approved biosimilar of trastuzumab. Objective This study aimed to evaluated the efficacy, safety, and immunogenicity of HLX02 compared with reference trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive recurrent or metastatic breast cancer. Patients and Methods This randomized, double-blind, phase III study was conducted at 89 centers in China, the Philippines, Poland, and Ukraine. Eligible patients were randomized (1:1) to receive HLX02 or European Union (EU)-sourced trastuzumab (initial dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks for up to 12 months) in combination with docetaxel intravenously. The primary endpoint was overall response rate up to week 24 (ORR24). Equivalence was declared if the 95% confidence interval (CI) of difference was within ± 13.5%. Safety and immunogenicity were evaluated in patients who received at least one dose of study medication. Results Between 11 November 2016 and 10 July 2019, a total of 649 patients were enrolled. The ORR24 was 71.3 and 71.4% in the HLX02 (n = 324) and EU-trastuzumab (n = 325) groups, with a difference of − 0.1% (95% CI − 7 to 6.9), which fell entirely in the predefined equivalence margins. No statistically significant differences were observed in all secondary efficacy analyses. Safety profiles and immunogenicity were comparable in HLX02 and EU-trastuzumab groups. In total, 98.8% of patients in each group experienced at least one treatment-emergent adverse event (TEAE), 23.8 and 24.9% experienced serious TEAEs, and 0.6% in each group had antidrug antibodies. Conclusions Among patients with HER2-positive recurrent or metastatic breast cancer, HLX02 demonstrated equivalent efficacy and similar safety and immunogenicity to reference trastuzumab. Clinical Trial Registration Chinadrugtrials.org CTR20160526 (12 September 2016), ClinicalTrials.gov NCT03084237 (20 March 2017), EudraCT 2016-000206-10 (27 April 2017). Supplementary Information The online version contains supplementary material available at 10.1007/s40259-021-00475-w., Plain Language Summary Trastuzumab is a biologic drug used to treat patients with certain types of breast cancer and stomach cancer. Biosimilars are medications that are almost identical to and indistinguishable from original biologic drugs but usually less expensive and more accessible. The main purpose of this study was to evaluate the efficacy (treatment effects) of HLX02 (trastuzumab biosimilar) compared with reference trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive recurrent or metastatic breast cancer. Other objectives were to evaluate the safety of HLX02 by monitoring adverse events and assessing its potential to induce antibody production (which can prevent a drug from being effective). Patients with HER2-positive recurrent or metastatic breast cancer were randomly allocated to receive HLX02 (n = 324) or European Union (EU)-sourced trastuzumab (n = 325). Study drugs (HLX02 or EU-trastuzumab) were given intravenously, with an initial dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks for up to 12 months. Statistical analyses showed that HLX02 was equivalent to trastuzumab in efficacy evaluations. Adverse events observed in the HLX02 treatment group were consistent with those seen with trastuzumab in the current and previous clinical studies. Additionally, no statistically significant differences were seen in the tendency to stimulate antibody production between the two study drugs. To conclude, HLX02 and reference trastuzumab had similar efficacy and safety profiles. These data support the approval of HLX02 as a trastuzumab biosimilar. Supplementary Information The online version contains supplementary material available at 10.1007/s40259-021-00475-w.

Purpose of the study. Demonstrate the possibilities of statistical analysis of the digital archive at pathological department (PD). To conduct internal quality control of the coding of malignant tumors according to the ICD-O-3 system of pathology reports using the example of gastric cancer (GC).Materials and methods. We retrospectively analyzed the digital archive of 368,157 pathology reports of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2000 to 2019. For the study, 4,857 pathology reports of patients operated for gastric malignancies (ICD-X codes: C16.0 – C16.9) were selected for the period from 2000 to 2019.Results. The analysis of 368,157 protocols of the digital archive of PD revealed 4,614 malignant epithelial tumors of the stomach: tubular adenocarcinoma – 2,958, signet ring cell carcinoma – 791, undifferentiated cancer – 565, mucinous adenocarcinoma – 210, neuroendocrine neoplasia – 90. A significant increase in the ICD-O codes for "adenocarcinoma NOS" was found in 2018 and 2019. The pathology reports for these 2 years were reviewed by an independent pathologist and changes were made to the ICD-O codes according to the WHO classification digestive system tumors 2019. The adenocarcinoma NOS (8140/3) was replaced by the codes: tubular adenocarcinoma (ICD-O: 8211/3) – 41%, papillary adenocarcinoma (8260/3) – 9% and adenocarcinoma with mixed subtypes (8255/3) – 29%.Conclusion. The study, based on analysis of coding ICD-O stomach MN demonstrated the importance of digital archive at the PD, as a tool for rapid static analysis pathology reports and quality control of coding. The coding system can be the basis for large multicenter studies in oncology. Therefore, it is important to control the quality of coding of the pathology reports and to timely update the codes when new pathological classifications are released.

The study and analysis of the treatment outcomes were carried out in 69 patients aged from 40 to 85 years (mean age 53.0±1.0) who had tumours of the body or cardiac part of the stomach T3-4 (according to the UICC classification (ninth edition, 2014)). The distribution of patients according to the localization of tumour lesions in the stomach was as follows: 43 (62.3%) cases found in the body region and 22 (31.9%) found in the proximal section (of which 14 (20 3%) were in the cardia (Type III according to Siewert J.R.), 8 (11.6%) patients had the transition to the abdominal oesophagus (type II according to Siewert JR), 4 (5.8%) patients had the tumour located in the stump of the resected organ. Histologically, the vast majority of neoplasms were represented by adenocarcinoma (94.8%). All other types of tumours made up for 5.2%. The patients received photodynamic therapy with the Photolon photosensitizer and subsequent irradiation with a laser with a wavelength λ = 0.67 μm crossed irradiation fields, which was introduced through the biopsy channel of the endoscope. The light dose and the number of irradiation sessions were determined depending on the degree of damage to the oesophagus and stomach (from 4 to 7 sessions). The light dose of the session was up to 200 J. The power density of the laser radiation is 25 mW/cm2. Endoscopic photodynamic therapy can be used at the stage of combined treatment in combination with chemotherapy and surgery and is an effective means of preventing the failure of the oesophageal-small intestinal anastomosis in the early postoperative period. Due to photodynamic therapy in the preoperative period, the number of complications in the early postoperative period has significantly decreased. The leakage of the oesophageal-intestinal anastomosis developed in 4 cases, which make up 5.8%.

Like other cancer, Stomach cancer is also a life-threatening disease. It is the result of uncontrolled cell growth in the inner lining of the stomach. The condition is often unrecognizable in the early stages as its symptoms are similar to other diseases like gastritis and ulcer. This article stresses on the different points of stomach cancer & its risk factor, symptomatology, investigation in a concise manner & also emphasizes how Homoeopathy manages in such cases by its holistic approach of treatment. Stomach cancer; Ulcer; Homoeopathy; Helicobacter pylori; Similimum

Objective: Remnant Gastric Cancer (RGC) describes cancers occurring in the remaining stomach and/or anastomosis in the follow-up after gastric cancer or benign gastric surgery. RGC is diagnosed in esophago-gastroscopy follow-ups of patients who underwent this surgery in the past. Again, the increase in the success of gastric cancer surgery and following medical treatments has increased the incidence of RGC in long-term follow-up after gastric cancer surgery. Laparoscopic surgery has been also reported in few cases. In the present study, the purpose was to present the results of the first five patients that underwent laparoscopic total gastrectomy due to RGC in our clinic. Material and Methods: The patients who underwent laparoscopic gastric cancer surgery between November 2014 and December 2018 were evaluated retrospectively. Results: Mean age of the patients was 62.4 years (ranging between 49 and 74 years). Two of these patients had a surgical history due to gastric cancer and 3 due to peptic ulcer. Surgery was completed laparoscopically in all patients. In the early period, one patient had to undergo re-surgery due to stenosis in Jejuno-Jejunostomy, and the patient died. One patient underwent laparotomy due to colonic stenosis in the second month after the surgery. Recurrence was detected on the 140th and 180th days of follow-up in the other two patients. Conclusion: Laparoscopic surgery is a technically applicable method in RGC; however, it is also a risk factor for past surgical postoperative complications. Early recurrence in this group of patients requires a comparison of open and laparoscopic surgery.

Accurate preoperative nodal staging is critical in determining the appropriate therapy and prognosis for stomach cancer. A staging computed tomography should inform the treating surgeon about the nodal burden to decide the appropriate surgical plan or perioperative chemotherapy. Nodal staging is also a powerful predictor of the outcome of surgery and overall survival. Imaging of nodes is also important in the assessment of response following the chemotherapy. In this article, we will discuss lymphatic drainage of stomach and different nodal stations, identification of nodal stations on cross sectional imaging, and different types of surgical nodal clearance for gastric cancer.

Helicobacter pylori (H. pylori) is a Gram-negative, helically shaped flagellated bacterium. Major diseases associated with H. pylori infection include peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The incidence of H. pylori in the anatomotopographic regions of the stomach, such as antrum, corpus, fundus, and incisura angularis, has been investigated. Do the rates of H. pylori in the settlements change over time according to the age ranges of the hosts? Does this change affect the diseases caused by or related to H. pylori? It is estimated that the outcomes, which have been obtained, may provide a new perspective in terms of understanding the etiopathogenesis of H. pylori-induced diseases. A comprehensive literature search of PubMed/MEDLINE databases had been conducted using a combination of terms, "Helicobacter pylori," "Sydney System," "stomach," "pyloric antrum," "gastric corpus," "stomach cancer," and "Helicobacter pylori and age." There are very few articles examining the relationship between the topographic locations of H. pylori and host age range in the English language literature. Therefore, it is also purposed to emphasize the outcomes of our current research about the mentioned topic. In our opinion, similar studies should reveal the settlement and age range in the different geographic locations and societies as in our study. We believe that these findings will contribute to the efforts for understanding overtly of H. pylori-induced disease of the stomach.

The possibilities of performing simultaneous surgery for synchronous colon and stomach cancer in a 77-year-old patient are presented

The study of anthropometric and bioimpedance parameters in assessing the physical development of patients helps to clarify the diagnosis, predict the course of the disease, and identify groups of increased risk for the development of the disease. The aim of this study was to identify anthropometric and bioimpedance metrics in patients with stomach cancer. Anthropometric and bioimpedansometric examination of 250 patients with verified gastric cancer, 123 men and 127 women was carried out. As a comparison group, the study used the results of anthropometric and bioimpedance measurements of healthy 221 men and 267 women of the same age in the Krasnoyarsk Territory population. To determine a set of anthropometric and bioimpedansometric variables, allowing to classify the observed people depending on the presence (group of patients with gastric cancer) or the absence of stomach cancer (group of healthy people), the method of discriminant analysis was applied. To test the hypothesis about the homogeneity of the covariance matrices of the compared groups, the multidimensional Box M-criterion was used. The statistical significance of the power of the discriminant function was assessed using the Wilks test. For each discriminant function, the role of its components was assessed by comparing the matrices of total variances and covariances using the F-test. Shoulder diameter for men and women, chest diameter (transverse size) for men and women, waist circumference for men, waist / hip ratio for men and women; lean mass in men, total fluid in men, fat mass in women, phase angle in men and women are statistically significantly different in the observed groups. The developed discriminant models with an accuracy of 75-77% suggest the presence of gastric cancer in patients and can be used in clinical practice at the stage of general medical examination in groups at increased risk of developing the disease.

In the Russian Federation, more than 600 thousand new cases of cancer are registered annually, of which stomach cancer is 7.3%. Unfortunately, most of them are still being diagnosed at a later stage. This is due to the fact that residents of the country are not sufficiently informed about the availability of free screening programs. The purpose of our study is to analyze the clinical and anamnestic parameters and data from the «GastroPanel» among the adult population of the Krasnoyarsk Territory for non-invasive diagnosis of gastritis and screening of early gastric cancer. Material and research methods. The paper presents the results of a comprehensive clinical and laboratory study of practically healthy volunteers, patients with chronic atrophic gastritis (CAG) and stomach cancer (GC) I-II st. The study was carried out from June 2019 to September 2019, with the permission of the local ethics committee of the Federal Research Center of the FRC KSC SB RAS The results of our study revealed that patients aged 45 years and older, suffering from pain in the epigastric region and dyspepsia, with a history of stomach diseases, with signs of atrophy according to the results of the serum pepsinogen test, are at risk of developing early gastric cancer. This approach will identify a significant part of precancerous conditions among the population for their further thorough examination.