• Clinical Endoscopy
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• v.57 no.1
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• pp.11-17
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• 2024

Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer. Histological diagnosis of gastric cancer using artificial intelligence is also promising. However, previous studies on the use of artificial intelligence to diagnose gastric cancer were small-scale; thus, large-scale studies are necessary to examine whether a high diagnostic performance can be achieved. In addition, the diagnosis of gastric cancer using artificial intelligence has not yet become widespread in clinical practice, and further research is necessary. Therefore, in the future, artificial intelligence must be further developed as an instrument, and its diagnostic performance is expected to improve with the accumulation of numerous cases nationwide.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6031-6034
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• 2013

This study describes recent trends in incidence, survival and prevalence of subgroups of esophageal and gastric cancer in Linzhou city between 2003 and 2009. Data of esophageal and gastric cancer for the period of interest were extracted from the Linzhou Cancer Registry. Using information on tumor morphology or anatomical site, data were divided into six groups; esophageal squamous cell carcinoma, esophageal adenocarcinoma, other and unspecified types of esophageal cancer, and cardia, non-cardia, and unspecified anatomical site of stomach cancer. Incidence, survival and prevalence rates for each of the six cancer groups were calculated. The majority of esophageal cancers were squamous cell carcinomas (82%). Cardiac cancer was the major gastric cancer group (64%). The incidence of esophageal squamous cell carcinoma and gastric cardiac cancer increased between 2003 and 2009. Both esophageal and gastric cancer had a higher incidence in males compared with females. Overall survival was poor in all sub-groups with 1 year survival ranging from 45.9 to 65.6% and 5 year survival ranging from 14.7 to 30.5%. Prevalence of esophageal squamous cell carcinoma and gastric cardiac cancer was high (accounting for 80% overall). An increased focus on prevention and early diagnosis, especially in esophageal squamous cell carcinoma and gastric cardiac cancer, is required.

• Journal of Gastric Cancer
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• v.20 no.2
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• pp.165-175
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• 2020

Purpose: The guidelines for pathological evaluation of early gastric cancer (EGC) recommend wider section intervals for surgical specimens (5-7 mm) than those for endoscopically resected specimens (2-3 mm). Studies in surgically resected EGC specimens showed not negligible lymph node metastasis risks in EGCs meeting the expanded criteria for endoscopic submucosal dissection (ESD). Materials and Methods: This retrospective study included 401 EGC lesions with an endoscopic size of ≤ 30 mm detected in 386 patients. Pathological specimens obtained by ESD or surgery were cut into 2-mm section intervals for reference. Submucosal or lymphovascular invasion (LVI) was evaluated arbitrarily in 4- or 6-mm section intervals. McNemar's tests compared the differences between submucosal and LVI. Results: Submucosal invasion was detected in 29.2% (117/401) and LVI in 9.5% (38/401) at 2-mm interval. The submucosal invasion detection rates in 4-mm intervals decreased to 88.0% or 90.6% (both P<0.001), while the LVI detection rates decreased to 86.8% or 57.9% (P=0.025 and P<0.001, respectively). In 6-mm intervals, the submucosal and LVI detection rates decreased further to 72.7-80.3% (P<0.001 for all three sets) and 55.3-63.2% (P<0.001 for all three sets), respectively. Among 150 out-of-indication cases at 2-mm interval, 4-10 (2.7%-6.7%) at 4-mm intervals, and 10-17 (6.7%-11.3%) at 6-mm intervals were misclassified as lesions meeting the curative resection criteria due to the underestimation of submucosal or LVI. Conclusions: After ESD, the 2-mm wide section interval was suitable for the pathological evaluation of focal submucosal or LVI. Thus, if an EGC lesion meets the expanded criteria for the ESD specimen pathological evaluation, it could be safely followed up.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5677-5679
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• 2012

Background and Aim: Gastric cancer is the second most common cancer worldwide. In this study the clinical and histological features of gastric cancer in the cardia and distal stomach were evaluated. Method: Proximal and distal gastric cancer diagnosed and treated in eight provinces of Iran from 2010-2011 were reviewed in all collected cases. The age standardized incident rates were calculated and tumor location and histological type were recorded. Results: The age-standardized incidence rate for the eight centers was 40.6 per 100,000 populations per year with an upper and lower range of 22.1 and 102.4 per 100,000 population per year. Thirty four percent of the tumors were located in the cardia, 3% in fundus, and 63% in the distal stomach. In 7 provinces the prevalence of distal tumors was significantly greater than proximal tumors (p=0.006). A significant relationship was observed between diffuse form of gastric cancer and distal gastric tumors (p=0.007) and between poor tumor differentiation and distal gastric tumors (p<0.001). Conclusions: the result of this study shows that distal gastric cancer is more common than proximal gastric cancer in Iran.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10565-10571
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• 2015

Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trials have provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventing gastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancer mortality following the implementation of programs to detect early stage gastric cancers. There are currently no clear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrant populations. However, it is likely that a proportion of US physicians are already recommending gastric cancer screening for Asian patients and some Asian immigrants to the US may be completing screening for gastric cancer in their native countries. Surveys of US primary care physicians and Asian American communities should be conducted to assess current provider practices and patient uptake with respect to gastric cancer prevention and control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groups could consider a shared decision-making approach to helicobacter pylori identification and eradication, as well as gastric endoscopy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4821-4824
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• 2015

Gastric cancer is the 2nd most common cause of death among all cancers and is the 4th most common cancer in the world. The number of deaths due to gastric cancer is about 800,000 annually. Gastric cancer is more common in men as compared to women and is 3rd most common cancer after colorectal and breast cancers in women. A progressive rise in the incidence rate has been observed in females over the last 5 years. The highest incidence of stomach cancer is in China, South America and Eastern Europe. The incidence of gastric cancer has 20 fold variation worldwide. Global variation is linked by two factors which play important role in developing gastric cancer. One is infection with Helicobacter pylori and the $2^{nd}$ is diet. South Asia is a region with low risk, despite a high prevalence of H.pylori. Gastric carcinoma is common in southern region of India. Gastric cancer is more readily treated if diagnosed early. This study aims to provide awareness about gastric cancer as well as an updated knowledge about risk factors and epidemiology of gastric cancer in Pakistan.

• Journal of Gastric Cancer
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• v.22 no.4
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• pp.264-272
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• 2022

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted cancer screening services worldwide. We aimed to measure the impact of COVID-19 on gastric cancer screening rates based on age, sex, household income, and residential area. Materials and Methods: We analyzed data from the Korean National Cancer Screening Survey from 2017 to 2021 for adults aged 40-74 years. We evaluated the gastric cancer screening rate within two years in accordance with the National Cancer Screening Program protocol recommendations and that within the previous year. We compared the trends in the pre- and post-COVID-19 outbreak periods. Results: Before the COVID-19 outbreak, there was little change in the gastric cancer screening rates until 2019. After the COVID-19 outbreak, the screening rate as per recommendation decreased from 70.8% in 2019 to 68.9% in 2020 and that for one year decreased from 32.7% in 2019 to 27.2% in 2020. However, as the COVID-19 pandemic continued after 2020, both gastric cancer screening rates as per recommendations and for one year rebounded. Although a similar trend was observed for the upper endoscopy screening rate, the upper gastrointestinal series screening rate decreased from 7.8% in 2020 to 3.1% in 2021. During the pandemic, the screening rate decreased among younger adults (40-49), those residing in metropolitan regions, and those with high incomes. Conclusions: Despite a decline in gastric cancer screening rate during the COVID-19 pandemic, the rate surged in 2021. Further studies are needed to estimate the impact of cancer screening delays on future cancer-related mortalities.

• Journal of Gastric Cancer
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• v.15 no.3
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• pp.218-221
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• 2015

Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

• Journal of Gastric Cancer
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• v.16 no.1
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• pp.14-20
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• 2016

Purpose: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. Materials and Methods: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. Results: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. Conclusions: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

• Journal of Gastric Cancer
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• v.18 no.4
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• pp.356-367
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• 2018

Purpose: Kallikrein (KLK) proteases are hormone-like signaling molecules with critical functions in different cancers. This study investigated the expression of KLK6 in gastric cancer and its potential role in the growth, migration, and invasion of gastric cancer cells. Materials and Methods: In this study, we compared protein levels of KLK6, vascular endothelial growth factor (VEGF), and matrix metallopeptidase (MMP) 9 in normal gastric epithelial and gastric cancer cell lines by western blot. Fluorescence-activated cell sorting was employed to sort 2 clones of SGC-7901 cells with distinct KLK6 expression, namely, KLK6-high ($KLK6^{high}$) and KLK6-low ($KLK6^{low}$), which were then expanded. Lastly, immunohistochemical analysis was performed to investigate KLK6 expression in gastric cancer patients. Results: The expression levels of KLK6, VEGF, and MMP 9, were significantly higher in the gastric cancer cell lines SGC-7901, BGC-823, MKN-28, and MGC-803 than in the normal gastric epithelial cell line GES-1. Compared to $KLK6^{low}$ cells, $KLK6^{high}$ cells showed enhanced viability, colony-forming ability, migration, and invasion potential in vitro. Importantly, immunohistochemical analysis of a human gastric cancer tissue cohort revealed that the staining for KLK6, VEGF, and MMP9 was markedly stronger in the cancerous tissues than in the adjacent normal tissues. KLK6 expression also correlated with that of VEGF and MMP9 expression, as well as several key clinicopathological parameters. Conclusions: Together, these results suggest an important role for KLK6 in human gastric cancer progression.