1.Progress in clinical diagnosis and treatment for gastric polyps.
Journal of Central South University(Medical Sciences) 2020;45(1):74-78
Gastric polyps are common precancerous diseases. With the intensive study on the characteristics of different types of gastric polyps in recent years, only 1.7% of the gastric polyps were found to have dysplasia and cancer, and most of the dysplasia and cancer were found in polyps larger than 1 cm. Traditional idea suggests that polyps should be removed immediately, but routine removal of all polyps results in an increased financial burden on patients. At present, there are controversies about whether endoscopic treatment is necessary for different pathological types and small gastric polyps.
Humans
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Hyperplasia
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Polyps
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Precancerous Conditions
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Stomach Neoplasms
3.Agreement evaluation of the severity of oral epithelial dysplasia in oral leukoplakia.
Jia Kuan PENG ; Hong Xia DAN ; Hao XU ; Xin ZENG ; Qianming CHEN
Chinese Journal of Stomatology 2022;57(9):921-926
Objective: To evaluate the inter-observer agreement of the severity of oral epithelial dysplasia in oral leukoplakia, providing a theoretical basis for the development of a more objective grading system. Methods: This study included 60 digital pathological slides of oral leukoplakia from Oral Medicine Department of West China Hospital of Stomatology, Sichuan University, and 239 tissue microarray images of oral leukoplakia from State Key Laboratory of Oral Diseases, Sichuan University, to evaluate the agreement of grading. Besides, 1 000 patches were generated from the 60 digital pathological slides and were divided into 500 small-sized patches (224 pixel×224 pixel) and 500 large-sized patches (1 024 pixel×1 024 pixel), to evaluate the agreement of feature detection. Gradings and feature detections were completed by three pathological experts from the oral pathology departments of two Grade 3, Class A stomatological hospitals in China. Kappa coefficient was used to quantify the inter-observer agreement among pathologists. Results: Minimal agreement was found in the grading of oral epithelial dysplasia among pathologists (Kappa=0.30 in the pathological slide group, Kappa=0.30 in the tissue microarray group). None agreement was found in feature detection within the small-sized patches group (median Kappa=0.14 for architectural features, median Kappa=0.18 for cytological features), and minimal agreement was found in feature detection within the large-sized patches group (median Kappa=0.25 for architectural features, median Kappa=0.25 for cytological features). Conclusions: Generally, the agreement of grading and feature detection of oral epithelial dysplasia in oral leukoplakia is poor. Development of a more objective grading system of oral epithelial dysplasia based on artificial intelligence may be helpful to improve the agreement.
Artificial Intelligence
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China
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Humans
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Leukoplakia, Oral
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Observer Variation
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Precancerous Conditions
4.Decreased Esophageal Sensitivity to Acid in Morbidly Obese Patients: A Cause for Concern?.
Vicente ORTIZ ; Diego ALVAREZ-SOTOMAYOR ; Esteban SÁEZ-GONZÁLEZ ; Francia Carolina DÍAZ-JAIME ; Marisa IBORRA ; Julio PONCE ; Vicente GARRIGUES
Gut and Liver 2017;11(3):358-362
BACKGROUND/AIMS: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. METHODS: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non-MO patients with a prior diagnosis of abnormal esophageal acid exposure. RESULTS: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0.006; 95% confidence interval [CI], 0.001 to 0.075; p=0.000). MO patients were more likely to present with decreased esophageal sensitivity to the instillation of acid than non-MO controls (57% vs 14%; OR, 8; 95% CI, 1.79 to 35.74; p=0.009). Subgroup analysis revealed no differences in esophageal sensitivity in MO patients with and without abnormal esophageal acid exposure (43% vs 31%; p=0.707). CONCLUSIONS: Silent gastroesophageal reflux disease (GERD) is common among MO individuals, likely due to decreased esophageal sensitivity to acid. The absence of typical GERD symptoms in these patients may delay discovery of precancerous conditions, such as Barrett’s esophagus. We believe that these patients may require a more aggressive diagnostic work-up to rule out the presence of silent GERD.
Cross-Sectional Studies
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Diagnosis
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Esophagus
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Gastroesophageal Reflux
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Humans
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Hydrochloric Acid
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Obesity
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Odds Ratio
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Precancerous Conditions
7.Status, Challenges, and Prospects of Treating Chronic Atrophic Gastritis by Chinese Medical Diagnosis and Treatment.
Wei WEI ; Yang YANG ; Hai-xia SHI
Chinese Journal of Integrated Traditional and Western Medicine 2015;35(12):1424-1426
Chronic atrophic gastritis (CAG), a chronic disease of the digestive system resulting from multi-pathogenic factors, is precancerous state of gastric cancer. Authors reviewed the current situation of Chinese medical diagnosis and treatment of CAG, and looked forward to its prospect by combining with their own clinical experience and scientific researches.
Chronic Disease
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Gastritis, Atrophic
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diagnosis
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therapy
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Humans
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Medicine, Chinese Traditional
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Precancerous Conditions
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Stomach Neoplasms