1.Multidisciplinary experts consensus on diagnosis and treatment of precancerous lesions of hepatocellular carcinoma (2023 version).
Chinese Journal of Hepatology 2023;31(12):1250-1261
According to the latest statistical data, the incidence and mortality rate of hepatocellular carcinoma in China are still on the rise, posing a major threat to the health of the Chinese population. The occurrence is closely related to the formation of precancerous lesions in the liver. The clinical and basic research on precancerous lesions of hepatocellular carcinoma has developed rapidly, and the concepts and specific techniques for diagnosis and treatment have also undergone new changes and advancements. Therefore, based on the first version in 2020, this consensus has organized multidisciplinary experts to compile and improve a new version by integrating the latest progress in their respective professional fields at home and abroad. It aims to enhance clinicians' understanding of precancerous lesions of hepatocellular carcinoma standardize the pathology, imaging, and molecular diagnostic criteria, broaden early screening methods, formulate scientifically rational treatment plans, and help promote the advancement of diagnosis and treatment strategies and to enhance the overall 5-year survival rate of patients with hepatocellular carcinoma.
Humans
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Carcinoma, Hepatocellular/therapy*
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Consensus
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Liver Neoplasms/therapy*
;
Precancerous Conditions/therapy*
3.Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions.
Vikneswaran NAMASIVAYAM ; Calvin J KOH ; Stephen TSAO ; Jonathan LEE ; Khoon Lin LING ; Christopher KHOR ; Tony LIM ; James Weiquan LI ; Aung Myint OO ; Benjamin C H YIP ; Ikram HUSSAIN ; Tju Siang CHUA ; Bin Chet TOH ; Hock Soo ONG ; Lai Mun WANG ; Jimmy B Y SO ; Ming THE ; Khay Guan YEOH ; Tiing Leong ANG
Annals of the Academy of Medicine, Singapore 2022;51(7):417-435
Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.
Adenomatous Polyps
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Endoscopy
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Humans
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Precancerous Conditions/therapy*
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Singapore
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Stomach Neoplasms/therapy*
4.New developments for endoscopic management of Barrett's esophagus with high grade dysplasia.
Journal of Zhejiang University. Medical sciences 2010;39(5):534-541
Barrett's esophagus is now clearly recognized as a preneoplasic condition. Progression of metaplasia through dysplasia to adenocarcinoma is a widely accepted theory for esophageal carcinogenesis. That high grade dysplasia is frequently found in association with esophageal adenocarcinoma. Long-term endoscopic surveillance of high grade dysplasia in Barrett's esophagus facilitates detection and treatment of esophageal cancers in the early stage.
Barrett Esophagus
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diagnosis
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pathology
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therapy
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Esophageal Neoplasms
;
diagnosis
;
Esophagoscopy
;
Humans
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Hyperplasia
;
pathology
;
Precancerous Conditions
;
diagnosis
5.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
6.Quality evaluation of the literature on clinical randomized controlled trials of traditional Chinese medicine for treatment of gastric precancerous lesions in the past 20 years.
Qingqing ZHANG ; Di WU ; Yichen WANG ; Fengyun GUO ; Shengnan YANG ; Ping WANG
Journal of Zhejiang University. Medical sciences 2023;52(5):636-645
OBJECTIVES:
To evaluate the methodological quality of randomized controlled trials (RCTs) of traditional Chinese medicines for the treatment of gastric precancerous lesions in the past 20 years.
METHODS:
The RCTs on traditional Chinese medicines for gastric precancerous lesions were searched from the CNKI, Wanfang database, VIP, PubMed, and Embase from January 2001 to December 2021. The retrieved articles were screened, extracted and evaluated based on the 2010 edition of CONSORT statement, Cochrane Risk of Bias Assessment Scale and additional evaluation indicators.
RESULTS:
A total of 840 papers were included. According to the Cochrane Risk of Bias Assessment Scale, the high risk of bias in the application of randomized methods was 5.95%; the risk of uncertainty for the allocation scheme concealment was 98.93%; the risk of uncertainty for blinding of patients or testers was 98.69%; the risk of uncertainty for blinding of the outcome assessor was 100.00%; the risk of bias for completeness of the outcome data was 2.86%; and the risk of uncertainty for selective reporting was 98.45%. The CONSORT statement evaluating the quality of reporting showed that 100.00% of the RCT articles reported the 8 entries; 36.79% of the literature mentioned the method of randomized sequence generation, but only 27.62% of the literature mentioned who implemented the randomized program, 1.07% of the literature hid the randomized program and 1.31% of the studies were blinded; 36.67% of the literature reported adverse reactions; no literature reported sample size prediction methods. Additional evaluation indicators showed that 17.02% of the studies had ethical approval; 43.81% of the literature specified Chinese medicine evidence; 16.55% of the studies excluded severe heterotrophic hyperplasia; 7.26% of the studies conducted follow-up; and 65.12% of the literature used composite efficacy indicators; 46.67% of the literature applied pathological histological evaluation; 2.62% of the literature applied quality of life evaluation.
CONCLUSIONS
The overall risk of bias in RCTs of traditional Chinese medicines for gastric precancerous lesions is high, and the quality of most of the study reports needs to be improved. In the future, it is necessary to strengthen the study design of RCTs and refer to appropriate traditional Chinese medicines evidence grading standards, select study protocols according to different purposes, provide objective and strong evidence for clinical studies on traditional Chinese medicines, and carry out clinical study design and result reporting suitable for traditional Chinese medicines according to the CONSORT principle.
Humans
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Medicine, Chinese Traditional
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Randomized Controlled Trials as Topic
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Precancerous Conditions/drug therapy*
7.Research progress in establishment of N-methyl-N'-nitro-N-nitroso-guanidine-induced rat model of Precancerous lesion of gastric cancer.
Yu-Ting LU ; Hua-Yi LIU ; Jia-Ju SHANG ; Yi-Jia MAO ; Guang-Ze OUYANG ; Liu YANG
China Journal of Chinese Materia Medica 2021;46(16):4089-4095
Gastric cancer(GC), one of the most common malignancies worldwide, seriously threatens human health due to its high morbidity and mortality. Precancerous lesion of gastric cancer(PLGC) is a critical stage for preventing the occurrence of gastric cancer, and PLGC therapy has frequently been investigated in clinical research. Exploring the proper animal modeling methods is necessary since animal experiment acts as the main avenue of the research on GC treatment. At present, N-methyl-N'-nitro-N-nitroso-guanidine(MNNG) serves as a common chemical inducer for the rat model of GC and PLGC. In this study, MNNG-based methods for modeling PLGC rats in related papers were summarized, and the applications and effects of these methods were demonstrated by examples. Additionally, the advantages, disadvantages, and precautions of various modeling methods were briefly reviewed, and the experience of this research group in exploring modeling methods was shared. This study is expected to provide a reference for the establishment of MNNG-induced PLGC animal model, and a model support for the following studies on PLGC.
Animals
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Gastric Mucosa
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Methylnitronitrosoguanidine/toxicity*
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Precancerous Conditions/chemically induced*
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Rats
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Stomach Neoplasms/drug therapy*
9.Result of Laser Cordectomy in Early Glottic Cancer and Observation of Malignant Transformation from Precancerous Lesion.
Dongbin AHN ; Ji Hyun PARK ; Sung Jae HEO ; Chang Mook PARK ; Da Jung JUNG ; Yemo NAM ; Jin Ho SOHN ; June Sik PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2010;53(7):425-429
BACKGROUND AND OBJECTIVES: Laser cordectomy has been widely acknowledged to have advantages for the treatment of early glottic carcinoma. This study was performed to assess the results of laser cordectomy for its oncologic safeness, time-effectiveness, and to report a few interesting precancerous cases that have progressed to glottic cancer. SUBJECTS AND METHOD: Subjects (47) who had undergone laser cordectomy for the treatment of early glottic cancer from April 2006 to July 2009 were enrolled in this study. We analyzed the oncologic outcomes, the duration of hospital treatment after the surgery, and postoperative complications by reviewing of medical records. RESULTS: For 47 cases, the mean age was 66 years and the mean follow up period was 22.6 months. The mean duration of treatment was 1.9 days. Among them, 24 cases were classified into T1a, 12 T1b, and 2 T2. Local recurrence was observed in 2 cases, so salvage treatments, such as radiation therapy or near total laryngectomy, were performed, and both of them were alive in the disease-free state. The most common complication was anterior commissure web, which was observed in 6 cases (15.8%), followed by granuloma observed in 5 cases (13.1%). Serious complications such as aspiration, respiratory distress, and dysphagia were not found in any of 47 cases. Also, we could observe 3 cases in which the precancerous glottic lesion had progressed to glottic carcinoma over a long period of time. CONCLUSION: Laser cordectomy might be the treatment of choice for patient's convenience because of its excellent oncologic outcomes, low morbidity, and time-effectiveness.
Deglutition Disorders
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Follow-Up Studies
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Glottis
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Granuloma
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Laryngectomy
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Laser Therapy
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Medical Records
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Postoperative Complications
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Precancerous Conditions
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Recurrence
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Respiratory Aspiration