China is a country with high incidence of gastric cancer, most of which are advanced gastric cancer, accounting for about half of the new cases in the world. Environmental factors play a crucial role in the occurrence and development of gastric cancer. Helicobacter pylori and Epstein Barr virus(EBV) infection have been confirmed as one of the important pathogenic factors of gastric cancer. With the development and application of molecular biology and sequencing technology, molecular typing based on patient genetic characteristics has been proposed to guide accurate treatment and predict prognosis. Surgery is the cornerstone of gastric cancer treatment. Laparoscopy has been developing rapidly in the past 20 years on account of its clinical application advantages such as minimally invasive and magnified visual field and refined anatomy, making it one of the standard treatment options for early gastric cancer, with its indications for the treatment of gastric cancer continuously expanding. The application of endoscopic treatment and reduction surgery for early gastric cancer further improves the quality of life of patients, and surgical treatment of gastric cancer tends to be precise and minimally invasive. The comprehensive treatment of surgery combined with radiotherapy and chemotherapy is a standard treatment of local advanced gastric cancer. The exploration of related drugs and treatment models is the current research hotspot, and the development and application of targeted therapy and immunotherapy provide more choices in this field. The treatment of advanced gastric cancer is focused on the exploration of chemotherapy, targeted therapy and immunotherapy. Some studies have shown good prospects and provided more opportunities for conversion therapy. This article will share the new developments in the field of gastric cancer research in 2018.
China ; epidemiology ; Combined Modality Therapy ; Epstein-Barr Virus Infections ; complications ; Helicobacter Infections ; complications ; Helicobacter pylori ; Herpesvirus 4, Human ; Humans ; Laparoscopy ; Prognosis ; Stomach Neoplasms ; epidemiology ; etiology ; pathology ; therapy

BACKGROUND/AIMS: Controversy exists regarding the characteristics of Helicobacter pylori infection-negative gastric cancer (HPIN-GC). The aim of this study was to evaluate clinicopathologic features of HPIN-GC compared to H. pylori infection-positive gastric cancer (HPIP-GC) using a comprehensive analysis that included genetic and environmental factors. METHODS: H. pylori infection status of 705 resectable gastric cancer patients was determined by the rapid urease test, testing for anti-H. pylori antibodies, histologic analysis and culture of gastric cancer tissue samples, and history of H. pylori eradication. HPIN-GC was defined as gastric cancer that was negative for H. pylori infection based on all five methods and that had no evidence of atrophy in histology or serology. RESULTS: The prevalence of HPIN-GC was 4% (28/705). No significant differences with respect to age, sex, smoking, drinking, family history of gastric cancer or obesity were observed between the two groups. HPIN-GC tumors were marginally more likely to involve the cardia (14.3% for HPIN-GC vs 5.3% for HPIP-GC, p=0.068). The Lauren classification, histology, and TNM stage did not differ according to H. pylori infection status. Microsatellite instability was not different between the two groups, but p53 overexpression in HPIN-GC was marginally higher than in HPIP-GC (56.0% for HPIN-GC vs 37.0% for HPIP-GC, p=0.055). CONCLUSIONS: The prevalence of HPIN-GC was extremely low, and its clinicopathologic characteristics were similar to HPIP-GC.
Antibodies, Bacterial/analysis ; Female ; Helicobacter Infections/*complications/epidemiology/microbiology ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Stomach Neoplasms/epidemiology/*microbiology/*pathology/surgery ; Urease/analysis

Helicobacter pylori can cause variety of upper gastrointestinal disorders such as peptic ulcer, mucosa associated lymphoid tissue (MALT)-lymphoma, and gastric cancer. The prevalence of H. pylori infection has significantly decreased in Korea since 1998 owing to active eradication of H. pylori. Along with its decrease, the prevalence of peptic ulcer has also decreased. However, the mean age of gastric ulcer increased and this is considered to be due to increase in NSAID prescription. Gastric cancer is one of the leading causes of cancer deaths in Korea and Japan, and IARC/WHO has classified H. pylori as class one carcinogen of gastric cancer. Despite the decreasing prevalence of H. pylori infection, the total number of gastric cancer in Korea has continuously increased from 2006 to 2011. Nevertheless, the 5 year survival rate of gastric cancer patients significantly increased from 42.8% in 1993 to 67% in 2010. This increase in survival rate seems to be mainly due to early detection of gastric cancer and endoscopic mucosal dissection treatment. Based on these findings, the prevalence of peptic ulcer is expected to decrease even more with H. pylori eradication therapy and NSAID will become the main cause of peptic ulcer. Although the prevalence of gastric cancer has not changed along with decreased the prevalence of H. pylori, gastric cancer is expected to decrease in the long run with the help of eradication therapy and endoscopic treatment of precancerous lesions.
Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Gastrointestinal Diseases/complications/*epidemiology ; Helicobacter Infections/complications/drug therapy/epidemiology ; Humans ; Lymphoma, B-Cell, Marginal Zone/epidemiology ; Peptic Ulcer/epidemiology/etiology ; Prevalence ; Stomach Neoplasms/etiology/mortality/pathology

OBJECTIVETo study the role of Helicobacter pylori (H. pylori) infection in newly diagnosed childhood immune thrombocytopenia (ITP).

METHODSA total of 495 children with newly diagnosed ITP who were hospitalized for the first time between January 2011 and December 2013 were included as the case group. A total of 123 children with common respiratory tract infection (not ITP or other diseases of blood system) were randomly selected as the control group. All patients were divided into four groups by age: <1 year group, 1-3 years group, 3-7 years group, and 7-14 years group. The incidence of H. pylori infection in all age groups and the clinical outcomes of ITP children with or without H. pylori infection were retrospectively analyzed.

RESULTSThe incidence rate of H. pylori infection in the case group increased with increasing age. There was no significant difference in the incidence rate of H. pylori infection between the case and the control groups among subjects of the same age (P>0.05). All the ITP patients were not given anti-H. pylori treatment and only received the treatment (glucocorticoid and/or immunoglobulin) for ITP, and their remission rate declined with increasing age. There was no significant difference in the remission rate between the ITP children with H. pylori infection and those without H. pylori infection in the same age group (P>0.05).

CONCLUSIONSH. pylori infection may not be a major cause of ITP in children, and the clinical outcomes of children with acute ITP are not affected by receiving anti-H. pylori treatment or not.

Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Helicobacter Infections ; complications ; epidemiology ; Helicobacter pylori ; Humans ; Incidence ; Infant ; Male ; Purpura, Thrombocytopenic, Idiopathic ; etiology

BACKGROUND/AIMS: The connection between Helicobacter pylori and complicated peptic ulcer disease in peptic ulcer bleeding (PUB) patients taking nonsteroidal anti-inflammatory drugs has not been established. In this study, we sought to determine whether delayed H. pylori eradication therapy in PUB patients increases complicated recurrent peptic ulcers. METHODS: We identified inpatient PUB patients using the Taiwan National Health Insurance Research Database. We categorized patients into early (time lag < or =120 days after peptic ulcer diagnosis) and late H. pylori eradication therapy groups. The Cox proportional hazards model was used. The primary outcome was rehospitalization for patients with complicated recurrent peptic ulcers. RESULTS: Our data indicated that the late H. pylori eradication therapy group had a higher rate of complicated recurrent peptic ulcers (hazard ratio [HR], 1.52; p=0.006), with time lags of more than 120 days. However, our results indicated a similar risk of complicated recurrent peptic ulcers (HR, 1.20; p=0.275) in time lags of more than 1 year and (HR, 1.10; p=0.621) more than 2 years. CONCLUSIONS: H. pylori eradication within 120 days was associated with decreased complicated recurrent peptic ulcers in patients with PUB. We recommend that H. pylori eradication should be conducted within 120 days in patients with PUB.
Adult ; Aged ; Female ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Patient Readmission/*statistics & numerical data ; Peptic Ulcer/complications/*epidemiology/microbiology ; Peptic Ulcer Hemorrhage/complications ; Proportional Hazards Models ; Recurrence ; Time-to-Treatment/*statistics & numerical data ; Treatment Outcome ; Young Adult

Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. There are, however, distinct differences in incidence rates in different geographic regions. While the incidence rate of gastric cancer has been falling, that of gastric cardia cancers is reportedly on the rise in some regions. Helicobacter pylori (H. pylori) infection is a major risk factor of non-cardia gastric cancer, and data has emerged concerning the role of H. pylori eradication for primary prevention of gastric cancer. Dietary, lifestyle and metabolic factors have also been implicated. Although addressing these other factors may contribute to health, the actual impact in terms of cancer prevention is unclear. Once irreversible histological changes have occurred, endoscopic surveillance would be necessary. A molecular classification system offers hope for molecularly tailored, personalised therapies for gastric cancer, which may improve the prognosis for patients.
Female ; Global Health ; Helicobacter Infections ; complications ; prevention & control ; Helicobacter pylori ; Humans ; Incidence ; Male ; Obesity ; complications ; Risk Factors ; Stomach Neoplasms ; epidemiology ; genetics ; microbiology ; prevention & control

Helicobacter pylori (Hp) is a high prevalence of chronic infectious pathogens, though not necessarily lead to symptoms, but it can affect the immune system. More than of the world's population harbors the bacterium, and most adult Hp infection was obtained in childhood. Hp infection is a major cause of peptic ulcer, although children rarely suffer from peptic ulcer disease. Hp infection is closely related to chronic gastritis, dyspepsia, chronic diarrhea and recurrent abdominal pain in children. In recent years, Hp infection may also participate in some of non-digestive diseases, such as children's nutritional iron deficiency anemia, growth retardation, malnutrition, autoimmune idiopathic thrombocytopenic purpura, chronic urticaria, as well as the development of adult atherosclerosis-related cardiovascular diseases and some nervous system diseases. Hp infection can be a lifetime issues of children. Hp infection of children will bring many socio-economic problems. In this paper, the correlation of Hp infection in stomach and oral cavity, and diagnostic technology, prevention as well as treatment strategies for Hp infection will be discussed.
Helicobacter Infections ; complications ; diagnosis ; epidemiology ; genetics ; Helicobacter pylori ; Humans ; Mouth ; microbiology ; Stomach ; microbiology

OBJECTIVETo investigate the effect of Helicobacter pylori (Hp) eradication therapy on prognosis in children with Henoch-Schonlein purpura (HSP).

METHODSA total of 153 children with HSP were divided into Hp infection treatment group (n=22), Hp infection control group (n=21), and Hp infection-negative group (n=110). The Hp infection treatment group received one-week triple therapy for Hp eradication in addition to conventional treatment, while the Hp infection control group and Hp infection-negative group received conventional treatment. All patients were followed up for prognostic evaluation.

RESULTSThe response rates of the Hp infection treatment, control, and negative groups were 86% (19/22), 90% (19/21) and 85% (94/110), respectively (P>0.05). The recurrence rates of HSP in the Hp infection treatment, control, and negative groups were 14% (3/22), 24% (5/21) and 31% (34/110), respectively (P>0.05). The incidence of Henoch-Schonlein purpura nephritis (HSPN) in the Hp infection-negative group (36%, 40/110) and control group (33%, 7/21) was significantly higher than that in the Hp infection treatment group (5%, 1/22) (P<0.05 for both), but no significant difference in the incidence of HSPN was found between the control and negative groups (P>0.05).

CONCLUSIONSOne-week triple therapy for Hp eradication may be useful to reduce the incidence of HSPN in children with HSP infected with Hp.

Child ; Child, Preschool ; Female ; Helicobacter Infections ; complications ; drug therapy ; Helicobacter pylori ; Humans ; Incidence ; Male ; Prognosis ; Purpura, Schoenlein-Henoch ; epidemiology ; etiology ; Recurrence

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B12 deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%), followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.
Adult ; Aged ; Anemia, Pernicious/complications/*diagnosis/epidemiology ; Asian Continental Ancestry Group ; Autoimmune Diseases/complications/epidemiology ; Female ; Gastrointestinal Diseases/complications/drug therapy/epidemiology ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans ; Isoantibodies/blood ; Male ; Middle Aged ; Nervous System Diseases/complications/epidemiology ; Parietal Cells, Gastric/immunology ; Republic of Korea/epidemiology ; Retrospective Studies ; Vitamin B 12/blood/therapeutic use

BACKGROUND/AIMS: Current international guidelines recommend colorectal cancer screening for average-risk people over 50 years of age. Accordingly, we aimed to estimate the prevalence of colorectal neoplasms in all age groups and evaluate associated risk factors. METHODS: Data of 14,932 subjects who underwent colonoscopy from July 2006 to January 2012 at Health Promotion Center, Gangnam Severance Hospital (Seoul, Korea) as part of a health check-up were reviewed retrospectively. RESULTS: The overall prevalence of colorectal neoplasms and adenoma were 34.6% and 25.3%, respectively. Colorectal adenoma was found in 3.2%, 13.0%, 21.7%, 33.8%, 44.0%, 50.5%, and 54.2% of subjects under 30 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and over 80 years of age (trend p<0.0001). Independent predictors of colorectal adenoma included male gender (OR 2.38, 95% CI 2.084-2.718), positive occult blood (2.266, 1.761-2.917), positive serology of Helicobacter pylori (1.253, 1.114-1.409) and hypertriglyceremia (1.267, 1.065-1.508). Compared to the 30-39 years of age reference group, the ORs for each age group were 0.195 (under 30 years), 1.634 (40-49 years), 2.954 (50-59 years), 5.159 (60-69 years), 5.640 (70-79 years), 11.020 (over 80 years), while the 95% CIs were 0.071-0.536 (under 30 years), 1.340-1.992 (40-49 years), 2.421-3.604 (50-59 years), 4.109-6.476 (60-69 years), 3.822-8.322 (70-79 years), and 2.809-42.234 (over 80 years). CONCLUSIONS: Colorectal adenoma prevalence increased proportionally with age. Only subjects under the age of 30 years had a definitely lower prevalence of colorectal adenoma. Male gender, positive occult blood, positive serology of H. pylori, and hypertriglyceremia were associated risk factors of colorectal adenoma.
Adenoma/*epidemiology/etiology ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Colonoscopy ; Colorectal Neoplasms/*epidemiology/etiology ; Female ; Helicobacter Infections/complications ; Helicobacter pylori ; Humans ; Hypertriglyceridemia/complications ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Factors