Chinese integrated guideline on the management of gastric precancerous conditions and lesions

Wang, Ping; Chen, Yingxuan; Li, Li; Lu, Yuanyuan; Zhou, Weixun; Bian, Li-Qun; Zhang, Beihua; Yin, Xiaolan; Li, Junxiang; Chen, Jie; Zhang, Shutian; Shi, Yongquan; Tang, Xudong

doi:10.1186/s13020-022-00677-6

Cited by 10 publications

(5 citation statements)

References 161 publications

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“…The AITonguequiry model has demonstrated an enhanced ability to detect PLGC before endoscopy. In a cross-sectional survey conducted by the Digestive Endoscopy Society of the Chinese Medical Association in 2014, involving 8892 patients diagnosed with chronic gastritis via gastroscopy across 10 cities and 33 centers, it was found that 56.7% of patients had PLGC [ 36 , 37 ]. Notably, among patients recommended for endoscopic examination according to the AITonguequiry model, the detection rate of PLGC reached 73%.…”

Section: Discussionmentioning

confidence: 99%

Development of an artificial intelligent model for pre-endoscopic screening of precancerous lesions in gastric cancer

Wang,

Zhang,

Zhang

et al. 2024

Chin Med

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Background Given the high cost of endoscopy in gastric cancer (GC) screening, there is an urgent need to explore cost-effective methods for the large-scale prediction of precancerous lesions of gastric cancer (PLGC). We aim to construct a hierarchical artificial intelligence-based multimodal non-invasive method for pre-endoscopic risk screening, to provide tailored recommendations for endoscopy. Methods From December 2022 to December 2023, a large-scale screening study was conducted in Fujian, China. Based on traditional Chinese medicine theory, we simultaneously collected tongue images and inquiry information from 1034 participants, considering the potential of these data for PLGC screening. Then, we introduced inquiry information for the first time, forming a multimodality artificial intelligence model to integrate tongue images and inquiry information for pre-endoscopic screening. Moreover, we validated this approach in another independent external validation cohort, comprising 143 participants from the China-Japan Friendship Hospital. Results A multimodality artificial intelligence-assisted pre-endoscopic screening model based on tongue images and inquiry information (AITonguequiry) was constructed, adopting a hierarchical prediction strategy, achieving tailored endoscopic recommendations. Validation analysis revealed that the area under the curve (AUC) values of AITonguequiry were 0.74 for overall PLGC (95% confidence interval (CI) 0.71–0.76, p < 0.05) and 0.82 for high-risk PLGC (95% CI 0.82–0.83, p < 0.05), which were significantly and robustly better than those of the independent use of either tongue images or inquiry information alone. In addition, AITonguequiry has superior performance compared to existing PLGC screening methodologies, with the AUC value enhancing 45% in terms of PLGC screening (0.74 vs. 0.51, p < 0.05) and 52% in terms of high-risk PLGC screening (0.82 vs. 0.54, p < 0.05). In the independent external verification, the AUC values were 0.69 for PLGC and 0.76 for high-risk PLGC. Conclusion Our AITonguequiry artificial intelligence model, for the first time, incorporates inquiry information and tongue images, leading to a higher precision and finer-grained pre-endoscopic screening of PLGC. This enhances patient screening efficiency and alleviates patient burden.

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Section: Discussionmentioning

confidence: 99%

Development of an artificial intelligent model for pre-endoscopic screening of precancerous lesions in gastric cancer

Wang,

Zhang,

Zhang

et al. 2024

Chin Med

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“…Genetic risk factors were not included in this study. GC shows familial aggregation in ~10% of cases, and there is an inherited genetic predisposition with known specific gene mutations in up to 3% of cases [ 47 ]. The role of low-penetrance genes in GC is an important step in genetic counselling since an early therapeutic endoscopic intervention could be offered.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, Risk Factors for Gastric Cancer and Surveillance of Premalignant Gastric Lesions: A Prospective Cohort Study of Central Saudi Arabia

Zacharakis,

Almasoud,

Arahmane

et al. 2023

Current Oncology

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(1) Background: Saudi Arabia (SA) is a country with a low incidence of gastric cancer (GC). In this study, we sought to assess the epidemiology of GC, its clinicopathological profiles, and its association with risk factors as well as to identify premalignant gastric lesions (PGL) and examine neoplastic progression. (2) Methods: This five-year prospective study screened for GC and PGL in asymptomatic Saudi patients, aged 45–75 years (n = 35,640) and living in Al Kharj, Riyadh province in central SA. Those who were positive in a high-sensitivity guaiac fecal occult blood test (HSgFOBT+) and had negative results in colonoscopy offered to undergo upper GI endoscopy (n = 1242). Factors associated with GC were examined. (3) Results: The five-year participation rate was 87% (1080/1242). The incidence rate of GC was 26.9 new cases per 100,000 population per year (9.6 new cases per year/total population at risk—35,640), and it was 8.9 cases per 1000 persons per year among the 1080 subjects with HSgFOBT+ and negative colonoscopy results. The five-year mortality rate was 67% among patients with GC (n = 48), 3.0% among participants in the gastric screening program (n = 1080) and 0.09% among the original population participating in the colorectal screening program (n = 35,640). Intestinal-type adenocarcinoma was the most frequent type (77%), with the tumor most commonly located in the antrum (41%). Overall, 334 participants had PGL, and seven of them (2.1%) showed neoplastic progression to GC during the follow-up. Factors associated with GC were age, Helicobacter pylori (HP) infection, obesity (body mass index BMI > 30), smoking, a diet of salty preserved foods, low income and a family history of GC. (4) Conclusions: The incidence of GC is low in central SA, but screening for PGL and GC among patients with HSgFOBT+ and negative colonoscopy may prevent or result in the early treatment of GC. HP eradication, normal body weight, not smoking and adhering to a healthy diet can reduce the risk of GC. The resulting data provide important input for the improvement of national guidelines.

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“…Traditional Chinese medicine and its active components have demonstrated distinct advantages in influencing the release of inflammatory factors and treating GPL ( 120 ). However, the underlying mechanisms how they affect the inflammatory microenvironment to prevent GPL, along with their true effect in GPL clinical trials, remain unclear.…”

Section: Challenges and Future Perspectivesmentioning

confidence: 99%

Inflammatory microenvironment in gastric premalignant lesions: implication and application

Zhang,

Shen,

Liu

et al. 2023

Front. Immunol.

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Gastric precancerous lesions (GPL) are a major health concern worldwide due to their potential to progress to gastric cancer (GC). Understanding the mechanism underlying the transformation from GPL to GC can provide a fresh insight for the early detection of GC. Although chronic inflammation is prevalent in the GPL, how the inflammatory microenvironment monitored the progression of GPL-to-GC are still elusive. Inflammation has been recognized as a key player in the progression of GPL. This review aims to provide an overview of the inflammatory microenvironment in GPL and its implications for disease progression and potential therapeutic applications. We discuss the involvement of inflammation in the progression of GPL, highlighting Helicobacter pylori (H. pylori) as a mediator for inflammatory microenvironment and a key driver to GC progression. We explore the role of immune cells in mediating the progression of GPL, and focus on the regulation of inflammatory molecules in this disease. Furthermore, we discuss the potential of targeting inflammatory pathways for GPL. There are currently no specific drugs for GPL treatment, but traditional Chinese Medicine (TCM) and natural antioxidants, known as antioxidant and anti-inflammatory properties, exhibit promising effects in suppressing or reversing the progression of GPL. Finally, the challenges and future perspectives in the field are proposed. Overall, this review highlights the central role of the inflammatory microenvironment in the progression of GPL, paving the way for innovative therapeutic approaches in the future.

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Chinese integrated guideline on the management of gastric precancerous conditions and lesions

Cited by 10 publications

References 161 publications

Development of an artificial intelligent model for pre-endoscopic screening of precancerous lesions in gastric cancer

Development of an artificial intelligent model for pre-endoscopic screening of precancerous lesions in gastric cancer

Epidemiology, Risk Factors for Gastric Cancer and Surveillance of Premalignant Gastric Lesions: A Prospective Cohort Study of Central Saudi Arabia

Inflammatory microenvironment in gastric premalignant lesions: implication and application

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