Gastric atrophy and xanthelasma are markers for predicting the development of early gastric cancer

Fukui, Hirokazu; Sada, Ryota; Fukuhara, Manabu; Marui, Saiko; Tanke, Gensho; Endo, Masatsugu; Ohara, Yoshiaki; Matsuda, Fumihiko; Nakajima, Jun; Henmi, Shinichiro; Saito, Sumio; Tsumura, Takehiko; Maruo, Takanori; Kimura, Tōru; Osaki, Yukio

doi:10.1007/s00535-015-1081-0

Cited by 44 publications

(62 citation statements)

References 32 publications

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“…Sekikawa et al [26,27] revealed that the prevalence of gastric xanthomas (“xanthelasma” in the original manuscripts) is significantly higher in patients with gastric cancer (47.6-51.7%) and they found that gastric xanthomas were independent factors related to gastric cancer. In multivariate analysis, the odds ratio of gastric xanthomas for developing gastric cancer was 6.38, which was significantly higher compared to open-type atrophy (7.37), male (2.60), and age ≥65 (1.59) [26].…”

Section: Discussionmentioning

confidence: 99%

“…1, 2) once it has developed. There have been some studies investigating the relationship between gastric xanthomas and cancer [26,27], however, it still remains unclear how gastric xanthomas are involved in the development of gastric cancer. In this study, we investigated the clinicopathological features of gastric cancer with or without xanthomas in detail using a database of a high-volume center treating over 200 cases of gastric cancer per year.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Kitamura¹,

Muguruma²,

Okamoto³

et al. 2017

Digestion

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Background/Aims: Gastric xanthomas are frequently observed in the stomach as small yellowish plaques or nodules. A close relationship among Helicobacter pylori infection, atrophic gastritis, and xanthomas has been reported. We assessed the clinicopathological features of gastric cancer with or without xanthomas. Methods: A total of 91 patients who were diagnosed as having early gastric cancer were enrolled. We evaluated the gastritis status using scores for gastritis and atrophy, positivity of H. pylori infection, the prevalence rate of xanthomas, and the clinicopathological features of gastric cancer. Results: Gastric xanthomas were observed in 72.5% of early gastric cancer cases. Scores for gastritis and atrophy were significantly higher in the xanthoma-positive group than those in the xanthoma-negative group. A higher prevalence of differentiated-type adenocarcinoma was found in the xanthoma-positive group. Among the cases with multiple gastric xanthomas, the prevalence of males was significantly higher than that of females. Conclusion: A high prevalence rate of gastric xanthomas in gastric cancer cases was shown. Xanthomas were highly associated with age, the severities of gastritis and atrophy, and differentiated-type adenocarcinoma. Regardless of the eradication of H. pylori, xanthomas may be useful predictive markers for the development of differentiated-type adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Kitamura¹,

Muguruma²,

Okamoto³

et al. 2017

Digestion

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“…Unfortunately, we did not obtain any data on plasma insulin and c-peptide, and the number of patients who developed early gastric cancer was small. However, our study demonstrated unequivocally that the presence of DM was significantly related to the development of early gastric cancer in patients with gastric xanthelasma.Naturally, it is very important to examine the presence of Helicobacter pylori infection and to evaluate the severity of gastric atrophy in order to predict the development of early gastric cancer in patients undergoing endoscopic examination [1,5]. However, our data additionally demonstrate that xanthelasma may also be a useful predictive marker for the development of early gastric cancer.…”

mentioning

confidence: 54%

“…Naturally, it is very important to examine the presence of Helicobacter pylori infection and to evaluate the severity of gastric atrophy in order to predict the development of early gastric cancer in patients undergoing endoscopic examination [1,5]. However, our data additionally demonstrate that xanthelasma may also be a useful predictive marker for the development of early gastric cancer.…”

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confidence: 54%

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Reply to the letter by Fujishiro et al. concerning “Controversy regarding gastric cancer and diabetes”

et al. 2015

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We thank Fujishiro et al. for their interest in our recently published article [1] and for their insightful comments. Several reports have focused on the association between diabetes mellitus (DM) and the risk of gastric cancer [2,3]. In previous studies, however, the criteria for both DM and the diagnosis of gastric cancer varied, which means that any results suggesting an association between DM and gastric cancer development remain controversial. Our endoscopic follow-up study clearly showed that the presence of DM diagnosed on the basis of medical history and/or serological examination was associated with the development of early gastric cancer [4].We compared the clinical features of patients with gastric xanthelasma between those who developed early gastric cancer and those who did not. Interestingly, there was a significantly higher incidence of DM and a higher level of fasting plasma glucose in the gastric xanthelasma patients who developed gastric cancer than in those who did not (46.7 vs. 19.6 %, p = 0.043 and 120.3 ± 11.6 vs. 105.2 ± 2.2, p = 0.043, respectively). Gastric cancer development showed no significant relationship to age, sex, body mass index or the level of hemoglobin A1c. Unfortunately, we did not obtain any data on plasma insulin and c-peptide, and the number of patients who developed early gastric cancer was small. However, our study demonstrated unequivocally that the presence of DM was significantly related to the development of early gastric cancer in patients with gastric xanthelasma.Naturally, it is very important to examine the presence of Helicobacter pylori infection and to evaluate the severity of gastric atrophy in order to predict the development of early gastric cancer in patients undergoing endoscopic examination [1,5]. However, our data additionally demonstrate that xanthelasma may also be a useful predictive marker for the development of early gastric cancer. Endoscopic examination is very helpful for evaluation of gastric atrophy and xanthelasma, and therefore endoscopic surveillance may be advisable to isolate patients who are at risk of gastric cancer development at an earlier stage.

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Stratification of gastric cancer risk using a deep neural network

Nakahira

Ishihara

Aoyama³

et al. 2019

JGH Open

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Background and Aim Stratifying gastric cancer (GC) risk and endoscopy findings in high‐risk individuals may provide effective surveillance for GC. We developed a computerized image‐ analysis system for endoscopic images to stratify the risk of GC. Methods The system was trained using images taken during endoscopic examinations with non‐magnified white‐light imaging. Patients were classified as high‐risk (patients with GC), moderate‐risk (patients with current or past Helicobacter pylori infection or gastric atrophy), or low‐risk (patients with no history of H. pylori infection or gastric atrophy). After selection, 20,960, 17,404, and 68,920 images were collected as training images for the high‐, moderate‐, and low‐risk groups, respectively. Results Performance of the artificial intelligence (AI) system was evaluated by the prevalence of GC in each group using an independent validation dataset of patients who underwent endoscopic examination and H. pylori serum antibody testing. In total, 12,824 images from 454 patients were included in the analysis. The time required for diagnosing all the images was 345 seconds. The AI system diagnosed 46, 250, and 158 patients as low‐, moderate‐, and high risk, respectively. The prevalence of GC in the low‐, moderate‐, and high‐risk groups was 2.2, 8.8, and 16.4%, respectively (P = 0.0017). Three experienced endoscopists also successfully stratified the risk; however, interobserver agreement was not satisfactory (kappa value of 0.27, indicating fair agreement). Conclusion The current AI system detected significant differences in the prevalence of GC among the low‐, moderate‐, and high‐risk groups, suggesting its potential for stratifying GC risk.

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Gastric atrophy and xanthelasma are markers for predicting the development of early gastric cancer

Abstract: Gastric xanthelasma is a useful marker for predicting the development of gastric cancer.

Cited by 44 publications

References 32 publications

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Reply to the letter by Fujishiro et al. concerning “Controversy regarding gastric cancer and diabetes”

Stratification of gastric cancer risk using a deep neural network

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