Gastric Cancer Surveillance in a High-Risk Population in Tuscany (Central Italy): Preliminary Results

Abstract

Background/Aims: The surveillance of subjects at high risk for developing gastric cancer (GC) may represent an effective strategy for reducing specific morbidity and mortality. The aim of this study was to identify GC at its initial phase and to identify precancerous lesions in a group of GC high-risk subjects. Methods: We enrolled first-degree relatives of patients affected by GC who resided in a GC high-risk area (Tuscany, Central Italy). The study’s protocol included the collection of several individual measurements, including a blood sample for the determination of specific biomarkers, an upper digestive tract endoscopy with detailed gastric biopsies and Helicobacter pylori (Hp) treatment followed by a specific check. Results: We enrolled 167 subjects who were members of 128 different familial groups with GC history. We identified 1 case of initial-phase GC, 1 gastric dysplasia type II, 32 intestinal metaplasia, 10 gastric atrophy, and 21 atrophic chronic gastritis. 81 subjects were Hp-positive and underwent eradication therapy. Conclusion: This study of a GC high-risk Italian population reveals positive results in terms of population compliance, the identification of specific gastric lesions requiring close follow-up and successful therapy for Hp infection. To define future surveillance strategies, a longer follow-up of these patients is necessary.

Decreased expression of Sox7 correlates with the upregulation of the Wnt/β-catenin signaling pathway and the poor survival of gastric cancer patients

“…In order to develop sensitive and specific therapies against GC, molecular biomarkers must be determined (24). Abnormal expression levels of members of the Sox gene family usually correlate with malignant and metastatic tumors (16,25).…”

Current issues and future perspectives of gastric cancer screening

“…Most of the reported studies are cross-sectional studies in which the serologic test was performed simultaneously with upper endoscopic screening. Although several studies have been reported from European countries, their outcomes were mainly for chronic atrophic gastritis which is a surrogate endpoint even if it can be a precursor of gastric cancer [33][34][35] . Lomba-Viana et al [36] previously reported the results of a 5-year follow-up study of the serum pepsinogen test for the early detection of gastric cancer in Portugal.…”

Empirical evidence of the continuing improvement in cost efficiency of an endoscopic surveillance programme for gastric cancer in Singapore from 2004 to 2010

“…This study as a free standing cost analysis, despite its inability to compute the cost-effectiveness ratio, provided important empirical evidence for programme management and ultimately for value-for-money decision making. Cost studies of long-term GC surveillance have long been anticipated worldwide given that research already illustrated the benefit of GC surveillance [27,28]. Exploring the mechanisms underlying our results would be of universal interest to GC researchers.…”