Endoscopic full-thickness biopsy of the gastric wall with defect closure by using an endoscopic suturing device: survival porcine study

Rajan, Elizabeth; Gostout, Christopher J.; Bonin, Eduardo A.; Moran, Edmund J.; Locke, Richard G.; Szarka, Lawrence A.; Talley, Nicholas J.; Deters, Jodie L.; Miller, Charles A.; Knipschield, Mary A.; Lurken, Matthew S.; Stoltz, Gary J.; Bernard, Cheryl E.; Grover, Madhusudan; Farrugia, Gianrico

doi:10.1016/j.gie.2012.07.010

Cited by 36 publications

(20 citation statements)

References 22 publications

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“…Many Japanese series have consistently reported that early diagnosis and treatment of GC, with a 5-year survival rate approximately 90% (29). However, the diagnosis of gastrointestinal (GI) endoscopy cannot find all precancerous diseases and the early stages GC (30). Therefore, in order to improve this situation, increasing attention has been given to the identification of genes and the exact regulatory mechanism of GC development and progress.…”

Section: Discussionmentioning

confidence: 99%

Integrated analysis of long non-coding RNA competing interactions reveals the potential role in progression of human gastric cancer

Liang

Yao

et al. 2016

International Journal of Oncology

112

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Abstract. Abnormal expression of long non-coding RNAs (lncRNAs) have been shown to play an important role in tumor biology. The Cancer Genome Atlas (TCGA) platform is a large sample sequencing database of lncRNAs, and further analysis of the associations between these data and patients' clinical related information can provide new approaches to find the functions of lncRNA. In the present study, 361 RNA sequencing profiles of gastric cancer (GC) patients were selected from TCGA. Then, we constructed the lncRNA-miRNA-mRNA competitive endogenous RNA (ceRNA) network of GC. There were 25 GC specific lncRNAs (fold change >2, p<0.05) identified, 19 of them were included in ceRNA network. Subsequently, we selected these 19 key lncRNAs and analyzed the correlations with clinical features and overall survival, 14 of them were discriminatively expressed with tumor size, tumor grade, TNM stage and lymphatic metastasis (p<0.05). In addition, eight lncRNAs (RPLP0P2, FOXD2-AS1, H19, TINCR, SLC26A4-AS1, SMIM10L2A, SMIM10L2B and SNORD116-4) were found to be significantly associated with overall survival (log-rank p<0.05). Finally, two key lncRNAs HOTAIR and UCA1 were selected for validation of their expression levels in 82 newly diagnosed GC patients by qRT-PCR. Results showed that the fold changes between TCGA and qRT-PCR were 100% in agreement. In addition, we also found that HOTAIR was significantly correlated with tumor size and lymphatic metastasis (p<0.05), and UCA1 was significantly correlated with tumor size, TNM stage and lymphatic metastasis (p<0.05).The clinical relevance of the two lncRNAs and the bioinformatics analysis results were almost the same. Overall, our study showed the GC specific lncRNAs expression patterns and a ceRNA network in GC. Clinical features related to GC specific lncRNAs also suggested these lncRNAs are worthwhile for further study as novel candidate biomarkers for the clinical diagnosis of GC and potential indicators for prognosis. IntroductionNoncoding RNAs (ncRNAs) are transcripts that have no ability of coding proteins, which widely exit in high eukaryotics. According to their characteristics, ncRNAs can be divided into several subtypes including transfer RNA, small nucleolar RNA (snoRNA), ribosomal RNA (rRNA), microRNA (miRNA) and long non-coding RNA (lncRNA). The amount of the ncRNAs transcripts is >98% of the whole genome transcripts and have been suggested to represent transcriptional noise (1). However, more and more evidence indicates that transcriptional output of genome is far more complex than predicted, and suggests new paradigms of ncRNA regulation (2).Recent studies suggest that the ncRNAs may play important biological roles in transcriptional regulation, cellular development, formation of chromosome and RNA modification (3). Based on the transcript size, ncRNAs are grouped into small ncRNAs (<200 bp) and long ncRNAs (>200 bp, up to 100 kb). lncRNA is the functional end-product, and the level of lncRNA expression correlates directly with the level of the active molecule. Thus, ...

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Section: Discussionmentioning

confidence: 99%

Integrated analysis of long non-coding RNA competing interactions reveals the potential role in progression of human gastric cancer

Liang

Yao

et al. 2016

International Journal of Oncology

112

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“…Furthermore, endoscopic biopsy and pathological morphological observation cannot detect all precancerous lesions and early stages of GC (19). Therefore, in order to improve this situation, the identification of the genes and regulatory mechanisms involved in lymph node metastasis has become a research area of increasing interest.…”

Section: Discussionmentioning

confidence: 99%

Identification and functional characterization of long non-coding RNAs in human gastric cancer

Liang

Yao

et al. 2018

Oncol Lett

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Abstract. Abnormal regulation of long non-coding RNAs (lncRNAs) appears to be a primary feature of numerous types of human cancer. However, the association between the dysregulation of lncRNAs and functional alterations in gastric cancer (GC) remains unclear. In previous studies, we applied microarray and bioinformatics analyses to screen for key lncRNAs from the tumor tissues and matched adjacent non-tumor tissues of 10 patients with GC. There were seven key lncRNAs demonstrated to be significantly different between carcinoma tissues and adjacent non-tumor tissues. In the present study, the expression of these seven selected lncRNAs were validated in 82 patients with GC to further investigate the association between lncRNAs and GC clinical characterization. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) results demonstrated that RP5-919F19, MCPH1 antisense RNA 1 (CTD-2541M15) and urothelial carcinoma-associated 1 (UCA1) exhibited consistent upregulation in cancer compared with adjacent non-tumor tissues, whereas AP000459, LOC101928316, tumor suppressor candidate 8 (LINC01071) and maternally expressed 3 (MEG3) showed consistent downregulation. The results from the microarray and RT-qPCR experiments achieved 100% agreement. A correlation analysis indicated that RP5-919F19, LOC101928316 and MEG3 were significantly associated with tumor differentiation degree, RP5-919F19, UCA1 and MEG3 were significantly associated with lymph node metastasis, and RP5-919F19, CTD-2541M15 and UCA1 were significantly associated with tumor-node-metastasis stage (P<0.05). In addition, it was identified that the differential expression of LINC01071 and LOC101928316 significantly correlated with the age and gender of the GC patients, respectively (P<0.05). The results suggest that the lncRNAs RP5-919F19, LOC101928316, CTD-2541M15, UCA1 and MEG3 are closely associated with the invasion and metastasis of GC, which reveals these indicators as potential specificity biomarkers for the diagnosis, prognosis and classification of GC. Thus, these lncRNAs merit further study as novel candidate biomarkers for the clinical diagnosis of GC and as potential targets for therapy. IntroductionGastric cancer (GC) is one of the most lethal types of cancer and has been increasing in incidence and mortality over the last several decades. In China, it has been estimated that ~464,000 new cases were diagnosed in 2012, which accounts for over 40% of the total cases (~989,600) worldwide (1). According to evidence from clinical studies, the majority of patients with GC are diagnosed at an advanced stage and are thus not suitable for radical surgery (2). Previous studies have also reported that earlier diagnosis and treatment of GC could produce a 5-year survival rate of >90% (3).Recent developments in the field of digestive system endoscopy have been remarkable due to their association with decreased trauma, accelerated recovery and fewer complications (4,5). However, endoscopic biopsy and observation of pathological morphology are unable t...

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“…Surgically obtained gastric muscle biopsy specimens from patients with gastroparesis have shown a decrease in ICC in the majority of patients, changes in macrophages, and a variable decrease in nerve fibers 11 . We have previously reported on different experimental endoscopic techniques for deep gastric wall biopsies to include the entire MP 12,13 . Our group introduced the “no hole” concept (close, then cut) to eliminate the risk of peritonitis from leaked gastric contents 14 .…”

Section: Discussionmentioning

confidence: 99%

Innovative gastric endoscopic muscle biopsy to identify all cell types, including myenteric neurons and interstitial cells of Cajal in patients with idiopathic gastroparesis: a feasibility study (with video)

Rajan

Gostout

Song

et al. 2016

Gastrointestinal Endoscopy

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Background and Aims The pathophysiology of some gastrointestinal neuromuscular diseases (GINMD) remains largely unknown. This is in part due to the inability to obtain ample deep gastric wall biopsies that include the intermuscular layer of the muscularis propria (MP) to evaluate the enteric nervous system, interstitial cells of Cajal (ICC) and related cells. We report on a novel technique for gastric endoscopic muscle biopsy (gEMB). Methods Patients with idiopathic gastroparesis were prospectively enrolled in a feasibility study using a novel “no hole” gEMB. Main outcome measures were technical success, adverse events and histological confirmation of the intermuscular layer, including myenteric neurons and ICC. The gEMB was a double resection clip–assist technique. A site was identified on the anterior wall of the gastric body as recommended by the International Working Group on histological techniques. Endoscopic mucosal resection was performed to unroof and expose the underlying MP. The exposed MP was then retracted into the cap of an over-the-scope clip. The clip was deployed and the pseudopolyp of MP created was resected. This resulted in a “nohole” gEMB. Results Three patients with idiopathic gastroparesis underwent gEMB. Patients had severe delayed gastric emptying with a mean of 49 ± 16.8% of retained gastric contents at 4 hours. They had no history of gastric or small-bowel surgery, and did not use steroids or other immunosuppressive drugs. The gEMB procedure was successfully performed with no procedural adverse events. Postprocedure abdominal pain was controlled with nonsteroidal anti-inflammatory agents and opioid analgesics. Mean length of resected MP was 10.3 ± 1.5 mm. Mean procedure time was 25.7 ± 6 minutes. Tissue samples on hematoxylin and eosin (H&E) stain confirmed presence of both inner circular and outer longitudinal muscle as well as the intermuscular layer. H&E stain showed reduced myenteric ganglia in 1 patient. In 2 patients, specialized immunohistochemistry was performed, which showed marked decrease in myenteric neurons as delineated by an antibody to Protein Gene Product (PGP) 9.5 and severe decrease in ICC across the muscle layers. At 1 month follow-up, upper endoscopy showed a well-healed scar in 2 patients and minimal ulceration with retained clip in 1 patient. CT abdomen confirmed the integrity of the gastric wall in all patients. Due to lack of an immune infiltrate in the resected samples, patients were not considered suitable for immunosuppressive or steroid therapy. Conclusions gEMB is feasible and easy to perform, with acquisition of tissue close to surgical samples to identify myenteric ganglia, ICC and multiple cell types. The ability to perform gEMB represents a paradigm shift in endoscopic tissue diagnosis of gastric neuromuscular pathologies.

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Endoscopic full-thickness biopsy of the gastric wall with defect closure by using an endoscopic suturing device: survival porcine study

Cited by 36 publications

References 22 publications

Integrated analysis of long non-coding RNA competing interactions reveals the potential role in progression of human gastric cancer

Integrated analysis of long non-coding RNA competing interactions reveals the potential role in progression of human gastric cancer

Identification and functional characterization of long non-coding RNAs in human gastric cancer

Innovative gastric endoscopic muscle biopsy to identify all cell types, including myenteric neurons and interstitial cells of Cajal in patients with idiopathic gastroparesis: a feasibility study (with video)

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