Onset and Progression of Precancerous Lesions on Gastric Mucosa of Patients Treated for Gastric Lymphoma

Zullo, Angelo; Rago, Angela; Felici, Stefano; Licci, Stefano; Ridola, Lerenzo; Toritto, Tommaso Caravita di

doi:10.15403/jgld-516

“…Zullo et al stated that in the examination of primary gastric cancer lesions, CT and magnetic resonance imaging diagnostic methods can be used to detect lesions, a certain examination efficiency can be obtained, the application of the magnetic resonance examination method is as follows, the effect is more obvious, and the advantages are more significant; in the application of the corresponding spiral detection method for judgment, the corresponding treatment method can also be formulated through this effective treatment plan, in terms of its role. Its targeted use requirements also meet the actual use reference value [ 7 ]. Yi et al showed that MRI is also more sensitive than CT imaging in detecting perineural spread and pathological lymph nodes [ 8 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Diagnostic Value of Spiral CT and Magnetic Resonance Imaging Scanning in Gastric Cancer and Precancerous Lesions

Zhen

¹

,

Xie

²

,

Liu

³

2022

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In order to explore the diagnostic value of spiral CT and magnetic resonance imaging scanning in gastric cancer and precancerous lesions, the author selected 56 gastric cancer patients treated in a medical center (group) as the experimental subjects, and all patients underwent MRI, multislice spiral CT scan, and enhanced CT scan two weeks before surgery; at the same time, the gastric cancer staging results of patients were diagnosed according to surgical pathology. All patients were examined under the condition of knowledge and performed breath-holding exercise before examination. The status, location, and extent of tumor lesions were evaluated. In comparison of T staging of gastric cancer patients with magnetic resonance scanning imaging and postoperative pathological examination results, among them, T staging of 3 patients did not match the results of pathological examination, the accuracy rates of T staging on magnetic resonance scanning imaging were T 1 = 94.7 % , T 2 = 87.6 % , T 3 = 91.2 % , and T 4 = 94.7 % , and the total accuracy was 92.1%. Comparison of helical CT scan imaging and postoperative pathological examination results is as follows. Among them, T staging of 8 patients did not match the results of pathological examination, 3 patients were ulcerative, 5 were protuberance, the accuracy rates of T staging in spiral CT scan imaging were T 1 = 90.8 % , T 2 = 82.2 % , T 3 = 76.9 % , and T 4 = 87.6 % , and the total accuracy was 84.5%. The total accuracy rate of imaging N staging was 77.5%, and the total accuracy rate of spiral CT scanning imaging N staging was 80.8%. The accuracy rates of M0 and M1 staging in magnetic resonance imaging were 100.0% and 96.5%, respectively, and the accuracy rates of M0 and M1 staging in spiral CT scan imaging were 96.5% and 96.5%, respectively. The accuracy rate of magnetic resonance imaging for the diagnosis of gastric cancer N staging was 77.4%, and the reason for the low accuracy rate was mainly because the enhancement effect was not obvious due to insufficient enhancement. The accuracy rate of spiral CT in diagnosing N staging of gastric cancer was 80.9%, which was mainly due to the small diameter of the middle celiac artery lymph nodes. Magnetic resonance and spiral CT scans have high value in the early diagnosis and staging of gastric cancer.

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“…H. pylori plays a major role in different benign and malignant gastroduodenal diseases, and its eradication definitely changes the natural history of peptic ulcer, nonulcer dyspepsia and gastric MALT-lymphoma [1–3]. Therefore, current European guidelines suggest searching for the infection under different clinical conditions [14].…”

Section: Discussionmentioning

confidence: 99%

Real-time gastric juice analysis with EndoFaster for H. pylori diagnosis: a large, multicentre study

Zullo

¹

,

Germanà²,

Galliani³

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Background Helicobacter pylori infection is the main cause of the most frequent gastroduodenal diseases. Because its prevalence is decreasing in developed countries, gastric biopsies are negative in several patients. By measuring ammonium in the gastric juice, EndoFaster allows to exclude H. pylori infection during endoscopy. This study aimed to assess the accuracy of device versions working with either 6 ml or 3 ml of gastric juice. Study design This prospective study involved 12 endoscopic units. During endoscopy, EndoFaster testing was performed and standard five gastric biopsies were taken. The accuracy was calculated by considering histological assessment as the gold standard for H. pylori diagnosis. Results Gastric juice analysis was attempted in 1279 patients, but it failed in 131 (15.5%) and in 10 (2.3%), with the 6 ml and the 3 ml device, respectively (P < 0.001). Overall, EndoFaster detected H. pylori infection with an 86.3% sensitivity, 83.3% specificity, 52.7% positive predictive value, 96.6% negative predictive value and 83.8% accuracy. The performance was not affected either by ongoing proton pump inhibitor therapy or a previous H. pylori eradication. No significant difference in accuracy emerged between the two versions of the device. Conclusion The novel version of the EndoFaster device operating with 3 ml gastric juice may be performed in virtually all patients, and it allows excluding H. pylori infection with a very high accuracy. Gastric biopsies can be avoided in a definite portion of cases without endoscopic lesions or other clinical indications.

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“…[19][20][21] A long-term follow-up is advised following gastric lymphoma remission after H. pylori eradication, not only for a potential disease recurrence, but also for the increased risk of gastric cancer development in these patients. 22 In conclusion, data this systematic review suggest considering H. pylori eradication as first-line therapy to treat infected patients with early-stage, high-grade gastric lymphoma.…”

Section: Discussionmentioning

confidence: 87%

“…A long‐term follow‐up is advised following gastric lymphoma remission after H. pylori eradication, not only for a potential disease recurrence, but also for the increased risk of gastric cancer development in these patients 22 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of Helicobater pylori eradication in patients with diffuse large B‐cell lymphoma of the stomach: A systematic review

Francesco

¹

,

Manta

²

,

Marmo³

et al. 2022

European J of Haematology

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Objectives The role of Helicobater pylori eradication in the treatment of high‐grade diffuse large B‐cell lymphoma (DLBCL) of the stomach is unclear. Methods We performed a systematic review and meta‐analysis of currently available data. DLBCL‐remission rate after eradication therapy, post‐remission maintenance, and response rate in the case of additional oncological therapy were extracted. Results By considering data of seven studies, the DLBCL remission was achieved in 81 (53.3%; 95% CI = 45.3–61.2) out of 152 H. pylori eradicated patients. The regression rate did not differ between pure DLCBL and DLCBL with MALT component, between stage I and stage II disease, and between Caucasians and Asians. Disease regression was maintained in all patients after at a median of 63 months (range: 46–29) follow‐up. In those non‐responders, DLBLC remission after additional chemo‐immunotherapy was achieved in 63 (98.4%; 95% CI = 95.4–100) out of 64 patients. Conclusions Data this systematic review suggest considering H. pylori eradication as first‐line therapy to treat infected patients with early‐stage, high‐grade gastric lymphoma.

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Onset and Progression of Precancerous Lesions on Gastric Mucosa of Patients Treated for Gastric Lymphoma

Cited by 12 publications

References 29 publications

Diagnostic Value of Spiral CT and Magnetic Resonance Imaging Scanning in Gastric Cancer and Precancerous Lesions

Diagnostic Value of Spiral CT and Magnetic Resonance Imaging Scanning in Gastric Cancer and Precancerous Lesions

Real-time gastric juice analysis with EndoFaster for H. pylori diagnosis: a large, multicentre study

Efficacy of Helicobater pylori eradication in patients with diffuse large B‐cell lymphoma of the stomach: A systematic review

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