miR-363 promotes proliferation and chemo-resistance of human gastric cancer via targeting of FBW7 ubiquitin ligase expression.

Dysregulation of microRNA expression is involved in several pathological activities associated with gastric cancer progression and chemo-resistance. However, the role and molecular mechanisms of miR-363 in the progression and chemo-resistance of gastric cancer remain enigmatic. In this study, we validated that miR-363 expression was higher in gastric cancer tissues than in adjacent normal tissues. Multivariate analysis identifies high levels of miR-363 expression as an independent predictor for postoperative recurrence and lower overall survival. Increased miR-363 expression promotes gastric cancer cell proliferation and chemo-resistance through directly targeting the tumor suppressor F-box and WD repeat domain-containing 7 (FBW7). Clinically, our data reveal that overexpression of miR-363 correlates with the poor survival outcomes in patients with gastric cancer, and docetaxel + cisplatin + 5-FU (DCF) regimen response is impaired in patients with miR-363 overexpression. These data suggest that miR-363 may be a potential therapeutic target for gastric cancer and serve as a biomarker for predicting response to DCF regimen treatment.

Observation of microvessels and invasion in early colorectal neoplasms on narrow band imaging: combination with CD34 and matrix metalloproteinase-7 expression.

OBJECTIVE: The study aims to clarify the role of narrow band imaging (NBI) in the prediction of invasion depth and the formation of lesion appearance under NBI with immunohistochemical analysis. MATERIALS AND METHODS: As a prospective single-center study, Sano's classification of capillary pattern (CP) was applied to differentiate early colorectal neoplasms under NBI observation. Only lesions with CP type III were analyzed, compared with final histologic findings, and further immunohistochemical analysis with CD34 and matrix metalloproteinase-7 (MMP-7) was performed. RESULTS: As for the 203 cases of CP type III lesions, the sensitivity, specificity, and accuracy for CP type IIIA/IIIB were, respectively, 88.4, 93.6, and 92.5% to differentiate high-grade neoplasia or slight submucosal invasive carcinoma from deep submucosal invasive carcinoma. NBI prediction for invasion depth corresponded to immunohistochemical outcomes of CD34 and MMP-7, which might explain the reason why CP type IIIB displays nearly avascular or loose microvascular areas on the lesion surface. CONCLUSION: NBI is of excellent use in predicting invasion depth for early colorectal neoplasms, and positive expression of MMP-7 is associated with the appearance of CP type IIIB.

New dual therapy for primary treatment of Helicobacter pylori infection: A prospective randomized study in Shanghai, China.

OBJECTIVE: To evaluate the eradication rates, side effects and the patient compliance of a dual therapy with rabeprazole and amoxicillin as the first-line therapy in patients with Helicobacter pylori (H. pylori) infection. METHODS: A total of 120 patients diagnosed endoscopically with non-ulcer dyspepsia with H. pylori infection were randomly assigned into two groups, one treated with amoxicillin 1 g thrice daily plus rabeprazole 10 mg twice daily (R10A group) or 20 mg twice daily (R20A group) for 14 days. H. pylori eradication was evaluated by (13) C-urea breath test (UBT) at 4-6 weeks after the completion of treatment. H. pylori eradication rate was analyzed by per-protocol (PP) and intention-to-treat (ITT) analyses together with 95% confidence interval (CI). Side effects and patients' compliance were also recorded. RESULTS: Overall, 117 patients (58 in the R10A group and 59 in the R20A group) completed the study, among whom five did not undertake the UBT. H. pylori eradication was achieved in 89.8% of patients in the R20A group by ITT analysis and 93.0% by PP analysis, which was significantly higher than those in the R10A group (75.9% and 80.0%, respectively, P < 0.05). Side effects, including skin rash, abdominal discomfort, headache, insomnia and nausea, were all mild and were treated symptomatically without the need to discontinue the treatment. CONCLUSION: The modified dual therapy with high doses of rabeprazole and amoxicillin is considered an effective and safe primary therapy for H. pylori eradication and could be recommended as the first-line eradication regimen for certain patients.

Narrow band imaging: application for early-stage gastrointestinal neoplasia.

Narrow-band imaging (NBI) is an imaging technique for endoscopy using optical filters to narrow the bandwidth of spectral transmittance. Through this narrow spectrum, NBI contrasts surface structure and microvascular architecture of various lesions. In this article we focus on the application of NBI for early-stage neoplasia in the esophagus, stomach and colon with a three-step strategy of endoscopic diagnosis: (i) the detection of abnormality; (ii) the differentiation between non-neoplasia and neoplasia; and (iii) staging for tumor extension and depth of invasion.

Endoscopic resection for gastric epithelial neoplasia: how to solve pathological discrepancy and achieve curative resection?

OBJECTIVE: Endoscopic resection (ER) was introduced to China from Japan, while most pathologists are influenced by Western criteria. Japanese and Western pathologists have debated for decades how best to distinguish between gastric intraepithelial neoplasia (GIEN) and early gastric cancer (EGC). In this study we aimed to find out how to solve this pathological discrepancy and improve the curative resection of lesions based on our experiences. METHODS: In total, 143 patients with GIEN or EGC were treated by ER in our hospital from April 2008 to April 2012. The risk factors related to the degree of malignancy of the lesions and the non-curability of ER were analyzed. Pathological discrepancy between forceps biopsies and ER specimens was also compared. RESULTS: According to the histological types of the ER specimens, there were 67 patients with low-grade intraepithelial neoplasia (LGIN), 35 with high-grade intraepithelial neoplasia (HGIN) and 41 with EGC. The ER histological type was significantly correlated with gender, ER method, macroscopic type, tumor size, ulcer and histological type of the forceps biopsy (P < 0.05). The discrepancy between forceps biopsy and ER specimens was 41.3% (59/143). Furthermore, the depth of tumor invasion and ER histological type were associated with the curative resection of HGIN and EGC (P < 0.05). CONCLUSIONS: The pathological discrepancy shows that patients with HGIN in forceps biopsy should be considered candidates for ER. The risk factors of lesion malignancy and ER curability indicate the great importance of pretreatment evaluation for ER.