Gastroenterology Report最新文献

Background: Current techniques for monitoring gastroesophageal reflux are limited to measuring physicochemical parameters. We presented a novel pH-integrated ultrathin endoscope (the EndoMonitor System) for simultaneous acquisition of reflux images and pH data. This preclinical study evaluated the performance of the latest version of the EndoMonitor System.

Methods: The stability and hydrogen ion selectivity of the pH electrode in the EndoMonitor System were evaluated. Subsequently, six types of reflux events were simulated in an isolated organ (porcine esophagus-stomach). Complete duodenal ligation was used to create porcine gastroesophageal reflux models. The number of reflux episodes and acid exposure time were assessed and compared with the pH-impedance catheter results.

Results: The detection rates for distal acid reflux, distal mixed reflux, and horizontal acid reflux events of the EndoMonitor System were significantly higher than those of the pH-impedance catheter (100% vs 18.6%, 100% vs 32.7%, and 100% vs 49.1%, respectively; all P < 0.001). Furthermore, the EndoMonitor System demonstrated superior detection performance in proximal acid and mixed reflux events compared with the pH-impedance catheter (100% vs 90.9% and 100% vs 88.1%, respectively; both P < 0.05). In vivo reflux monitoring demonstrated statistically higher detection rates of reflux events with the EndoMonitor System in two-thirds of the experimental groups (P < 0.05), with a more remarkable overall detection advantage (100% vs 82.0%; P < 0.001). The acid exposure time measurement results for these two devices were comparable (mean ± standard deviation: 2.62 ± 1.82 vs 2.52 ± 1.74 min; P = 0.161).

Conclusions: The EndoMonitor System improves the accuracy of identifying reflux events and simplifies the monitoring process. It was also highly operable. This study provided important preclinical experience for clinical trials.

Background: Inflammatory bowel disease (IBD) imposes a significant economic and social burden. We aimed to assess the burden of IBD globally, regionally, and nationally.

Methods: The incidence, mortality, prevalence, and disability-adjusted life year were obtained from Global Burden of Disease 2021. Estimated annual percentage change, average annual percent change, and age-period-cohort model were used to access trends. Associations between age-standardized rate (ASR) and socio-demographic index were explored. Predictions were made using Bayesian age-period-cohort model and Nordpred.

Results: In 2021, IBD affected 3.8 million people, with ASR of incidence and death of 4.4 and 0.5. The global ASR of incidence increased from 1990 to 2021, while ASR of death, prevalence, and disability-adjusted life year decreased. The age-standardized death rate (ASDR) did not show a significant increase from 2019 to 2021 in most regions and countries. High-incidence regions, such as Western Europe, continued to face significant burdens. East Asian, especially China, was experiencing a sharp increase in incidence. ASR of incidence and death increased with rising socio-demographic index. By 2035, the ASR of incidence and death of IBD will gradually decline.

Conclusion: The global burden of IBD remains severe with changing epidemiological trends. Reducing the burden requires changes in public health policies, disease prevention, and healthcare services.

Introduction: Stool DNA testing based on methylated syndecan-2 (mSDC2) is a potential novel non-invasive screening test for colorectal cancer (CRC). This study aimed to assess its positive predictive value (PPV) in real-world practice.

Methods: This study retrospectively recruited consecutive patients with positive stool DNA-based SDC2 methylation tests from 18 hospitals between November 2016 and July 2021. Included patients were classified into the average-risk equivalent or increased-risk population and the previous-negative-colonoscopy or no-previous-colonoscopy groups. Multivariate logistic regression was conducted to investigate the risk factors that affect the detection of advanced colorectal neoplasia (ACN) in patients with a positive mSDC2 test. The primary outcome was the PPV for ACN.

Results: The overall PPVs for ACN, CRC, and colorectal neoplasia were 28.5%, 12.8%, and 44.6%, respectively. The PPV for ACN was higher in the no-previous-colonoscopy group than in the previous-negative-colonoscopy group (30.1% vs 18.5%, P = 0.008) and higher in the increased-risk population than in the average-risk equivalent population (41.1% vs 21.6%, P < 0.001). However, the PPV (18.5%) was still high for patients with a previous negative colonoscopy. For ACN detection in patients with a positive mSDC2 test, old age, increased risk, and smoking history were identified as independent risk factors; previous negative colonoscopy was identified as a protective factor.

Conclusions: The mSDC2 test, which has a high PPV for both ACN and CRC, is expected to be an alternative CRC screening strategy. Patients with a positive mSDC2 test might require a colonoscopy as soon as possible, even if the previous colonoscopy was negative.

Background: According to the Global Cancer Observatory 2020 report, pancreatic cancer occupies the 11th position among the leading causes of cancer-related mortality in both sexes, with nearly 500,000 deaths annually worldwide. This study aimed to evaluate the trend of mortality due to pancreatic cancer in Montenegro from 1990 to 2018 and to contribute to the effective planning of preventive strategies for pancreatic cancer as well as future health policies and initiatives.

Methods: We utilized national data on the causes of death from pancreatic cancer and codes 157 from the 9th and C25 from the 10th revision of the International Classification of Diseases. The trend was described by using Joinpoint, Poisson, and linear regression.

Results: Mortality rates of pancreatic cancer in Montenegro consistently increased (P < 0.05) for the overall level for both men and women, with the average annual percentage change (AAPC) in the AAPC order (95% confidence interval): 1.7% (0.9%-2.5%) overall, 1.3% (0.4%-2.1%) in men, and 2.2% (0.9%-3.5%) in women. The majority of those who died from pancreatic cancer were aged 65-74 years (32.7%), 55-64 years (26.3%), and 75-84 years (24.1%).

Conclusions: The persistent increase in pancreatic cancer mortality rates in Montenegro, observed in both men and women, highlights a concerning public health trend. With the highest proportion of deaths occurring among individuals aged 55-84 years, these findings underscore the urgent need for policymakers to implement a national strategy targeting early detection, prevention, and improved management, especially among the most affected age groups.

Background: We aimed to investigate long-term survival outcome in patients with locally advanced esophagogastric junction adenocarcinoma and upper third gastric adenocarcinoma (EGJ-UG adenocarcinoma) who underwent proximal gastrectomy (PG) or total gastrectomy (TG).

Methods: We searched and analyzed the data from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with T2-3 EGJ-UG adenocarcinoma receiving TG or PG were included. We performed a propensity score 1:2 matching, and matched datasets were generated and compared.We obtained the patients' long-term survival benefits according to stratification of surgical approaches.

Results: Of 1,291 patients identified from the SEER database, 901 (69.8%) patients received PG and 390 (30.2%) patients received TG. After matching, 584 patients in the PG group were matched by propensity score to 344 patients in the TG group. There were no differences in overall survival and cancer-specific survival in matched data between different surgical approaches. For patients with tumor size ≤4 cm, similar long-term survival was observed in patients receiving PG and TG. For patients with tumor size >4 cm, TG was associated with improved overall survival and cancer-specific survival compared with PG.

Conclusion: This study has shown similar survival outcomes between PG and TG for patients with T2-3 EGJ-UG adenocarcinoma and with tumor size <4 cm.