Modulation of Risks of Gastric Cancer after H.pylori Eradication
梁伟强
时长:23:13 分会场:2019中国肠道大会 - 消化道肿瘤大会
Helicobacter pylori (HP) infection is the most important cause of non-cardia gastric cancer, which is triggered by chronic gastric inflammation. Eradication of HP could reduce the risk of subsequent gastric cancer by about 50%, but not totally eliminate the risk. In particular, patients with advanced pre-neoplastic gastric lesions may still progress to gastric cancer development despite successful HP eradication. In this regard, we have recently shown that eradication in older patients (>60 years) could still result in significant reduction in gastric cancer risk [1]. The chemopreventive effects, however, would be more obvious with longer time lapse (>10 years) from eradication therapy. Apart from HP eradication, we have also evaluated the roles of other potential chemopreventive agents on post-HP eradication gastric cancer development. Aspirin is one of the most frequently used chemopreventive agents, particularly on prevention of gastrointestinal cancers. Our territory wide cohort study showed that the use of aspirin was associated with a frequency-, dose-, and duration-dependent reduction in gastric cancer risk after HP eradication [2]. The effect was most prominent in those who used aspirin daily or for five or more years. Moreover, the use of metformin was also found to reduce the risk of gastric cancer development among diabetic patients who had HP eradicated [3]. In contrast, gastric atrophy is generally considered to be an important risk factor for gastric cancer. It however remains controversial whether the use of proton pump inhibitors (PPIs), with potent acid suppressive effects, would result in a higher risk of gastric cancer. Past studies are largely confounded by the difference in HP infection statuses and relatively short follow up duration. Our recent study showed that even after H. pylori eradication, long term use of PPIs are still associated with an increased risk of gastric cancer by about two-fold [4]. Subgroup analysis further showed that the increased cancer risk was only observed among those non-aspirin users but not aspirin users. Hence, long-term PPIs could still be used cautiously among high risk patients. In conclusion, we have shown in this series of studies that chemopreventive agents (aspirin and metformin) as well PPIs could further modulate the risk of gastric cancer development after HP eradication.
梁伟强
香港大学玛丽医院内科学系
"伟强教授现任李树芬医学基金会胃肠学教授和香港大学李嘉诚医学院人力资源副院长。同时,梁教授担任香港玛丽医院综合内视镜中心联合主任。梁教授1991年毕业于香港中文大学内科学院,并于威尔士亲王医院完成住院医师和专科培训。随后,梁教授赴美国贝勒医学院消化内科进行海外深造。 梁教授在胃肠病学和内视镜检查领域有广泛的研究,包括幽门螺杆菌和胃部癌变,炎症性肠病,胶囊内镜检查,大肠镜筛查和胃肠癌的表观遗传变化。梁教授发表了大量文章,被引用次数超过12,000次,H因子为59(Scopus)。梁教授担任《Helicobacter》,《Best Practice & Research – Clinical Gastroenterology》, 《Journal of Digestive Disease》和《中华消化杂志》期刊的编委会成员。梁教授曾任2013-2015年度香港炎症性肠病协会主席,2017年度亚太消化病周科学委员会主席。 "
更多视频
Role of the Microbiome in Cancer
Emad El-Omar 时长:30:27
Gut microbiome - bile acid its impact on liver cancer development
Bile acids are critical components of the gastrointestinal tract that link the gut microbiota to hepatic and intestinal metabolism and therefore influence gastrointestinal motility, intestinal permeability, and carcinogenesis. The gut microbiota regulates bile acid production and signalling via the biotransformation of intestinal bile acids to unconjugated and secondary forms that readily activate bile acid receptors. Bile acids are also ligands for the G protein-coupled bile acid receptor 1 (TGR5) and for the nuclear hormone receptor farnesoid X receptor (FXR). The profiles of bile acids and gut microbiota influence each other; bile acids can modulate microbiota composition, which in turn regulates the size and composition of the bile acid pool. Disruption of bile acid–microbiota crosstalk promotes inflammation and a gastrointestinal disease phenotype, which can contribute to the development of gastrointestinal cancers, including colorectal cancer and hepatocellular carcinoma (HCC). This presentation will discuss our recent population and animal studies on the gut microbiome – bile acid crosstalk and its role in the development of HCC. We would also highlight that the modulation of gut microbiota and bile acid profiles holds promise as a novel therapeutic approach for the treatment of gastrointestinal cancers and represents the next frontier for gastrointestinal cancer research.
贾伟 时长:24:42
Translating gut microbiota research in digestive cancers;ideas,data and realization
结直肠癌是一种重要的全球性癌症。元基因组学研究揭示了结直肠癌患者的微生物变化,功能性研究阐明了几种细菌在结直肠癌发生中的作用,包括核梭杆菌,某些大肠杆菌和脆弱拟杆菌。最近的研究也指出,肠道微生物群对于癌症治疗亦非常重要,尤其是在免疫疗法的功效。这些发现为利用这些微生物进行临床应用提供了新的机会。 在众多的临床应用中,生物标志物是其中最具潜力的一环,是诊断疾病存或其严重程度的指标。鉴于结直肠癌持续上升及早期癌症的可治疗性,发展一个精确的非侵入性测试有重大的公共卫生意义。肠道菌群为结直肠癌筛查和疾病预测提供了丰富的生物标志物来源。在这次分享中,我将回顾结肠直肠癌微生物群的最新文献,并讨论肠道微生物群在结肠直肠癌诊断和治疗中的临床应用。
黄曦 时长:29:43
评论