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  • 1
    Keywords: CERVICAL-CANCER ; COLON-CANCER ; HUMAN-PAPILLOMAVIRUS DNA ; POLYMERASE-CHAIN-REACTION ; HELICOBACTER-PYLORI ; EPSTEIN-BARR-VIRUS ; HUMAN CYTOMEGALOVIRUS ; JC virus ; MULTIPLEX PCR ; STREPTOCOCCUS-BOVIS
    Abstract: Numerous studies have found the presence of viral DNA in colorectal tumor tissues. However, whether viral infections contribute to the risk of colorectal cancer (CRC) is still under debate. We aimed to provide an overview of published epidemiological studies on the association between viral infections and CRC. A systematic literature search was performed in PubMed to find relevant studies published until 8 May 2014. Information collected included study population, sample type, laboratory method and prevalence of viral infection in cancer or precancer patients and controls. We found 41 studies that fulfilled the selection criteria, all of which had cross-sectional or case-control designs, and most of which were of small to moderate size. Viral infections included human papillomaviruses (HPV), human polyomaviruses, human herpesviruses, human bocavirus and Inoue-Melnick virus. Inconsistent results were observed across studies. Many studies reported higher viral DNA prevalence in tumor tissues than in normal noncancerous tissues either in the same patients or in CRC-free controls. However, potential contamination or temporal sequence of the infection and cancer development were often unclear. Seroprevalence studies assessing antibody titers indicative of viral infections did not find statistically significant differences between CRC cases and healthy controls. Overall published evidence on the role of viral infections in CRC etiology remains limited. Given the potential importance of viral infections and their implication for prevention, there is a strong need for large, methodologically rigorous epidemiological studies.
    Type of Publication: Journal article published
    PubMed ID: 25186851
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  • 2
    Keywords: PATHWAY ; DIFFERENTIATION ; QUERCETIN ; MUTATIONS ; adenocarcinoma ; GASTRIC-CANCER ; WNT ; BETA-CATENIN EXPRESSION ; TUMOR STEM-CELLS ; DYSREGULATION
    Abstract: OBJECTIVES: Risk of pancreatic cancer between Helicobacter pylori infected and noninfected persons is controversial, and therefore a meta-analysis was performed. METHODS: PubMed was searched up to September 2014. Only population-based nested case-control studies comparing the serological prevalence of Helicobacter pylori between pancreatic cancer cases and cancer-free controls were eligible. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for pancreatic cancer risk between Helicobacter pylori infected and noninfected persons were estimated. RESULTS: Five eligible nested case-control studies were included, with 1446 pancreatic cancer cases and 2235 cancer-free controls. On the whole, the proportion of pancreatic cancer cases among those infected with Helicobacter pylori was not significant different from those noninfected (OR, 0.99; 95% CI, 0.65-1.50; P = 0.96). Likewise, seropositivity of cytotoxin-associated gene A (CagA) showed nonsignificant association with pancreatic cancer (OR, 0.92; 95% CI, 0.65-1.30; P = 0.63). The CagA-positive virulent strains of Helicobacter pylori did not increase the risk of pancreatic cancer (OR, 0.97; 95% CI, 0.50-1.89; P = 0.93). However, CagA-negative nonvirulent strains of Helicobacter pylori had a significant increased risk for pancreatic cancer (OR, 1.47; 95% CI, 1.11-1.96; P = 0.008). CONCLUSIONS: The CagA-negative non-virulent strains of Helicobacter pylori may be a potential risk factor of pancreatic cancer. High-quality prospective large-scaled studies are required for more conclusive results.
    Type of Publication: Journal article published
    PubMed ID: 26390415
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  • 3
    Abstract: OBJECTIVES: To compare the proportion of stage I lung cancer and population mortality in China to those in U.S. and Europe where lung cancer screening by low-dose computed tomography (LDCT) has been already well practiced. METHODS: The proportions of stage I lung cancer in LDCT screening population in U.S. and Europe were retrieved from NLST and NELSON trials. The general proportion of stage I lung cancer in China was retrieved from a rapid meta-analysis, based on a literature search in the China National Knowledge Infrastructure database. The lung cancer mortality and prevalence of China, U.S. and Europe was retrieved from Globocan 2012 fact sheet. Mortality-to-prevalence ratio (MPR) was applied to compare the population survival outcome of lung cancer. RESULTS: The estimated proportion of stage I lung cancer in China is merely 20.8% among hospital-based cross-sectional population, with relative ratios (RRs) being 2.40 (95% CI 2.18-2.65) and 2.98 (95% CI 2.62-3.38) compared by LDCT-screening population in U.S. and Europe trials, respectively. MPR of lung cancer is as high as 58.9% in China, with RRs being 0.46 (95% CI 0.31-0.67) and 0.58 (95% CI 0.39-0.85) compared by U.S. and Europe, respectively. CONCLUSIONS: By the epidemiological inference, the LDCT mass screening might be associated with increasing stage I lung cancer and therefore improving population survival outcome. How to translate the experiences of lung cancer screening by LDCT from developed counties to China in a cost-effective manner needs to be further investigated.
    Type of Publication: Journal article published
    PubMed ID: 27705946
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  • 4
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  • 5
    Keywords: CARE ; OUTCOMES ; MANAGEMENT ; GUIDELINES ; COSTS ; SEPTIC SHOCK
    Abstract: OBJECTIVES: This study describes the epidemiological and microbiological profile of sepsis during the first decade of the 21(st) century in mainland China. METHODS: The sepsis-related mortality data from 2003 and 2007 were retrieved from the China Health Statistical Yearbook. The microbiology data were retrieved and selected from a literature search of the China Academic Journal Database between 2001 and 2009. A meta-analysis was performed to synthesize the available data on the proportion of positive blood cultures in septic patients and the microorganism distribution. RESULTS: The sepsis mortality in small and medium-sized cities and rural areas declined obviously over time. The mortality of the subpopulations aged 1-54 years tended to be lower than the national averages. In contrast, the sepsis mortality among neonates and the elderly (〉/=75 years) was obviously higher than national averages. While the mortality in the elderly declined between 2003 and 2007, the neonate sepsis mortality increased dramatically, especially among male neonates. The overall positivity of blood culture were 17.0%, 13.3% and 10.6% among neonatal, pediatric and adult patients with suspected sepsis, respectively; this proportion tended to decrease over time. Among identified microorganisms, the proportions of Gram (+) and (-) bacteria were similar (47.2% vs. 44.5%) among adult patients, while Gram (+) bacteria was predominant among neonatal (77.4%) and pediatric (73.2%) patients and increased in prevalence over time. The positivity of blood cultures and proportions of microorganisms varied by geographical region across mainland China. Sepsis with fungus was rare but was more prevalent in adult sepsis patients (6.4%) than in neonatal patients (0.8%). CONCLUSIONS: The difference in sepsis mortality between urban and rural areas decreased over time. Males, the elderly, and neonates were found to be high-risk subpopulations. Gram (+) bacteria were predominant among neonates with sepsis, but the proportion of patients with Gram (+) or Gram (-) bacteria was similar among adults with sepsis.
    Type of Publication: Journal article published
    PubMed ID: 25455799
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  • 6
    Keywords: RISK ; HUMAN-PAPILLOMAVIRUS ; POLYMERASE-CHAIN-REACTION ; adenocarcinoma ; NASOPHARYNGEAL CARCINOMA ; HELICOBACTER-PYLORI INFECTION ; EBV ; CLINICOPATHOLOGICAL FEATURES ; GASTRODUODENAL DISEASES ; IN-SITU DETECTION
    Abstract: Epstein-Barr virus (EBV) infection is found in a subset of gastric cancers. Previous reviews have exclusively focused on EBV-encoded small RNA (EBER) positivity in gastric cancer tissues, but a comprehensive evaluation of other type of studies is lacking. We searched the PubMed database up to September, 2014, and performed a systematic review. We considered studies comparing EBV nucleic acids positivity in gastric cancer tissue with positivity in either adjacent non-tumor tissue of cancer patients or non-tumor mucosa from healthy individuals, patients with benign gastric diseases, or deceased individuals. We also considered studies comparing EBV antibodies in serum from cancer patients and healthy controls. Selection of potentially eligible studies and data extraction were performed by 2 independent reviewers. Due to the heterogeneity of studies, we did not perform formal meta-analysis. Forty-seven studies (8069 cases and 1840 controls) were identified. EBER positivity determined by in situ hybridization (ISH) was significantly higher in cancer tissues (range 5.0%-17.9%) than in adjacent mucosa from the same patients or biopsies from all control groups (almost 0%). High EBV nuclear antigen-1 (EBNA-1) positivity by PCR was found in gastric cancer tissues, but most were not validated by ISH or adjusted for inflammatory severity and lymphocyte infiltration. Only 4 studies tested for EBV antibodies, with large variation in the seropositivities of different antibodies in both cases and controls, and did not find an association between EBV seropositivity and gastric cancer. In summary, tissue-based ISH methods strongly suggest an association between EBV infection and gastric cancer, but PCR method alone is invalid to confirm such association. Very limited evidence from serological studies and the lack of novel antibodies warrant further investigations to identify potential risk factors of EBV for gastric cancer.
    Type of Publication: Journal article published
    PubMed ID: 25997049
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