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| 1 | Risk for gastric neoplasias in patients with chronic atrophic gastritis:A critical reappraisal显示文摘Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inappropriate for location (metaplastic atrophy).Epidemiological data suggest that CAG is associated with two different types of tumors:Intestinal-type gastric cancer (GC) and type Ⅰ gastric carcinoid (TⅠGC).The pathophysiological mechanisms which lead to the development of these gastric tumors are different.It is accepted that a multistep process initiating from Helicobacter pylori-related chronic inflammation of the gastric mucosa progresses to CAG,intestinal metaplasia,dysplasia and,finally,leads to the development of GC.The TⅠGC is a gastrin-dependent tumor and the chronic elevation of gastrin,which is associated with CAG,stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of TⅠGC.Thus,several events occur in the gastric mucosa before the development of intestinal-type GC and/or TⅠGC and these take several years.Knowledge of CAG incidence from superficial gastritis,its prevalence in different clinical settings and possible risk factors associated with the progression of this condition to gastric neoplasias are important issues.This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias. | Lucy Vannella Edith Lahner Bruno Annibale | 2012 | World Journal of Gastroenterology2012，18，12： | 73 |
| 2 | Treatment of Helicobacter pylori infection in atrophic gastritis显示文摘Helicobacter pylori(Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmission of infection. There is no ideal treatment for Hp. Hp infection is not cured by a single antibiotic, and sometimes, a combined treatment with three or more antibiotics is ineffective. Atrophic gastritis(AG) is a chronic disease whose main features are atrophy and/or intestinal metaplasia of the gastric glands, which arise from long-standing Hp infection. AG is reportedly linked to an increased risk for gastric cancer, particularly when extensive intestinal metaplasia is present. Active or past Hp infection may be detected by conventional methods in about two-thirds of AG patients. By immunoblotting of sera against Hp whole-cell protein lysates, a previous exposure to Hp infection is detected in all AG patients. According to guidelines, AG patients with Hp positivity should receive eradication treatment. The goals of treatment are as follows:(1) Cure of infection, resolution of inflammation and normalization of gastric functions;(2) possible reversal of atrophic and metaplastic changes of the gastric mucosa; and(3) prevention of gastric cancer. An ideal antibiotic regimen for Hp should achieve eradication rates of approximately 90%, and complex multidrug regimens are required to reach this goal. Amongst the factors associated with treatment failure are high bacterial load, high gastric acidity, Hp strain, smoking, low compliance, overweight, and increasing antibiotic resistance. AG, when involving the corporal mucosa, is linked to reduced gastric acid secretion. At a non-acidic intra-gastric p H, the efficacy of the common treatment regimens combining proton pump inhibitors with one or more antibiotics may not be the same as that observed in patients with Hp gastritis in an acid-producing stomach. Although the efficacy of these therapeutic regimens has been thoroughly tested in subjects with Hp infection, there is a paucity of evidence in the subgroupof patients with AG. Bismuth-based therapy may be an attractive treatment in the specific setting of AG, and specific studies on the efficacy of bismuth-based therapies are needed in patients with AG. | Edith Lahner Marilia Carabotti Bruno Annibale | 2018 | World Journal of Gastroenterology2018，24，22： | 57 |
| 3 | Pernicious anemia: New insights from a gastroenterological point of view显示文摘Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B12 defi ciency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen .Without performing Schilling's test,intrinsic factor deficiency may not be proven, andintrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Longstanding Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastricbody mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron defi ciency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids. | Edith Lahner Bruno Annibale | 2009 | World Journal of Gastroenterology2009，15，41： | 13 |
| 4 | Helicobacter pylori and functional dyspepsia: An unsolved issue?显示文摘Patients with Helicobacter pylori(H. pylori) infection may complain of dyspeptic symptoms without presence of macroscopic lesions on gastroduodenal mucosa. Such a condition is usually recognized as functional dyspepsia, and different pathogenetic mechanisms are involved. The role of H. pylori in these patients is controversial. Several trials assessed the potential role of H. pylori eradication in improving dyspeptic symptoms, and data of some meta-analyses demonstrated that cure of infection is associated with a small(10%), but significant therapeutic gain as compared to placebo. The reason for which dyspeptic symptoms regress in some patients following bacterial eradication, but persist in others remains unclear. Regrettably, trials included in the meta-analyses are somewhat different for study design, definition of symptoms, assessment of symptoms changes, and some may be flawed by potential pitfalls. Consequently, the information could be not consistent. We critically reviewed the main available trials, attempting to address future research in this | Angelo Zullo Cesare Hassan Vincenzo De Francesco Alessro Repici Raffaele Manta Silverio Tomao Bruno Annibale Dino Vaira | 2014 | World Journal of Gastroenterology2014，20，27： | 8 |
| 5 | Helicobacter pylori infection and drugs malabsorption显示文摘Drug absorption represents an important factor affecting the efficacy of oral drug treatment.Gastric secretion and motility seem to be critical for drug absorption.A causal relationship between impaired absorption of orally administered drugs and Helicobacter pylori(H.pylori)infection has been proposed.Associations have been reported between poor bioavailability of l-thyroxine and l-dopa and H.pylori infection.According to the Maastricht Florence Consensus Report on the management of H.pylori infection,H.pylori treatment improves the bioavailability of both these drugs,whereas the direct clinical benefits to patients still await to be established.Less strong seems the association between H.pylori infection and other drugs malabsorption,such as delavirdine and ketoconazole.The exact mechanisms forming the basis of the relationship between H.pylori infection and impaired drugs absorption and/or bioavailability are not fully elucidated.H.pylori infection may trigger a chronic inflammation of the gastric mucosa,and impaired gastric acid secretion often follows.The reduction of acid secretion closely relates with the wideness and the severity of the damage and may affect drug absorption.This minireview focuses on the evidence of H.pylori infection associated with impaired drug absorption. | Edith Lahner Camilla Virili Maria Giulia Santaguida Bruno Annibale Marco Centanni | 2014 | World Journal of Gastroenterology2014，20，30： | 6 |
| 6 | Lack of specific association between gastric autoimmunity hallmarks and clinical presentations of atrophic body gastritis显示文摘AIM: To investigate the possible relationships between gastric autoimmune phenomena and clinical presentations of this disorder, in consecutive atrophic body gastritis patients.METHODS: A total of 140 atrophic body gastritis patients,diagnosed as consecutive outpatients presenting with macrocytic or iron deficiency anemia, or longstanding dyspepsia underwent gastroscopy with antral and body biopsies, assay of intrinsic factor, parietal cells and Helicobacter pylori(H pylori) antibodies. Gastritis was assessed according to Sydney System.RESULTS: Parietal cell antibodies were equally distributed in all clinical presentations, whereas the positivity of intrinsic factor antibodies (49/140, 35%) was significantly higher in pernicious anemia patients (49.2%) than in iron deficiency (21.1%) and dyspeptic patients (27.8%). No specific pattern of autoantibodies was related to the clinical presentations of atrophic body gastritis. A positive correlation was obtained between the body atrophy score and the intrinsic factor antibody levels (r = 0.2216,P = 0.0085). Associated autoimmune diseases were present in 25/140 (17.9%) patients, but the prevalence of autoimmune diseases was comparable, irrespective of the clinical presentations.CONCLUSION: The so-called hallmarks of gastric autoimmunity, particularly in intrinsic factor antibody cannot be usefully employed in defining an autoimmune pattern in the clinical presentations of ABG. | Bruno Annibale Edith Lahner Riccardo Negrini Flavia Baccini Cesare Bordi Bruno Monarca Gianfranco Delle Fave | 2005 | World Journal of Gastroenterology2005，11，34： | 6 |
| 7 | Artifi cial neural networks in the recognition of the presence of thyroid disease in patients with atrophic body gastritis显示文摘AIM: To investigate the role of artifi cial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artifi cial neural networks (ANNs) using a data optimisation procedure (standard ANNs,T&T-IS protocol,TWIST protocol). The target variable was the presence of thyroid disease. RESULTS: Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specifi city of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy,sensitivity and specifi city of 74.7% and 75.8%,78.8% and 81.8%,and 70.5% and 69.9%,respectively. The increase of sensitivity of the TWIST protocol was statistically signifi cant compared to T&T-IS. CONCLUSION: This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status. | Edith Lahner Marco Intraligi Massimo Buscema Marco Centanni Lucy Vannella Enzo Grossi Bruno Annibale | 2008 | World Journal of Gastroenterology2008，14，4： | 6 |
| 8 | Possible contribution of artificial neural networks and linear discriminant analysis in recognition of patients with suspected atrophic body gastritis显示文摘AIM: To investigate whether ANNs and LDA could recognize patients with ABG in a database, containing only clinical and biochemical variables, of a pool of patients with and without ABG, by selecting the most predictive variables and by reducing input data to the minimum.METHODS: Data was collected from 350 consecutive outpatients (263 with ABG, 87 with non-atrophic gastritis and/or celiac disease [controls]). Structured questionnaires with 22 items (anagraphic, anamnestic, clinical, and biochemical data) were filled out for each patient. All patients underwent gastroscopy with biopsies. ANNs and LDA were applied to recognize patients with ABG.Experiment 1: random selection on 37 variables, experiment 2: optimization process on 30 variables, experiment 3:input data reduction on 8 variables, experiment 4: use of only clinical input data on 5 variables, and experiment 5:use of only serological variables.RESULTS: In experiment 1, overall accuracies of ANNs and LDA were 96.6% and 94.6%, respectively, for predicting patients with ABG. In experiment 2, ANNs and LDA reached an overall accuracy of 98.8% and 96.8%,respectively. In experiment 3, overall accuracy of ANNs was 98.4%. In experiment 4, overall accuracies of ANNs and LDA were, respectively, 91.3% and 88.6%. In experiment 5, overall accuracies of ANNs and LDA were,respectively, 97.7% and 94.5%.CONCLUSION: This preliminary study suggests that advanced statistical methods, not only ANNs, but also LDA,may contribute to better address bioptic sampling during gastroscopy in a subset of patients in whom ABG may be suspected on the basis of aspecific gastrointestinal symptoms or non-digestive disorders. | Edith Lahner Enzo Grossi Marco Intraligi Massimo Buscema Vito D Corleto Gianfranco Delle Fave Bruno Annibale | 2005 | World Journal of Gastroenterology2005，11，37： | 4 |
| 9 | Hepatic metastases from gastric cancer:A surgical perspective显示文摘Management of patients with hepatic metastases as the sole metastatic site at diagnosis of gastric cancer(synchronous setting) or detected during follow-up(metachronous) is controversial. The prevailing attitude in these cases is passive, leading to surgical palliation and, possibly, to chemotherapy. Authors focused this editorial in order to promote a more pragmatic attitude. They stress the importance of recognizing the good candidates to curative surgery of both gastric cancer and hepatic metastases(synchronous setting) or hepatic disease alone(metachronous disease) from those who will not benefit from surgical therapy. In fact, in adequately selected subgroup of patients surgery, especially if integrated in multimodal therapeutic strategies, may achieve unexpected 5-year survival rates, ranging from 10% to 40%. The critical revision of the literature suggests that some simple clinical criteria exist that may be effectively employed in patients selection. These are mainly related to the gastric cancer(factors T, N, G) and to the extent of hepatic involvement(factor H). Upon these criteria it is possible to adequately select about 50% of cases. In the remaining 50% of cases a critical discussion on a case-by-case basis is recommended, considering that among these patients some potential long-survivors exist, that survival is strictly influenced by the ablation of the tumor bulk and by multimodality treatments including chemotherapy and that in expert institutions this kind of surgery is performed with very low mortality and morbidity rates. | Guido Alberto Massimo Tiberio Franco Roviello Annibale Donini Giovanni de Manzoni | 2015 | World Journal of Gastroenterology2015，21，41： | 2 |
| 10 | Intestinal metaplasia surveillance:Searching for the roadmap显示文摘Atrophic gastritis and intestinal metaplasia(IM) of the stomach are common and are associated with an increased risk for gastric cancer.In the absence of guidelines,a pragmatic management has been performed in Western countries in patients with these premalignant conditions.Recently,formal European guidelines have been delivered on this topic.Basically,it has been recommended that patients with extensive atrophic gastritis(AG) and/or extensive IM should be offered endoscopic surveillance every 3 years.On the contrary,no scheduled endoscopic/histological control has been advised for those patients with precancerous conditions confined to the antrum.In this commentary,we highlighted some potential weaknesses in the management formally recommended by the new guidelines.In detail,we discussed that AG and IM patients do not share the same gastric cancer risk,at least in Western countries,deserving a different approach.Some factors significantly associated with gastric cancer risk,such as IM type,first-degree family history of gastric cancer,and smoking habit have not been considered in tailoring the endoscopic follow-up.Finally,some data would suggest that a 3-year follow-up in patients with extensive gastric precancerous conditions could result in an inadequate secondary prevention. | Angelo Zullo Cesare Hassan Alessandro Repici Bruno Annibale | 2013 | World Journal of Gastroenterology2013，19，10： | 2 |
| 11 | The stomach and iron deficiency anaemia: a forgotten link显示文摘 | B Annibale G Capurso G Delle Fave | 2003 | Digestive and Liver Disease2003，，4： | 2 |
| 12 | Full Robotic Gastrectomy with Extended (D2) Lymphadenectomy for Gastric Cancer: Surgical Technique and Preliminary Results显示文摘 | Annibale D’Annibale Vito Pende Graziano Pernazza Igor Monsellato Paolo Mazzocchi Giorgio Lucandri Emilio Morpurgo Tania Contardo Gianna Sovernigo | 2011 | Journal of Surgical Research2011，，2： | 2 |
| 13 | Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate显示文摘 | Merola Elettra Sbrozzi-vanni Andrea Panzuto Francesco D’ambra Giancarlo Di Giulio Emilio Pilozzi Emanuela Capurso Gabriele Lahner Edith Bordi Cesare Annibale Bruno Delle Fave Gianfranco | 2012 | Neuroendocrinology2012，，3： | 2 |
| 14 | Systematic review: gastric cancer incidence in pernicious anaemia显示文摘 | L. Vannella E. Lahner J. Osborn B. Annibale | 2012 | Aliment Pharmacol Ther2012，，4： | 2 |
| 15 | Malignant ascites: pathophysiology and treatment显示文摘 | Emanuel Cavazzoni Walter Bugiantella Luigina Graziosi Maria Silvia Franceschini Annibale Donini | 2013 | International Journal of Clinical Oncology2013，，1： | 2 |
| 16 | Concomitant altera- tions in intragastric pH and ascorbic acid concentration in patients with heficobacter pylori gastritis and associated iron deficiency anaemia显示文摘 | Annibale B Capurso G Lahner E | 2003 | Gut2003，52，4： | 1 |
| 17 | Iron deficiency anemia and Helicobacter pylori infection显示文摘 | Annibale B Capurso G Martino G | 2000 | Int J Antimicrob Agents2000，16，4： | 1 |
| 18 | Heat transfer enhancement by air injection in upward heated mixed-convection flow of water 显示文摘 | CELATA G P CHIARADIA A ANNIBALE F D | 1999 | Int J of Multiphase Flow1999，25，： | 1 |
| 19 | Directcontact evaporation of nearly saturated R114 in water显示文摘 | CELATA G P CUMO M D'ANNIBALE F | 1995 | International Journal of Heat and Mass Transfer1995，38，8： | 1 |
| 20 | A genome-wide scan for linkage to human exceptional longevity identifies a locus on chromosome 4 显示文摘 | Mark J D Stephanie J | 2001 | Proc Natl Acad Sci USA2001，98，10： | 1 |
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