A Comprehensive Analysis For The Early Risk Factors Of Alimentary Tumors

?Study background?Alimentary cancers were several common cancers and several of the most fatal malignancies in the world.The traditional treatments for them include surgery,radiotherapy and chemotherapy.However,the therapeutic effects of them were unsatisfactory due to the low efficiency of surgery and the side effects of chemoradiotherapy.Thus,it is needed to explore the effective detection methods and feasible preventative methods.The diagnosis of early alimentary tumors is very important to the diagnosis and therapy of them,which can improve the over 5-year survival rate.In the wake of developments in molecular diagnostics,enhancing the early diagnosis,exploring the potential risk factors and studying the candidate molecular markers are becoming the promising methods.In addition,lifestyle factors may be associated with the development of tumors,specifically alimentary tumors.The lifestyle intervention may be used as inversed factors for the alimentary tumors and the precancerous lesions.Therefore,we will comprehensively explore the associations between lifestyle factors and the developments of the alimentary tumors and the precancerous lesions by systematic review and meta-analysis.Furthermore,we will carry out a series of experiments to detect the potential molecular markers and verify their functions associated with the developments of the alimentary tumors and the precancerous lesions,and find the novel methods for the prevention,early diagnosis and treatments of the alimentary tumors and the precancerous lesions.In this study,the alimentary tumors included esophageal cancer,gastric cancer,pancreatic cancer and colorectal cancer;the precancerous lesions included Barrett's esophagus,the precancerous lesions of stomach and colorectal adenoma.?Study aims?1.To evaluate the diagnosis efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions.2.To explore the associations between lifestyle factors and the risks of esophageal cancer and Barrett's esophagus.3.To explore the associations between red meat and processed meat consumption and gastric cancer risk.4.To explore the associations between fruit,vegetable,red meat and processed meat consumption and the risks of pancreatic cancer.5.To explore the associations between red meat and processed meat consumption and the risks of colorectal cancer and colorectal adenoma.6.To explore the potential markers for gastric cancer and to detect their functions in the developments of gastric cancer.?Study methods?1.We performed a systematic search of Pubmed,Embase,and Cochrane library to identify all eligible studies according to inclusion and exclusion standards that examined the diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions.2.We performed a systematic search of Pubmed,Embase,Cochrane library and Web of Science to identify all eligible studies to analyze the associations between lifestyle risk factors and the risks of esophageal cancer and Barrett's esophagus.3.We performed a systematic search of Pubmed and Embase to identify all eligible studies to analyze the associations between lifestyle risk factors(consumption of red meat and processed meat)and the risk of gastric cancer.4.We performed a systematic search of Pubmed,Embase,and Web of Science to identify all eligible studies to analyze the associations between lifestyle risk factors(consumption of fruit,vegetable,red meat and processed meat)and the risk of pancreatic cancer.5.We performed a systematic search of Pubmed,Embase,and Web of Science to identify all eligible studies to analyze the associations between lifestyle risk factors and the risks of colorectal cancer and adenoma.6.We explored the potential markers for gastric cancer by analyzing the database of TCGA and the analysis of proteomics in the human tissues of gastric cancer and the adjacent tissues.?Study results?1.Ten studies met the inclusion standards,including a total of 699 patients and 902 lesions.The pooled sensitivity,specificity,and area under the curve of CE were 0.90(95% confidence interval,0.87-0.92),0.82(95% confidence interval,0.79-0.86),and 0.9464,respectively.In subgroup analysis of diagnostic accuracy,CE showed higher accuracy versus standard white light endoscopy for EGC(P = 0.005)and PGLs(P = 0.001).2.Sixty-two studies were included that involved more than 240,000 participants and 12,000 cases.Smoking,alcohol consumption,high body fatness and less sleep time are associated with increased risk of BE.Aspirin use and the consumption of vitamin C,folate and dietary fiber may be protective against BE.A total of eight studies were included in this analysis.Dietary vegetable not fruits consumption may be associated with decreased BE risk.Fat and red and processed meat consumption may not contribute to an increased BE risk.We finally selected 22 eligible studies and we found case-control but not cohort studies to associate consumption of red and processed meat with EC risk.3.We finally selected 42 eligible studies and the present analysis suggested null results between red and processed meat consumption and GC risk in cohort studies,although case-control studies yielded positive associations.4.Twelve prospective studies were eligible and the meta-analysis does not support significant associations between fruit and vegetable consumption and PC risk.We collected and analyzed data from a total of 28 studies and we found case-control but not cohort studies to associate consumption of red and processed meat with risk of PC.5.We ultimately selected 60 eligible studies and in the systematic review and meta-analysis,we found consumption of red and processed meat was associated with the risk of overall colorectal cancer but not rectal cancer.We identified 40 studies and our analysis provided evidence that the consumption of red meat and processed meat was associated with an increased incidence of CRA.There were no associations between the consumption of total meat and white meat with CRA incidence.No associations were found between total meat,white meat,red meat and processed meat consumption and the recurrence of CRA.6.We found two candidate molecular markers for gastric cancer,including HSP47,PDGFR-? and S100A9.We found significantly different expression of S100A9 in gastric cancer cell lines and GES,and in the tissues of gastric cancer and adjacent tissues.?Study conclusions?1.Chromoendoscopy seems to have a high diagnostic efficacy and improve the detection of EGC and PGLs compared with standard white light endoscopy.2.Smoking,alcohol consumption,high body fatness and less sleep time are associated with increased risk of BE.Aspirin use and the consumption of vitamin C,folate and dietary fiber may be protective against BE.Dietary vegetable not fruits consumption may be associated with decreased BE risk.Case-control but not cohort studies are associated with consumption of red and processed meat with EC risk.Further large prospective studies are needed to validate these findings.3.Case-control but not cohort studies are associated with consumption of red and processed meat with GC risk.Further large prospective studies are needed to validate these findings.4.Case-control but not cohort studies are associated with consumption of red and processed meat with PC risk.No significant associations are found between fruit and vegetable consumption and PC risk.Further large prospective studies are needed to validate these findings.5.Consumption of red and processed meat was associated with the risk of overall colorectal cancer but not rectal cancer.The consumption of red meat and processed meat was associated with an increased incidence of CRA.6.The significantly different expressions of S100A9 were associated with the development of gastric cancer.