Sy Leung

An evaluation of invasive and non-invasive tests for the diagnosis of Helicobacter pylori infection in Chinese.

Different tests are available for diagnosing Helicobacter pylori infection.

13C‐urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese

Conventional 13C‐urea breath testing (13C‐UBT) includes a test meal to delay gastric emptying, which, theoretically, improves the accuracy of the test. Citric acid has been proposed as the best test meal. However, recent studies have suggested that a test meal may not be necessary.

One-week ranitidine bismuth citrate-based triple therapy for the eradication of Helicobacter pylori in Hong Kong with high prevalence of metronidazole resistance.

To compare 1‐week ranitidine bismuth citrate‐based (RBC) triple therapy vs. omeprazole‐based (O) triple therapy for the eradication of Helicobacter pylori infection in Hong Kong with high prevalence of metronidazole resistance.

Aberrant epithelial expression of trefoil family factor 2 and mucin 6 in Helicobacter pylori infected gastric antrum, incisura, and body and its association with antralisation

Aims: To determine gastric expression of trefoil family factor 2 (TFF2) and MUC6 in Helicobacter pylori positive and negative subjects, and its association with antralisation at the gastric incisura. Methods: Gastric biopsies from the antrum, incisura, and body of 76 dyspeptic patients without ulcers were used for the determination of H pylori infection, histological changes, and epithelial TFF2 and MUC6 expression. Results: In the foveola, the rates of TFF2 and MUC6 immunostaining were greater in H pylori infected (n  =  27) than in uninfected patients (n  =  49) at the antrum (59.3% v 4.1% for TFF2 and 63.0% v 4.1% for MUC6; both p < 0.001) and incisura (44.4% v 2.0% for TFF2 and 48.1% v 0% for MUC6; both p < 0.001). In the deeper glands, the rates were also greater in H pylori infected than in uninfected patients at the incisura (85.2% v 22.4% for both TFF2 and MUC6; p < 0.001). Antral-type mucosa was present at the incisura in 28 of the 76 patients. TFF2 and MUC6 expression in the foveola and deeper glands was significantly associated with antral-type mucosa, independent of H pylori status. Conclusions:Helicobacter pylori infection increases the expression of TFF2 and MUC6 in the gastric epithelium. Aberrant TFF2 and MUC6 expression is associated with antralisation of gastric incisura.

Helicobacter pylori infection, interleukin 1 beta polymorphism andpredisposition to gastric cancer through the CpG island methylation pathway

Aims: Artificial neural networks (ANN) are computer programs used to identify complexrelations within data that cannot be detected with conventional linear-statistical analysis.The routine clinical predictions of need for lower gastrointestinal endoscopy have beenbased on population statistics with little meaning for individual patient. This results in largenumber of unnecessary colonoscopies. We aimed to develop a neural network algorithmwhich can accurately predict presence of pathology in patients attending routine outpatientclinics. Methods: 300 patients undergoing lower gastrointestinal endoscopy prospectivelycompleted a specifically developed questionnaire which included 40 variables based onclinical symptoms, signs, past and family history. Complete data sets of 50 percent of serieswere used to train the artificial neural network; the remaining 50 percent were used forinternal validation. The primary output used was a positive finding on the colonoscopy,including polyps, cancer, diverticular disease or colitis. Results: The outcome and pathologyreports of all the patients were obtained and assessed. Clear correlation between actual datavalue and artificial neural network value were found (r = 0.931; P = 0.0001). The predictiveaccuracy of neural network was 95% in the training group and was 89% (95% CI 84-96)in the validation set. This accuracy was significantly higher than the clinical accuracy (69%).Conclusions: We have shown that ANN is more accurate than standard statistics whenapplied to prediction in individual patients of need for lower gastrointestinal endoscopy.These results have obvious implications, with at least 20% resultant decrease in need forunnecessary lower gastrointestinal endoscopy. The logistic and economic impact with thisdevelopment is tremendous.Andrea M. Harrington, Margaret Lee, Sim-Yee Ong, Eric Yong, Pam Farmer, John M. Hutson and Bridget R. Southwell

Restoration of XAF1 expression inhibits gastric and colonic tumorigenesis in vivo

This journal suppl. contain abstracts of the 8th Medical Research Conference, Medical Science Group, Queen Mary Hospital, Hong Kong

Aberrant epithelial expression of trefoil family factor 2 and mucin 6 in helicobacter pylori-infected gastric antrum, incisura and body: a useful marker for antralization

Aberrant epithelial expression of trefoil family factor 2 and Mucin 6 in helicobacter pylori-infected gastric antrum, incisura and body—a useful marker for antralization YI YANG, HARRY HUA-XIANG XIA, SHIU KUM LAM, WAI MAN WONG, HESS KWAN LOK CHEUNG, SUET YI LEUNG, SIU TSAN YUEN, GOERGE ELIA, NICHOLAS A WRIGHT, BENJAMIN CHUN YU WONG Departments of Medicine and Pathology,The University of Hong Kong, Queen Mary Hospital, Hong Kong, China and Histopathology Unit, Imperial Cancer Research Fund, London, UK