Relationship between Red Blood Cell Distribution Width (RDW), Bilirubin, and Clinical Characteristics of Patients with Gastric Cancer

The purpose of the present study was to investigate whether a relationship exists between bilirubin, RDW, and prognostic factors for gastric cancer (tumor stage - tumor markers). Methods: The study included 112 individuals admitted to Tishreen University Hospital and the Oncology Center in Latakia during the period between July 2018 and December 2019. They were distributed into two groups as follow: the group of gastric cancer patients included 56 patients (33 males and 23 females) between the ages of 37 and 83 years, and the control group included 56 individuals (34 males and 22 females) between the ages of 37 and 80 years. The stage of gastric cancer was evaluated based on the AJCC (American Joint Committee on Cancer) cancer staging system. Patients were interrogated, and social and behavioral information were obtained, then venous blood samples were obtained for biomedical evaluation. Statistical analysis was done using SPSS version 25 software. Results: Bilirubin and RDW were significantly associated with the prognostic factors of gastric cancer. RDW was positively associated with the tumor stage and tumor markers (CEA and CA19-9). Total bilirubin (TBIL) and indirect bilirubin (IBIL) were negatively associated with these factors, while direct bilirubin (DBIL) showed no significant association. Patients with gastric cancer had higher RDW than healthy controls, while total bilirubin (TBIL) and indirect bilirubin (IBIL) were significantly decreased. The results of our study indicate that both RDW and bilirubin could be potential prognostic factor for gastric cancer.

The prevalence of gastric intestinal metaplasia through upper gastrointestinal endoscopy and histological study, and association with Helicobacter pylori in the university hospitals of Tishreen university

gastric intestinal metaplasia (GIM) is considered to be a precursor of gastric cancer which is still the fourth most common cancer and second leading cause of cancer related death worldwide after lung cancer. There is also a relationship between gastric intestinal metaplasia and H.pylory which is one of the most important factors predisposing it . As a result, H. pylori eradication is one of the most promising approaches in gastric cancer prevention. The aim of the study was investigated the prevalence of GIM and its subtypes, and the prevalence of H. pylori infection in GIM. the study was conducted on 200 patients who were undergoing esophagogastroduodenoscopy (EGD) with biopsy between January 2016 and April 2017, in the university hospitals of Tishreen university. Specimens were stained with hematoxylin and eosin to determine the pattern of intestinal metaplasia. And Helicobacter pylori was investigated by Giemsa staining. The prevalence of GIM was 16%. The prevalence of complete IM was higher than incomplete IM. The prevalence of H. pylori infection was 50% in GIM, without presence of statistical importance ) P > 0.05). The prevalence of chronic gastritis was 100% in GIM (P Value = 0.02). Gastric intestinal metaplasia was more prevalent in older patients. GIM is a common finding in patients undergoing EGD with biopsy in our region. Chronic gastritis is considered as the most important reason for the development of GIM.

Risk Factors of Esophagojejunal Anastomotic Leakage after Gastrectomy for Gastric Cancer

This is s retrospective analytic study of 27 cases of esophagojejunal anastomotic leakage after gastrectomy for gastric cancer during the period 1\1\1997 -1\1\2014 at AL Assad University Hospital, Lattakia, Syria. The most common risk factors of leakage were: factors related to the patient: (age, sex, hemoglobin level, total protein level, and albumin level); factors related to surgical resection: (combined resection of other organs, mechanical and manual esophago-jejunostomy) and factors related to the tumor: (tumor stage, tumor location, and ends of anastomosis free of tumor)

Serologic detection of CagA positive Helicobacter pylori in patients with different gastroduodenal diseases

This study aimed to know the relation between cagA positive Helicobacter pylori (HP) strains and diseases such as gastric and duodenal ulcers and gastric adenocarcinoma. The study included 61 dyspeptic patients from gastrointestinal (GI) endoscopy department patients in Al-Assad university hospital in Lattakia. During upper (GI) endoscopy, gastric biopsy specimens were obtained for Clo-test and histologic examination. Blood was obtained from Clo-test positive patients for serologic tests of HP and cagA. After upper (GI) endoscopy and histologic examination, patients were divided into 4 groups: chronic gastritis (28 patients), gastric ulcer (5 patients), duodenal ulcer (17 patients) and gastric adenocarcinoma (11 patients). CagA antibodies were positive in 68.85% of patients. The difference in the proportion of CagA antibody positive between the four groups was highly significant (P= 0.006). The highest positive proportion was in gastric adenocarcinoma (90.91%) then duodenal ulcer (88.24%) then gastric ulcer (80%), while the lowest positive proportion was in chronic gastritis (46.43%). There was no difference in HP antibody levels between the four groups (P = 0.90) but these levels were significantly higher in cagA+ patients compared to cagA- (P= 0.05). This study found a positive relation between cagA+ and diseases such as peptic ulcer and gastric adenocarcinoma in Syria .

Comparing Conventional and Laparoscopic Gastrectomy for Cancer

To compare total and subtotal gastrectomy performed by laparoscopic technique with those performed by open surgery, and to determine whether laparoscopic surgery has an important role and advantages in gastric resection.