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Open Access Research article

Evaluation and clinical significance of the stomach age model for evaluating aging of the stomach-a multicenter study in China

Qin-Yan Gao123, Zhen-Hua Wang123, Yun Cui123, Jian-Qiu Sheng4, Kun-He Zhang5, Rui-Hua Shi6, Jian-Ming Xu7, Wei-Chang Chen8, Xiu-Li Zuo9, Shu-De Li10, Yue-Xiang Chen11, Yan-Yan Song12 and Jing-Yuan Fang123*

Author Affiliations

1 GI Division, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai Institution of Digestive Disease, 145 Middle Shandong Rd, Shanghai 200001, China

2 Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Shanghai Jiao-Tong University, 145 Middle Shandong Rd, Shanghai 200001, China

3 State Key Laboratory of Oncogene and Related Genes, 145 Middle Shandong Rd, Shanghai 200001, China

4 The Military General Hospital of Beijing PLA, 5 East sishitiao nanmencang, Beijing 100700, China

5 The First Affiliated Hospital of NanChang University, 17 Yongwaizheng Street, Nanchang 330006, China

6 The First Affiliated Hospital of NanJing Medical University, 300 Guangzhou Rd, Nanjing 210029, China

7 The First Affiliated Hospital of Anhui University, 218 Jixi Rd, Hefei 230022, China

8 The First Affiliated Hospital of SooChow University, 188 Shizi Street Suzhou 215006, China

9 Qilu Hospital of Shandong University, 107 West Wenhua Rd, Jinan 250012 China

10 Second Military Medical University Changhai Hospital, 168 Changhai Rd, Shanghai 200433, China

11 Second Military Medical University Changzheng Hospital, 415 Fengyang Rd, Shanghai 200003, China

12 Department of Statistics, Shanghai Jiao-Tong University School of Medicine, 227 South Chongqing Rd, Shanghai 200025, China

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BMC Clinical Pathology 2014, 14:29  doi:10.1186/1472-6890-14-29

Published: 28 June 2014

Abstract

Background

A higher prevalence of chronic atrophic gastritis (CAG) occurs in younger adults in Asia. We used Stomach Age to examine the different mechanisms of CAG between younger adults and elderly individuals, and established a simple model of cancer risk that can be applied to CAG surveillance.

Methods

Stomach Age was determined by FISH examination of telomere length in stomach biopsies. Δψm was also determined by flow cytometry. Sixty volunteers were used to confirm the linear relationship between telomere length and age while 120 subjects were used to build a mathematical model by a multivariate analysis. Overall, 146 subjects were used to evaluate the validity of the model, and 1,007 subjects were used to evaluate the relationship between prognosis and Δage (calculated from the mathematical model). ROC curves were used to evaluate the relationship between prognosis and Δage and to determine the cut-off point for Δage.

Results

We established that a tight linear relationship between the telomere length and the age. The telomere length was obvious different between patients with and without CAG even in the same age. Δψm decreased in individuals whose Stomach Age was greater than real age, especially in younger adults. A mathematical model of Stomach Age (real age + Δage) was successfully constructed which was easy to apply in clinical work. A higher Δage was correlated with a worse outcome. The criterion of Δage >3.11 should be considered as the cut-off to select the subgroup of patients who require endoscopic surveillance.

Conclusion

Variation in Stomach Age between individuals of the same biological age was confirmed. Attention should be paid to those with a greater Stomach Age, especially in younger adults. The Δage in the Simple Model can be used as a criterion to select CAG patients for gastric cancer surveillance.

Keywords:
Stomach Age; Chronic atrophic gastritis; Gastric cancer surveillance; Model