AIM: To study gastric mucosal interleukine-8 (IL-8) mRNA expression, the cytotoxin-associated gene A (cagA) mutation, and serum pepsinogen (PG) I/II ratio related risk in Thai gastric cancer. METHODS: There were consent 134 Thai non-cancer volunteers who underwent endoscopic narrow band imaging examination, and 86 Thais advance gastric cancer patients who underwent endoscopic mucosal biopsies and gastric surgery. Tissue samples were taken by endoscopy with 3 points biopsies. The serum PG I, II, and Helicobacter pylori (H. pylori) immunoglobulin G (IgG) antibody for H. pylori were tested by enzyme-linked immunosorbent assay technique. The histopathology description of gastric cancer and non-cancer with H. pylori detection was defined with modified Sydney Score System. Gastric mucosal tissue H. pylori DNA was extracted and genotyped for cagA mutation. Tissue IL-8 and cyclooxygenase-2 (COX-2) mRNA expression were conducted by real time relative quantitation polymerase chain reaction. From 17 Japanese advance gastric cancer and 12 benign gastric tissue samples, all were tested for genetic expression with same methods as well as Thai gastric mucosal tissue samples. The multivariate analysis was used for the risk study. Correlation and standardized t-test were done for quantitative data, P value < 0.05 was considered as a statistically significant. RESULTS: There is a high non cagA gene of 86.8 per cent in Thai gastric cancer although there are high yields of the East Asian type in the positive cagA. The H. pylori infection prevalence in this study is reported by combined histopathology and H. pylori IgG antibody test with 77.1% and 97.4% of sensitivity and specificity, respectively. The serum PG I/II ratio in gastric cancer is significantly lower than in the non-cancer group, P = 0.045. The serum PG I/II ratio of less than 3.0 and IL-8 mRNA expression ≥ 100 or log₁₀≥ 2 are significant cut off risk differences between Thai cancer and non-cancer, P = 0.03 and P < 0.001, respectively. There is a significantly lower PGI/II ratio in Japanese than that in Thai gastric cancer, P = 0.026. Serum PG I/II ratio at cut off less than 3.0 and IL-8 mRNA expression Raw RQ > 100 or log₁₀ > 2 are significantly difference between Thai cancer group when compared to non-cancer group, P = 0.013 and P < 0.001, respectively. In the correlation study, low PG I/II ratio does not associate with chronic atrophic gastritis severity score in Thais non-cancer cases. However, there is a trend, but not significant convert correlation between IL-8 mRNA expression level and low PG I/II ratio in Thai positive H. pylori infection. The high expression of IL-8 gene demonstrates a poorer prognosis by stage and histology. CONCLUSION: Predominant gastric mucosal IL-8 mRNA expression level, H. pylori infection, and low PG I/II ratio are relative risks for Thai gastric cancer without correlation with cagA mutation.

Background: Mesh repair is the current recommendation for the treatment of incisional hernia; however, the best mesh has yet to be determined. The objective of this study was to compare the inflammatory response and collagen deposition in primary incisional hernia repair (P) and different macroporous mesh materials, including polypropylene with poliglecaprone (PP-PG), polyvinylidene fluoride (PVDF), and polyester (PE), using quantitative methods. Methods: Sixty male rats were divided into four groups. Anterior abdominal wall defects were created and either suture or mesh repair was done. Rats were euthanized on days 14, 90, and 180, and the gross findings were recorded. The inflammatory and collagen levels in the abdominal wall tissues were measured using enzyme-linked immunosorbent assay (ELISA). Results: The PE group demonstrated significant mesh shrinkage at 180 days. The extent of PE mesh shrinkage ranged from 22–42% (mean = 30.49%). At 14 days, the PVDF group had higher interleukin-6 (IL-6) levels than the PP-PG (P = .004) and PE groups (P = .019). At 90 days, the collagen type I (Col I) levels in the PE group were significantly lower than those in the others, and the collagen type I/III (Col I/III) ratios in the PE group were lower than those in the P group (P = .006). Conclusions: The persistently high IL-6 levels until 180 days and the decrease in Col I levels and Col I/III ratio at 90 days seem to predict mesh shrinkage at 180 days. The mesh induces high Col I levels, but those associated with low Col III levels should be preferred.

Background and Aim: Helicobacter pylori infection rates and severity and susceptibility to gastric diseases vary widely in different populations because of different H. pylori strains, lifestyles, and genetic factors. South and Southeast Asia is a region where many ethnic groups are intermingled, and H. pylori strains have been shifting from Western‐type to East Asian‐type strains. We aimed to investigate the different endoscopic and histopathologic features in five South and Southeast Asian countries.Methods: We examined differences in endoscopic and histopathological gastritis and H. pylori infection status in 2426 patients from South and Southeast Asian populations in Vietnam, Thailand, Myanmar, Bangladesh, and Nepal.Results: Among Asian patients with abdominal symptoms, such as epigastric pain, nausea, abdominal discomfort, constipation, and heartburn, the prevalence of gastric disease, H. pylori infection status (current, past, and non‐infection), and severity of histopathological gastritis significantly differed between countries. Less than 10% of patients had atrophy and intestinal metaplasia, irrespective of country and H. pylori infection status; their severity when present was also mild. Although patients with gastric cancer had higher rates of atrophy and intestinal metaplasia compared with those with other diseases, half of them had no pathological atrophy or intestinal metaplasia.Conclusions: Gastric condition and susceptibility to gastric disease differed among South and Southeast Asian populations. H. pylori infection rates remain high in Asian countries, but the frequency and severity of atrophy and gastric mucosal atrophy were low.

Systemic chemotherapy may relieve symptoms and induce tumor downstaging in patients with unresectable gastric cancer. However, the survival benefit of primary tumor resection after chemotherapy remains unclear. This study aimed to determine the survival outcomes of conversion surgery in patients with unresectable gastric cancer. This retrospective cohort study reviewed the data of patients with unresectable advanced gastric cancer treated with systemic chemotherapy between 2005 and 2019. The primary outcome was overall survival (OS). Patient characteristics and clinicopathological stages were assessed. The rates of conversion surgery and tumor progression after conversion surgery were determined. The study included 86 patients, of whom 26 (30.2%) responded to systemic chemotherapy and underwent conversion surgery. Most patients had a diffuse-type, poorly differentiated adenocarcinoma, a single non-curative factor, and peritoneal metastasis, if present. The leucovorin plus oxaliplatin regimen was the dominant first-line chemotherapy regimen. All patients who underwent conversion surgery achieved R0 resection. The median time to progression was 8.9 months. The median survival time was 25.8 (95% confidence interval [CI], 19.88–32.85) months in the conversion group and 10.1 (95% CI, 6.54–11.93) months in the non-conversion group (p < 0.001). For patients with unresectable advanced gastric cancer who respond favorably to systemic chemotherapy, conversion surgery should be considered as a treatment option. This approach can improve OS and delay disease progression. Nonetheless, the present study could not reveal the predictors of OS besides chemotherapy resistance. Therefore, a multimodal approach combining systemic chemotherapy with conversion surgery should be considered.

Background/Objectives: Gastric cancer (GC) remains a major health burden in Northern Thailand. Elevated expression of interleukin-8 (IL-8) and vascular endothelial growth factor A (VEGF-A) is often associated with poor prognosis and tumor progression in gastric cancer. However, the concurrent expression of VEGF-A and IL-8 regarding chemotherapy response and survival outcomes in Thai patients remains poorly understood. This study characterizes VEGF-A and IL-8 expression profiles in Northern Thai gastric cancer patients to fill these knowledge gaps. Methods: mRNA expression of VEGF-A and IL-8 was analyzed in 83 advanced GC patients using RT-qPCR. Outcomes were evaluated by using Kaplan-Meier curves and multivariable Cox proportional-hazard models to identify independent prognostic factors. Results: VEGF-A was upregulated in 31.51% of patients, while IL-8 was elevated in 71.15%. No significant correlation was found between VEGF-A and IL-8; 53.19% of cases showed discordant patterns (high IL-8 level with low VEGF-A level). Post-treatment VEGF-A induction was observed in a subset of patients. Multivariable analysis identified VEGF-A overexpression as an independent predictor of poor prognosis (Hazard Ratio: 2.09; P<0.05). Neoadjuvant chemotherapy was associated with superior survival compared to adjuvant regimens. Conclusions: VEGF-A and IL-8 display unique expression patterns and differential responses to chemotherapy. The independent prognostic value of VEGF-A and its compensatory upregulation highlight its potential as a clinically actionable biomarker. These findings support personalized molecular profiling to guide anti-angiogenic and combinatorial therapies in Northern Thai GC patients.