Infections

All Conditions

Symptoms and General Pathology

Neoplasms

Digestive System Diseases

Rare Diseases

Communicable Diseases

Stomach Neoplasms

Atrophy

Gastritis, Atrophic

Metaplasia

Gastritis

Carcinoma

Carcinoma in Situ

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Gastroenteritis

Stomach Cancer

According the endoscopic reports and pathological reports, the decision support system recognise patients' disease types and grades, and generate guidelines based survilliance or treatment recommendations.

AI recongnize disease and generate recommendations

The purpose of this study is to develop and validate a clinical decision support system based on automated algorithms. This system can use natural language processing to extract data from patients' endoscopic reports and pathological reports, identify patients' disease types and grades, and generate guidelines based follow-up or treatment recommendations

Artificial Intelligence for Determination of Gastroscopy Surveillance Intervals

Development and Validation of Gastroscopy Surveillance Recommendations Based on Natural Language Processing for Patients With Gastric Cancer and Precancerous Diseases

The diagnostic accuracy of gastric diseases with deep learning algorithm

The accuracy of recommentions for different disease with deep learning algorithm

The diagnostic sensitivity of gastric diseases with deep learning algorithm

The diagnostic specificity of gastric diseases with deep learning algorithm

The diagnostic positive predictive valu of gastric diseases with deep learning algorithm

The diagnostic negative predictive value of gastric diseases with deep learning algorithm

The F-score of gastric diseases with deep learning algorithm

Xiuli Zuo

director of Qilu Hospital gastroenterology department

Adenocarcinoma

Endoscopic mucosal resection removes tissue in a piece meal technique or by snare limited to the mucosa.

The waterjet-assisted endoscopic submucosal dissection (WESD) technology allows pressure controlled injection of fluids through the tip of a recently developed HybridKnife®. Submucosal injection, circumferential cutting and dissection of lesions.

Endoscopic mucosal resection

Waterjet-assisted ESD

HybridKnife

Horst Neuhaus, MD

Conventional techniques of endoscopic mucosal resection (EMR) by snare resection do usually not achieve resection of gastrointestinal mucosal neoplastic lesions larger than 1 cm in diameter in a single piece. Complete R0 resection cannot be histologically confirmed. In contrast to EMR the technique of endoscopic submucosal dissection (ESD) allows en-bloc resection even of large neoplastic lesions. The waterjet-assisted ESD technology (WESD) allows pressure controlled injection of fluids through the tip of a recently developed HybridKnife®. Submucosal injection, circumferential cutting and dissection of lesions as well as coagulation of bleeding sources can be performed with the same device without need for changing the instrument. Our group reported on effective en-bloc resection of esophageal areas in all of 14 cases of an Erlangen porcine model. We subsequently compared WESD with EMR of predefined esophageal mucosal lesions in anesthetizised pigs in a randomized controlled trial. The results demonstrated that WESD more frequently achieved a complete resection with a significantly lower number of specimen. WESD caused no perforations and bleedings could be endoscopically managed during the procedure. In addition we recently reported on this technology in a first clinical trial on WESD for early Barrett's neoplasia . The results indicated that WESD can be safely and effectively performed in the esophagus.

Therefore the primary objective of this study is to compare the R0 resection rate of ESD and EMR for visible lesions of HIgh grade intraepithelial neoplasia (HGIN) or esophageal adenocarcinoma (EAC). Secondary objectives are related to completeness of resection, safety of the procedures, the medium term outcome and comparison of costs.

Conventional techniques of endoscopic mucosal resection (EMR) by snare resection do usually not achieve resection of gastrointestinal mucosal neoplastic lesions larger than 1 cm in diameter in a single piece ("en-bloc"). En-bloc resection can even fail in cases of smaller lesions depending on their location and shape. Extension of EMR by piecemeal resection is therefore frequently required for removal of the targeted neoplastic area. However the histological evaluation of several specimen can usually not identify the outer margins of the neoplastic area. Thus complete R0 resection cannot be histologically confirmed. Histologically important additional information, e.g. infiltration of lymphatic vessels or submucosal infiltration may be missed in between resected specimen due to coagulation artifacts or left tissue bridges. In addition piecemeal EMR of early neoplasia in Barrett's esophagus is associated with a high recurrence rate probably because of minor remnants of neoplastic tissue. In contrast to EMR the technique of endoscopic submucosal dissection (ESD) allows en-bloc resection even of large neoplastic lesions. Variations of this method have been increasingly used for various types of early gastrointestinal neoplasia mainly in Asian countries. In Japan ESD has been approved for treatment of selected cases of early gastric and colorectal neoplasia as an alternative to surgery. A recent meta-analysis of non-randomized controlled trials showed that ESD of early gastrointestinal tumors is superior to EMR in terms of en-bloc resection and curative resection rates but it is more time-consuming and is associated with higher rates of bleeding and perforation. A few small series on ESD were also reported from Western countries.

The waterjet-assisted ESD technology (WESD) allows pressure controlled injection of fluids through the tip of a recently developed HybridKnife®. Submucosal injection, circumferential cutting and dissection of lesions as well as coagulation of bleeding sources can be performed with the same device without need for changing the instrument. These options should accelerate the procedure and may increase its safety and efficacy. Experimental trials in ex vivo and in vivo pig models showed that the gastrointestinal mucosa of different sites can be effectively and safely lifted by gentle placement of the HybridKnife® on the wall and needleless injection of saline solution with pressures between 30 - 70 bar. Our group reported on effective en-bloc resection of esophageal areas in all of 14 cases of an Erlangen porcine model. We subsequently compared WESD with EMR of predefined esophageal mucosal lesions in anesthetizised pigs in a randomized controlled trial. The results demonstrated that WESD more frequently achieved a complete resection with a significantly lower number of specimen. WESD caused no perforations and bleedings could be endoscopically managed during the procedure.

Furthermore, we applied WESD for early gastric neoplasia in a prospective single center study. This study involved 29 consecutive patients. The results confirmed the experimental findings that WESD simplifies the ESD procedure and can be effectively and safely performed. Repici et al. applied the WESD methodology to colorectal neoplasia larger than 3 cm in diameter. Also this clinical study showed that WESD is a safe and effective method to provide en-bloc and curative resection of selected cases of colorectal neoplastic lesions.

In addition we recently reported on this technology in a first clinical trial on WESD for early Barrett's neoplasia. The results indicated that WESD can be safely and effectively performed in the esophagus. It achieved en-bloc resection of early BE neoplasia in 27 of 30 patients. The rate of histologically complete resection (R0) was 38.5 % which was higher than previously reported for focal EMR of BE-EAC. We discussed that higher rates can be expected in case of well delineated lesions and definition of R0 resection as histologically complete resection of adenocarcinoma or HGIN. This definition would not consider LGIN at lateral margins as incomplete resection which is in accordance to a recent trial on ESD of early colorectal neoplasia. Possible remnants of LGIN seem to be clinically irrelevant because they are not considered as exclusion criteria for RFA after complete endoscopic removal of HGIN or EAC. RFA is considered to be the best available ablation technique for eradication of residual BE mucosa after focal EMR. On the other hand R0 resection of HGIN or EAC is considered to be important because a complete histological evaluation of the specimen minimizes the risk of overlooking criteria for advanced tumor stages (e.g. cancerous infiltration of lymphatic vessels or submucosal tissue) which are related with an increased risk of lymph node metastases thus requiring major surgery. The risk of a more advanced lesion is increased in visible lumps or nodules consisting of HGIN. In this context it should be considered that there is poor inter-observer agreement among pathologists in distinguishing HGD from intra-mucosal adenocarcinoma.

Therefore the primary objective of this study is to compare the R0 resection rate of ESD and EMR for visible lesions of HGIN or EAC. Secondary objectives are related to completeness of resection, safety of the procedures, the medium term outcome and comparison of costs.

ESD Versus EMR for Treatment of Early Barrett's Adenocarcinoma

Water-jet Assisted Endoscopic Submucosal Dissection (ESD) Versus Endoscopic Mucosal Resection (EMR) for Treatment of Early Barrett's Adenocarcinoma

Evangelisches Krankenhaus Düsseldorf

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Uterine Cervical Neoplasms

Papillomavirus Infections

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Uterine Cervical Diseases

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Sexually Transmitted Diseases

Sexually Transmitted Diseases, Viral

Virus Diseases

DNA Virus Infections

Tumor Virus Infections

Disease Attributes

High-risk HPV testing for the cytology of lower genital tract

High-risk HPV

Thin prep liquid-based cytology test for the cytology of lower genital tract

Lei Li, M.D.

Ming Wu, M.D.

Lei Li, MD

This study is to investigate the oncologic and obstetric outcomes in patients with conization for uterine cervical lesions from January 1, 2000 to January 1, 2019 in Peking Union Medical College Hospital.

The primary objectives consist of following:

1. The cumulative incidences of precancerous lesions and cancers of lower genital tract in patients who accepted conization for high grade intraepithelial neoplasia (HSIL), carcinoma in situ and stage IA1 cancer (FIGO 2009)
2. The cumulative pregnancy rates in patients sparing the fertility

The secondary objectives consist of following:

1. The effects of surgical protocols (modified Sturmdorf method and "8" figure suture) and energy equipment (cold knife and monopolar electrical cautery) on the oncologic and obstetric outcomes, and on the histological components.
2. A full description of histological components of the conization specimens
3. The cytological and virus outcomes after conization, based on the thin prep liquid-based cytology test (TCT) and high-risk human papillomavirus (HPV) testing

A Cohort Study for the Following up of Conization

Oncologic and Obstetric Outcomes After Conization for Uterine Cervical Lesion: A Cohort Study

The cumulative incidences of precancerous lesions and cancers of lower genital track in patients who accepted conization for high grade intraepithelial neoplasia (HSIL), carcinoma in situ and stage IA1 cancer (FIGO 2009)

The cumulative pregnancy rates in patients sparing the fertility

The cytological after conization based on the thin prep liquid-based cytology test (TCT)

The virus outcomes after conization high-risk human papillomavirus (HPV) testing

The cumulative pregnancy loss rates in patients sparing the fertility

The cumulative live birth rates in patients sparing the fertility

Lei Li

Professor

Vulvar Neoplasms

Vulvar Diseases

Vulvar Cancer

Anti-Infective Agents

Antineoplastic Agents

All Drugs and Chemicals

Artesunate

Artemisinins

Artemisinin

Artenimol

Antimalarials

Antiprotozoal Agents

Antiparasitic Agents

Antiviral Agents

Anthelmintics

Artesunate formulated as topical ointment, 40% Four 5-day cycles of artesunate ointment every 2 weeks

Placebo ointment Four 5-day cycles of placebo ointment every 2 weeks

topical ointment, as a non-surgical treatment

Artesunate ointment

Placebo ointment

Mihaela Plesa

Ahmad Bayat, MD

Edward C. Grendys, MD FACOG, FACS

Donna White

Megan Park

Chad Michener, MD

Mariam AlHilli, MD

Steven Waggonner, MD

Robert DeBernardo, MD

Roberto Vargas, MD

Lindsey Beffa, MD

Johanna Kelley, MD

Daniel Margul, MD

Michelle Kuznicki, MD

This is a phase II double-blind, placebo-controlled study of artesunate ointment for the treatment of HPV-associated vulvar HSIL (usual type vulvar intraepithelial neoplasia 2/3).

Eligible participants in this study are randomized 2:1 to receive either artesunate or placebo ointment for the treatment of vulvar HSIL. Both groups receive four 5-day cycles of topical ointment, at weeks 0, 2, 4, and 6. Dosing visits may be done in person or as telehealth (ointment may be shipped directly to the patient). Participants are followed closely with vulvar examinations or colposcopies at weeks 8, 18, 6-months and 12-months.

Double-blind, placebo-controlled randomized trial

This study is only for biological females

Phase II Study of Artesunate Ointment for the Treatment of Vulvar High Grade Squamous Intraepithelial Lesions (Vulvar HSIL, VIN2/3)

A Phase II Double-blind, Placebo-controlled, Randomized Trial of Topical Artesunate Ointment for the Treatment of Patients With Vulvar High-grade Squamous Intraepithelial Lesions (Vulvar HSIL)

Number of participants who have complete histologic response following topical artesunate ointment

Number of participants who achieve clearance of HPV genotypes present at screening. These genotypes become undetectable over the study window.

Number of participants with documented partial response following topical artesunate

Number of participants with documented complete response who do not have recurrence of their vulvar HSIL over the study window

Number of participants who report artesunate-related serious adverse events

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Artificial Intelligence for Determination of Gastroscopy Surveillance Intervals	NCT05631015	Helicobacter Py... Atrophic Gastri... Intestinal Meta... Low Grade Intra... High Grade Intr... Early Gastric C... Gastric Cancer	AI recongnize d...	18 Years - 80 Years	Shandong University
ESD Versus EMR for Treatment of Early Barrett's Adenocarcinoma	NCT01871636	High Grade Intr... Barrett Adenoca...	Endoscopic muco... Waterjet-assist... HybridKnife	18 Years -	Evangelisches Krankenhaus Düsseldorf
A Cohort Study for the Following up of Conization	NCT03961178	Precancerous Le... Conization High Grade Intr... Uterine Cervica... Fertility Pregnancy Human Papilloma...	High-risk HPV TCT	18 Years -	Peking Union Medical College Hospital
Artificial Intelligence for Determination of Gastroscopy Surveillance Intervals	NCT05631015	Helicobacter Py... Atrophic Gastri... Intestinal Meta... Low Grade Intra... High Grade Intr... Early Gastric C... Gastric Cancer	AI recongnize d...	18 Years - 80 Years	Shandong University
ESD Versus EMR for Treatment of Early Barrett's Adenocarcinoma	NCT01871636	High Grade Intr... Barrett Adenoca...	Endoscopic muco... Waterjet-assist... HybridKnife	18 Years -	Evangelisches Krankenhaus Düsseldorf
Phase II Study of Artesunate Ointment for the Treatment of Vulvar High Grade Squamous Intraepithelial Lesions (Vulvar HSIL, VIN2/3)	NCT06075264	Vulvar Diseases HPV Infection Vulvar HSIL Pre-Cancerous D... HPV Disease VIN, Usual Type VIN 2 of Usual ... VIN 3 of Usual ... Vin II Vin III VIN Grade 2 VIN Grade 3 High Grade Intr...	Artesunate oint... Placebo ointmen...	18 Years -	Frantz Viral Therapeutics, LLC

Spots Global Cancer Trial Database for high grade intraepithelial neoplasia