Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10472-10483
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10472
Lamb’s tripe extract and vitamin B12 capsule plus celecoxib reverses intestinal metaplasia and atrophy: A retrospective cohort study
Si-Ran Wu, Jie Liu, Li-Feng Zhang, Na Wang, Lu-Yao Zhang, Qiong Wu, Jun-Ye Liu, Yong-Quan Shi
Si-Ran Wu, Jie Liu, Li-Feng Zhang, Na Wang, Lu-Yao Zhang, Yong-Quan Shi, State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital, Air Force Military Medical University, Xi'an 710032, Shaanxi Province, China
Qiong Wu, Department of Clinical Nutrition, Xijing Hospital, Air Force Military Medical University, Xi'an 710032, Shaanxi Province, China
Jun-Ye Liu, Department of Radiation Protective Medicine, Air Force Military Medical University, Xi'an 710032, Shaanxi Province, China
Author contributions: Wu SR, Liu J, Shi YQ, Wu Q, and Liu JY designed the research; Wu SR, Liu J, Zhang LF, and Zhang LY made up the methodology; Liu J, Zhang LF, Zhang LY, and Wang N performed the research; Wu SR, Liu J, Zhang LY, and Wu Q managed the data; Liu J, Wu Q, Liu JY, and Wang N acquired the funding; Wu SR and Liu J finished the original draft; Shi YQ, Liu JY, and Wu Q reviewed and edited the paper.
Supported by Shaanxi Foundation for Innovation Team of Science and Technology, No. 2018TD-003; and Project from State Key Laboratory of Cancer Biology, No. 2019CBSKL2019ZZ07.
Institutional review board statement: This study was performed in accordance with the ethical principles for medical research as outlined in the Declaration of Helsinki. The study was approved by the institutional research ethics committee of the First Affiliated Hospital, the Air Force Medical University (KY20212048-C-1).
Informed consent statement: According to the approval of the institutional research ethics committee of the First Affiliated Hospital, the Air Force Medical University, this retrospective cohort study could be applied with exception to the requirement of informed consent forms or documents.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Quan Shi, MD, Chief Physician, Doctor, State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital, Air Force Military Medical University, No. 127 Changle West Road, Xincheng District, Xi'an 710032, Shaanxi Province, China. shiyquan@fmmu.edu.cn
Received: March 27, 2021
Peer-review started: March 27, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: October 24, 2021
Article in press: October 24, 2021
Published online: December 6, 2021
Processing time: 247 Days and 23.6 Hours
ARTICLE HIGHLIGHTS
Research background

A large number of intestinal metaplasia (IM) patients need to be effectively treated, which can successfully reduce the risk of gastric cancer (GC). Some medicines have showed the potential to reverse the IM lesion. It would help doctors in clinical practice and refute the concept that IM could not be reversed.

Research motivation

Lamb’s tripe extract and vitamin B12 capsule (LTEVB12) and celecoxib have been proved to reverse IM in past studies. But the IM regression effect of LTEVB12 and celecoxib still have to be evaluated thoroughly by operative link on gastritis assessment (OLGA) and operative link on the gastric intestinal metaplasia assessment (OLGIM) stages. What’s more, the combination of these two kinds of drugs may enhance the effect of IM regression.

Research objectives

This study aimed to validate the efficacy of LTEVB12 initial therapy and celecoxib rescue therapy on IM.

Research methods

This study was a retrospective cohort study. A total of 255 patients were included to receive LTEVB12 initial therapy in this study. The patients with failure of IM regression continued to celecoxib receive rescue therapy. After each therapy finished, patients underwent endoscopy and biopsy examination. OLGA and OLGIM stages were applied to evaluate the reversal of atrophic gastritis (AG) and IM.

Research results

For LTEVB12 initial therapy, the reversal rates of IM and AG were 52.95% and 48.24%, respectively. For celecoxib rescue therapy, the effective rates for IM and AG were 56.25% and 51.56%, respectively. The IM regression rate of complete therapy was up to 85.03% (P < 0.05). For both therapies, patients with high stages (III or IV) of both OLGA and OLGIM evaluation systems showed a higher IM or AG regression rate than those patients with low stages (I or II). Among high stage (OLGIM III and IV) patients, the IM regression rate was above 70% for each therapy.

Research conclusions

Each monotherapy could effectively reverse IM and AG. The LTEVB12 initial therapy and celecoxib rescue therapy, significantly increased the regression effect, which showed strong potential to reduce the risk of GC. IM may be not the point of no return among gastric precancerous lesions.

Research perspectives

LTEVB12 initial therapy and celecoxib rescue therapy can achieve better effect on IM regression compared with either monotherapy. IM could be reversed by clinical intervention.