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I am a gastroenterologist who seeks to use both science and clinical practice to improve the prevention, diagnosis, and therapy of digestive malignancies. My clinical practice is focused on the use of advanced endoscopic imaging procedures (such as endoscopic ultrasound, chromoendoscopy, and confocal endomicroscopy) to improve cancer detection, and therapeutic endoscopic procedures to remove or destroy cancer and precancerous lesions.My research is aimed at improving digestive cancer outcomes and reducing cancer disparities through data science, cohort building, and biomarker development. My research is currently supported by an NIH Mentored Career Development Award (K08CA252635). I have formal pre-doctoral (NIH-Clinical Research Training Program) and post-doctoral (T32DK007056) training in epidemiology and clinical research.
The goal of the Stanford GPC Study is to 1) identify non-invasive markers to identify patients at high risk for advanced GPCs and 2) develop molecular risk stratification models to predict which patients with advanced GPCs will progress onto gastric cancer. We are seeking to recruit subjects between the ages of 30 to 84 with 1) a personal history of GPC (either intestinal metaplasia or gastric atrophy) 2) a family history of gastric cancer or 3) dyspepsia or abdominal pain. The research involves a brief questionnaire, blood draw, saliva specimen, and gastric biopsies. We hope that through this research we will develop molecular tests which will improve the early detection of gastric cancer.
EpidemiologyEpidemiology of gastric cancerRacial and ethnic disparities in gastric cancer Gastric intestinal metaplasia and other precancerous lesionsMolecular marker developmentMicrobiome
The GAstric Precancerous Conditions Study
Gastric cancer afflicts 27,000 Americans annually and carries a dismal prognosis. One reason
for poor outcomes is late diagnosis, as the majority of gastric cancers in the United States
are diagnosed at a relatively advanced stage where curative resection is unlikely. Gastric
intestinal metaplasia (GIM) is a precancerous change of the stomach which increases risk for
subsequent gastric cancer multiple-fold.
The Gastric Precancerous Conditions Study (GAPS) is an observational study with two
over-arching objectives: 1) improve the non-invasive identification of patients with GIM, and
2) develop biological markers to predict the subset of GIM which will progress onto gastric
To achieve Aim 1, a case-control study (N=300 pairs) matching cases of GIM with
age-/gender-matched controls will be recruited form the population of subjects undergoing
clinically-indicated endoscopy. Determination of gastric pathology will be made by two,
independent gastrointestinal pathologists. At time of endoscopy, a detailed clinical
questionnaire is administered by face-to-face interview. Saliva and blood is collected prior
to endoscopy. At time of endoscopy, protocoled clinical biopsies (per Revised Sydney
Protocol) as well as additional research specimens are collected. Scoring of GIM will be
performed based on the Operative Link for GIM scoring system.
To achieve Aim 2, patients with histologically-confirmed GIM (N=300) will be followed
longitudinally. Biennial endoscopic surveillance will be performed, with repeat biopsies,
specimen collection, and histologic scoring. Progression of GIM will be defined as upstaging
of GIM score, or development of either dysplasia or carcinoma on any biopsy.
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The Gastric Cancer Foundation: A Gastric Cancer Registry
The Gastric Cancer Registry will combine data acquired directly from patients with gastric
cancer; with a family history of gastric cancer in a first or second degree relative; or
persons with a known germline mutation in their CDH1 (E-Cadherin) gene via an online
questionnaire with genomic data obtained from saliva, blood and tissue samples. The purpose
of this registry is to gain better understanding of the causes of gastric cancer, both
environmental and genetic; whether certain genomic data can predict outcomes of treatment and