Latest information on COVID-19
Support teaching, research, and patient care.
I am a gastroenterologist with a clinical focus on advanced endoscopic procedures including ERCP, endoscopic ultrasound, and techniques of advanced endoscopic resection of neoplastic and malignant lesions of the gastrointestinal tract.My research is aimed at improving the diagnosis and management of gastrointestinal malignancies though epidemiology, clinically-impactful biomarkers, understanding genetic bases of cancer risk, and evaluation of next generation sequencing methods for cancer prevention in real-world settings. 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.
Epidemiology<br/>Epidemiology of gastric cancer<br/>Racial and ethnic disparities in gastric cancer <br/>Gastric intestinal metaplasia and other precancerous lesions<br/>Molecular marker development
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.
View full details