Pub Date : 2024-09-07DOI: 10.3748/wjg.v30.i33.3846
Raffaele Pellegrino, Antonietta Gerarda Gravina
Bibliometric analyses are increasing in the field of gastric cancer. This letter discusses a recently published analysis that focused on the bidirectional relationship between depression and gastric cancer and evaluated the types of papers published in this field and the changes in the direction of research. There is an increasing need for new, clinically relevant studies of this association.
{"title":"Depression weights in patients with gastric cancer: Bibliometric analysis as a weapon to chart the future of research.","authors":"Raffaele Pellegrino, Antonietta Gerarda Gravina","doi":"10.3748/wjg.v30.i33.3846","DOIUrl":"10.3748/wjg.v30.i33.3846","url":null,"abstract":"<p><p>Bibliometric analyses are increasing in the field of gastric cancer. This letter discusses a recently published analysis that focused on the bidirectional relationship between depression and gastric cancer and evaluated the types of papers published in this field and the changes in the direction of research. There is an increasing need for new, clinically relevant studies of this association.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.3748/wjg.v30.i33.3803
Eyad Gadour, Sarah Al Ghamdi, Bogdan Miutescu, Hossam E Shaaban, Zeinab Hassan, Aymen Almuhaidb, Hussein H Okasha
This editorial elaborates on the current and future applications of linear endoscopic ultrasound (EUS), a substantial diagnostic and therapeutic modality for various anatomical regions. The scope of endosonographic assessment is broad and, among other factors, allows for the evaluation of the mediastinal anatomy and related pathologies, such as mediastinal lymphadenopathy and the staging of central malignant lung lesions. Moreover, EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations, such as computed tomography or magnetic resonance imaging. We focus on its current uses in the mediastinum, including lung and esophageal cancer staging, as well as evaluating mediastinal lymphadenopathy and submucosal lesions. The editorial also explores future perspectives of EUS in mediastinal examination, including ultrasound-guided therapies, artificial intelligence integration, advancements in mediastinal modalities, and improved diagnostic approaches for various mediastinal lesions.
这篇社论阐述了线性内窥镜超声(EUS)的当前和未来应用,EUS是一种针对不同解剖区域的重要诊断和治疗方式。内窥镜评估的范围很广,除其他因素外,还可评估纵隔解剖和相关病变,如纵隔淋巴结病和肺部中央恶性病变的分期。此外,事实证明 EUS 评估能更准确地检测出计算机断层扫描或磁共振成像等标准成像检查漏诊的小病灶。我们重点介绍了 EUS 目前在纵隔中的应用,包括肺癌和食管癌的分期,以及纵隔淋巴结病变和粘膜下病变的评估。社论还探讨了 EUS 在纵隔检查中的未来前景,包括超声引导治疗、人工智能整合、纵隔模式的进步以及各种纵隔病变的改进诊断方法。
{"title":"Linear endoscopic ultrasound: Current uses and future perspectives in mediastinal examination.","authors":"Eyad Gadour, Sarah Al Ghamdi, Bogdan Miutescu, Hossam E Shaaban, Zeinab Hassan, Aymen Almuhaidb, Hussein H Okasha","doi":"10.3748/wjg.v30.i33.3803","DOIUrl":"10.3748/wjg.v30.i33.3803","url":null,"abstract":"<p><p>This editorial elaborates on the current and future applications of linear endoscopic ultrasound (EUS)<b>,</b> a substantial diagnostic and therapeutic modality for various anatomical regions. The scope of endosonographic assessment is broad and, among other factors, allows for the evaluation of the mediastinal anatomy and related pathologies, such as mediastinal lymphadenopathy and the staging of central malignant lung lesions. Moreover, EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations, such as computed tomography or magnetic resonance imaging. We focus on its current uses in the mediastinum, including lung and esophageal cancer staging, as well as evaluating mediastinal lymphadenopathy and submucosal lesions. The editorial also explores future perspectives of EUS in mediastinal examination, including ultrasound-guided therapies, artificial intelligence integration, advancements in mediastinal modalities, and improved diagnostic approaches for various mediastinal lesions.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.3748/wjg.v30.i33.3818
Shi-Cai Liu, Han Zhang
At present, cancer is still an important factor threatening human health. Colorectal cancer (CRC) is one of the top three most common cancers worldwide and one of the deadliest malignancies in humans. The latest data showed that CRC incidence and mortality rank third and second, respectively, among global malignancies. Early and accurate diagnosis is crucial to reduce the morbidity, mortality and improve survival of patients with CRC, but the current early diagnostic methods have limitations. The effectiveness and compliance of diagnostic methods have a certain impact on whether people choose screening. In this editorial, we explore strategies for the early diagnosis of CRC, including stool-based, blood-based, direct visualization, and imaging examinations.
{"title":"Early diagnostic strategies for colorectal cancer.","authors":"Shi-Cai Liu, Han Zhang","doi":"10.3748/wjg.v30.i33.3818","DOIUrl":"10.3748/wjg.v30.i33.3818","url":null,"abstract":"<p><p>At present, cancer is still an important factor threatening human health. Colorectal cancer (CRC) is one of the top three most common cancers worldwide and one of the deadliest malignancies in humans. The latest data showed that CRC incidence and mortality rank third and second, respectively, among global malignancies. Early and accurate diagnosis is crucial to reduce the morbidity, mortality and improve survival of patients with CRC, but the current early diagnostic methods have limitations. The effectiveness and compliance of diagnostic methods have a certain impact on whether people choose screening. In this editorial, we explore strategies for the early diagnosis of CRC, including stool-based, blood-based, direct visualization, and imaging examinations.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.3748/wjg.v30.i33.3799
Rui-Nan Zhang, Jian-Gao Fan
The incidence rates of hepatocellular carcinoma (HCC) have increased in recent decades. Despite advancements in therapy and early diagnosis improving short-term prognosis, long-term outcomes remain poor. Long noncoding RNAs (lncRNAs) and lipid metabolism play crucial roles in the development and progression of HCC. Enhanced lipid synthesis promotes HCC progression, and lncRNAs can reprogram the expression of lipogenic enzymes. Consequently, lipid metabolism-related (LMR)-lncRNAs regulate lipid anabolism, accelerating the onset and progression of HCC. This suggests that LMR-lncRNAs could serve as novel prognostic biomarkers and therapeutic targets.
{"title":"Lipid metabolism-related long noncoding RNAs: A potential prognostic biomarker for hepatocellular carcinoma.","authors":"Rui-Nan Zhang, Jian-Gao Fan","doi":"10.3748/wjg.v30.i33.3799","DOIUrl":"10.3748/wjg.v30.i33.3799","url":null,"abstract":"<p><p>The incidence rates of hepatocellular carcinoma (HCC) have increased in recent decades. Despite advancements in therapy and early diagnosis improving short-term prognosis, long-term outcomes remain poor. Long noncoding RNAs (lncRNAs) and lipid metabolism play crucial roles in the development and progression of HCC. Enhanced lipid synthesis promotes HCC progression, and lncRNAs can reprogram the expression of lipogenic enzymes. Consequently, lipid metabolism-related (LMR)-lncRNAs regulate lipid anabolism, accelerating the onset and progression of HCC. This suggests that LMR-lncRNAs could serve as novel prognostic biomarkers and therapeutic targets.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.3748/wjg.v30.i33.3823
Qian-Yu Wang, Wen-Tao Zhong, Yi Xiao, Guo-Le Lin, Jun-Yang Lu, Lai Xu, Guan-Nan Zhang, Jun-Feng Du, Bin Wu
Background: A growing body of research indicates significant differences between left-sided colon cancers (LCC) and right-sided colon cancers (RCC). Pan-immune-inflammation value (PIV) is a systemic immune response marker that can predict the prognosis of patients with colon cancer. However, the specific distinction between PIV of LCC and RCC remains unclear.
Aim: To investigate the prognostic and clinical significance of PIV in LCC and RCC patients.
Methods: This multicenter retrospective cohort study included 1510 patients with colon cancer, comprising 801 with LCC and 709 with RCC. We used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival (DFS) in these patients. Kaplan-Meier analysis, as well as univariate and multivariate analyses, were used to examine the risk factors for DFS. The correlation between PIV and the clinical characteristics was statistically analyzed in these patients.
Results: A total of 1510 patients {872 female patients (58%); median age 63 years [interquartile ranges (IQR): 54-71]; patients with LCC 801 (53%); median follow-up 44.17 months (IQR 29.67-62.32)} were identified. PIV was significantly higher in patients with RCC [median (IQR): 214.34 (121.78-386.72) vs 175.87 (111.92-286.84), P < 0.001]. After propensity score matching, no difference in PIV was observed between patients with LCC and RCC [median (IQR): 182.42 (111.88-297.65) vs 189.45 (109.44-316.02); P = 0.987]. PIV thresholds for DFS were 227.84 in LCC and 145.99 in RCC. High PIV (> 227.84) was associated with worse DFS in LCC [PIV-high: Adjusted hazard ratio (aHR) = 2.39; 95% confidence interval: 1.70-3.38; P < 0.001] but not in RCC (PIV-high: aHR = 0.72; 95% confidence interval: 0.48-1.08; P = 0.114).
Conclusion: These findings suggest that PIV may predict recurrence in patients with LCC but not RCC, underscoring the importance of tumor location when using PIV as a colon cancer biomarker.
{"title":"Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location.","authors":"Qian-Yu Wang, Wen-Tao Zhong, Yi Xiao, Guo-Le Lin, Jun-Yang Lu, Lai Xu, Guan-Nan Zhang, Jun-Feng Du, Bin Wu","doi":"10.3748/wjg.v30.i33.3823","DOIUrl":"10.3748/wjg.v30.i33.3823","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research indicates significant differences between left-sided colon cancers (LCC) and right-sided colon cancers (RCC). Pan-immune-inflammation value (PIV) is a systemic immune response marker that can predict the prognosis of patients with colon cancer. However, the specific distinction between PIV of LCC and RCC remains unclear.</p><p><strong>Aim: </strong>To investigate the prognostic and clinical significance of PIV in LCC and RCC patients.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included 1510 patients with colon cancer, comprising 801 with LCC and 709 with RCC. We used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival (DFS) in these patients. Kaplan-Meier analysis, as well as univariate and multivariate analyses, were used to examine the risk factors for DFS. The correlation between PIV and the clinical characteristics was statistically analyzed in these patients.</p><p><strong>Results: </strong>A total of 1510 patients {872 female patients (58%); median age 63 years [interquartile ranges (IQR): 54-71]; patients with LCC 801 (53%); median follow-up 44.17 months (IQR 29.67-62.32)} were identified. PIV was significantly higher in patients with RCC [median (IQR): 214.34 (121.78-386.72) <i>vs</i> 175.87 (111.92-286.84), <i>P</i> < 0.001]. After propensity score matching, no difference in PIV was observed between patients with LCC and RCC [median (IQR): 182.42 (111.88-297.65) <i>vs</i> 189.45 (109.44-316.02); <i>P</i> = 0.987]. PIV thresholds for DFS were 227.84 in LCC and 145.99 in RCC. High PIV (> 227.84) was associated with worse DFS in LCC [PIV-high: Adjusted hazard ratio (aHR) = 2.39; 95% confidence interval: 1.70-3.38; <i>P</i> < 0.001] but not in RCC (PIV-high: aHR = 0.72; 95% confidence interval: 0.48-1.08; <i>P</i> = 0.114).</p><p><strong>Conclusion: </strong>These findings suggest that PIV may predict recurrence in patients with LCC but not RCC, underscoring the importance of tumor location when using PIV as a colon cancer biomarker.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.3748/wjg.v30.i32.3739
Gaetano Piccolo, Matteo Barabino, Guglielmo Niccolò Piozzi, Paolo Pietro Bianchi
Gallbladder cancer (GBC) is a rare disease with a poor prognosis. Simple cholecystectomy may be an adequate treatment only for very early disease (Tis, T1a), whereas reoperation is recommended for more advanced disease (T1b and T2). Radical cholecystectomy should have two fundamental objectives: To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes. However, recent studies have shown that compared with lymph node dissection alone, liver resection does not improve survival outcomes. The oncological roles of lymphadenectomy and liver resection is distinct. Therefore, for patients with incidental GBC without liver invasion, hepatic resection is not always mandatory.
{"title":"Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer.","authors":"Gaetano Piccolo, Matteo Barabino, Guglielmo Niccolò Piozzi, Paolo Pietro Bianchi","doi":"10.3748/wjg.v30.i32.3739","DOIUrl":"10.3748/wjg.v30.i32.3739","url":null,"abstract":"<p><p>Gallbladder cancer (GBC) is a rare disease with a poor prognosis. Simple cholecystectomy may be an adequate treatment only for very early disease (Tis, T1a), whereas reoperation is recommended for more advanced disease (T1b and T2). Radical cholecystectomy should have two fundamental objectives: To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes. However, recent studies have shown that compared with lymph node dissection alone, liver resection does not improve survival outcomes. The oncological roles of lymphadenectomy and liver resection is distinct. Therefore, for patients with incidental GBC without liver invasion, hepatic resection is not always mandatory.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.3748/wjg.v30.i32.3748
Quan Lu, Quan-Zhou Peng, Jun Yao, Li-Sheng Wang, De-Feng Li
Background: The majority of esophageal subepithelial lesions originating from the muscularis propria (SEL-MPs) are benign in nature, although a subset may exhibit malignant characteristics. Conventional endoscopic resection techniques are time-consuming and lack efficacy for small SEL-MPs.
Aim: To evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection (ESMR-L) following unroofing technique for small esophageal SEL-MPs.
Methods: From January 2021 to September 2023, 17 patients diagnosed with esophageal SEL-MPs underwent ESMR-L following unroofing technique at the endoscopy center of Shenzhen People's Hospital. Details of clinicopathological characteristics and clinical outcomes were collected and analyzed.
Results: The mean age of the patients was 50.12 ± 12.65 years. The mean size of the tumors was 7.47 ± 2.83 mm and all cases achieved en bloc resection successfully. The average operation time was 12.2 minutes without any complications. Histopathology identified 2 Lesions (11.8%) as gastrointestinal stromal tumors at very low risk, 12 Lesions (70.6%) as leiomyoma and 3 Lesions (17.6%) as smooth muscle proliferation. No recurrence was found during the mean follow-up duration of 14.18 ± 9.62 months.
Conclusion: ESMR-L following roofing technique is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm, but it cannot ensure en bloc resection and may require further treatment.
{"title":"Ligation-assisted endoscopic submucosal resection following unroofing technique for small esophageal subepithelial lesions originating from the muscularis propria.","authors":"Quan Lu, Quan-Zhou Peng, Jun Yao, Li-Sheng Wang, De-Feng Li","doi":"10.3748/wjg.v30.i32.3748","DOIUrl":"10.3748/wjg.v30.i32.3748","url":null,"abstract":"<p><strong>Background: </strong>The majority of esophageal subepithelial lesions originating from the muscularis propria (SEL-MPs) are benign in nature, although a subset may exhibit malignant characteristics. Conventional endoscopic resection techniques are time-consuming and lack efficacy for small SEL-MPs.</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of ligation-assisted endoscopic submucosal resection (ESMR-L) following unroofing technique for small esophageal SEL-MPs.</p><p><strong>Methods: </strong>From January 2021 to September 2023, 17 patients diagnosed with esophageal SEL-MPs underwent ESMR-L following unroofing technique at the endoscopy center of Shenzhen People's Hospital. Details of clinicopathological characteristics and clinical outcomes were collected and analyzed.</p><p><strong>Results: </strong>The mean age of the patients was 50.12 ± 12.65 years. The mean size of the tumors was 7.47 ± 2.83 mm and all cases achieved <i>en bloc</i> resection successfully. The average operation time was 12.2 minutes without any complications. Histopathology identified 2 Lesions (11.8%) as gastrointestinal stromal tumors at very low risk, 12 Lesions (70.6%) as leiomyoma and 3 Lesions (17.6%) as smooth muscle proliferation. No recurrence was found during the mean follow-up duration of 14.18 ± 9.62 months.</p><p><strong>Conclusion: </strong>ESMR-L following roofing technique is an effective and safe technique for management of esophageal SEL-MPs smaller than 20 mm, but it cannot ensure <i>en bloc</i> resection and may require further treatment.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.3748/wjg.v30.i32.3726
Yu-Nuo Yang, Li-Sheng Wang, Yan-Qi Dang, Guang Ji
The emergence of immunotherapy, particularly immune checkpoint inhibitors (ICIs), represents a groundbreaking approach to treating gastric cancer (GC). However, the prognosis of GC patients receiving ICI treatment is influenced by various factors. This manuscript identified sarcopenia and myosteatosis as inde-pendent prognostic factors impacting the outcomes of GC patients treated with ICIs. Additionally, this study introduced a visual predictive model to estimate the prognosis of GC patients. If confirmed by further studies, this observation could provide valuable insights to propel the advancement of personalized clinical medicine and the integration of precision medicine practices.
{"title":"Evaluating the efficacy of immunotherapy in gastric cancer: Insights from immune checkpoint inhibitors.","authors":"Yu-Nuo Yang, Li-Sheng Wang, Yan-Qi Dang, Guang Ji","doi":"10.3748/wjg.v30.i32.3726","DOIUrl":"10.3748/wjg.v30.i32.3726","url":null,"abstract":"<p><p>The emergence of immunotherapy, particularly immune checkpoint inhibitors (ICIs), represents a groundbreaking approach to treating gastric cancer (GC). However, the prognosis of GC patients receiving ICI treatment is influenced by various factors. This manuscript identified sarcopenia and myosteatosis as inde-pendent prognostic factors impacting the outcomes of GC patients treated with ICIs. Additionally, this study introduced a visual predictive model to estimate the prognosis of GC patients. If confirmed by further studies, this observation could provide valuable insights to propel the advancement of personalized clinical medicine and the integration of precision medicine practices.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.3748/wjg.v30.i32.3755
Goran Augustin, Quirino Lai, Maja Cigrovski Berkovic
<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT)-induced acute pancreatitis (AP) during pregnancy has rarely been described. Due to this rarity, there are no diagnostic or treatment algorithms for pregnant patients.</p><p><strong>Aim: </strong>To determine appropriate diagnostic methods, therapeutic options, and factors related to maternal and fetal outcomes for PHPT-induced AP in pregnancy.</p><p><strong>Methods: </strong>A literature search of articles in English, Japanese, German, Spanish, and Italian was performed using PubMed (1946-2023), PubMed Central (1900-2023), and Google Scholar. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol was followed. The search terms included "pancreatite acuta," "iperparatiroidismo primario," "gravidanza," "travaglio," "puerperio," "postpartum," "akute pankreatitis," "primärer hyperparathyreoidismus," "Schwangerschaft," "Wehen," "Wochenbett," "pancreatitis aguda," "hiperparatiroidismo primario," "embarazo," "parto," "puerperio," "posparto," "acute pancreatitis," "primary hyperparathyroidism," "pregnancy," "labor," "puerperium," and "postpartum." Additional studies were identified by reviewing the reference lists of retrieved studies. Demographic, imaging, surgical, obstetric, and outcome data were obtained.</p><p><strong>Results: </strong>Fifty-four cases were collected from the 51 studies. The median maternal age was 29 years. PHPT-induced AP starts at the 20<sup>th</sup> gestational week; higher gestational weeks were seen in mothers who died (mean gestational week 28). Median values of amylase (1399, Q1-Q3 = 519-2072), lipase (2072, Q1-Q3 = 893-2804), serum calcium (3.5, Q1-Q3 = 3.1-3.9), and parathormone (PTH) (384, Q1-Q3 = 123-910) were reported. In 46 cases, adenoma was the cause of PHPT, followed by 2 cases of carcinoma and 1 case of hyperplasia. In the remaining 5 cases, the diagnosis was not reported. Neck ultrasound was positive in 34 cases, whereas sestamibi was performed in 3 cases, and neck computed tomography or magnetic resonance imaging was performed in 9 cases (the enlarged parathyroid gland was not localized in 3 cases). Surgery was the preferred treatment during pregnancy in 33 cases (median week of gestation 25, Q1-Q3 = 20-30) and postpartum in 12 cases. The timing was not reported in the remaining 9 cases, or surgery was not performed. AP was managed surgically in 11 cases and conservatively in 43 (79.6%) cases. Maternal and fetal mortality was 9.3% (5 cases). Surgery was more common in deceased mothers (60.0% <i>vs</i> 16.3%; <i>P</i> = 0.052), and PTH values tended to be higher in this group (910 pg/mL <i>vs</i> 302 pg/mL; <i>P</i> = 0.059). Maternal mortality was higher with higher serum lipase levels and earlier delivery week. Higher calcium (4.1 mmol/L <i>vs</i> 3.3 mmol/L; <i>P</i> = 0.009) and PTH (1914 pg/mL <i>vs</i> 302 pg/mL; <i>P</i> = 0.003) values increased fetal/child mortality, as well as abortions (40.0% <i>vs</i> 0
背景:原发性甲状旁腺功能亢进症(PHPT)诱发妊娠期急性胰腺炎(AP)的病例很少见。目的:确定妊娠期原发性甲状旁腺功能亢进症(PHPT)诱发急性胰腺炎的适当诊断方法、治疗方案以及与母体和胎儿结局相关的因素:方法:使用 PubMed(1946-2023 年)、PubMed Central(1900-2023 年)和 Google Scholar 对英文、日文、德文、西班牙文和意大利文的文章进行文献检索。研究遵循了系统综述和元分析首选报告项目(PRISMA)协议。检索词包括 "pancreatite acuta"、"iperparatiroidismo primario"、"gravidanza"、"travaglio"、"puerperio"、"postpartum"、"akute pankreatitis"、"primärer hyperparathyreoidismus"、"Schwangerschaft"、"Wehen、"妊娠"、"分娩"、"产褥期 "和 "产后"。"其他研究是通过查阅检索到的研究的参考文献列表确定的。获得了人口统计学、影像学、外科、产科和结果数据:从 51 项研究中收集了 54 个病例。产妇年龄中位数为 29 岁。PHPT诱发的AP始于第20孕周;死亡的产妇孕周更高(平均孕周28周)。淀粉酶(1399,Q1-Q3 = 519-2072)、脂肪酶(2072,Q1-Q3 = 893-2804)、血清钙(3.5,Q1-Q3 = 3.1-3.9)和促甲状旁腺激素(PTH)(384,Q1-Q3 = 123-910)的中位值均有报告。在 46 个病例中,腺瘤是 PHPT 的病因,其次是 2 例癌和 1 例增生。其余 5 例未报告诊断结果。34例患者的颈部超声检查结果呈阳性,3例患者进行了铯同位素检查,9例患者进行了颈部计算机断层扫描或磁共振成像检查(3例患者的甲状旁腺肿大未定位)。33例患者在妊娠期(中位妊娠周数为25周,Q1-Q3=20-30周)和12例患者在产后首选手术治疗。其余 9 例未报告手术时间,或未实施手术。11 例 AP 采用手术治疗,43 例(79.6%)采用保守治疗。产妇和胎儿死亡率为 9.3%(5 例)。手术在死亡产妇中更为常见(60.0% vs 16.3%; P = 0.052),该组产妇的 PTH 值往往更高(910 pg/mL vs 302 pg/mL;P = 0.059)。血清脂肪酶水平越高、分娩周数越早的产妇死亡率越高。钙(4.1 mmol/L vs 3.3 mmol/L;P = 0.009)和PTH(1914 pg/mL vs 302 pg/mL;P = 0.003)值越高,胎儿/婴儿死亡率越高,流产(40.0% vs 0.0%;P = 0.007)和难产(60.0% vs 8.2%;P = 0.01)也越高:结论:如果在入院时不检测血清钙,PHPT 引起的妊娠 AP 的明确诊断就会被延迟,而早期诊断和及时干预则会带来良好的孕产妇和胎儿预后。
{"title":"Primary hyperparathyroidism-induced acute pancreatitis in pregnancy: A systematic review with a diagnostic-treatment algorithm.","authors":"Goran Augustin, Quirino Lai, Maja Cigrovski Berkovic","doi":"10.3748/wjg.v30.i32.3755","DOIUrl":"10.3748/wjg.v30.i32.3755","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT)-induced acute pancreatitis (AP) during pregnancy has rarely been described. Due to this rarity, there are no diagnostic or treatment algorithms for pregnant patients.</p><p><strong>Aim: </strong>To determine appropriate diagnostic methods, therapeutic options, and factors related to maternal and fetal outcomes for PHPT-induced AP in pregnancy.</p><p><strong>Methods: </strong>A literature search of articles in English, Japanese, German, Spanish, and Italian was performed using PubMed (1946-2023), PubMed Central (1900-2023), and Google Scholar. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol was followed. The search terms included \"pancreatite acuta,\" \"iperparatiroidismo primario,\" \"gravidanza,\" \"travaglio,\" \"puerperio,\" \"postpartum,\" \"akute pankreatitis,\" \"primärer hyperparathyreoidismus,\" \"Schwangerschaft,\" \"Wehen,\" \"Wochenbett,\" \"pancreatitis aguda,\" \"hiperparatiroidismo primario,\" \"embarazo,\" \"parto,\" \"puerperio,\" \"posparto,\" \"acute pancreatitis,\" \"primary hyperparathyroidism,\" \"pregnancy,\" \"labor,\" \"puerperium,\" and \"postpartum.\" Additional studies were identified by reviewing the reference lists of retrieved studies. Demographic, imaging, surgical, obstetric, and outcome data were obtained.</p><p><strong>Results: </strong>Fifty-four cases were collected from the 51 studies. The median maternal age was 29 years. PHPT-induced AP starts at the 20<sup>th</sup> gestational week; higher gestational weeks were seen in mothers who died (mean gestational week 28). Median values of amylase (1399, Q1-Q3 = 519-2072), lipase (2072, Q1-Q3 = 893-2804), serum calcium (3.5, Q1-Q3 = 3.1-3.9), and parathormone (PTH) (384, Q1-Q3 = 123-910) were reported. In 46 cases, adenoma was the cause of PHPT, followed by 2 cases of carcinoma and 1 case of hyperplasia. In the remaining 5 cases, the diagnosis was not reported. Neck ultrasound was positive in 34 cases, whereas sestamibi was performed in 3 cases, and neck computed tomography or magnetic resonance imaging was performed in 9 cases (the enlarged parathyroid gland was not localized in 3 cases). Surgery was the preferred treatment during pregnancy in 33 cases (median week of gestation 25, Q1-Q3 = 20-30) and postpartum in 12 cases. The timing was not reported in the remaining 9 cases, or surgery was not performed. AP was managed surgically in 11 cases and conservatively in 43 (79.6%) cases. Maternal and fetal mortality was 9.3% (5 cases). Surgery was more common in deceased mothers (60.0% <i>vs</i> 16.3%; <i>P</i> = 0.052), and PTH values tended to be higher in this group (910 pg/mL <i>vs</i> 302 pg/mL; <i>P</i> = 0.059). Maternal mortality was higher with higher serum lipase levels and earlier delivery week. Higher calcium (4.1 mmol/L <i>vs</i> 3.3 mmol/L; <i>P</i> = 0.009) and PTH (1914 pg/mL <i>vs</i> 302 pg/mL; <i>P</i> = 0.003) values increased fetal/child mortality, as well as abortions (40.0% <i>vs</i> 0","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.3748/wjg.v30.i32.3783
Vasily Isakov
A bibliometric analysis of studies dedicated to autoimmune gastritis (AIG) recently published demonstrated a noteworthy surge in publications over the last three years. This can be explained by numerous publications from different regions of the world reporting the results of several studies that stimulated reassessment of our view of AIG as a precancerous condition. Follow-up studies and retrospective analyses showed that the risk of gastric cancer (GC) in AIG patients is much lower than expected if the patients ever being infected with Helicobacter pylori (H. pylori) were excluded. The low prevalence of precancerous lesions, such as the incomplete type of intestinal metaplasia, may explain the low risk of GC in AIG patients because the spasmolytic polypeptide-expressing metaplasia commonly observed in AIG does not involve clonal reprogramming of the gastric gland and can be considered as an adaptive change rather than a true precancerous lesion. However, changes in gastric secretion due to the progression of gastric atrophy during the course of AIG cause changes in the gastric mic-robiome, stimulating the growth of bacterial species such as streptococci, which may promote the development of precancerous lesions and GC. Thus, Streptococcus anginosus exhibited a robust proinflammatory response and induced the gastritis-atrophy-metaplasia-dysplasia sequence in mice, reproducing the well-established process for carcinogenesis associated with H. pylori. Prospective studies in H. pylori-naïve patients evaluating gastric microbiome changes during the long-term course of AIG might provide an explanation for the enigmatic increase in GC incidence in the last decades in younger cohorts, which has been reported in economically developed countries.
{"title":"Autoimmune gastritis studies and gastric cancer: True renaissance or bibliometric illusion.","authors":"Vasily Isakov","doi":"10.3748/wjg.v30.i32.3783","DOIUrl":"10.3748/wjg.v30.i32.3783","url":null,"abstract":"<p><p>A bibliometric analysis of studies dedicated to autoimmune gastritis (AIG) recently published demonstrated a noteworthy surge in publications over the last three years. This can be explained by numerous publications from different regions of the world reporting the results of several studies that stimulated reassessment of our view of AIG as a precancerous condition. Follow-up studies and retrospective analyses showed that the risk of gastric cancer (GC) in AIG patients is much lower than expected if the patients ever being infected with <i>Helicobacter pylori</i> (<i>H. pylori</i>) were excluded. The low prevalence of precancerous lesions, such as the incomplete type of intestinal metaplasia, may explain the low risk of GC in AIG patients because the spasmolytic polypeptide-expressing metaplasia commonly observed in AIG does not involve clonal reprogramming of the gastric gland and can be considered as an adaptive change rather than a true precancerous lesion. However, changes in gastric secretion due to the progression of gastric atrophy during the course of AIG cause changes in the gastric mic-robiome, stimulating the growth of bacterial species such as streptococci, which may promote the development of precancerous lesions and GC. Thus, <i>Streptococcus anginosus</i> exhibited a robust proinflammatory response and induced the gastritis-atrophy-metaplasia-dysplasia sequence in mice, reproducing the well-established process for carcinogenesis associated with <i>H. pylori</i>. Prospective studies in <i>H. pylori</i>-naïve patients evaluating gastric microbiome changes during the long-term course of AIG might provide an explanation for the enigmatic increase in GC incidence in the last decades in younger cohorts, which has been reported in economically developed countries.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}