首页 > 最新文献

Canadian Journal of Gastroenterology and Hepatology最新文献

英文 中文
Delineating Molecular Subtypes through Gene Set Variation Analysis Confers Therapeutic and Prognostic Capability in Gastric Cancer. 通过基因集变异分析描绘分子亚型赋予胃癌的治疗和预后能力。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-07-15 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5415758
Yuzhang Zhu, Ting Sun, Lei Zhang, Faming Fei, Yi Bao, Zhenzhen Gao

To claim the features of nontumor tissue in gastric cancer patients, especially in those who have undergone gastrectomy, and to identify the molecular subtypes, we collected the immunogenic and hallmark gene sets from gene set enrichment analysis. The activity changes of these gene sets between tumor (375) and nontumor (32) tissues acquired from the Cancer Genome Atlas (TCGA-STAD) were calculated, and the novel molecular subtypes were delineated. Subsequently, prognostic gene sets were determined using least absolute shrinkage and selection operator (lasso) regression prognostic method. In addition, functional analysis was conducted. Totally, three subtypes were constructed in the present study, and there were differences in survival among three groups. Functional analysis showed genes from normal gene set were related to cell adhesion, and genes from tumor gene set were associated with focal adhesion, PI3K-Akt signaling pathway, regulation of actin cytoskeleton, and VEGF signaling pathway. Our study created lasting value beyond molecular subtypes and underscored the significance of normal tissues in gastric cancer development, which drawn a novel prognostic model for gastric treatment.

为了了解胃癌患者,特别是胃切除术患者非肿瘤组织的特征,并确定分子亚型,我们从基因集富集分析中收集了免疫原性和标志基因集。计算了从肿瘤基因组图谱(TCGA-STAD)中获得的肿瘤(375)和非肿瘤(32)组织中这些基因组的活性变化,并描绘了新的分子亚型。随后,使用最小绝对收缩和选择算子(套索)回归预测方法确定预后基因集。此外,还进行了功能分析。本研究共构建了三种亚型,三组间生存率存在差异。功能分析显示,正常基因集的基因与细胞粘附相关,肿瘤基因集的基因与局灶性粘附、PI3K-Akt信号通路、肌动蛋白细胞骨架调控、VEGF信号通路相关。我们的研究创造了超越分子亚型的持久价值,强调了正常组织在胃癌发展中的重要性,为胃癌治疗建立了新的预后模型。
{"title":"Delineating Molecular Subtypes through Gene Set Variation Analysis Confers Therapeutic and Prognostic Capability in Gastric Cancer.","authors":"Yuzhang Zhu,&nbsp;Ting Sun,&nbsp;Lei Zhang,&nbsp;Faming Fei,&nbsp;Yi Bao,&nbsp;Zhenzhen Gao","doi":"10.1155/2022/5415758","DOIUrl":"https://doi.org/10.1155/2022/5415758","url":null,"abstract":"<p><p>To claim the features of nontumor tissue in gastric cancer patients, especially in those who have undergone gastrectomy, and to identify the molecular subtypes, we collected the immunogenic and hallmark gene sets from gene set enrichment analysis. The activity changes of these gene sets between tumor (375) and nontumor (32) tissues acquired from the Cancer Genome Atlas (TCGA-STAD) were calculated, and the novel molecular subtypes were delineated. Subsequently, prognostic gene sets were determined using least absolute shrinkage and selection operator (lasso) regression prognostic method. In addition, functional analysis was conducted. Totally, three subtypes were constructed in the present study, and there were differences in survival among three groups. Functional analysis showed genes from normal gene set were related to cell adhesion, and genes from tumor gene set were associated with focal adhesion, PI3K-Akt signaling pathway, regulation of actin cytoskeleton, and VEGF signaling pathway. Our study created lasting value beyond molecular subtypes and underscored the significance of normal tissues in gastric cancer development, which drawn a novel prognostic model for gastric treatment.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"5415758"},"PeriodicalIF":2.7,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40620969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
qHBsAg for the Identification of Liver Histological Abnormalities in HBeAg-Negative Chronic Hepatitis B Patients with Normal and Mildly Elevated ALT Levels. qHBsAg对hbeag阴性慢性乙型肝炎患者ALT水平正常和轻度升高的肝脏组织学异常的识别
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-07-14 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8695196
Qinyi Gan, Yan Huang, Chuanwu Zhu, Shuang Zhao, Haoshuang Fu, Minghao Cai, Jiexiao Wang, Chenxi Zhang, Simin Guo, Zhujun Cao, Qing Xie

Backgrounds: Noninvasive detection of histological abnormalities remains challenging in patients with HBeAg-negative chronic HBV infection with normal or mildly elevated levels of alanine aminotransferase (ALT). This study aimed to assess the utility of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying significant histological lesions in this population.

Methods: This is a single-center study with retrospective analysis of 392 treatment-naive patients of HBeAg-negative chronic HBV infection with normal or mildly elevated levels of ALT.

Results: In this cohort, significant necroinflammation and fibrosis were found in 69.4% and 61.5% of patients, respectively. Patients with qHBsAg >1000 IU/mL (N = 236) had more hepatic inflammation of ≥G2 (75.4% vs. 60.9%, P < 0.01) or fibrosis ≥ S2 (66.1% vs. 54.5%, P < 0.05) compared to those without (N = 156). Serum HBsAg (cutoff point = 1000 IU/mL), aspartate aminotransferase (AST) level (cutoff point = 25 IU/L), age (cutoff point = 40 years), and HBV family history were identified as independent predictors of significant histological abnormalities in multivariate logistic analysis.

Conclusions: A significantly higher proportion of patients with histological abnormalities were found in patients with qHBsAg >1000 IU/mL than those without. The qHBsAg level together with age, AST, and family history of HBV infection could be used as an algorithm to help noninvasive patient selection for antiviral therapy.

背景:在hbeag阴性的慢性HBV感染且丙氨酸转氨酶(ALT)水平正常或轻度升高的患者中,无创检测组织学异常仍然具有挑战性。本研究旨在评估血清定量乙型肝炎表面抗原(qHBsAg)在该人群中识别重要组织学病变的效用。方法:这是一项单中心研究,回顾性分析了392例初诊hbeag阴性慢性HBV感染,alt水平正常或轻度升高的患者。结果:在该队列中,分别有69.4%和61.5%的患者发现显著的坏死性炎症和纤维化。qHBsAg >1000 IU/mL的患者(N = 236)的肝炎症≥G2 (75.4% vs. 60.9%, P < 0.01)或纤维化≥S2 (66.1% vs. 54.5%, P < 0.05)的发生率高于无qHBsAg患者(N = 156)。在多因素logistic分析中,血清HBsAg(临界值= 1000 IU/mL)、天冬氨酸转氨酶(AST)水平(临界值= 25 IU/L)、年龄(临界值= 40岁)和HBV家族史被确定为显著组织学异常的独立预测因素。结论:qHBsAg >1000 IU/mL的患者出现组织学异常的比例明显高于未出现组织学异常的患者。qHBsAg水平与年龄、AST和HBV感染家族史可作为一种算法,帮助患者进行无创抗病毒治疗的选择。
{"title":"qHBsAg for the Identification of Liver Histological Abnormalities in HBeAg-Negative Chronic Hepatitis B Patients with Normal and Mildly Elevated ALT Levels.","authors":"Qinyi Gan,&nbsp;Yan Huang,&nbsp;Chuanwu Zhu,&nbsp;Shuang Zhao,&nbsp;Haoshuang Fu,&nbsp;Minghao Cai,&nbsp;Jiexiao Wang,&nbsp;Chenxi Zhang,&nbsp;Simin Guo,&nbsp;Zhujun Cao,&nbsp;Qing Xie","doi":"10.1155/2022/8695196","DOIUrl":"https://doi.org/10.1155/2022/8695196","url":null,"abstract":"<p><strong>Backgrounds: </strong>Noninvasive detection of histological abnormalities remains challenging in patients with HBeAg-negative chronic HBV infection with normal or mildly elevated levels of alanine aminotransferase (ALT). This study aimed to assess the utility of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying significant histological lesions in this population.</p><p><strong>Methods: </strong>This is a single-center study with retrospective analysis of 392 treatment-naive patients of HBeAg-negative chronic HBV infection with normal or mildly elevated levels of ALT.</p><p><strong>Results: </strong>In this cohort, significant necroinflammation and fibrosis were found in 69.4% and 61.5% of patients, respectively. Patients with qHBsAg >1000 IU/mL (<i>N</i> = 236) had more hepatic inflammation of ≥<i>G</i>2 (75.4% vs. 60.9%, <i>P</i> < 0.01) or fibrosis ≥ <i>S</i>2 (66.1% vs. 54.5%, <i>P</i> < 0.05) compared to those without (<i>N</i> = 156). Serum HBsAg (cutoff point = 1000 IU/mL), aspartate aminotransferase (AST) level (cutoff point = 25 IU/L), age (cutoff point = 40 years), and HBV family history were identified as independent predictors of significant histological abnormalities in multivariate logistic analysis.</p><p><strong>Conclusions: </strong>A significantly higher proportion of patients with histological abnormalities were found in patients with qHBsAg >1000 IU/mL than those without. The qHBsAg level together with age, AST, and family history of HBV infection could be used as an algorithm to help noninvasive patient selection for antiviral therapy.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"8695196"},"PeriodicalIF":2.7,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40620968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serum Glial Cell Line-Derived Neurotrophic Factor (sGDNF) Is a Novel Biomarker in Predicting Cirrhosis in Patients with Chronic Hepatitis B. 血清胶质细胞系衍生神经营养因子(sGDNF)是预测慢性乙型肝炎患者肝硬化的一种新的生物标志物。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-07-09 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1048104
Guangyue Yang, Liping Zhuang, Tiantian Sun, Yee Hui Yeo, Le Tao, Wei Zhang, Wenting Ma, Liu Wu, Zongguo Yang, Yanqin Yang, Dongying Xue, Jie Zhang, Rilu Feng, Ebert Matthias P, Steven Dooley, Ekihiro Seki, Ping Liu, Cheng Liu

Objectives: We assessed the potential of glial cell line-derived neurotrophic factor (GDNF) as a useful biomarker to predict cirrhosis in chronic hepatitis B (CHB) patients.

Methods: A total of 735 patients from two medical centers (385 CHB patients and 350 healthy controls) were included to determine the association of serum and tissue GDNF levels with biopsy-proven cirrhosis. The diagnostic accuracy of serum GDNF (sGDNF) was estimated and compared with other indices of cirrhosis.

Results: We showed significantly higher levels of sGDNF in CHB patients with fibrosis (28.4 pg/ml vs. 11.6 pg/ml in patients without) and patients with cirrhosis (33.8 pg/ml vs. 23.5 pg/ml in patients without). The areas under receiver operating curve (AUROCs) of sGDNF were 0.83 (95% confidence interval (CI): 0.80-0.87) for predicting liver fibrosis and 0.84 (95% CI: 0.79-0.89) for cirrhosis. Findings from the serum protein level and hepatic mRNA expression were consistent. Using the best cutoff to predict cirrhosis, we categorized the patients into sGDNF-high and sGDNF-low groups. The sGDNF-high group had significantly larger Masson's trichrome and reticulin staining-positive area, higher Scheuer score, and METAVIR fibrosis stage (all p < 0.001) but not steatosis. On multivariable regression, sGDNF was independently associated with cirrhosis with an odds ratio of 6.98 (95% CI: 1.10-17.94). Finally, we demonstrated that sGDNF outperformed AST to platelet ratio index, FIB-4, fibroscore, forn index, and fibrometer in differentiating F4 vs. F3.

Conclusion: Using serum, tissue mRNA, and biopsy data, our study revealed a significant potential of sGDNF as a novel noninvasive biomarker for cirrhosis in CHB patients.

目的:我们评估了神经胶质细胞系来源的神经营养因子(GDNF)作为预测慢性乙型肝炎(CHB)患者肝硬化的有用生物标志物的潜力。方法:共纳入来自两个医疗中心的735例患者(385例慢性乙型肝炎患者和350例健康对照),以确定血清和组织GDNF水平与活检证实的肝硬化的关系。评估血清GDNF (sGDNF)诊断肝硬化的准确性,并与其他肝硬化指标进行比较。结果:我们发现伴有纤维化的CHB患者(无纤维化患者为28.4 pg/ml,无纤维化患者为11.6 pg/ml)和肝硬化患者(无纤维化患者为33.8 pg/ml,无肝硬化患者为23.5 pg/ml)中sGDNF水平显著升高。sGDNF预测肝纤维化的受试者工作曲线下面积(auroc)为0.83(95%可信区间(CI): 0.80-0.87),预测肝硬化的受试者工作曲线下面积(auroc)为0.84 (95% CI: 0.79-0.89)。血清蛋白水平和肝脏mRNA表达结果一致。使用最佳截断值预测肝硬化,我们将患者分为高sgdnf组和低sgdnf组。高sgdnf组的马松三色和网状蛋白染色阳性面积显著增大,Scheuer评分较高,METAVIR纤维化分期(均p < 0.001),但无脂肪变性。在多变量回归中,sGDNF与肝硬化独立相关,比值比为6.98 (95% CI: 1.10-17.94)。最后,我们证明sGDNF在区分F4与F3方面优于AST与血小板比率指数、FIB-4、纤维评分、形态指数和纤维计。结论:利用血清、组织mRNA和活检数据,我们的研究揭示了sGDNF作为慢性乙型肝炎患者肝硬化的一种新的无创生物标志物的巨大潜力。
{"title":"Serum Glial Cell Line-Derived Neurotrophic Factor (sGDNF) Is a Novel Biomarker in Predicting Cirrhosis in Patients with Chronic Hepatitis B.","authors":"Guangyue Yang,&nbsp;Liping Zhuang,&nbsp;Tiantian Sun,&nbsp;Yee Hui Yeo,&nbsp;Le Tao,&nbsp;Wei Zhang,&nbsp;Wenting Ma,&nbsp;Liu Wu,&nbsp;Zongguo Yang,&nbsp;Yanqin Yang,&nbsp;Dongying Xue,&nbsp;Jie Zhang,&nbsp;Rilu Feng,&nbsp;Ebert Matthias P,&nbsp;Steven Dooley,&nbsp;Ekihiro Seki,&nbsp;Ping Liu,&nbsp;Cheng Liu","doi":"10.1155/2022/1048104","DOIUrl":"https://doi.org/10.1155/2022/1048104","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the potential of glial cell line-derived neurotrophic factor (GDNF) as a useful biomarker to predict cirrhosis in chronic hepatitis B (CHB) patients.</p><p><strong>Methods: </strong>A total of 735 patients from two medical centers (385 CHB patients and 350 healthy controls) were included to determine the association of serum and tissue GDNF levels with biopsy-proven cirrhosis. The diagnostic accuracy of serum GDNF (sGDNF) was estimated and compared with other indices of cirrhosis.</p><p><strong>Results: </strong>We showed significantly higher levels of sGDNF in CHB patients with fibrosis (28.4 pg/ml vs. 11.6 pg/ml in patients without) and patients with cirrhosis (33.8 pg/ml vs. 23.5 pg/ml in patients without). The areas under receiver operating curve (AUROCs) of sGDNF were 0.83 (95% confidence interval (CI): 0.80-0.87) for predicting liver fibrosis and 0.84 (95% CI: 0.79-0.89) for cirrhosis. Findings from the serum protein level and hepatic mRNA expression were consistent. Using the best cutoff to predict cirrhosis, we categorized the patients into sGDNF-high and sGDNF-low groups. The sGDNF-high group had significantly larger Masson's trichrome and reticulin staining-positive area, higher Scheuer score, and METAVIR fibrosis stage (all <i>p</i> < 0.001) but not steatosis. On multivariable regression, sGDNF was independently associated with cirrhosis with an odds ratio of 6.98 (95% CI: 1.10-17.94). Finally, we demonstrated that sGDNF outperformed AST to platelet ratio index, FIB-4, fibroscore, forn index, and fibrometer in differentiating F4 vs. F3.</p><p><strong>Conclusion: </strong>Using serum, tissue mRNA, and biopsy data, our study revealed a significant potential of sGDNF as a novel noninvasive biomarker for cirrhosis in CHB patients.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"1048104"},"PeriodicalIF":2.7,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40522083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Comparison of an Inside Stent and a Fully Covered Self-Expandable Metallic Stent as Preoperative Biliary Drainage for Patients with Resectable Perihilar Cholangiocarcinoma. 内支架和全覆盖自膨胀金属支架作为可切除肝周胆管癌患者术前胆道引流的比较
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-07-05 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3005210
Hiroshi Mori, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Masanao Nakamura, Masatoshi Ishigami, Shunsuke Onoe, Takashi Mizuno, Tomoki Ebata, Mitsuhiro Fujishiro

Background: There is a need for a more tolerable preoperative biliary drainage (PBD) method for perihilar cholangiocarcinoma (PHCC). In recent years, inside stents (ISs) have attracted attention as a less suffering PBD method. Few studies have compared IS with a fully covered self-expandable metallic stent (FCSEMS) as PBD for resectable PHCC. The aim of this study is to compare them.

Methods: This study involved 86 consecutive patients (IS: 51; FCSEMS: 35). The recurrent biliary obstruction (RBO) rate until undergoing surgery or being diagnosed as unresectable, time to RBO, factors related to RBO, incidence of adverse events related to endoscopic retrograde cholangiography, and postoperative complications associated with each stent were evaluated retrospectively.

Results: There was no significant difference between the two groups in the incidence of adverse events after stent insertion. After propensity score matching, the mean (SD) time to RBO was 37.9 (30.2) days in the IS group and 45.1 (35.1) days in the FCSEMS group, with no significant difference (P=0.912, log-rank test). A total of 7/51 patients in the IS group and 3/35 patients in the FCSEMS group developed RBO. The only risk factor for RBO was bile duct obstruction of the future excisional liver lobe(s) due to stenting (HR 29.8, P=0.008) in the FCSEMS group, but risk factors could not be indicated in the IS group. There was no significant difference in the incidence of bile leakage or liver failure. In contrast, pancreatic fistula was significantly more common in the FCSEMS group (13/23 patients) than in the IS group (3/28 patients) (P < 0.001), especially in patients who did not undergo pancreatectomy (P=0.001).

Conclusions: As PBD, both IS and FCSEMS achieved low RBO rates. Compared with FCSEMS, IS shows no difference in RBO rate, is associated with fewer postoperative complications, and is considered an appropriate means of PBD for resectable PHCC. This trail is registered with UMIN000025631.

背景:肝周胆管癌(PHCC)需要一种更耐受的术前胆道引流(PBD)方法。近年来,内支架(IS)作为一种痛苦较小的胆道引流(PBD)方法备受关注。很少有研究将内支架与全覆盖自膨胀金属支架(FCSEMS)作为可切除PHCC的PBD进行比较。本研究旨在对两者进行比较:本研究涉及 86 例连续患者(IS:51 例;FCSEMS:35 例)。回顾性评估了接受手术或被诊断为不可切除前的复发性胆道梗阻(RBO)率、RBO发生时间、RBO相关因素、内镜逆行胆管造影相关不良事件的发生率以及与每种支架相关的术后并发症:结果:两组患者在支架植入后的不良反应发生率无明显差异。经过倾向评分匹配后,IS组患者到达RBO的平均(标清)时间为37.9(30.2)天,FCSEMS组为45.1(35.1)天,两组无明显差异(P=0.912,log-rank检验)。IS组和FCSEMS组分别有7/51和3/35的患者出现了RBO。在FCSEMS组中,RBO的唯一风险因素是支架手术导致未来切除肝叶的胆管阻塞(HR 29.8,P=0.008),但在IS组中无法指出风险因素。胆汁渗漏或肝功能衰竭的发生率没有明显差异。相反,胰瘘在 FCSEMS 组(13/23 例)明显多于 IS 组(3/28 例)(P < 0.001),尤其是在未接受胰腺切除术的患者中(P=0.001):作为 PBD,IS 和 FCSEMS 的 RBO 率都很低。与 FCSEMS 相比,IS 的 RBO 率没有差异,术后并发症较少,被认为是可切除 PHCC 的合适 PBD 方法。本研究已在 UMIN000025631 注册。
{"title":"Comparison of an Inside Stent and a Fully Covered Self-Expandable Metallic Stent as Preoperative Biliary Drainage for Patients with Resectable Perihilar Cholangiocarcinoma.","authors":"Hiroshi Mori, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Masanao Nakamura, Masatoshi Ishigami, Shunsuke Onoe, Takashi Mizuno, Tomoki Ebata, Mitsuhiro Fujishiro","doi":"10.1155/2022/3005210","DOIUrl":"10.1155/2022/3005210","url":null,"abstract":"<p><strong>Background: </strong>There is a need for a more tolerable preoperative biliary drainage (PBD) method for perihilar cholangiocarcinoma (PHCC). In recent years, inside stents (ISs) have attracted attention as a less suffering PBD method. Few studies have compared IS with a fully covered self-expandable metallic stent (FCSEMS) as PBD for resectable PHCC. The aim of this study is to compare them.</p><p><strong>Methods: </strong>This study involved 86 consecutive patients (IS: 51; FCSEMS: 35). The recurrent biliary obstruction (RBO) rate until undergoing surgery or being diagnosed as unresectable, time to RBO, factors related to RBO, incidence of adverse events related to endoscopic retrograde cholangiography, and postoperative complications associated with each stent were evaluated retrospectively.</p><p><strong>Results: </strong>There was no significant difference between the two groups in the incidence of adverse events after stent insertion. After propensity score matching, the mean (SD) time to RBO was 37.9 (30.2) days in the IS group and 45.1 (35.1) days in the FCSEMS group, with no significant difference (<i>P</i>=0.912, log-rank test). A total of 7/51 patients in the IS group and 3/35 patients in the FCSEMS group developed RBO. The only risk factor for RBO was bile duct obstruction of the future excisional liver lobe(s) due to stenting (HR 29.8, <i>P</i>=0.008) in the FCSEMS group, but risk factors could not be indicated in the IS group. There was no significant difference in the incidence of bile leakage or liver failure. In contrast, pancreatic fistula was significantly more common in the FCSEMS group (13/23 patients) than in the IS group (3/28 patients) (<i>P</i> < 0.001), especially in patients who did not undergo pancreatectomy (<i>P</i>=0.001).</p><p><strong>Conclusions: </strong>As PBD, both IS and FCSEMS achieved low RBO rates. Compared with FCSEMS, IS shows no difference in RBO rate, is associated with fewer postoperative complications, and is considered an appropriate means of PBD for resectable PHCC. This trail is registered with UMIN000025631.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"3005210"},"PeriodicalIF":2.7,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40512776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined Liver Stiffness and Α-fetoprotein Further beyond the Sustained Virologic Response Visit as Predictors of Long-Term Liver-Related Events in Patients with Chronic Hepatitis C. 慢性丙型肝炎患者联合肝僵硬度和Α-fetoprotein进一步超越持续病毒学反应访问作为长期肝脏相关事件的预测因子
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-07-04 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5201443
Sheng-Hung Chen, Hsueh-Chou Lai, Wen-Pang Su, Jung-Ta Kao, Po-Heng Chuang, Wei-Fan Hsu, Hung-Wei Wang, Tsung-Lin Hsieh, Hung-Yao Chen, Cheng-Yuan Peng
Aims Long-term risk stratification using combined liver stiffness (LS) and clinically relevant blood tests acquired at the baseline further beyond the sustained virologic response (SVR) visit for chronic hepatitis C (CHC) has not been thoroughly investigated. This study retrospectively investigated the prognostics of liver-related events (LREs) further beyond the SVR visit. Methods Cox regression and random forest models identified the key factors, including longitudinal LS and noninvasive test results, that could predict LREs, including hepatocellular carcinoma, during prespecified follow-ups from 2010 to 2021. Kaplan–Meier survival analysis estimated the significance of between-group risk stratification. Results Of the entire eligible cohort (n = 520) of CHC patients with SVR to antiviral therapy, 28 (5.4%) patients developed post-SVR LREs over a median follow-up period of 6.1 years (interquartile range = 3.5–8.7). The multivariate Cox regression analysis identified two significant predictors of LREs after the year 3 post-SVR (Y3PSVR) baseline (LRE, n = 15 of 28, 53.6%, median follow-up = 4.1 [1.6–6.4] years after Y3PSVR): LS at Y3PSVR (adjusted hazard ratio [aHR] = 3.980, 95% confidence interval [CI] = 2.085–7.597, P < 0.001), and α-fetoprotein (AFP) at Y3PSVR (aHR = 1.017, 95% CI = 1.001–1.034, P=0.034). LS ≥1.45 m/s and AFP ≥3.00 ng/mL for Y3PSVR yielded positive likelihood ratios of 4.24 and 2.62, respectively. Kaplan–Meier analysis revealed that among the stratified subgroups, the subgroup with concurrent LS ≥1.45 m/s and AFP ≥3.00 ng/mL at Y3PSVR exhibited the highest risk of LREs after Y3PSVR (log-rank P < 0.001). Conclusion We recommend the combined use of concurrent LS and AFP in future prediction models for LREs in CHC. Patients with concurrently high LS and AFP values further beyond the SVR visit may require a recall policy involving intense surveillance.
目的:慢性丙型肝炎(CHC)的长期风险分层尚未得到彻底的研究,该研究使用联合肝硬度(LS)和在基线时获得的临床相关血液检查,进一步超出了持续病毒学反应(SVR)访问。本研究回顾性调查了SVR访视后肝脏相关事件(LREs)的预后。方法:在2010年至2021年的预定随访期间,Cox回归和随机森林模型确定了可以预测LREs(包括肝细胞癌)的关键因素,包括纵向LS和无创伤检测结果。Kaplan-Meier生存分析估计了组间风险分层的重要性。结果:在接受抗病毒治疗的SVR CHC患者的整个符合条件的队列(n = 520)中,28例(5.4%)患者在中位随访6.1年(四分位数间距= 3.5-8.7)期间出现SVR后LREs。多因素Cox回归分析确定了两个显著的预测指标,即在svr后3年(Y3PSVR)基线后LREs (LRE, n = 15 / 28, 53.6%,中位随访= 4.1[1.6-6.4]年):Y3PSVR时LS(校正风险比[aHR] = 3.980, 95%可信区间[CI] = 2.085-7.597, P < 0.001)和Y3PSVR时α-胎蛋白(AFP) (aHR = 1.017, 95% CI = 1.001-1.034, P=0.034)。Y3PSVR的LS≥1.45 m/s和AFP≥3.00 ng/mL的阳性似然比分别为4.24和2.62。Kaplan-Meier分析显示,在分层亚组中,Y3PSVR时并发LS≥1.45 m/s和AFP≥3.00 ng/mL的亚组Y3PSVR后LREs的风险最高(log-rank P < 0.001)。结论:我们建议在CHC LREs的未来预测模型中联合使用并发LS和AFP。同时LS和AFP值高于SVR就诊的患者可能需要涉及强化监测的召回政策。
{"title":"Combined Liver Stiffness and Α-fetoprotein Further beyond the Sustained Virologic Response Visit as Predictors of Long-Term Liver-Related Events in Patients with Chronic Hepatitis C.","authors":"Sheng-Hung Chen,&nbsp;Hsueh-Chou Lai,&nbsp;Wen-Pang Su,&nbsp;Jung-Ta Kao,&nbsp;Po-Heng Chuang,&nbsp;Wei-Fan Hsu,&nbsp;Hung-Wei Wang,&nbsp;Tsung-Lin Hsieh,&nbsp;Hung-Yao Chen,&nbsp;Cheng-Yuan Peng","doi":"10.1155/2022/5201443","DOIUrl":"https://doi.org/10.1155/2022/5201443","url":null,"abstract":"Aims Long-term risk stratification using combined liver stiffness (LS) and clinically relevant blood tests acquired at the baseline further beyond the sustained virologic response (SVR) visit for chronic hepatitis C (CHC) has not been thoroughly investigated. This study retrospectively investigated the prognostics of liver-related events (LREs) further beyond the SVR visit. Methods Cox regression and random forest models identified the key factors, including longitudinal LS and noninvasive test results, that could predict LREs, including hepatocellular carcinoma, during prespecified follow-ups from 2010 to 2021. Kaplan–Meier survival analysis estimated the significance of between-group risk stratification. Results Of the entire eligible cohort (n = 520) of CHC patients with SVR to antiviral therapy, 28 (5.4%) patients developed post-SVR LREs over a median follow-up period of 6.1 years (interquartile range = 3.5–8.7). The multivariate Cox regression analysis identified two significant predictors of LREs after the year 3 post-SVR (Y3PSVR) baseline (LRE, n = 15 of 28, 53.6%, median follow-up = 4.1 [1.6–6.4] years after Y3PSVR): LS at Y3PSVR (adjusted hazard ratio [aHR] = 3.980, 95% confidence interval [CI] = 2.085–7.597, P < 0.001), and α-fetoprotein (AFP) at Y3PSVR (aHR = 1.017, 95% CI = 1.001–1.034, P=0.034). LS ≥1.45 m/s and AFP ≥3.00 ng/mL for Y3PSVR yielded positive likelihood ratios of 4.24 and 2.62, respectively. Kaplan–Meier analysis revealed that among the stratified subgroups, the subgroup with concurrent LS ≥1.45 m/s and AFP ≥3.00 ng/mL at Y3PSVR exhibited the highest risk of LREs after Y3PSVR (log-rank P < 0.001). Conclusion We recommend the combined use of concurrent LS and AFP in future prediction models for LREs in CHC. Patients with concurrently high LS and AFP values further beyond the SVR visit may require a recall policy involving intense surveillance.","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"5201443"},"PeriodicalIF":2.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40592862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Association Between Serum Afamin Levels with Nonalcoholic Associated Fatty Liver Disease. 血清Afamin水平与非酒精相关性脂肪肝的关系
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-06-28 eCollection Date: 2022-01-01 DOI: 10.1155/2022/7175108
Shenghui Chen, Zhening Liu, Li Cen, Jinghua Wang, Juanwen Zhang, Xiaofeng Zhang, Chengfu Xu

Afamin is a member of the hepatokine that are strongly associated with various metabolic diseases. The relationship between afamin and nonalcoholic fatty liver disease (NAFLD) remains unclear. This study aimed to explore the correlation between serum afamin levels and NAFLD. We analyzed 88 NAFLD patients and 88 age- and sex-matched healthy controls who took their health examinations at the First Affiliated Hospital, Zhejiang University School of Medicine. The association was further confirmed in 22 biopsy-confirmed NAFLD patients and 36 healthy controls. Serum afamin levels were evaluated using an enzyme-linked immunosorbent assay (ELISA). NAFLD patients had significantly higher serum afamin levels than the healthy controls (14.79 ± 5.04 mg/L versus 10.83 ± 3.24 mg/L; P < 0.001). Serum afamin levels were positively correlated with metabolic parameters including the body mass index, waist circumference, systolic blood pressure, liver enzymes, and lipid profiles. A multiple regression analysis showed that serum afamin levels were independently related to the risk of NAFLD (OR: 1.289, 95% CI, 1.141-1.456; P < 0.001). The receiver operating characteristic (ROC) analysis showed that the area under curve (AUC) of serum afamin plus the BMI for detecting NAFLD was 0.878. In participants with liver biopsies, the serum afamin plus the BMI detected NAFLD with an AUC of 0.758. In conclusion, serum afamin levels were positively associated with prevalence and risk of NAFLD, and serum afamin plus the BMI had a high diagnostic performance for NAFLD. This study provides epidemiological evidence of afamin in NAFLD.

Afamin是与多种代谢疾病密切相关的肝因子中的一员。维生素与非酒精性脂肪性肝病(NAFLD)之间的关系尚不清楚。本研究旨在探讨血清afamin水平与NAFLD的相关性。我们分析了88名NAFLD患者和88名年龄和性别匹配的健康对照,他们在浙江大学医学院第一附属医院接受了健康检查。在22例活检证实的NAFLD患者和36例健康对照中进一步证实了这种关联。采用酶联免疫吸附试验(ELISA)评估血清afamin水平。NAFLD患者血清afamin水平显著高于健康对照组(14.79±5.04 mg/L vs 10.83±3.24 mg/L);P < 0.001)。血清维生素a水平与代谢参数(包括体重指数、腰围、收缩压、肝酶和脂质谱)呈正相关。多元回归分析显示血清afamin水平与NAFLD风险独立相关(OR: 1.289, 95% CI: 1.141-1.456;P < 0.001)。受试者工作特征(ROC)分析显示,血清afamin加BMI检测NAFLD的曲线下面积(AUC)为0.878。在接受肝活检的参与者中,血清维生素a和BMI检测到NAFLD的AUC为0.758。综上所述,血清afamin水平与NAFLD的患病率和风险呈正相关,血清afamin加上BMI对NAFLD具有较高的诊断效能。本研究提供了NAFLD中维生素a的流行病学证据。
{"title":"Association Between Serum Afamin Levels with Nonalcoholic Associated Fatty Liver Disease.","authors":"Shenghui Chen,&nbsp;Zhening Liu,&nbsp;Li Cen,&nbsp;Jinghua Wang,&nbsp;Juanwen Zhang,&nbsp;Xiaofeng Zhang,&nbsp;Chengfu Xu","doi":"10.1155/2022/7175108","DOIUrl":"https://doi.org/10.1155/2022/7175108","url":null,"abstract":"<p><p>Afamin is a member of the hepatokine that are strongly associated with various metabolic diseases. The relationship between afamin and nonalcoholic fatty liver disease (NAFLD) remains unclear. This study aimed to explore the correlation between serum afamin levels and NAFLD. We analyzed 88 NAFLD patients and 88 age- and sex-matched healthy controls who took their health examinations at the First Affiliated Hospital, Zhejiang University School of Medicine. The association was further confirmed in 22 biopsy-confirmed NAFLD patients and 36 healthy controls. Serum afamin levels were evaluated using an enzyme-linked immunosorbent assay (ELISA). NAFLD patients had significantly higher serum afamin levels than the healthy controls (14.79 ± 5.04 mg/L versus 10.83 ± 3.24 mg/L; <i>P</i> < 0.001). Serum afamin levels were positively correlated with metabolic parameters including the body mass index, waist circumference, systolic blood pressure, liver enzymes, and lipid profiles. A multiple regression analysis showed that serum afamin levels were independently related to the risk of NAFLD (OR: 1.289, 95% CI, 1.141-1.456; <i>P</i> < 0.001). The receiver operating characteristic (ROC) analysis showed that the area under curve (AUC) of serum afamin plus the BMI for detecting NAFLD was 0.878. In participants with liver biopsies, the serum afamin plus the BMI detected NAFLD with an AUC of 0.758. In conclusion, serum afamin levels were positively associated with prevalence and risk of NAFLD, and serum afamin plus the BMI had a high diagnostic performance for NAFLD. This study provides epidemiological evidence of afamin in NAFLD.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"7175108"},"PeriodicalIF":2.7,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40593767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia: A Large-Scale Retrospective Study. 胃低级别上皮内瘤变的内镜射频消融与氩等离子凝固的比较:一项大规模回顾性研究。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-06-22 eCollection Date: 2022-01-01 DOI: 10.1155/2022/2349940
Nanjun Wang, Ningli Chai, Longsong Li, Huikai Li, Yaqi Zhai, Xiuxue Feng, Shengzhen Liu, Wengang Zhang, Enqiang Linghu

Background: Gastric low-grade intraepithelial neoplasia (LGIN) is a precancerous lesion of gastric cancer. Endoscopic therapies represented by radiofrequency ablation (RFA) and argon plasma coagulation (APC) have been applied to treat gastric LGIN in recent years. However, no comparative study examining the effectiveness and safety profiles of RFA and APC has been reported.

Methods: A single-center, large-scale, retrospective study, including 73 and 50 patients treated with RFA and APC, respectively, was conducted in the First Medical Center of Chinese PLA General Hospital from October 2015 to October 2020, with a two-year follow-up. Effectiveness, complications, operative factors, and other data were assessed.

Results: At 2 years of follow-up, cure, relapse, recurrence, and progression rates were 90.4%, 9.6%, 9.6%, and 2.7% in the RFA group, respectively, versus 90%, 10%, 12%, and 4% in the APC group, respectively, with no statistically significant differences between the two groups (all p > 0.05). However, the mean lesion size was significantly larger in the RFA group (2.6 ± 1.0 cm) than in the APC group (1.5 ± 0.6 cm) (p < 0.001); there was also a significant difference in the composition ratio of large lesions between the two groups (p < 0.001). No serious postoperative complications showed in either group, and the abdominal pain was the most common symptom in the short term after surgery.

Conclusions: RFA and APC are both safe and effective destructive therapies for gastric LGIN. RFA is more suitable for flat and large lesions, while APC is more suitable for small lesions, especially those with slight local uplift or depression. An intraoperative submucosal injection is expected to be an effective method for relieving postoperative abdominal pain.

背景:胃低级别上皮内瘤变(LGIN)是胃癌的癌前病变。近年来,以射频消融(RFA)和氩等离子凝固(APC)为代表的内镜治疗已被应用于胃LGIN的治疗。然而,目前还没有关于RFA和APC的有效性和安全性的比较研究报道。方法:选取2015年10月至2020年10月在中国人民解放军总医院第一医学中心分别接受RFA和APC治疗的患者73例和50例,采用单中心、大规模、回顾性研究,随访2年。评估疗效、并发症、手术因素及其他数据。结果:随访2年时,RFA组的治愈率、复发率、复发率、进展率分别为90.4%、9.6%、9.6%、2.7%,APC组的治愈率分别为90%、10%、12%、4%,两组间差异无统计学意义(p > 0.05)。RFA组的平均病灶大小(2.6±1.0 cm)明显大于APC组(1.5±0.6 cm) (p < 0.001);两组间大病灶组成比例也有显著差异(p < 0.001)。两组均未出现严重的术后并发症,术后短期内腹痛是最常见的症状。结论:RFA和APC均是安全有效的胃LGIN破坏性治疗方法。RFA更适合扁平、大的病灶,APC更适合小的病灶,尤其是局部有轻微隆起或凹陷的病灶。术中粘膜下注射有望成为缓解术后腹痛的有效方法。
{"title":"Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia: A Large-Scale Retrospective Study.","authors":"Nanjun Wang,&nbsp;Ningli Chai,&nbsp;Longsong Li,&nbsp;Huikai Li,&nbsp;Yaqi Zhai,&nbsp;Xiuxue Feng,&nbsp;Shengzhen Liu,&nbsp;Wengang Zhang,&nbsp;Enqiang Linghu","doi":"10.1155/2022/2349940","DOIUrl":"https://doi.org/10.1155/2022/2349940","url":null,"abstract":"<p><strong>Background: </strong>Gastric low-grade intraepithelial neoplasia (LGIN) is a precancerous lesion of gastric cancer. Endoscopic therapies represented by radiofrequency ablation (RFA) and argon plasma coagulation (APC) have been applied to treat gastric LGIN in recent years. However, no comparative study examining the effectiveness and safety profiles of RFA and APC has been reported.</p><p><strong>Methods: </strong>A single-center, large-scale, retrospective study, including 73 and 50 patients treated with RFA and APC, respectively, was conducted in the First Medical Center of Chinese PLA General Hospital from October 2015 to October 2020, with a two-year follow-up. Effectiveness, complications, operative factors, and other data were assessed.</p><p><strong>Results: </strong>At 2 years of follow-up, cure, relapse, recurrence, and progression rates were 90.4%, 9.6%, 9.6%, and 2.7% in the RFA group, respectively, versus 90%, 10%, 12%, and 4% in the APC group, respectively, with no statistically significant differences between the two groups (all <i>p</i> > 0.05). However, the mean lesion size was significantly larger in the RFA group (2.6 ± 1.0 cm) than in the APC group (1.5 ± 0.6 cm) (<i>p</i> < 0.001); there was also a significant difference in the composition ratio of large lesions between the two groups (<i>p</i> < 0.001). No serious postoperative complications showed in either group, and the abdominal pain was the most common symptom in the short term after surgery.</p><p><strong>Conclusions: </strong>RFA and APC are both safe and effective destructive therapies for gastric LGIN. RFA is more suitable for flat and large lesions, while APC is more suitable for small lesions, especially those with slight local uplift or depression. An intraoperative submucosal injection is expected to be an effective method for relieving postoperative abdominal pain.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"2349940"},"PeriodicalIF":2.7,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40476001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors and Timing of Additional Surgery after Noncurative ESD for Early Gastric Cancer. 早期胃癌无治愈性ESD后追加手术的危险因素及时机。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-06-21 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3421078
Kaipeng Duan, Dongbao Li, Dongtao Shi, Jie Pei, Jiayu Ren, Weikang Li, Anqi Dong, Tao Chen, Jin Zhou

Background: Patients with early gastric cancer undergoing noncurative endoscopic submucosal dissection (ESD) have a risk of tumor recurrence and metastasis, and some patients need additional surgery. The purpose of this study was to explore the risk factors of cancer residue and lymph node (LN) metastasis after noncurative ESD for early gastric cancer and to compare the short outcome of early and delayed additional surgery.

Methods: The clinicopathological characteristics of 30 early gastric cancer patients who received noncurative ESD and additional surgery were studied retrospectively. Multivariable regression was utilized to examine the independent risk factors for residual cancer and LN metastasis. Receiver operating characteristic curve was used to analyze the multivariable model's predictive performance. Furthermore, the perioperative safety and radical tumor performance of early surgery (≤30 days, n = 11), delayed surgery (>30 days, n = 11) after ESD, and upfront surgery (n = 59) were compared.

Results: Multivariable regression showed that diffuse type of Lauren classification, submucosal invasion, and positive human epidermal growth factor receptor-2 (HER-2) were risk factors for residual cancer. Undifferentiated carcinoma, vascular invasion, and positive vertical margin were risk factors for LN metastasis. The area under the curve (AUC) of the multifactor model predicting cancer residue and LN metastasis was 0.761 and 0.792, respectively. The early surgery group experienced higher intraoperative blood loss and a longer operation time than the delayed surgery and upfront surgery groups. There was no significant difference in the number of LN dissections, LN metastasis rate, and postoperative complications among the three groups.

Conclusion: Diffuse type of Lauren classification, submucosal invasion, and positive HER-2 are risk factors for residual cancer, while undifferentiated carcinoma, vascular invasion, and positive vertical margin are risk factors for LN metastasis. Delayed additional surgery after ESD (>30 days) has higher intraoperative safety, without affecting the radical resection in early gastric cancer patients.

背景:早期胃癌患者行内镜下粘膜下剥离术(ESD)有肿瘤复发和转移的风险,部分患者需要额外手术治疗。本研究的目的是探讨早期胃癌非治愈性ESD术后肿瘤残留和淋巴结转移的危险因素,并比较早期和延迟追加手术的短期预后。方法:回顾性分析30例早期胃癌患者的临床病理特点。采用多变量回归分析残余癌和淋巴结转移的独立危险因素。采用受试者工作特征曲线分析多变量模型的预测性能。比较ESD术后早期手术(≤30天,n = 11)、延迟手术(>30天,n = 11)和术前手术(n = 59)的围手术期安全性和肿瘤根治性表现。结果:多变量回归显示弥漫性Lauren分型、粘膜下浸润、人表皮生长因子受体2 (HER-2)阳性是残留癌发生的危险因素。未分化癌、血管浸润和垂直边缘阳性是淋巴结转移的危险因素。预测肿瘤残留和淋巴结转移的多因素模型的曲线下面积(AUC)分别为0.761和0.792。早期手术组术中出血量高于延迟手术组和术前手术组,手术时间较术前手术组长。三组在淋巴结清扫数、淋巴结转移率、术后并发症方面无显著差异。结论:Lauren弥漫性分型、粘膜下浸润、HER-2阳性是淋巴结残留癌的危险因素,未分化癌、血管浸润、垂缘阳性是淋巴结转移的危险因素。ESD后延迟追加手术(>30天)术中安全性更高,不影响早期胃癌患者根治性切除。
{"title":"Risk Factors and Timing of Additional Surgery after Noncurative ESD for Early Gastric Cancer.","authors":"Kaipeng Duan,&nbsp;Dongbao Li,&nbsp;Dongtao Shi,&nbsp;Jie Pei,&nbsp;Jiayu Ren,&nbsp;Weikang Li,&nbsp;Anqi Dong,&nbsp;Tao Chen,&nbsp;Jin Zhou","doi":"10.1155/2022/3421078","DOIUrl":"https://doi.org/10.1155/2022/3421078","url":null,"abstract":"<p><strong>Background: </strong>Patients with early gastric cancer undergoing noncurative endoscopic submucosal dissection (ESD) have a risk of tumor recurrence and metastasis, and some patients need additional surgery. The purpose of this study was to explore the risk factors of cancer residue and lymph node (LN) metastasis after noncurative ESD for early gastric cancer and to compare the short outcome of early and delayed additional surgery.</p><p><strong>Methods: </strong>The clinicopathological characteristics of 30 early gastric cancer patients who received noncurative ESD and additional surgery were studied retrospectively. Multivariable regression was utilized to examine the independent risk factors for residual cancer and LN metastasis. Receiver operating characteristic curve was used to analyze the multivariable model's predictive performance. Furthermore, the perioperative safety and radical tumor performance of early surgery (≤30 days, <i>n</i> = 11), delayed surgery (>30 days, <i>n</i> = 11) after ESD, and upfront surgery (<i>n</i> = 59) were compared.</p><p><strong>Results: </strong>Multivariable regression showed that diffuse type of Lauren classification, submucosal invasion, and positive human epidermal growth factor receptor-2 (HER-2) were risk factors for residual cancer. Undifferentiated carcinoma, vascular invasion, and positive vertical margin were risk factors for LN metastasis. The area under the curve (AUC) of the multifactor model predicting cancer residue and LN metastasis was 0.761 and 0.792, respectively. The early surgery group experienced higher intraoperative blood loss and a longer operation time than the delayed surgery and upfront surgery groups. There was no significant difference in the number of LN dissections, LN metastasis rate, and postoperative complications among the three groups.</p><p><strong>Conclusion: </strong>Diffuse type of Lauren classification, submucosal invasion, and positive HER-2 are risk factors for residual cancer, while undifferentiated carcinoma, vascular invasion, and positive vertical margin are risk factors for LN metastasis. Delayed additional surgery after ESD (>30 days) has higher intraoperative safety, without affecting the radical resection in early gastric cancer patients.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"3421078"},"PeriodicalIF":2.7,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Usefulness of Noncontrast MRI-Based Radiomics Combined Clinic Biomarkers in Stratification of Liver Fibrosis. 非对比mri放射组学联合临床生物标志物在肝纤维化分层中的应用。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-06-21 eCollection Date: 2022-01-01 DOI: 10.1155/2022/2249447
Ru Zhao, Hong Zhao, Ya-Qiong Ge, Fang-Fang Zhou, Long-Sheng Wang, Hong-Zhen Yu, Xi-Jun Gong

Purpose: To develop and validate a radiomic nomogram based on texture features from out-of-phase T1W images and clinical biomarkers in prediction of liver fibrosis.

Materials and methods: Patients clinically diagnosed with chronic liver fibrosis who underwent liver biopsy and noncontrast MRI were enrolled. All patients were assigned to the nonsignificant fibrosis group with fibrosis stage <2 and the significant fibrosis group with stage ≥2. Texture parameters were extracted from out-of-phase T1-weighted (T1W) images and calculated using the Artificial Intelligent Kit (AK). Boruta and LASSO regressions were used for feature selection and a multivariable logistic regression was used for construction of a combinational model integrating radiomics and clinical biomarkers. The performance of the models was assessed by using the receiver operator curve (ROC) and decision curve.

Results: ROC analysis of the radiomics model that included the most discriminative features showed AUCs of the training and test groups were 0.80 and 0.78. A combinational model integrating RADscore and fibrosis 4 index was established. ROC analysis of the training and test groups showed good to excellent performance with AUC of 0.93 and 0.86. Decision curves showed the combinational model added more net benefit than radiomic and clinical models alone.

Conclusions: The study presents a combinational model that incorporates RADscore and clinical biomarkers, which is promising in classification of liver fibrosis.

目的:开发并验证基于异相T1W图像纹理特征和临床生物标志物预测肝纤维化的放射组学图。材料和方法:纳入临床诊断为慢性肝纤维化并行肝活检和非对比MRI检查的患者。结果:纳入最具鉴别特征的放射组学模型的ROC分析显示,训练组和试验组的auc分别为0.80和0.78。建立RADscore与纤维化指数的联合模型。训练组和试验组的ROC分析结果均为良好至优异,AUC分别为0.93和0.86。决策曲线显示,联合模型比单独的放射学和临床模型增加了更多的净效益。结论:该研究提出了一种结合RADscore和临床生物标志物的联合模型,在肝纤维化的分类中有前景。
{"title":"Usefulness of Noncontrast MRI-Based Radiomics Combined Clinic Biomarkers in Stratification of Liver Fibrosis.","authors":"Ru Zhao,&nbsp;Hong Zhao,&nbsp;Ya-Qiong Ge,&nbsp;Fang-Fang Zhou,&nbsp;Long-Sheng Wang,&nbsp;Hong-Zhen Yu,&nbsp;Xi-Jun Gong","doi":"10.1155/2022/2249447","DOIUrl":"https://doi.org/10.1155/2022/2249447","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a radiomic nomogram based on texture features from out-of-phase T1W images and clinical biomarkers in prediction of liver fibrosis.</p><p><strong>Materials and methods: </strong>Patients clinically diagnosed with chronic liver fibrosis who underwent liver biopsy and noncontrast MRI were enrolled. All patients were assigned to the nonsignificant fibrosis group with fibrosis stage <2 and the significant fibrosis group with stage ≥2. Texture parameters were extracted from out-of-phase T1-weighted (T1W) images and calculated using the Artificial Intelligent Kit (AK). Boruta and LASSO regressions were used for feature selection and a multivariable logistic regression was used for construction of a combinational model integrating radiomics and clinical biomarkers. The performance of the models was assessed by using the receiver operator curve (ROC) and decision curve.</p><p><strong>Results: </strong>ROC analysis of the radiomics model that included the most discriminative features showed AUCs of the training and test groups were 0.80 and 0.78. A combinational model integrating RADscore and fibrosis 4 index was established. ROC analysis of the training and test groups showed good to excellent performance with AUC of 0.93 and 0.86. Decision curves showed the combinational model added more net benefit than radiomic and clinical models alone.</p><p><strong>Conclusions: </strong>The study presents a combinational model that incorporates RADscore and clinical biomarkers, which is promising in classification of liver fibrosis.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"2249447"},"PeriodicalIF":2.7,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years. 对慢性 HBV 感染妇女产后复发进行抗病毒治疗可缩短谷丙转氨酶恢复时间并降低 4 年内肝炎复发率。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2022-06-20 eCollection Date: 2022-01-01 DOI: 10.1155/2022/4753267
Min Quan, Cong Liu, Wei Li, Hui-Chun Xing

Background: Few studies explored whether anti-hepatitis B virus (HBV) therapy should be initiated during postpartum hepatitis flare.

Aim: This study aimed to analyze the effect of anti-HBV therapy on postpartum hepatitis flare and evaluate the prognosis within 4 years postpartum.

Methods: This retrospective study enrolled hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive pregnant women with HBV DNA ≥ 106 IU/mL. A total of 152 pregnant women were included: 103 in the prophylactic anti-HBV therapy group (PT-G) and 49 in the non-prophylactic anti-HBV therapy group (NPT-G). The women with a postpartum flare were assigned to the anti-HBV therapy group (AT-G) and non-anti-HBV therapy group (NAT-G) to analyze the effect of postpartum anti-HBV therapy on hepatitis flare. Virological and biochemical parameters were assessed.

Results: Taking postpartum 12 weeks as the cutoff point, the ALT recovered time for postpartum flare women is shorter in AT-G (n = 16, 42.1%) or PT-G (n = 23, 34.8%) than in NAT-G (n = 14, 23.0%; x 2 = 4.067, P=0.044) or NPT-G (n = 4, 11.1%; x 2 = 5.579, P=0.018). Taking postpartum 26 weeks as the cutoff point, the ALT recovered time is shorter in AT-G (n = 35, 57.3%) or PT-G (n = 44, 66.7%) than in NAT-G (n = 32, 84.2%; x 2 = 7.707, P=0.006) or NPT-G (n = 16, 44.4%; x 2 = 4.749, P=0.029). Postpartum flare recovery time was positively correlated with HBV DNA level at delivery [r = 0.223, P=0.025, 95%CI (0.022~0.41)]. The hepatitis re-flare rates within postpartum 4 years in AT-G (n = 3, 9.68%) is lower than that in NAT-G (n = 24, 45.4%; x 2 = 14.003, P ≤ 0.001). The HBeAg, HBsAg, HBV DNA, and ALT level at postpartum 4 years in AT-G were lower than that in NAT-G (P < 0.001).

Conclusion: Anti-HBV therapy for postpartum hepatitis flare of women with chronic HBV could shorten the ALT recovery time and reduce hepatitis re-flare rates within 4 years of postpartum.

背景:目的:本研究旨在分析抗HBV治疗对产后肝炎复发的影响,并评估产后4年内的预后情况:这项回顾性研究纳入了乙型肝炎表面抗原(HBsAg)阳性和乙型肝炎e抗原(HBeAg)阳性、HBV DNA≥106 IU/mL的孕妇。共纳入 152 名孕妇:预防性抗 HBV 治疗组(PT-G)103 人,非预防性抗 HBV 治疗组(NPT-G)49 人。产后复发的妇女被分配到抗 HBV 治疗组(AT-G)和非抗 HBV 治疗组(NAT-G),以分析产后抗 HBV 治疗对肝炎复发的影响。对病毒学和生化指标进行了评估:以产后 12 周为分界点,AT-G 组(n = 16,42.1%)或 PT-G 组(n = 23,34.8%)产后复发妇女的 ALT 恢复时间短于 NAT-G 组(n = 14,23.0%;x 2 = 4.067,P=0.044)或 NPT-G 组(n = 4,11.1%;x 2 = 5.579,P=0.018)。以产后 26 周为分界点,AT-G(35 人,57.3%)或 PT-G(44 人,66.7%)的 ALT 恢复时间短于 NAT-G(32 人,84.2%;x 2 = 7.707,P=0.006)或 NPT-G(16 人,44.4%;x 2 = 4.749,P=0.029)。产后复发时间与分娩时的 HBV DNA 水平呈正相关[r = 0.223,P=0.025,95%CI (0.022~0.41)]。AT-G 在产后 4 年内的肝炎复发率(n = 3,9.68%)低于 NAT-G(n = 24,45.4%;x 2 = 14.003,P ≤ 0.001)。AT-G产后4年的HBeAg、HBsAg、HBV DNA和ALT水平均低于NAT-G(P < 0.001):结论:对产后肝炎复发的慢性 HBV 妇女进行抗 HBV 治疗可缩短 ALT 恢复时间,降低产后 4 年内肝炎复发率。
{"title":"Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years.","authors":"Min Quan, Cong Liu, Wei Li, Hui-Chun Xing","doi":"10.1155/2022/4753267","DOIUrl":"10.1155/2022/4753267","url":null,"abstract":"<p><strong>Background: </strong>Few studies explored whether anti-hepatitis B virus (HBV) therapy should be initiated during postpartum hepatitis flare.</p><p><strong>Aim: </strong>This study aimed to analyze the effect of anti-HBV therapy on postpartum hepatitis flare and evaluate the prognosis within 4 years postpartum.</p><p><strong>Methods: </strong>This retrospective study enrolled hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive pregnant women with HBV DNA ≥ 10<sup>6</sup> IU/mL. A total of 152 pregnant women were included: 103 in the prophylactic anti-HBV therapy group (PT-G) and 49 in the non-prophylactic anti-HBV therapy group (NPT-G). The women with a postpartum flare were assigned to the anti-HBV therapy group (AT-G) and non-anti-HBV therapy group (NAT-G) to analyze the effect of postpartum anti-HBV therapy on hepatitis flare. Virological and biochemical parameters were assessed.</p><p><strong>Results: </strong>Taking postpartum 12 weeks as the cutoff point, the ALT recovered time for postpartum flare women is shorter in AT-G (<i>n</i> = 16, 42.1%) or PT-G (<i>n</i> = 23, 34.8%) than in NAT-G (<i>n</i> = 14, 23.0%; <i>x</i> <sup>2</sup> = 4.067, <i>P</i>=0.044) or NPT-G (<i>n</i> = 4, 11.1%; <i>x</i> <sup>2</sup> = 5.579, <i>P</i>=0.018). Taking postpartum 26 weeks as the cutoff point, the ALT recovered time is shorter in AT-G (<i>n</i> = 35, 57.3%) or PT-G (<i>n</i> = 44, 66.7%) than in NAT-G (<i>n</i> = 32, 84.2%; <i>x</i> <sup>2</sup> = 7.707, <i>P</i>=0.006) or NPT-G (<i>n</i> = 16, 44.4%; <i>x</i> <sup>2</sup> = 4.749, <i>P</i>=0.029). Postpartum flare recovery time was positively correlated with HBV DNA level at delivery [<i>r</i> = 0.223, <i>P</i>=0.025, 95%CI (0.022~0.41)]. The hepatitis re-flare rates within postpartum 4 years in AT-G (<i>n</i> = 3, 9.68%) is lower than that in NAT-G (<i>n</i> = 24, 45.4%; <i>x</i> <sup>2</sup> = 14.003, <i>P</i> ≤ 0.001). The HBeAg, HBsAg, HBV DNA, and ALT level at postpartum 4 years in AT-G were lower than that in NAT-G (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Anti-HBV therapy for postpartum hepatitis flare of women with chronic HBV could shorten the ALT recovery time and reduce hepatitis re-flare rates within 4 years of postpartum.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":" ","pages":"4753267"},"PeriodicalIF":2.7,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40406416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Canadian Journal of Gastroenterology and Hepatology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1