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Unraveling the Heterogeneity of Tumor Immune Microenvironment in Hepatocellular Carcinoma by SingleCell RNA Sequencing and its Implications for Prognosis and Therapeutic Response. 单细胞RNA测序揭示肝癌肿瘤免疫微环境的异质性及其对预后和治疗反应的影响
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-28 DOI: 10.5152/tjg.2024.24118
Ying Han, Lele Song, Lingna Lv, Chunlei Fan, Huiguo Ding

Tumor immune microenvironment (TIME) has become a new hotspot in cancer research over the past few years. Tumor immune microenvironment of hepatocellular carcinoma (HCC) is especially intriguing as HCC is reported to be highly heterogeneous by previous genomic and cytological studies. It is also closely related to patient prognosis and therapeutic outcome. The recently emerged single-cell RNA sequencing (scRNAseq) technique provides a new tool for TIME study, and current studies have made great advances in defining the roles of TIME in HCC pathogenesis and therapy. Current evidence suggests that heterogeneity is a key player influencing therapeutic response, drug resistance, and prognosis. However, our understanding is limited on the roles of TIME heterogeneity in HCC development, prognosis, and therapeutic response, especially in the era of immunotherapy. This review aims to unravel the heterogeneity of TIME in HCC by scRNAseq, with specific focuses on the cellular, transcriptional, and marker perspectives of TIME heterogeneity in HCC, as well as assessing prognostic and therapeutic response by heterogeneity markers. By summarizing current discoveries regarding TIME heterogeneity, we hope to provide clues on the crucial roles of various cellular components in the development and progression of HCC. We also hope to identify potential markers and therapeutic targets for prognosis assessment and personalized treatment to improve patient outcomes. Combined therapies from multiple dimensions regarding heterogeneity may provide new opportunities to treat HCC more effectively.

肿瘤免疫微环境(Tumor immune microenvironment, TIME)是近年来肿瘤研究的新热点。肝细胞癌(HCC)的肿瘤免疫微环境特别有趣,因为先前的基因组和细胞学研究报道HCC具有高度异质性。它还与患者的预后和治疗结果密切相关。近年来出现的单细胞RNA测序(scRNAseq)技术为TIME的研究提供了新的工具,目前的研究在明确TIME在HCC发病机制和治疗中的作用方面取得了很大进展。目前的证据表明异质性是影响治疗反应、耐药性和预后的关键因素。然而,我们对时间异质性在HCC发展、预后和治疗反应中的作用的了解有限,特别是在免疫治疗时代。本综述旨在通过scRNAseq揭示HCC中TIME的异质性,特别关注HCC中TIME异质性的细胞、转录和标记角度,以及通过异质性标记评估预后和治疗反应。通过总结目前关于TIME异质性的发现,我们希望为各种细胞成分在HCC发生和进展中的关键作用提供线索。我们也希望找到潜在的标志物和治疗靶点,用于预后评估和个性化治疗,以改善患者的预后。针对异质性的多维度联合治疗可能为更有效地治疗HCC提供新的机会。
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引用次数: 0
Unraveling the Mysteries of Autoimmune Gastritis. 揭示自身免疫性胃炎的奥秘。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-25 DOI: 10.5152/tjg.2024.24563
İrfan Soykan, Ramazan Erdem Er, Yigit Baykara, Cağdaş Kalkan

Autoimmune gastritis is an immune-mediated disease characterized by the destruction of parietal cells and atrophy of the oxyntic mucosa due to anti-parietal cell antibodies. It may lead to serious conditions including iron/vitamin B12 and micronutrient deficiencies, neurological disorders, and gastric malignancies. The exact mechanism of this disease is not exactly understood; however, dysregulated immunological mechanisms appear to be major contributors. Patients with this disease are often asymptomatic but may present with gastrointestinal symptoms and/or iron/vitamin B12 deficiencies. Although important serological markers are available and despite advanced endoscopic techniques, the definitive diagnosis relies on histopathological examination of gastric corporal biopsy specimens. Autoimmune gastritis is closely related with increased risk of gastric neuroendocrine tumors and gastric adenocarcinoma. Patients with autoimmune gastritis do not benefit from specific treatments, thus, management is directed to restore micronutrient deficiencies and to prevent occurrence of neoplastic transformation with appropriate endoscopic surveillance.

自身免疫性胃炎是一种免疫介导的疾病,其特征是由于抗壁细胞抗体导致壁细胞破坏和氧合粘膜萎缩。它可能导致严重的疾病,包括铁/维生素B12和微量营养素缺乏,神经系统疾病和胃恶性肿瘤。这种疾病的确切机制尚不完全清楚;然而,失调的免疫机制似乎是主要原因。这种疾病的患者通常无症状,但可能出现胃肠道症状和/或铁/维生素B12缺乏。尽管有重要的血清学标志物可用,尽管先进的内窥镜技术,明确的诊断依赖于胃活检标本的组织病理学检查。自身免疫性胃炎与胃神经内分泌肿瘤、胃腺癌发病风险增高密切相关。自身免疫性胃炎患者不能从特异性治疗中获益,因此,治疗的目的是恢复微量营养素缺乏,并在适当的内镜监测下防止肿瘤转化的发生。
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引用次数: 0
Assessment of Serum Dynamic Thiol/Disulfide Homeostasis and Oxidative/Nitrosative Stress in Patients with Crohn's Disease. 克罗恩病患者血清动态硫醇/二硫稳态和氧化/亚硝化应激的评估
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-25 DOI: 10.5152/tjg.2024.23519
Ancel Aysun Bağdaş, Sezgin Barutçu, Ahmet Saracaloğlu, Abdullah Tuncay Demiryürek

Background/aims: Crohn's disease (CD) is a major subtype of chronic relapsing inflammatory gastrointestinal disorders. In this study, we assessed the possible contributions of serum oxidative/nitrosative stress and dynamic thiol/disulfide homeostasis to CD pathogenesis.

Materials and methods: Patients with active CD (A-CD) at onset (n = 38), CD patients in the remission (R-CD) (n = 38), and healthy controls (n = 38) were prospectively included in this study. Serum oxidative/nitrosative parameters as well as total thiol and native thiol levels were analyzed.

Results: We observed significant augmentation in nitric oxide (NO) levels in both A-CD and R-CD patients compared to healthy controls. We detected marked reductions in the 3-nitrotyrosine levels in the patient groups. Glutathione, glutathione peroxidase, and myeloperoxidase levels were observed to be significantly lower in both the active and remission groups (P < .001). In the A-CD group, native thiol (P < .001) and total thiol (P < .01) levels were lower, and disulfide levels were higher than those of the control group (P < .01), while the native thiol/total thiol ratio was reduced and disulfide/total thiol (P < .001) and disulfide/native thiol (P < .001) ratios were elevated. Remarkably, no change in dynamic thiol/disulfide homeostasis was found in the R-CD group.

Conclusion: Our results showed increased serum NO levels and decreased antioxidant enzymes, particularly during the active phase of CD. Determination of thiol/disulfide homeostasis could help differentiate between the active and remission phases of the disease. Thiol/ disulfide parameters can be used as biomarkers for A-CD.

背景/目的:克罗恩病(CD)是慢性复发性炎性胃肠道疾病的主要亚型。在这项研究中,我们评估了血清氧化/亚硝化应激和动态硫醇/二硫体内平衡对CD发病机制的可能贡献。材料和方法:本研究前瞻性纳入发病期活动性CD (A-CD)患者(n = 38)、缓解期CD (R-CD)患者(n = 38)和健康对照(n = 38)。分析血清氧化/亚硝化参数以及总硫醇和天然硫醇水平。结果:我们观察到与健康对照相比,A-CD和R-CD患者的一氧化氮(NO)水平显著升高。我们检测到患者组中3-硝基酪氨酸水平明显降低。活性组和缓解组的谷胱甘肽、谷胱甘肽过氧化物酶和髓过氧化物酶水平均显著降低(P < 0.001)。A-CD组天然硫醇(P < 0.001)和总硫醇(P < 0.01)水平低于对照组,二硫含量高于对照组(P < 0.01),天然硫醇/总硫醇比值降低,二硫/总硫醇比值升高(P < 0.001),二硫/天然硫醇比值升高(P < 0.001)。值得注意的是,在R-CD组中没有发现动态硫醇/二硫稳态的变化。结论:我们的研究结果显示血清NO水平升高,抗氧化酶下降,特别是在CD的活动期。硫醇/二硫体内平衡的测定有助于区分疾病的活动期和缓解期。硫醇/二硫参数可作为A-CD的生物标志物。
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引用次数: 0
Metabolic Dysfunction Associated Fatty Liver Disease in Long-Term Cholecystectomy Patients: A Cross-Sectional Study. 长期胆囊切除术患者代谢功能障碍相关脂肪肝:一项横断面研究
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-25 DOI: 10.5152/tjg.2024.24337
Semih Sezer, Selim Demirci, Murat Kara

Background/aims: Cholecystectomy, while generally safe with low perioperative morbidity and mortality, has been linked to an increase in metabolic disorders. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a globally prevalent condition that leads to both hepatic and systemic complications. This study aimed to investigate the association between cholecystectomy and MAFLD.

Materials and methods: This cross-sectional study was designed to evaluate the relationship between cholecystectomy and MAFLD. Metabolic dysfunction-associated fatty liver disease was defined by the presence of hepatic steatosis in combination with any of the following conditions: diabetes mellitus (fasting plasma glucose ≥126 mg/dL), overweight (body mass index (BMI) ≥25 kg/m2), or metabolic dysregulation.

Results: A total of 163 participants with BMI ≥25 kg/m2, including consecutive cholecystectomized (N = 83) and non-cholecystectomized (N = 80) subjects, were included. The prevalence of MAFLD was found in 64 out of 83 (77.1%) cholecystectomized patients and in 30 out of 80 (37.5%) non-cholecystectomized subjects (P < .001). When age, gender, BMI, exercise habits, hypertension, diabetes mellitus, and cholecystectomy status were included in regression analyses, we found that only BMI [odds ratio (OR) = 1.155 (95% CI: 1.040-1.283)] and cholecystectomy [OR = 4.540 (95% CI: 2.200-9.370)] were independently associated with MAFLD (both P < .01). ROC analysis identified 10 years as the cut-off, with MAFLD risk being 2.7-7.3 times higher in patients with cholecystectomy for ≤10 and >10 years.

Conclusion: In our study, MAFLD was found to be 4.5 times more likely in cholecystectomized patients compared to those without cholecystectomy, with a significant increase in frequency observed after 10 years. These results suggest that cholecystectomized patients should be monitored for MAFLD.

背景/目的:胆囊切除术虽然通常安全且围手术期发病率和死亡率低,但与代谢紊乱的增加有关。代谢功能障碍相关脂肪性肝病(MAFLD)是一种全球流行的疾病,可导致肝脏和全身并发症。本研究旨在探讨胆囊切除术与MAFLD之间的关系。材料和方法:本横断面研究旨在评估胆囊切除术与MAFLD的关系。代谢功能障碍相关的脂肪肝疾病定义为肝脂肪变性并伴有以下任何一种情况:糖尿病(空腹血糖≥126 mg/dL)、超重(体重指数(BMI)≥25 kg/m2)或代谢失调。结果:共纳入163例BMI≥25 kg/m2的受试者,包括连续胆囊切除术(N = 83)和未胆囊切除术(N = 80)。83例胆囊切除术患者中64例(77.1%)和80例非胆囊切除术患者中30例(37.5%)发现了mld的患病率(P < 0.001)。当纳入年龄、性别、BMI、运动习惯、高血压、糖尿病和胆囊切除情况进行回归分析时,我们发现只有BMI[比值比(OR) = 1.155 (95% CI: 1.040-1.283)]和胆囊切除[OR = 4.540 (95% CI: 2.200-9.370)]与MAFLD独立相关(P均< 0.01)。ROC分析以10年为截止时间,≤10年和≤10年胆囊切除术患者的MAFLD风险高2.7-7.3倍。结论:在我们的研究中,胆囊切除术患者发生MAFLD的可能性是未行胆囊切除术患者的4.5倍,10年后发生率显著增加。这些结果提示,胆囊切除术患者应监测是否有mld。
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引用次数: 0
Pancreatic Cancer: Current Concepts, Trends, and Future Directions. 胰腺癌:当前概念、趋势和未来方向。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-18 DOI: 10.5152/tjg.2024.24544
Patrick Wenzel, Carolin Mogler, Kıvanç Görgülü, Hana Algül

Pancreatic ductal adenocarcinoma (PC) ranks among the deadliest cancers, with a less than 15% 5-year survival rate. Epidemiological studies project that it will become the second leading cause of cancer-associated mortalities in the following decades. The hallmarks of pancreatic cancer lead to tumor aggressiveness and therapeutic resistance. For this reason, the field has been focusing on multiple dimensions to generate better therapeutic approaches, including new adjuvant, neoadjuvant, and palliative concepts to extend the survival of PC patients. Over the last 2 decades, clinical trials have significantly improved disease prognosis and patient survival. To achieve better outcomes and to deeply understand the therapeutic approaches, molecular tumor boards have become crucial for deeper exploitation of tumor genetics and tumor biology, providing better stratification markers for therapeutic regimens. Using recently developed targeted therapies, such as KRAS inhibitors, the field has gathered momentum and been tooled up with the help of new sequencing technologies. Therefore, researchers and clinicians have geared up for the battle against PC. This review will systematically discuss recent developments in adjuvant, neoadjuvant, and palliative treatment modalities. Moreover, the paradigm-shifting importance of genetic profiling on pancreatic cancer. will be explained through a showcase to frame future directions.

胰腺导管腺癌(PC)是最致命的癌症之一,其5年生存率不到15%。流行病学研究预测,在接下来的几十年里,它将成为癌症相关死亡的第二大原因。胰腺癌的特征导致肿瘤侵袭性和治疗耐药性。因此,该领域一直专注于从多个维度来产生更好的治疗方法,包括新辅助、新辅助和姑息概念,以延长PC患者的生存期。在过去的二十年中,临床试验显著改善了疾病预后和患者生存率。为了获得更好的结果并深入了解治疗方法,分子肿瘤板对于更深入地利用肿瘤遗传学和肿瘤生物学至关重要,为治疗方案提供更好的分层标记。利用最近开发的靶向疗法,如KRAS抑制剂,该领域已经聚集了动力,并在新的测序技术的帮助下得到了加强。因此,研究人员和临床医生已经准备好对抗PC。本综述将系统地讨论辅助、新辅助和姑息治疗方式的最新进展。此外,胰腺癌基因图谱的范式转换的重要性。将通过展柜来说明未来的发展方向。
{"title":"Pancreatic Cancer: Current Concepts, Trends, and Future Directions.","authors":"Patrick Wenzel, Carolin Mogler, Kıvanç Görgülü, Hana Algül","doi":"10.5152/tjg.2024.24544","DOIUrl":"10.5152/tjg.2024.24544","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PC) ranks among the deadliest cancers, with a less than 15% 5-year survival rate. Epidemiological studies project that it will become the second leading cause of cancer-associated mortalities in the following decades. The hallmarks of pancreatic cancer lead to tumor aggressiveness and therapeutic resistance. For this reason, the field has been focusing on multiple dimensions to generate better therapeutic approaches, including new adjuvant, neoadjuvant, and palliative concepts to extend the survival of PC patients. Over the last 2 decades, clinical trials have significantly improved disease prognosis and patient survival. To achieve better outcomes and to deeply understand the therapeutic approaches, molecular tumor boards have become crucial for deeper exploitation of tumor genetics and tumor biology, providing better stratification markers for therapeutic regimens. Using recently developed targeted therapies, such as KRAS inhibitors, the field has gathered momentum and been tooled up with the help of new sequencing technologies. Therefore, researchers and clinicians have geared up for the battle against PC. This review will systematically discuss recent developments in adjuvant, neoadjuvant, and palliative treatment modalities. Moreover, the paradigm-shifting importance of genetic profiling on pancreatic cancer. will be explained through a showcase to frame future directions.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"69-81"},"PeriodicalIF":1.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sessile Serrated Lesions: Searching for the True Prevalence and Risk Factors in China. 无柄锯齿状病变:寻找中国的真实患病率和危险因素。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-11 DOI: 10.5152/tjg.2024.24188
Bing-Yue Yao, Li Zhang, Chuan-Xia Wu, Liang Zheng, Ben-Song Duan, Qin-Wei Xu, Jing-Jing Lian, Hai-Bin Zhang, Yu Wang, Jia Cao

Background/aims: Growing recognition identifies sessile serrated lesions (SSL) as colorectal cancer (CRC) precursors. However, the SSL detection rate remains debatable and lacks a definitive consensus. Additionally, understanding the influencing factors in SSL development is limited. We aim to retrospectively analyze the true prevalence and risk factors of SSL in China.

Materials and methods: This retrospective study collected medical data from patients who underwent colonoscopy at the Endoscopy Center of Shanghai East Hospital affiliated with Tongji University between March 1, 2019 and February 28, 2022. Data were sourced through the electronic medical record system and included information such as age, sex, lesion location, number, and pathology. This study predominantly focused on the detection rate and the clinical and endoscopic features of SSL.

Results: Of 72 287 colonoscopies in 3 years, 3905 cases were histologically confirmed as SSL. Among them, 2290 (58.6%) were male, and 1615 (41.4%) were female. The overall SSL detection rate was 5.40%, slightly surpassing Asian/Chinese averages but lower than Western rates. Males had a higher SSL detection rate (6.1%) than females (4.6%). Univariate analysis revealed a significant association between SSL with dysplasia/adenocarcinoma (SSL-D/AD) and obesity (Body Mass Index, BMI ≥ 24), CRC family history, and hypertension. After multivariable logistic regression, only obesity (BMI ≥ 24) remained a statistically significant independent risk factor for SSL-D/AD.

Conclusions: The SSL detection rate at our center is 5.4% and increases with age. Males have a significantly higher detection rate than females. Our findings suggest that endoscopists should consider risk factors for SSL-D/AD, such as obesity, CRC family history, and hypertension.

背景/目的:越来越多的人认识到,无梗锯齿状病变(SSL)是结直肠癌(CRC)的前体。然而,SSL检测率仍然存在争议,缺乏明确的共识。此外,对SSL开发中影响因素的理解也是有限的。我们的目的是回顾性分析中国SSL的真实患病率和危险因素。材料与方法:本回顾性研究收集了2019年3月1日至2022年2月28日在同济大学附属上海东方医院内镜中心接受结肠镜检查的患者的医学数据。数据来源于电子病历系统,包括年龄、性别、病变部位、数量和病理等信息。本研究主要集中在SSL的检出率和临床及内镜特征。结果:在3年内72287例结肠镜检查中,3905例组织学证实为SSL。其中男性2290例(58.6%),女性1615例(41.4%)。SSL的整体检出率为5.40%,略高于亚洲/中国的平均水平,但低于西方国家。男性的SSL检出率(6.1%)高于女性(4.6%)。单因素分析显示,SSL与发育不良/腺癌(SSL- d /AD)、肥胖(体重指数,BMI≥24)、CRC家族史和高血压之间存在显著关联。多变量logistic回归后,只有肥胖(BMI≥24)仍然是SSL-D/AD的有统计学意义的独立危险因素。结论:我院SSL检出率为5.4%,随年龄增长检出率呈上升趋势。男性的检出率明显高于女性。我们的研究结果表明,内镜医师应考虑SSL-D/AD的危险因素,如肥胖、结直肠癌家族史和高血压。
{"title":"Sessile Serrated Lesions: Searching for the True Prevalence and Risk Factors in China.","authors":"Bing-Yue Yao, Li Zhang, Chuan-Xia Wu, Liang Zheng, Ben-Song Duan, Qin-Wei Xu, Jing-Jing Lian, Hai-Bin Zhang, Yu Wang, Jia Cao","doi":"10.5152/tjg.2024.24188","DOIUrl":"10.5152/tjg.2024.24188","url":null,"abstract":"<p><strong>Background/aims: </strong>Growing recognition identifies sessile serrated lesions (SSL) as colorectal cancer (CRC) precursors. However, the SSL detection rate remains debatable and lacks a definitive consensus. Additionally, understanding the influencing factors in SSL development is limited. We aim to retrospectively analyze the true prevalence and risk factors of SSL in China.</p><p><strong>Materials and methods: </strong>This retrospective study collected medical data from patients who underwent colonoscopy at the Endoscopy Center of Shanghai East Hospital affiliated with Tongji University between March 1, 2019 and February 28, 2022. Data were sourced through the electronic medical record system and included information such as age, sex, lesion location, number, and pathology. This study predominantly focused on the detection rate and the clinical and endoscopic features of SSL.</p><p><strong>Results: </strong>Of 72 287 colonoscopies in 3 years, 3905 cases were histologically confirmed as SSL. Among them, 2290 (58.6%) were male, and 1615 (41.4%) were female. The overall SSL detection rate was 5.40%, slightly surpassing Asian/Chinese averages but lower than Western rates. Males had a higher SSL detection rate (6.1%) than females (4.6%). Univariate analysis revealed a significant association between SSL with dysplasia/adenocarcinoma (SSL-D/AD) and obesity (Body Mass Index, BMI ≥ 24), CRC family history, and hypertension. After multivariable logistic regression, only obesity (BMI ≥ 24) remained a statistically significant independent risk factor for SSL-D/AD.</p><p><strong>Conclusions: </strong>The SSL detection rate at our center is 5.4% and increases with age. Males have a significantly higher detection rate than females. Our findings suggest that endoscopists should consider risk factors for SSL-D/AD, such as obesity, CRC family history, and hypertension.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"15-23"},"PeriodicalIF":1.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781660","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
Multidisciplinary Approach to Perihilar and Intrahepatic Cholangiocarcinoma: A Single-Center Experience. 肝门周围和肝内胆管癌的多学科方法:单中心经验。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-11 DOI: 10.5152/tjg.2024.24301
Adnan Gundogdu, Taha Anil Kodalak, Hakan Kucukaslan, Serdar Topaloglu, Ummuhan Turali, Sukru Oguz, Davut Dohman, Hasan Dinc, Feyyaz Ozdemir, Mehmet Arslan, Umit Cobanoglu, Erdem Karabulut, Adnan Calik, Mehmet Halil Ozturk

Background/aims: Treatment of perihilar cholangiocarcinoma (PHCC) and intrahepatic cholangiocarcinoma (IHCC) is a challenging issue. We aimed to investigate the clinical characteristics of both tumors and the outcome of our treatment policy.

Material and methods: We retrospectively analyzed data of 117 patients who were diagnosed with PHCC or IHCC between January 2007 and September 2023. Postoperative outcomes and the effects of prognostic factors on overall survival (OS) were investigated.

Results: Surgical resection was performed on 47 patients (PHCC, n = 33 and IHCC, n = 14). Preoperative biliary drainage was applied in 32 of 33 cases with PHCC and 2 of 14 cases with IHCC. The mortality rate was 8.5% (n = 4). The complication rate was 68.1%. The R0 resection rate was 73% in PHCC. The mean OS time of PHCC cases that underwent R0 resection was 26.5 ± 24.8 months. The mean OS time of patients who underwent resection for IHCC was 28.7 ± 35.5 months. The OS was poorly affected by high CA19-9 levels (≥37 U/mL) (P = .005), the presence of lymphovascular invasion (P = .049), positive surgical margins after resection (P < .001), and the development of postoperative acute renal failure (P = .078). The OS of patients receiving adjuvant chemotherapy was significantly longer (P = .071). CA19-9 levels of more than 37 U/mL (P = .027) and positive surgical margin (P < .001) were independent factors for poor OS.

Conclusion: Surgical resection is the mainstay of multidisciplinary treatment for PHCC and IHCC. In advanced stages of IHCC, the combination of loco-regional therapies and repeat surgery, along with the enhanced efficacy of systemic chemotherapy, plays a significant role in a patient's survival.

背景/目的:肝门周围胆管癌(PHCC)和肝内胆管癌(IHCC)的治疗是一个具有挑战性的问题。我们的目的是研究这两种肿瘤的临床特征和我们的治疗策略的结果。材料和方法:我们回顾性分析了2007年1月至2023年9月期间诊断为PHCC或IHCC的117例患者的资料。研究术后结局及预后因素对总生存期(OS)的影响。结果:47例患者行手术切除,其中PHCC 33例,IHCC 14例。33例PHCC患者中32例术前行胆道引流,14例IHCC患者中2例术前行胆道引流。死亡率8.5% (n = 4),并发症发生率68.1%。PHCC的R0切除率为73%。行R0切除的PHCC患者平均生存时间为26.5±24.8个月。IHCC切除术患者的平均OS时间为28.7±35.5个月。高CA19-9水平(≥37 U/mL) (P = 0.005)、存在淋巴血管侵犯(P = 0.049)、切除后手术切缘阳性(P < 0.001)和术后发生急性肾功能衰竭(P = 0.078)对OS影响较小。接受辅助化疗的患者OS明显延长(P = 0.071)。CA19-9水平大于37 U/mL (P = 0.027)和手术切缘阳性(P < 0.001)是不良OS的独立因素。结论:手术切除是PHCC和IHCC多学科治疗的主要方法。在晚期IHCC中,局部-区域联合治疗和重复手术,以及全身化疗的疗效增强,对患者的生存起着重要作用。
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引用次数: 0
Turkish Society of Gastroenterology: Pancreas Working Group, Acute Pancreatitis Committee Consensus Report. 土耳其胃肠病学会:胰腺工作组,急性胰腺炎委员会共识报告。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-11 DOI: 10.5152/tjg.2024.24392
Deniz Öğütmen Koç, Göksel Bengi, Özlem Gül, Yeşim Özen Alahdab, Engin Altıntaş, Sezgin Barutçu, Yılmaz Bilgiç, Birol Bostancı, Mehmet Cindoruk, Kadri Çolakoğlu, Deniz Duman, Nergiz Ekmen, Ahmet Tarık Eminler, Yasemin Gökden, Süleyman Günay, Gözde Derviş Hakim, Kader Irak, Sabite Kacar, İsmail Hakkı Kalkan, Elmas Kasap, Aydın Şeref Köksal, Sedef Kuran, Nevin Oruç, Osman Özdoğan, Burak Özşeker, Erkan Parlak, Murat Saruç, İlker Şen, Gürhan Şişman, Mukaddes Tozlu, Nurettin Tunç, Nalan Gülşen Ünal, Hakan Ümit Ünal, Serkan Yaraş, Abdullah Emre Yıldırım, Müjde Soytürk, Dilek Oğuz, Orhan Sezgin

Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP.

急性胰腺炎(Apute pancreatitis,AP)是由于多种原因导致胰腺通过各种炎症途径发生急性炎症的一种临床症状。土耳其胃肠病学会胰腺工作组就急性胰腺炎的治疗制定了全面的指导声明,包括其流行病学、病因、临床表现、诊断标准、疾病严重程度、治疗、预后、局部和全身并发症。这些声明是通过文献综述、讨论和共识意见制定的。这些声明最终被用于制定 AP 多学科管理的概念框架。
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引用次数: 0
NOP2/Sun RNA Methyltransferase 4 Regulates the Mammalian Target of Rapamycin Signaling Pathway to Promote Hepatocellular Carcinoma Progression. NOP2/Sun RNA甲基转移酶4调控哺乳动物雷帕霉素信号通路靶点促进肝细胞癌进展
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.5152/tjg.2024.23684
Congren Wang, Shaoying Ke, Shaoze Lin, Conglin Lin, Zhibing Cai, Lingju Hong, Qunxiong Pan

Background/aims: NOP2/Sun RNA methyltransferase 4 (NSUN4) is a prognostic indicator for hepatocellular carcinoma (HCC). However, the mechanism of NSUN4 in HCC is still unexplored. This project mainly focuses on the function and mechanism of NSUN4 in HCC malignant progression.

Materials and methods: The relation between the expression level of NSUN4 and the prognosis of HCC was measured by the means of bioinformatics. The expression level of NSUN4 was assessed by quantitative reverse transcription polymerase chain reaction. The western blot was utilized to determine the protein expression level of NSUN4 and mammalian target of rapamycin (mTOR) pathway-related proteins in cells and mouse tumor tissues. Cell counting kit-8 and colony formation assays were employed to measure cell proliferation ability. The wound healing assay and Transwell experiment were conducted to measure the cells' migration and invasion abilities. Flow cytometry was applied to determine the cell cycle.

Results: NSUN4 was overexpressed in HCC tissues and cells, enhancing cell migration, proliferation, and invasion. The influence that NSUN4 exerted on HCC malignant progression could be reduced by the inhibitor of the mTOR pathway.

Conclusion: The study explained the mechanism and influence of NSUN4 on HCC progression by regulating the mTOR signaling pathway through in vitro and in vivo experiments, providing the theoretical basis and a new research direction for clinical prognostic prediction and treatment.

背景/目的:NOP2/Sun RNA甲基转移酶4 (NSUN4)是肝细胞癌(HCC)的预后指标。然而,NSUN4在HCC中的作用机制尚不清楚。本项目主要研究NSUN4在HCC恶性进展中的作用及机制。材料与方法:采用生物信息学手段检测NSUN4表达水平与HCC预后的关系。定量逆转录聚合酶链反应检测NSUN4的表达水平。western blot检测NSUN4和哺乳动物雷帕霉素靶蛋白(mTOR)通路相关蛋白在细胞和小鼠肿瘤组织中的表达水平。细胞计数试剂盒-8和集落形成法检测细胞增殖能力。采用创面愈合实验和Transwell实验检测细胞的迁移和侵袭能力。流式细胞术测定细胞周期。结果:NSUN4在HCC组织和细胞中过表达,促进细胞迁移、增殖和侵袭。mTOR通路抑制剂可降低NSUN4对HCC恶性进展的影响。结论:本研究通过体外和体内实验,解释了NSUN4通过调控mTOR信号通路对HCC进展的作用机制和影响,为临床预后预测和治疗提供了理论依据和新的研究方向。
{"title":"NOP2/Sun RNA Methyltransferase 4 Regulates the Mammalian Target of Rapamycin Signaling Pathway to Promote Hepatocellular Carcinoma Progression.","authors":"Congren Wang, Shaoying Ke, Shaoze Lin, Conglin Lin, Zhibing Cai, Lingju Hong, Qunxiong Pan","doi":"10.5152/tjg.2024.23684","DOIUrl":"10.5152/tjg.2024.23684","url":null,"abstract":"<p><strong>Background/aims: </strong>NOP2/Sun RNA methyltransferase 4 (NSUN4) is a prognostic indicator for hepatocellular carcinoma (HCC). However, the mechanism of NSUN4 in HCC is still unexplored. This project mainly focuses on the function and mechanism of NSUN4 in HCC malignant progression.</p><p><strong>Materials and methods: </strong>The relation between the expression level of NSUN4 and the prognosis of HCC was measured by the means of bioinformatics. The expression level of NSUN4 was assessed by quantitative reverse transcription polymerase chain reaction. The western blot was utilized to determine the protein expression level of NSUN4 and mammalian target of rapamycin (mTOR) pathway-related proteins in cells and mouse tumor tissues. Cell counting kit-8 and colony formation assays were employed to measure cell proliferation ability. The wound healing assay and Transwell experiment were conducted to measure the cells' migration and invasion abilities. Flow cytometry was applied to determine the cell cycle.</p><p><strong>Results: </strong>NSUN4 was overexpressed in HCC tissues and cells, enhancing cell migration, proliferation, and invasion. The influence that NSUN4 exerted on HCC malignant progression could be reduced by the inhibitor of the mTOR pathway.</p><p><strong>Conclusion: </strong>The study explained the mechanism and influence of NSUN4 on HCC progression by regulating the mTOR signaling pathway through in vitro and in vivo experiments, providing the theoretical basis and a new research direction for clinical prognostic prediction and treatment.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"24-33"},"PeriodicalIF":1.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781640","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
Liver Transplantation for Acute Liver Failure due to Mushroom Poisoning. 肝移植治疗蘑菇中毒急性肝衰竭。
IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.5152/tjg.2024.24226
Hayri Canbaz, Attila Bestemir, Sami Akbulut, Sezai Yilmaz, Yusuf Yavuz

Background/aims: Liver transplantation is a life-saving approach in some cases of mushroom poisoning, which is one of the important causes of acute liver failure. However, debate continues regarding the timing of liver transplantation. The aim of this study is to retrospectively evaluate the results of patients who underwent liver transplantation due to mushroom poisoning.

Materials and methods: In this descriptive and observational study, the demographic and clinical data of 26 patients who presented to emergency units due to clinical features of acute hepatic failure secondary to mushroom poisoning between October 2008 and November 2023 and who underwent emergent liver transplantation were retrospectively reviewed.

Results: A total of 26 patients with a median (IQR) age of 39 (36) years were included in this study. The patients were divided into two groups: alive (n = 18) and dead (n = 8). No statistically significant differences were found between groups in terms of age, BMI, blood groups, hepatic encephalopathy grade, biochemical analysis obtained on the first days of hospital admission (AST, ALT, creatinine, ammonia, PTT, INR, albumin, platelets, HGB), ICU stay, cold ischemia time (CIT) and warm ischemia time (WIT), total bilirubin (P = .052), and time from poisoning to admission (P = .051). On the other hand, there were statistically significant differences between the alive and dead groups in terms of MELD score (P = .016; 23 vs. 34), re-transplantation (P = .022; 0% vs. 37.5%), hospital stay (P = .004; 24 vs. 6 days), and follow up (P < .001; 3423 vs. 5 days).

Conclusions: This study showed that mortality was higher in patients with high MELD scores and patients who underwent re-transplantation. However, this study needs to be supported by multicenter prospective studies.

背景/目的:食用菌中毒是导致急性肝衰竭的重要原因之一,肝移植是治疗食用菌中毒的救命方法。然而,关于肝移植时机的争论仍在继续。本研究的目的是回顾性评价因蘑菇中毒而行肝移植的患者的结果。材料和方法:在这项描述性和观察性研究中,回顾性分析了2008年10月至2023年11月期间因蘑菇中毒致急性肝功能衰竭的临床特征而就诊于急诊室并接受紧急肝移植的26例患者的人口学和临床资料。结果:本研究共纳入26例患者,中位(IQR)年龄39(36)岁。将患者分为生存组(n = 18)和死亡组(n = 8),两组患者年龄、BMI、血型、肝性脑病分级、入院第一天生化指标(AST、ALT、肌酐、氨酐、PTT、INR、白蛋白、血小板、HGB)、ICU住院时间、冷缺血时间(CIT)、热缺血时间(WIT)、总胆红素(P = 0.052)、中毒至入院时间(P = 0.051)差异均无统计学意义。另一方面,存活组与死亡组在MELD评分方面差异有统计学意义(P = 0.016;23 vs. 34),再移植(P = 0.022;0%对37.5%)、住院时间(P = 0.004;24天vs. 6天),随访(P < 0.001;3423 vs. 5天)。结论:本研究表明,MELD评分高的患者和再次移植的患者死亡率更高。然而,本研究需要多中心前瞻性研究的支持。
{"title":"Liver Transplantation for Acute Liver Failure due to Mushroom Poisoning.","authors":"Hayri Canbaz, Attila Bestemir, Sami Akbulut, Sezai Yilmaz, Yusuf Yavuz","doi":"10.5152/tjg.2024.24226","DOIUrl":"10.5152/tjg.2024.24226","url":null,"abstract":"<p><strong>Background/aims: </strong>Liver transplantation is a life-saving approach in some cases of mushroom poisoning, which is one of the important causes of acute liver failure. However, debate continues regarding the timing of liver transplantation. The aim of this study is to retrospectively evaluate the results of patients who underwent liver transplantation due to mushroom poisoning.</p><p><strong>Materials and methods: </strong>In this descriptive and observational study, the demographic and clinical data of 26 patients who presented to emergency units due to clinical features of acute hepatic failure secondary to mushroom poisoning between October 2008 and November 2023 and who underwent emergent liver transplantation were retrospectively reviewed.</p><p><strong>Results: </strong>A total of 26 patients with a median (IQR) age of 39 (36) years were included in this study. The patients were divided into two groups: alive (n = 18) and dead (n = 8). No statistically significant differences were found between groups in terms of age, BMI, blood groups, hepatic encephalopathy grade, biochemical analysis obtained on the first days of hospital admission (AST, ALT, creatinine, ammonia, PTT, INR, albumin, platelets, HGB), ICU stay, cold ischemia time (CIT) and warm ischemia time (WIT), total bilirubin (P = .052), and time from poisoning to admission (P = .051). On the other hand, there were statistically significant differences between the alive and dead groups in terms of MELD score (P = .016; 23 vs. 34), re-transplantation (P = .022; 0% vs. 37.5%), hospital stay (P = .004; 24 vs. 6 days), and follow up (P < .001; 3423 vs. 5 days).</p><p><strong>Conclusions: </strong>This study showed that mortality was higher in patients with high MELD scores and patients who underwent re-transplantation. However, this study needs to be supported by multicenter prospective studies.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"107-113"},"PeriodicalIF":1.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Turkish Journal of Gastroenterology
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