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| 1 | Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis显示文摘It is estimated that 30%of the adult population in Japan is affected by nonalcoholic fatty liver disease(NAFLD).Fatty changes of the liver are generally diagnosed using imaging methods such as abdominal ultrasonography(US)and computed tomography(CT),but the sensitivity of these imaging techniques is low in cases of mild steatosis.Alanine aminotransferase levels may be normal in some of these patients,warranting the necessity to establish a set of parameters useful for detecting NAFLD,and the more severe form of the disease,nonalcoholic steatohepatitis(NASH).Although liver biopsy is currently the gold standard for diagnosing progressive NASH,it has many drawbacks,such as sampling error,cost,and risk of complications.Furthermore,it is not realistic to perform liver biopsies on all NAFLD patients.Diagnosis of NASH using various biomarkers,scoring systems and imaging methods,such as elastography,has recently been attempted.The NAFIC score,calculated from the levels of ferritin,fasting insulin,and typeⅣcollagen 7S,is useful for the diagnosis of NASH,while the NAFLD fibrosis score and the FIB-4 index are useful for excluding NASH in cases of advanced fibrosis.This article reviews the limitations and merits of liver biopsy and noninvasive diagnostic tests in the diagnosis of NAFLD/NASH. | Yoshio Sumida Atsushi Nakajima Yoshito Itoh | 2014 | World Journal of Gastroenterology2014，20，2： | 45 |
| 2 | Congenital tracheoesophageal fistula successfully diagnosed by CT esophagography显示文摘Tracheoesophageal 管(TEF ) 或 bronchoesophageal 管可能对损伤先天、煽动性、肿瘤,或第二等。先天的 TEF 或 bronchoesophageal 管通常与食道的闭锁被联系并且乐意地在幼年期被诊断。但是如果它没与食道的闭锁被联系,它可以坚持直到成人生活。一些理论被建议了在诊断解释这延期。我们在场有先天的 TEF 的一个 70 岁的人的一个盒子。TEF 被 multidetector 排 CT esophagography 成功地诊断。 | Koichi Nagata Yoshito Kamio Tamaki Ichikawa Mitsutaka Kadokura Akihiko Kitami Shungo Endo Haruhiro Inoue Shin-Ei Kudo | 2006 | World Journal of Gastroenterology2006，12，9： | 32 |
| 3 | Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy显示文摘Treatment strategies,whether as follow-up or'total incisional biopsy'for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen,are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic treatment.Based on the histological findings of the biopsy specimen,it is difficult to differentiate between reactive or regenerative changes,inflammation and neoplastic changes,intraepithelial and invasive tumors.Therefore,gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during follow-up.Recent advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and highfrequency generators,may make endoscopic treatment,such as endoscopic submucosal dissection(ESD),a therapeutic option for gastric intraepithelial neoplasia,including low-grade neoplasms.Future studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness. | Tsutomu Nishida Shusaku Tsutsui Motohiko Kato Takuya Inoue Shunsuke Yamamoto Yoshito Hayashi Tomofumi Akasaka Takuya Yamada Shinichiro Shinzaki Hideki Iijima Masahiko Tsujii Tetsuo Takehara | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 18 |
| 4 | Characteristics and prognosis of synchronous multiple early gastric cancer显示文摘AIM:To assess the clinicopathologic characteristics,risk factors,and prognosis for synchronous multiple early gastric cancer(SMGC).METHODS:A total of 146 patients with SMGC and1194 patients with single gastric cancer who had undergone gastrectomy between 1989 and 2008 were retrospectively analyzed to determine their clinicopathologic characteristics and postoperative survival.Tumors were classified into groups on the basis of location and histology.Smoking habits were evaluated using the Brinkman index.Clinical and pathological factors were compared using either Fisher’s exact test or Pearson’sχ2test.Logistic regression analysis was performed to identify independent risk factors.Survival rate was calculated using the Kaplan-Meier method.RESULTS:SMGCs accounted for 10.9%of gastric cancer cases and occurred predominantly in elderly male patients with a family history of gastric cancer who were both smokers and drinkers.These tumors were typically macroscopically elevated and histologically differentiated.There were no significant differences between SMGC and single gastric cancer patients with respect to tumor location,tumor size,lymph node metastasis,the number of metastatic lymph nodes,venous invasion,or tumor stage(P=0.052,P=0.347,P=0.595,P=0.805,P=0.559,and P=0.408,respectively).Further,there was no significant difference in postoperative survival between the patient groups(P=0.200).Of the 146SMGC patients,a single patient had remnant cancer.CONCLUSION:A careful preoperative endoscopy is necessary for patients who are at high risk of SMGC,and minimally invasive treatment may be indicated in some cases. | Taro Isobe Kousuke Hashimoto Junya Kizaki Naotaka Murakami Keishiro Aoyagi Kikuo Koufuji Yoshito Akagi Kazuo Shirouzu | 2013 | World Journal of Gastroenterology2013，19，41： | 17 |
| 5 | Epstein-Barr virus-associated gastric carcinoma: Evidence of age-dependence among a Mexican population显示文摘AIM: To investigate features of Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC) among a Mexican population.METHODS: Cases of primary gastric adenocarcinoma were retrieved from the files of the Departments of anatomic site of the gastric neoplasia was identified, and carcinomas were histologically classified as intestinal and diffuse types and subclassified as proposed by the Japanese Research Society for Gastric Cancer. EBV-encoded small non-polyadenylated RNA-1 (EBER-1)in situ hybridization was conducted to determine the presence of EBV in neoplastic cells.RESULTS: We studied 330 consecutive, non-selected,primary gastric carcinomas. Among these, there were173 male and 157 female patients (male/female ratio1.1/1). EBER-1 was detected in 24 (7.3%) cases (male/female ratio: 1.2/1). The mean age for the entire group was 58.1 years (range: 20-88 years), whereas the mean age for patients harboring EBER-1-positive gastric carcinomas was 65.3 years (range: 50-84 years). Age and histological type showed statistically significant differences, when EBER-1-positive and -negative gastric carcinomas were compared. EBER-1 was detected in hyperplastic- and dysplastic-gastric mucosa surrounding two EBER-1-negative carcinomas, respectively.CONCLUSION: Among Latin-American countries, Mexico has the lowest frequency of EBVaGC. Indeed, the Mexican population >50 years of age was selectively affected. Ethnic variations are responsible for the epidemiologic behavior of EBVaGC among the worldwide population. | Roberto Herrera-Goepfert Suminori Akiba Chihaya Koriyama Shan Ding Edgardo Reyes Tetsuhiko Itoh Yoshie Minakami Yoshito Eizuru | 2005 | World Journal of Gastroenterology2005，11，39： | 14 |
| 6 | Status of colitis-associated cancer in ulcerative colitis显示文摘Surgical therapy for ulcerative colitis(UC) depends on the medical therapy administered for the patient's condition. UC is a benign disease. However, it has been reported that the rare cases of cancer in UC patients are increasing, and such cases have a worse prognosis. Recently, surgical therapy has greatly changed, there has been quite an increase in the number of UC patients with high-grade dysplasia and/or cancer. These lesions are known as colitis-associated cancer(CAC). The relationship between inflammation and tumorigenesis is well-established, and in the last decade, a great deal of supporting evidence has been obtained from genetic, pharmacological, and epidemiological studies. Inflammatory bowel disease, especially UC, is an important risk factor for the development of colon cancer. We should determine the risk factors for UC patients with cancer based on a large body of data, and we should attempt to prevent the increase in the number of such patients using these newly identified risk factors in the near future. Actively introducing the surgical treatment in addition to medical treatment should be considered. Several physicians should analyze UC from their unique perspectives in order to establish new clinically relevant diagnostic and treatment methods in the future. This article discusses CAC, including its etiology, mechanism, diagnosis, and treatment in UC patients. | Tetsushi Kinugasa Yoshito Akagi | 2016 | World Journal of Gastrointestinal Oncology2016，8，4： | 11 |
| 7 | Human papillomavirus in esophageal squamous cell carcinoma in Colombia and Chile显示文摘AIM: To examine the presence of human papillomavirus (HPV) in esophageal squamous cell carcinoma (ESCC) specimens collected from Colombia and Chile located in the northern and southern ends of the continent, respectively. METHODS: We examined 47 and 26 formalin-fixed and paraffin-embedded ESCC specimens from Colombia and Chile, respectively. HPV was detected using GP5+/GP6+ primer pair for PCR, and confirmed by Southern blot analysis. Sequencing analysis of L1 region fragment was used to identify HPV genotype. In addition, P16INK4A protein immunostaining of all the specimens was conducted. RESULTS: HPV was detected in 21 ESCC specimens (29%). Sequencing analysis of L1 region fragment identified HPV-16 genome in 6 Colombian cases(13%) and in 5 Chilean cases (19%). HPV-18 was detected in 10 cases (21%) in Colombia but not in any Chilean case. Since Chilean ESCC cases had a higher prevalence of HPV-16 (without statistical significance), but a significantly lower prevalence of HPV-18 than in Colombian cases (P = 0.011) even though the two countries have similar ESCC incidence rates, the frequency of HPV-related ESCC may not be strongly affected by risk factors affecting the incidence of ESCC. HPV-16 genome was more frequently detected in p16 positive carcinomas, although the difference was not statistically significant. HPV-18 detection rate did not show any association with p16 expression. Well-differentiated tumors tended to have either HPV-16 or HPV-18 but the association was not statistically significant. HPV genotypes other than HPV-16 or 18 were not detected in either country. CONCLUSION: HPV-16 and HPV-18 genotypes can be found in ESCC specimens collected from two South American countries. Further studies on the relationship between HPV-16 presence and p16 expression in ESCC would aid understanding of the mechanism underlying the presence of HPV in ESCC. | Andres Castillo Francisco Aguayo Chihaya Koriyama Miyerlandi Torres Edwin Carrascal Alejandro Corvalan Juan P Roblero Cecilia Naquira Mariana Palma Claudia Backhouse Jorge Argandona Tetsuhiko Itoh Karem Shuyama Yoshito Eizuru Suminori Akiba | 2006 | World Journal of Gastroenterology2006，12，38： | 11 |
| 8 | Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades Ⅱ and Ⅲ hemorrhoids: Results from a multicenter study显示文摘AIM: To show that aluminum potassium sulfate and tannic acid(ALTA) sclerotherapy has a high success rate for Grade Ⅱ and Ⅲ hemorrhoids.METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades Ⅱ and Ⅲ hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy.RESULTS: One hundred and sixty-nine patients were diagnosed with Grade Ⅱ hemorrhoids and 435 patients were diagnosed with Grade Ⅲ hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades Ⅱ and Ⅲ hemo-rrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades Ⅱ and Ⅲ hemorrhoids(P = 0.09). There were forty-seven post-operative complications(low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure.CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade Ⅱ and Ⅲ hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease. | Hidenori Miyamoto Takenori Hada Gentaro Ishiyama Yoshito Ono Hideo Watanabe | 2016 | World Journal of Hepatology2016，8，20： | 10 |
| 9 | High concentrations of human β-defensin 2 in gastric juice of patients with Helicobacter pylori infection显示文摘AIM: Human β-defensin (HBD)-1 and HBD-2 are endogenous antimicrobial peptides. Unlike HBD-1, the HBD-2 expression is augmented by Helicobacter pylori (H pylori). We sought to determine HBD-1 and HBD-2 concentrations in gastric juice duringH pylori infection.METHODS: HBD-1 and HBD-2 concentrations were measured by radioimmunoassay in plasma and gastric juice of 49 H pylori-infected and 33 uninfected subjects and before and after anti-H pyloritreatment in 13 patients with H pylori-associated gastritis. Interleukin (IL)-1β and IL-8 concentrations in gastric juice were measured by enzyme-linked immunosorbent assay (ELISA). Histological grades of gastritis were determined using two biopsy specimens taken from the antrum and corpus. Reverse phase high performance liquid chromatography (RP-HPLC)was used to identify HBD-2.RESULTS: HBD-2 concentrations in gastric juice, but not in plasma, were significantly higher in H pylori-positive than -negative subjects, albeit the post-treatment levels were unchanged. Immunoreactivity for HBD-2 was exclusively identified in H pylori-infected mucosa by RPHPLC. HBD-2 concentrations in gastric juice correlated with histological degree of neutrophil and mononuclear cell infiltration in the corpus. IL-1β levels correlated with those of IL-8, but not HBD-2. Plasma and gastric juice HBD-1concentrations were similar in H pylori-infected and uninfected subjects.CONCLUSION: Our results place the β-defensins, especially HBD-2, in the front line of innate immune defence.Moreover, HBD-2 may be involved in the pathogenesis of H pylori-associated gastritis, possibly through its function as immune and inflammatory mediator. | Hajime Isomoto Hiroshi Mukae Hiroshi Ishimoto Yoshito Nishi Chun-Yang Wen Akihiro Wad Ken Ohnita Toshiya Hirayama Masamitsu Nakazato Shigeru Kohno | 2005 | World Journal of Gastroenterology2005，11，31： | 10 |
| 10 | Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma显示文摘AIM: To evaluate the significance of autologous blood transfusion (AT) in reducing homologous blood transfusion (HT) in surgery for hepatocellular carcinoma (HCC). METHODS: The proportion of patients who received HT was compared between two groups determined by the time of AT introduction; period A (1991-1994, n = 93) and period B (1995-2000, n = 201). Multivariate logistic regression analysis was performed in order to identify independent significant predictors of the need for HT. We also investigated the impact of AT and HT on long-term postoperative outcome after curative surgery for HCC. RESULTS: The proportion of patients with HT was significantly lower in period B than period A (18.9% vs 60.2%, P < 0.0001). Multivariate logistic regression analysis identified AT administration as a significant independent predictor of the need for HT (P < 0.0001). Disease-free survival in patients with AT was comparable to that without any transfusion. Multivariate analysis identified HT administration as an independent significant factor for poorer disease-free survival (P = 0.0380). CONCLUSION: AT administration significantly decreased the need for HT. Considering the postoperative survival disadvantage of HT, AT administration could improve the long-term outcome of HCC patients. | Yoshito Tomimaru Hidetoshi Eguchi Shigeru Marubashi Hiroshi Wada Shogo Kobayashi Masahiro Tanemura Koji Umeshita Yuichiro Doki Masaki Mori Hiroaki Nagano | 2011 | World Journal of Gastroenterology2011，17，32： | 8 |
| 11 | Choroidal and cutaneous metastasis from gastric adenocarcinoma显示文摘Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earlier literature. The frequency of gastric cancer as a primary lesion was 6% in cutaneous metastasis of men, and cutaneous metastasis occurs in 0.8% of all gastric cancers. We report a patient with gastric adenocarcinoma who presented with visual disorder in his left eye and skin pain on his head as his initial symptoms. These symptoms were diagnosed to be caused by choroidal and cutaneous metastasis of gastric adenocarcinoma. Two cycles of chemotherapy consisted of oral S-1 and intravenous cisplatin (SPIRITS regimen); this was markedly effective to reduce the primary gastric lesion and almost all the metastatic lesions. | Shoichiro Kawai Tsutomu Nishida Yoshito Hayashi Hisao Ezaki Takuya Yamada Shinichiro Shinzaki Masanori Miyazaki Kei Nakai Takayuki Yakushijin Kenji Watabe Hideki Iijima Masahiko Tsujii Kohji Nishida Tetsuo Takehara | 2013 | World Journal of Gastroenterology2013，19，9： | 6 |
| 12 | Claudin 1 mediates tumor necrosis factor alpha-induced cell migration in human gastric cancer cells显示文摘AIM:To investigate the role of claudin 1 in the regulation of genes involved in cell migration and tumor necrosis factor alpha(TNF-α)-induced gene expression in human gastric adenocarcinoma cells.METHODS:Knockdown experiments were conducted with claudin 1 small interfering RNA(si RNA),and theeffects on the cell cycle,apoptosis,migration and invasion were analyzed in human gastric adenocarcinoma MKN28 cells.The gene expression profiles of cells were analyzed by microarray and bioinformatics.RESULTS:The knockdown of claudin 1 significantly inhibited cell proliferation,migration and invasion,and increased apoptosis.Microarray analysis identified 245genes whose expression levels were altered by the knockdown of claudin 1.Pathway analysis showed that the top-ranked molecular and cellular function was the cellular movement related pathway,which involved MMP7,TNF-SF10,TGFBR1,and CCL2.Furthermore,TNFand nuclear frctor-κB were the top-ranked upstream regulators related to claudin 1.TNF-αtreatment increased claudin 1 expression and cell migration in MKN28 cells.Microarray analysis indicated that the depletion of claudin1 inhibited 80%of the TNF-α-induced m RNA expression changes.Further,TNF-αdid not enhance cell migration in the claudin 1 si RNA transfected cells.CONCLUSION:These results suggest that claudin 1 is an important messenger that regulates TNF-α-induced gene expression and migration in gastric cancer cells.A deeper understanding of these cellular processes may be helpful in establishing new therapeutic strategies for gastric cancer. | Atsushi Shiozaki Hiroki Shimizu Daisuke Ichikawa Hirotaka Konishi Shuhei Komatsu Takeshi Kubota Hitoshi Fujiwara Kazuma Okamoto Daisuke Iitaka Shingo Nakashima Yoshito Nako Mingyao Liu Eigo Otsuji | 2014 | World Journal of Gastroenterology2014，20，47： | 6 |
| 13 | E-cadherin and beta-catenin expression in Epstein-Barr virus-associated gastric carcinoma and their prognostic significance显示文摘AIM: To examine the role of E-cadherin and beta- catenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas (EBV-GCs). METHODS: We compared the frequency of E-cadherin and beta-catenin expression in 59 EBV-GCs and 120 non-EBV-GCs, and examined the association between patients' prognosis and the expressions of these proteins. RESULTS: Neither the cellular-membranous nor the cytoplasmic E-cadherin expression showed any difference between EBV-GCs and non-EBV-GCs. On the other hand, loss of membranous expression of beta- catenin occurred more frequently in non-EBV-GCs than EBV-GCs [odds ratio = 0.41; 95% confidence interval (CI), 0.19-0.90]. Furthermore, the nuclear and/or cytoplosmic expression of beta-catenin was seen more frequentlyin EBV-GCs than non-EBV-GCs (odds ratio = 2.23; 95% CI, 0.97-5.09), and was observed in a larger proportion of carcinoma cells of EBV-GCs than non-EBV-GCs (P = 0.024). Survival analysis for non-EBV-GC revealed that lymph node metastasis was significantly associated with poor prognosis (P < 0.001). Among EBV- GCs, the depth of invasion (P = 0.005), lymph node metastasis (P = 0.004) and an intestinal type by Lauren classification (hazard ratio = 9.47; 95% CI, 2.67-33.6) were significantly associated with poor prognosis. On the other hand, nuclear and/or cytoplasmic expression of beta-catenin was associated with a better prognosis in patients with EBV-GC (hazard ratio = 0.32; 95% CI, 0.11-0.93). CONCLUSION: We observed more frequent preservation of beta-catenin in cell membrane and accumulation in nuclei and/or cytoplasm in EBV-GCs than in non-EBV- GCs. Factors involved in the prognosis of EBV-GCs and non-EBV-GCs are different in the two conditions. | Chihaya Koriyama Suminori Akiba Tetsuhiko Itoh Kazunobu Sueyoshi Yoshie Minakami Alejandro Corvalan Suguru Yonezawa Yoshito Eizuru | 2007 | World Journal of Gastroenterology2007，13，29： | 6 |
| 14 | Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: An autopsy case report显示文摘We report an extremely rare case of pulmonary lipiodol embolism with acute respiratory distress syndrome(ARDS) after transcatheter arterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). A 77-yearold man who was diagnosed with a huge HCC wasadmitted for TACE. Immediately after the procedure, this patient experienced severe dyspnea. We suspected that his symptoms were associated with a pulmonary lipiodol embolism after TACE, and we began intensive treatment. However, his condition did not improve, and he died on the following day. A subsequent autopsy revealed that the cause of death was ARDS due to pulmonary lipiodol embolism. No cases have been previously reported for which an autopsy was performed to explain the most probable mechanism of pulmonary lipiodol embolism; thus, ours is the first report for such a rare case. | Keiichi Hatamaru Shunjiro Azuma Takuji Akamatsu Takeshi Seta Shunji Urai Yoshito Uenoyama Yukitaka Yamashita Kazuo Ono | 2015 | World Journal of Gastroenterology2015，21，4： | 5 |
| 15 | Sclerosing epithelioid fibrosarcoma of the liver infiltrating the inferior vena cava显示文摘Sclerosing epithelioid fibrosarcoma (SEF) is a rare and distinct variant of fibrosarcoma, composed of epithelioid tumor cells arranged in strands, nests, cords, or sheets embedded within a sclerotic collagenous matrix. We report a 39-year-old man with SEF of the liver, which infiltrated the inferior vena cava (IVC). The SEF of the liver was successfully resected, and the infiltrated IVC was also removed together with the liver tumor. Histopathological examination of the tumor showed typical histopathology of SEF. Immunohistochemically, the tumor was positive for vimentin. Recurrence was noted 7 mo after surgery. After chemotherapy, the recurrent tumor was resected surgically, and histopathological examination showed similar findingsto those of the primary tumor. To our knowledge, this is the first report of SEF of the liver with tumor invasion of the IVC. | Yoshito Tomimaru Hiroaki Nagano Shigeru Marubashi Shogo Kobayashi Hidetoshi Eguchi Yutaka Takeda Masahiro Tanemura Toru Kitagawa Koji Umeshita Nobuyuki Hashimoto Hideki Yoshikawa Kenichi Wakasa Yuichiro Doki Masaki Mori | 2009 | World Journal of Gastroenterology2009，15，33： | 5 |
| 16 | Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma显示文摘AIM:To investigate whether fresh frozen plasma (FFP) transfusion affects outcomes following hepatic resection for hepatocellular carcinoma (HCC) in terms of liver function,postoperative complications and cancer prognosis.METHODS:We retrospectively compared the incidence of postoperative complications between 204 patients who underwent hepatectomy for HCC with routine FFP transfusion in an early period (1983-1993,Group A) and 293 with necessity for FFP transfusion during a later period (1998-2006,Group B),and also between two subgroups of Group B [22 patients with FFP transfusion (Group B1) and 275 patients without FFP transfusion (Group B2)].Additionally,only in limited patients in Group B1 and Group B2 with intraoperative blood loss≥ 2000 mL (Group B1 ≥ 2000 mL and Group B2 ≥ 2000 mL),postoperative complications,liver function tests,and cancer prognosis were compared.RESULTS:No mortality was registered in Group B,compared to 8 patients (3.9%) of Group A.The incidence of morbidity in Group B2 [23.2% (64/275)] was not significantly different from Group B1 [40.9% (9/22)] and Group A [27.0% (55/204)].The incidence of complications and postoperative liver function tests were comparable between Group B1 ≥ 2000 mL vs Group B2 ≥ 2000 mL.Postoperative prognosis did not correlate with administration of FFP,but with tumor-related factors.CONCLUSION:The outcome of hepatectomy for HCC is not influenced by FFP transfusion.We suggest FFP transfusion be abandoned in patients who undergo hepatectomy for HCC. | Yoshito Tomimaru Hiroshi Wada Shigeru Marubashi Shogo Kobayashi Hidetoshi Eguchi Yutaka Takeda Masahiro Tanemura Takehiro Noda Koji Umeshita Yuichiro Doki Masaki Mori Hiroak Nagano | 2010 | World Journal of Gastroenterology2010，16，44： | 5 |
| 17 | Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial显示文摘 | Hansjochen Wilke Kei Muro Eric Van Cutsem Sang-Cheul Oh Gy?rgy Bodoky Yasuhiro Shimada Shuichi Hironaka Naotoshi Sugimoto Oleg Lipatov Tae-You Kim David Cunningham Philippe Rougier Yoshito Komatsu Jaffer Ajani Michael Emig Roberto Carlesi David Ferry Kuma | 2014 | Lancet Oncology2014，，11： | 4 |
| 18 | Factors associated with the overall survival of elderly patients with hepatocellular carcinoma显示文摘AIM:To identify the factors associated with overall survival of elderly patients with hepatocellular carcinoma(HCC).METHODS:A total of 286 patients with HCC(male/female:178/108,age:46-100 years),who were diagnosed and treated by appropriate therapeutic procedures between January 2000 and December 2010,were enrolled in this study.Patients were stratified into two groups on the basis of age:Elderly(≥ 75 years old) and non-elderly(< 75 years old).Baseline clinical characteristics as well as cumulative survival rates were then compared between the two groups.Univariate and multivariate analyses were used to identify the factors associated with prolonged overall survival of patients in each group.Cumulative survival rates in the two groups were calculated separately for each modified Japan Integrated Stage score(mJIS score) category by the Kaplan-Meier method.In addition,we compared the cumulative survival rates of elderly and non-elderly patients with good hepatic reserve capacity(≤ 2 points as per mJIS).RESULTS:In the elderly group,the proportion of female patients,patients with absence of hepatitis B or hepatitis C viral infection,and patients with coexisting extrahepatic comorbid illness was higher(56.8% vs 31.1%,P < 0.001;27.0% vs 16.0%,P = 0.038;33.8% vs 22.2%,P = 0.047;respectively) than that in the nonelderly group.In the non-elderly group,the proportion of hepatitis B virus(HBV)-infected patients was higher than that in the elderly group(9.4% vs 0%,P = 0.006).The cumulative survival rates in the elderly group were 53.7% at 3 years and 32.9% at 5 years,which were equivalent to those in the non-elderly group(55.9% and 39.4%,respectively),as shown by a log-rank test(P = 0.601).In multivariate analysis,prolonged survival was significantly associated with the extent of liver damage and stage(P < 0.001 and P < 0.001,respectively),but was not associated with patient age.However,on individual evaluation of factors in both groups,stage was significantly(P < 0.001) associated with prolonged survival.Regarding mJIS scores of ≤ 2,the rate of female patients with this score was higher in the elderly group when compared to that in the non-elderly group(P = 0.012) and patients ≥ 80 years of age tended to demonstrate shortened survival.CONCLUSION:Survival of elderly HCC patients was associated with liver damage and stage,but not age,except for patients ≥ 80 years with mJIS score ≤ 2. | Hideki Fujii Yoshito Itoh Naoki Ohnishi Masafumi Sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida Yasuo Ohkawara Kanji Yamaguchi Masahito Minami Takeshi Okanoue | 2012 | World Journal of Gastroenterology2012，18，16： | 4 |
| 19 | Esophageal early basaloid squamous carcinoma with unusual narrowband imaging magnified endoscopy findings显示文摘Basaloid squamous carcinoma(BSC)is a rare variant of esophageal cancer.There are very few reports of'early'BSC.Here we report a case of early BSC with unusual findings by narrowband imaging magnified endoscopy(NBI-ME).A 70-year-old man with a middle thoracic esophageal tumor was referred to our hospital.White-light endoscopy revealed a reddish depressed lesion 5 mm in diameter having a subepithelial tumor-like prominence with a gentle rising slope.NBI-ME revealed irregular loop-shaped microvessels coexistent with thick irregularly branched non-looped vessels.Iodine staining revealed a pale brown lesion.We performed endoscopic submucosal dissection for diagnostic treatment.Histologic examination showed the proliferation of basal cell-like hyperchromatic tumor cells in the lamina propria and with slight invasion into the submucosa at a depth of 320μm.The tumor cells formed solid nests and microcystic structures,containing an Alcian blue-positive mucoid matrix.The surface was covered with squamous epithelium without cellular atypia.Thin vessels were observed in the intra-epithelial papilla and thick vessels were observed around the solid nests beneath the epithelium.Based on these findings together,we diagnosed the lesion as BSC.In this case,the NBI-ME findings differed from those of typical squamous cell carcinoma in that both non-invasive cancer-like irregular loop-shaped microvessels coexisted with massively invasive cancerlike thick non-looped vessels.We speculate that the looped and non-looped vessels observed by NBI-ME histologically corresponded to thin vessels in the intraepithelial papilla and thick vessels around the tumor nests,respectively.These NBI-ME findings might be a feature of early esophageal BSC. | Yugo Kai Motohiko Kato Yoshito Hayashi Tomofumi Akasaka Shinichiro Shinzaki Tsutomu Nishida Masahiko Tsujii Eiichi Morii Tetsuo Takehara | 2014 | World Journal of Gastroenterology2014，20，35： | 4 |
| 20 | Partially hydrolyzed guar gum attenuates non-alcoholic fatty liver disease in mice through the gut-liver axis显示文摘BACKGROUND The gut-liver axis has attracted much interest in the context of chronic liver disease pathogenesis.Prebiotics such as dietary fibers were shown to attenuate non-alcoholic fatty liver disease(NAFLD)by modulating gut microbiota.Partially hydrolyzed guar gum(PHGG),a water-soluble dietary fiber,has been reported to alleviate the symptoms of various intestinal diseases and metabolic syndromes.However,its effects on NAFLD remain to be fully elucidated.To determine whether treatment with PHGG attenuates NAFLD development in mice through the gut-liver axis.METHODS Seven-week-old male C57BL/6J mice with increased intestinal permeability were fed a control or atherogenic(Ath)diet(a mouse model of NAFLD)for 8 wk,with or without 5%PHGG.Increased intestinal permeability was induced through chronic intermittent administration of low-dose dextran sulfate sodium.Body weight,liver weight,macroscopic findings in the liver,blood biochemistry[aspartate aminotransferase(AST)and alanine aminotransferase(ALT),total cholesterol,triglyceride,free fatty acids,and glucose levels],liver histology,myeloperoxidase activity in liver tissue,mRNA expression in the liver and intestine,serum endotoxin levels in the portal vein,intestinal permeability,and microbiota and short-chain fatty acid(SCFA)profiles in the cecal samples were investigated.RESULTS Mice with increased intestinal permeability subjected to the Ath diet showed significantly increased serum AST and ALT levels,liver fat accumulation,liver inflammatory(tumor necrosis factor-αand monocyte chemotactic protein-1)and fibrogenic(collagen 1a1 andαsmooth muscle actin)marker levels,and liver myeloperoxidase activity,which were significantly attenuated by PHGG treatment.Furthermore,the Ath diet combined with increased intestinal permeability resulted in elevated portal endotoxin levels and activated toll-like receptor(TLR)4 and TLR9 expression,confirming that intestinal permeability was significantly elevated,as observed by evaluating the lumen-to-blood clearance of fluorescein isothiocyanate-conjugated dextran.PHGG treatment did not affect fatty acid metabolism in the liver.However,it decreased lipopolysaccharide signaling through the gut-liver axis.In addition,it significantly increased the abundance of cecal Bacteroides and Clostridium subcluster XIVa.Treatment with PHGG markedly increased the levels of SCFAs,particularly,butyric acid,acetic acid,propionic acid,and formic acid,in the cecal samples.CONCLUSION PHGG partially prevented NAFLD development in mice through the gut-liver axis by modulating microbiota and downstream SCFA profiles. | Shun Takayama Kazuhiro Katada Tomohisa Takagi Takaya Iida Tomohiro Ueda Katsura Mizushima Yasuki Higashimura Mayuko Morita Tetsuya Okayama Kazuhiro Kamada Kazuhiko Uchiyama Osamu Handa Takeshi Ishikawa Zenta Yasukawa Tsutomu Okubo Yoshito Itoh Yuji Naito | 2021 | World Journal of Gastroenterology2021，27，18： | 4 |
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