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1Predictive value of C-reactive protein/albumin ratio in acute pancreatitis显示文摘BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and infection.However,their role in patients with acute pancreatitis is not clear.The present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis patients.METHODS:This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June 2015.Ranson scores,Atlanta classification and CRP/albumin ratios of the patients were calculated.RESULTS:The CRP/albumin ratio was higher in deceased patients compared to survivors.The CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time,CRP and erythrocyte sedimentation rate.In addition to the CRP/albumin ratio,necrotizing pancreatitis type,moderately severe and severe Atlanta classification,and total Ranson score were independent risk factors of mortality.It was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk.A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% specificity.It was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤16.28.Patients with CRP/albumin ratio >16.28 had a 19.3 times higher chance of death.CONCLUSION:The CRP/albumin ratio is a novel but promising,easy-to-measure,repeatable,non-invasive inflammationbased prognostic score in acute pancreatitis.Mustafa Kaplan Ihsan Ates Muhammed Yener Akpinar Mahmut Yuksel Ufuk Baris Kuzu Sabite Kacar Orhan Coskun Ertugrul Kayacetin 2017Hepatobiliary & Pancreatic Diseases International2017,16,4:53
2Biomarkers of gastric cancer:Current topics and future perspective显示文摘Gastric cancer(GC) is one of the most prevalent malignant types in the world and an aggressive disease with a poor 5-year survival. This cancer is biologically and genetically heterogeneous with a poorly understood carcinogenesis at the molecular level. Although the incidence is declining, the outcome of patients with GC remains dismal. Thus, the detection at an early stage utilizing useful screening approaches, selection of an appropriate treatment plan, and effective monitoring is pivotal to reduce GC mortalities. Identification of biomarkers in a basis of clinical information and comprehensive genome analysis could improve diagnosis, prognosis, prediction of recurrence and treatment response. This review summarized the current status and approaches in GC biomarker, which could be potentially used for early diagnosis, accurate prediction of therapeutic approaches and discussed the future perspective based on the molecular classification and profiling.Tasuku Matsuoaka Masakazu Yashiro 2018World Journal of Gastroenterology2018,24,26:48
3Prognostic factors of refractory NSCLC patients receiving anlotinib hydrochloride as the third-or further-line treatment显示文摘Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.Jing Wang Yizhuo Zhao Qiming Wang Li Zhang Jianhua Shi Zhehai Wang Ying Cheng Jianxing He Yuankai Shi Hao Yu Yang Zhao Weiqiang Chen Yi Luo Xiuwen Wang Kejun Nan Faguang Jin Jian Dong Baolan Li Zhujun Liu Baohui Han Kai Li 2018Cancer Biology & Medicine2018,15,4:46
4Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer显示文摘AIM:To investigate the impact of prognostic nutritional index(PNI)on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy.METHODS:The data for 386 patients with gastric cancer were extracted and analyzed between January2003 and December 2008 in our center.The patients were divided into two groups according to the cutoff value of the PNI:those with a PNI≥46 and those with a PNI<46.Clinicopathological features were compared between the two groups and potential prognostic factors were analyzed.The relationship between postoperative complications and PNI was analyzed by logistic regression.The univariate and multivariate hazard ratios were calculated using the Cox proportional hazard model.RESULTS:The optimal cutoff value of the PNI was set at 46,and patients with a PNI≥46 and those with a PNI<46 were classified into PNI-high and PNI-low groups,respectively.Patients in the PNI-low group were more likely to have advanced tumor(T),node(N),and TNM stages than patients in the PNI-high group.The low PNI is an independent risk factor for the incidence of postoperative complications(OR=2.223).The 5-year overall survival(OS)rates were 54.1%and21.1%for patients with a PNI≥46 and those with a PNI<46,respectively.The OS rates were significantly lower in the PNI-low group than in the PNI-high group among patients with stagesⅡ(P=0.001)andⅢ(P<0.001)disease.CONCLUSION:The PNI is a simple and useful marker not only to identify patients at increased risk for postoperative complications,but also to predict long-term survival after total gastrectomy.The PNI should be included in the routine assessment of advanced gastric cancer patients.Nan Jiang Jing-Yu Deng Xue-Wei Ding Bin Ke Ning Liu Ru-Peng Zhang Han Liang 2014World Journal of Gastroenterology2014,20,30:41
5Systemic inflammation in colorectal cancer: Underlying factors,effects, and prognostic significance显示文摘Systemic inflammation is a marker of poor prognosis preoperatively present in around 20%-40%of colorectal cancer patients.The hallmarks of systemic inflammation include an increased production of proinflammatory cytokines and acute phase proteins that enter the circulation.While the low-level systemic inflammation is often clinically silent,its consequences are many and may ultimately lead to chronic cancer-associated wasting,cachexia.In this review,we discuss the pathogenesis of cancer-related systemic inflammation,explore the role of systemic inflammation in promoting cancer growth,escaping antitumor defense,and shifting metabolic pathways,and how these changes are related to less favorable outcome.Anne E Tuomisto Markus J Makinen Juha P Vayrynen 2019World Journal of Gastroenterology2019,25,31:27
6Advances in prognostic factors in acute pancreatitis:a mini-review显示文摘BACKGROUND:Early assessment of the severity of acute pancreatitis is essential to the proper management of the disease.It is dependent on the criteria of the Atlanta classification system.DATA SOURCES:PubMed search of recent relevant articles was performed to identify information about the severity and prognosis of acute pancreatitis.RESULTS:The scoring systems included the Ranson's or Glasgow's criteria ≥3,the APACHE II classification system ≥8,and the Balthazar's criteria ≥4 according to the computed tomography enhanced scanning findings.The single factors on admission included age >65 years,obesity,hemoconcentration(>44%),abnormal chest X-ray,creatinine >2 mg/dl,C-reactive protein>150 mg/dl,procalcitonin >1.8 ng/ml,albumin <2.5 mg/dl,calcium <8.5 mg/dl,early hyperglycemia,increased intra-abdominal pressure,macrophage migration inhibitory factor,or a combination of IL-10 >50 pg/ml with calcium <6.6 mg/dl.CONCLUSION:The prediction of the severity of acute pancreatitis is largely based on well defined multiple factor scoring systems as well as several single risk factors.Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis 2010Hepatobiliary & Pancreatic Diseases International2010,9,5:25
7Criteria for the diagnosis and severity stratification of acute pancreatitis显示文摘Recent diagnostic and therapeutic progress for severe acute pancreatitis(SAP)remarkably decreased the casemortality rate.To further decrease the mortality rate of SAP,it is important to precisely evaluate the severity at an early stage,and initiate appropriate treatment as early as possible.Research Committee of Intractable Diseases of the Pancreas in Japan developed simpler criteria combining routinely available data with clinical signs.Severity can be evaluated by laboratory examinations or by clinical signs,reducing the defect values of the severity factors.Moreover,the severity criteria considered laboratory/clinical severity scores and contrastenhanced computed tomography(CE-CT)findings as independent risk factors.Thus,CE-CT scans are not necessarily required to evaluate the severity of acute pancreatitis.There was no fatal case in mild AP diagnosed by the CE-CT severity score,whereas case-mortality rate in those with SAP was 14.8%.Case-mortality of SAP that fulfilled both the laboratory/clinical and the CE-CT severity criteria was 30.8%.It is recommended,therefore,to perform CE-CT examination to clarify the prognosis in those patients who were diagnosed as SAP by laboratory/clinical severity criteria.Because the mortality rate of these patients with SAP is high,such patients should be transferred to advanced medical units.Makoto Otsuki Kazunori Takeda Seiki Matsuno Yasuyuki Kihara Masaru Koizumi Masahiko Hirota Tetsuhide Ito Keisho Kataoka Motoji Kitagawa Kazuo Inui Yoshifumi Takeyama 2013World Journal of Gastroenterology2013,19,35:24
8Prognostic significance of combined preoperative fibrinogen and CA199 in gallbladder cancer patients显示文摘AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospectively reviewed after surgery. A receiver operating characteristic(ROC) curve was plotted to verify the optimum cut-off values for plasma fibrinogen and CA199. Univariate and multivariate survival analyses were performed to identify the factors associated with GBC prognosis. based on the HRs calculated via multivariate survival analyses, patients with elevated plasma fibrinogen and CA199 levels were allocated a score of 2.1; those with an elevated plasma fibrinogen level only were allocated a score of 1, those with an elevated CA199 level only were allocated a score of 1.1, and those with neither of these abnormalities were allocated a score of 0.RESULTS ROC curve analysis showed that the optimum cut-off values for preoperative plasma fibrinogen and CA199 were 3.47 g/L and 25.45 U/mL, respectively. Multivariate analysis indicated that elevated preoperative plasma fibrinogen and CA199 levels were significantly correlated with worse overall survival(OS)(HR = 1.711, 95%CI: 1.114-2.627, P = 0.014, and HR = 1.842, 95%CI: 1.111-3.056, P = 0.018). When we combined these two parameters, the area under the ROC curve increased from 0.735(for preoperative plasma fibrinogen only) and 0.729(for preoperative CA199 only) to 0.765. When this combined variable was added to the multivariate analysis, the combination of plasma fibrinogen and CA199(P < 0.001), resection margin(P < 0.001) and TNM stage(P = 0.010) were independent prognostic factors for GBC.CONCLUSION The combination of plasma fibrinogen and CA199 may serve as a more efficient independent prognostic biomarker for postoperative GBC patients than either parameter alone.Wei-Yu Xu Hao-Hai Zhang Xiao-Bo Yang Yi Bai Jian-Zhen Lin Jun-Yu Long Jian-Ping Xiong Jun-Wei Zhang Xin-Ting Sang Hai-Tao Zhao 2018World Journal of Gastroenterology2018,24,13:24
9Prognostic significance of tumor immune microenvironment and immunotherapy:Novel insights and future perspectives in gastric cancer显示文摘Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunotherapy, especially using immune checkpoint inhibitors, led to an improved prognosis in many cancers. The use of immunotherapy was also associated with manageable adverse event profiles and promising results in the treatment of patients with gastric cancer, especially in heavily pretreated patients. These data have led to an accelerated approval of some checkpoint inhibitors in this setting. Understanding the complex relationship between the host immune microenvironment and tumor and the immune escape phenomenon leading to cancer occurrence and progression will subsequently lead to the identification of prognostic immune markers. Furthermore, this understanding will result in the discovery of both new mechanisms for blocking tumor immunosuppressive signals and pathways to stimulate the local immune response by targeting and modulating different subsets of immune cells. Due to the molecular heterogeneity of gastric cancers associated with differentclinico-biologic parameters, immune markers expression and prognosis, novel immunotherapy algorithms should be personalized and addressed to selected subsets of gastric tumors, which have been proven to elicit the best clinical responses. Future perspectives in the treatment of gastric cancer include tailored dual immunotherapies or a combination of immunotherapy with other targeted agents with synergistic antitumor effects.Daniela Cornelia Lazǎr Mihaela Flavia Avram Ioan Romosan Mǎrioara Cornianu Sorina Tǎan Adrian Goldis 2018World Journal of Gastroenterology2018,24,32:24
10Long-term outcomes and prognostic factors for patients with esophageal cancer following radiotherapy显示文摘AIM:To evaluate long-term outcomes and prognostic factors for esophageal squamous cell carcinoma(SCC) treated with three dimensional conformal radiotherapy(3D-CRT).METHODS:Between January 2005 and December 2006,153 patients(120 males,33 females) with pathologically confirmed esophageal SCC and treated with 3D-CRT in Cancer Hospital of Shantou University were included in this retrospective analysis.Median age was 60 years(range:37-84 years).The proportion of tumor location was as follows:upper thorax(including the cervical region),73(48%);middle thorax,73(48%);lower thorax,7(5%),respectively.The median radiation dose was 64 Gy(range:50-74 Gy).Fifty four cases(35%) received cisplatin-based concurrent chemotherapy.Univariate and multivariate analysis were performed to determine the association between the correlative factors and prognosis.RESULTS:The five-year overall survival rate was 26.3%,with a median follow-up of 49 mo(range:3-66 mo) for patients who were still alive.On univariate analysis,lesion location,lesion length by barium esophagogram,computed tomography imaging characteristics including Y diameter(anterior-posterior,AP,extent of tumor),gross tumor volume of primary lesion(GTV-E),volume of positive lymph nodes(GTV-LN),and the total target volume(GTV-T = GTV-E + GTVLN) were prognostic for overall survival.By multivariate analysis,only the Y diameter [hazard ratio(HR) 2.219,95%CI 1.141-4.316,P = 0.019] and the GTV-T(HR 1.372,95%CI 1.044-1.803,P = 0.023) were independent prognostic factors for survival.CONCLUSION:The overall survival of esophageal carcinoma patients undergoing 3D-CRT was promising.The best predictors for survival were GTV-T and Y diameter.Chuang-Zhen Chen Jian-Zhou Chen De-Rui Li Zhi-Xiong Lin Ming-Zhen Zhou Dong-Sheng Li Zhi-Jian Chen 2013World Journal of Gastroenterology2013,19,10:22
11Prognostic and survival analysis of 837 Chinese colorectal cancer patients显示文摘AIM:To develop a prognostic model to predict survival of patients with colorectal cancer (CRC). METHODS:Survival data of 837 CRC patients undergoing surgery between 1996 and 2006 were collected and analyzed by univariate analysis and Cox proportional hazard regression model to reveal the prognostic factors for CRC. All data were recorded using a standard data form and analyzed using SPSS version 18.0 (SPSS, Chicago, IL, United States). Survival curves were calculated by the Kaplan-Meier method. The log rank test was used to assess differences in survival. Univariate hazard ratios and significant and independent predictors of disease-specific survival and were identified by Cox proportional hazard analysis. The stepwise procedure was set to a threshold of 0.05. Statistical significance was defined asP < 0.05. RESULTS:The survival rate was 74% at 3 years and 68% at 5 years. The results of univariate analysis suggested age, preoperative obstruction, serum carcinoembryonic antigen level at diagnosis, status of resection, tumor size, histological grade, pathological type, lymphovascular invasion, invasion of adjacent organs, and tumor node metastasis (TNM) staging were positive prognostic factors (P < 0.05). Lymph node ratio (LNR) was also a strong prognostic factor in stage Ⅲ CRC (P < 0.0001). We divided 341 stage Ⅲ patients into three groups according to LNR values (LNR1, LNR ≤ 0.33, n = 211; LNR2, LNR 0.34-0.66, n = 76; and LNR3, LNR ≥ 0.67, n = 54). Univariate analysis showed a significant statistical difference in 3-year survival among these groups:LNR1, 73%; LNR2, 55%; and LNR3, 42% (P < 0.0001). The multivariate analysis results showed that histological grade, depth of bowel wall invasion, and number of metastatic lymph nodes were the most important prognostic factors for CRC if we did not consider the interaction of the TNM staging system (P < 0.05). When the TNM staging was taken into account, histological grade lost its statistical significance, while the specific TNM staging system showed a statistically significant difference (P < 0.0001). CONCLUSION:The overall survival of CRC patients has improved between 1996 and 2006. LNR is a powerful factor for estimating the survival of stage Ⅲ CRC patients.Ying Yuan Mo-Dan Li Han-Guang Hu Cai-Xia Dong Jia-Qi Chen Xiao-Fen Li Jing-Jing Li Hong Shen 2013World Journal of Gastroenterology2013,19,17:20
12在直肠的癌症的磁性的回声成像调查结果的临床的意义显示文摘 Staging of rectal cancer is essential to help guide clini-cians to decide upon the correct type of surgery and determine whether or not neoadjuvant therapy is indicated. Magnetic resonance imaging (MRI) is currently one of the most accurate modalities on which to base treatment decisions for patients with rectal cancer. MRI can accurately detect the mesorectal fascia, assess the invasion of the mesorectum or surrounding organs and predict the circumferential resection margin. Although nodal disease remains a difficult radiological diagnosis, new lymphographic agents and diffusion weighted imaging may allow identification of metastatic nodes by criteria other then size. In light of this, we have reviewed the literature on the accuracy of specific MRI findings for staging the local extent of primary rectal cancer. The aim of this review is to establish a correlation between MRI findings, prognosis, and available treatment options.Charles F Bellows Bernard Jaffe Lorenzo Bacigalupo Salvatore Pucciarelli Guiseppe Gagliardi 2011World Journal of Radiology2011,3,4:19
13Micro RNAs potential utility in colon cancer: Early detection, prognosis, and chemosensitivity显示文摘Over the past decade, research has shown that aberrant expression of micro RNA(mi RNA) is involved in colorectal cancer development and progression. Micro RNAs are small sequences of non-coding RNA that regulate expression of genes involved in important cellular functions, such as cell differentiation, multiplication, and apoptosis. A specific mi RNA may display the effects of a tumor suppressor or oncogene. Altered mi RNA expression is found in colorectal cancer(CRC) and patterns of mi RNA expression correlate with CRC detection and outcome. Studies also have examined the use of circulating serum mi RNA and fecal mi RNA expression as non-invasive markers for early detection. Here, we review recent evidence demonstrating the potential role of mi RNA in CRC and the implications of its use in the diagnosis, prognosis, and management of CRC.Michael Hollis Kavitha Nair Arpita Vyas Lakshmi Shankar Chaturvedi Sahil Gambhir Dinesh Vyas 2015World Journal of Gastroenterology2015,21,27:19
14Role of ion channels in gastrointestinal cancer显示文摘In their seminal papers Hanahan and Weinberg described oncogenic processes a normal cell undergoes to be transformed into a cancer cell.The functions of ion channels in the gastrointestinal(GI)tract influence a variety of cellular processes,many of which overlap with these hallmarks of cancer.In this review we focus on the roles of the calcium(Ca^2+),sodium(Na^+),potassium(K^+),chloride(Cl^-)and zinc(Zn^2+)transporters in GI cancer,with a special emphasis on the roles of the KCNQ1 K+channel and CFTR Cl-channel in colorectal cancer(CRC).Ca^2+is a ubiquitous second messenger,serving as a signaling molecule for a variety of cellular processes such as control of the cell cycle,apoptosis,and migration.Various members of the TRP superfamily,including TRPM8,TRPM7,TRPM6 and TRPM2,have been implicated in GI cancers,especially through overexpression in pancreatic adenocarcinomas and down-regulation in colon cancer.Voltage-gated sodium channels(VGSCs)are classically associated with the initiation and conduction of action potentials in electrically excitable cells such as neurons and muscle cells.The VGSC NaV1.5 is abundantly expressed in human colorectal CRC cell lines as well as being highly expressed in primary CRC samples.Studies have demonstrated that conductance through NaV1.5 contributes significantly to CRC cell invasiveness and cancer progression.Zn2+transporters of the ZIP/SLC39A and ZnT/SLC30A families are dysregulated in all major GI organ cancers,in particular,ZIP4 up-regulation in pancreatic cancer(PC).More than 70 K+channel genes,clustered in four families,are found expressed in the GI tract,where they regulate a range of cellular processes,including gastrin secretion in the stomach and anion secretion and fluid balance in the intestinal tract.Several distinct types of K+channels are found dysregulated in the GI tract.Notable are hERG1 upregulation in PC,gastric cancer(GC)and CRC,leading to enhanced cancer angiogenesis and invasion,and KCNQ1 down-regulation in CRC,where KCNQ1 expression is associated with enhanced disease-free survival in stage II,III,and IV disease.Cl-channels are critical for a range of cellular and tissue processes in the GI tract,especially fluid balance in the colon.Most notable is CFTR,whose deficiency leads to mucus blockage,microbial dysbiosis and inflammation in the intestinal tract.CFTR is a tumor suppressor in several GI cancers.Cystic fibrosis patients are at a significant risk for CRC and low levels of CFTR expression are associated with poor overall disease-free survival in sporadic CRC.Two other classes of chloride channels that are dysregulated in GI cancers are the chloride intracellular channels(CLIC1,3&4)and the chloride channel accessory proteins(CLCA1,2,4).CLIC1&4 are upregulated in PC,GC,gallbladder cancer,and CRC,while the CLCA proteins have been reported to be down-regulated in CRC.In summary,it is clear,from the diverse influences of ion channels,that their aberrant expression and/or activity can contribute to malignant transformation and tumor progression.Further,because ion channels are often localized to the plasma membrane and subject to multiple layers of regulation,they represent promising clinical targets for therapeutic intervention including the repurposing of current drugs.Kyle J Anderson Robert T Cormier Patricia M Scott 2019World Journal of Gastroenterology2019,25,38:19
15Diagnostic and prognostic potential of tissue and circulating long non-coding RNAs in colorectal tumors显示文摘Long non-coding RNAs(lncRNAs)are members of the non-protein coding RNA family longer than 200 nucleotides.They participate in the regulation of gene and protein expression influencing apoptosis,cell proliferation and immune responses,thereby playing a critical role in the development and progression of various cancers,including colorectal cancer(CRC).As CRC is one of the most frequently diagnosed malignancies worldwide with high mortality,its screening and early detection are crucial,so the identification of disease-specific biomarkers is necessary.LncRNAs are promising candidates as they are involved in carcinogenesis,and certain lncRNAs(e.g.,CCAT1,CRNDE,CRCAL1-4)show altered expression in adenomas,making them potential early diagnostic markers.In addition to being useful as tissue-specific markers,analysis of circulating lncRNAs(e.g.,CCAT1,CCAT2,BLACAT1,CRNDE,NEAT1,UCA1)in peripheral blood offers the possibility to establish minimally invasive,liquid biopsy-based diagnostic tests.This review article aims to describe the origin,structure,and functions of lncRNAs and to discuss their contribution to CRC development.Moreover,our purpose is to summarise lncRNAs showing altered expression levels during tumor formation in both colon tissue and plasma/serum samples and to demonstrate their clinical implications as diagnostic or prognostic biomarkers for CRC.Orsolya Galamb Barbara K Barták Alexandra Kalmár Zsófia B Nagy Krisztina A Szigeti Zsolt Tulassay Peter Igaz Béla Molnár 2019World Journal of Gastroenterology2019,25,34:18
16Novel immunological and nutritional-based prognostic index for gastric cancer显示文摘AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.Kai-Yu Sun Jian-Bo Xu Shu-Ling Chen Yu-Jie Yuan Hui Wu Jian-Jun Peng Chuang-Qi Chen Pi Guo Yuan-Tao Hao Yu-Long He 2015World Journal of Gastroenterology2015,21,19:18
17Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP显示文摘AIM To investigate predictive and prognostic value of serum alpha-fetoprotein(AFP) level and its dynamic changes in patients with advanced gastric cancer with elevated serum AFP(AFPAGC).METHODS One hundred and five patients with AFPAGC were enrolled in the study, and all of them underwent at least one cycle of systemic chemotherapy at our institute and had serum AFP ≥ 20 ng/m L at diagnosis or recurrence. Clinicopathologic features, serum AFP level at diagnosis and changes during treatment, first-line chemotherapy regimens, efficacy and toxicity, and survival information were collected. A Person's χ~2 or Fisher's exact test was used to measure the differences between variables. Survival prognostic factors were investigated using the Kaplan-Meier method and Cox regression.RESULTS Median serum AFP level was 161.7 ng/m L(range, 22.9-2557110 ng/m L). Objective response rates(ORR) was significantly lower in the AFP ≥ 160 ng/m L group than in the AFP < 160 ng/m L group(30.4% vs 68.3%, P < 0.001). ORR to doublet regimens was significantly lower in the AFP ≥ 160 ng/m L group, whereas ORR to triplet regimens was similar between the two groups. Liver metastasis rate was significantly higher in the AFP ≥ 160 ng/m L group than in the AFP < 160 ng/m L(69.8% vs 50.0%, P < 0.001). Overall survival(OS) in the two cohorts did not show any significant difference(P = 0.712). Dynamic changes of AFP were consistent with response to chemotherapy, and median OS of patients with a serum AFP decline ≥ 50% and those with a serum AFP decline < 50% was 17.5 m and 10.0 m, respectively(P = 0.003). Hepatic(P = 0.005), peritoneal(P < 0.001), non-regional lymph node metastasis(P < 0.001), and portal vein tumor thrombus(PVTT)(P = 0.042) were identified as independent prognostic factors for AFPAGC. CONCLUSION Real-time examination of AFP has great predictive and prognostic value for managing AFPAGC. For those with markedly elevated AFP, triplet regimens may be a better choice.Ya-Kun Wang Lin Shen Xi Jiao Xiao-Tian Zhang 2018World Journal of Gastroenterology2018,24,2:17
18Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma显示文摘AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival.Peng Liu,Jia-Mei Yang,Wen-Yang Niu,Tong Kan,Feng Xie,Dian-Qi Li,Ye Wang,Yan-Ming Zhou,Department of Special Treatment and Liver Transplantation,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China Peng Liu,Department of Hepatobiliary Surgery,Navy General Hospital,Beijing 100037,China 2010World Journal of Gastroenterology2010,16,9:15
19Cholangiocarcinoma:principles and current trends显示文摘BACKGROUND:Cholangiocarcinoma(CCA)is a lethal cancer of the biliary epithelium,originating from the liver(intrahepatic),at the confluence of the right and left hepatic ducts(hilar)or in the extrahepatic bile ducts.It is a rare malignancy associated with poor prognosis.DATA SOURCES:We searched the PubMed/MEDLINE database for relevant articles published from 1989 to 2008.The search terms used were related to 'cholangiocarcinoma' and its ' treatment'.Although no language restrictions were imposed initially,for the full-text review and final analysis,our resources only permitted the review of articles published in English.This review deals with the treatment of cholangiocarcinoma,the principles and the current trends.RESULTS:The risks and prognostic factors,symptoms and differential diagnosis are thoroughly discussed.In addition,the tools of preoperative diagnosis such as endoscopic retrograde cholangiopancreatography,digital image analysis,fluorescence in situ hybridization and magnetic resonance cholangiopancreatography are reviewed.Moreover,the treatment of CCA is discussed.CONCLUSIONS:The only curative treatment available is surgical management.Unfortunately,many patients present with unresectable tumors,the majority of whom die within a year of diagnosis.Surgical treatment involves major resections of the liver,pancreas and bile duct,with considerable mortality and morbidity.However,in selected cases and where indicated,appropriate management with aggressive surgery may achieve a good outcome with a prolonged survival expectancy.George N Zografos Athanasios Farfaras Flora Zagouri Dimosthenis Chrysikos Kostas Karaliotas 2011Hepatobiliary & Pancreatic Diseases International2011,10,1:14
20Role of Ki-67 as a prognostic factor in gastrointestinal stromal tumors显示文摘AIM:To investigate primarily the prognostic value of Ki-67,as well as other parameters,in gastrointestinal stromal tumors(GISTs).METHODS:Ki-67,c-KIT,platelet-derived growth factor receptor-alpha(PDGFRα),smooth muscle actin(SMA),CD34,S100 were stained for immunohistochemistry which was performed on formalin-fixed,paraffinembeded sections on representative block from each case.Proliferation index counted by Ki-67 antibody was calculated as a number of positive nuclear reaction over 100 cells.Immunoreactivity for c-KIT and PDGFRα was evaluated semiquantitatively(weak,intermediate,strong) and for c-KIT type of reactivity was analyzed(cytoplasmic,membrane and 'dot-like' staining).Immunoreactivity for SMA,CD34 and S100 were was evaluated as positive or negative antigen expression.Pathologic parameters investigated in this study included tumor size,cell type(pure spindle,pured epitheloid mixed spindle and epitheloid),mitotic count,hemorrhage,necrosis,mucosal ulceration.Clinical data included age,gender,primary tumor location and spread of disease.χ 2 test and Student's t-test were used for comparisons of baseline characteristics.The Cox's proportional hazard model was used for univariable and multivariable analyses.Survival rates were calculated by Kaplan-Meier method and statistical significance was determined by the log-rank test.RESULTS:According to the stage of disease,there were 36 patients with localized disease,29 patients with initially localized disease but with its recurrence in the period of follow up,and finally,35 patients had metastatic disease from the very beginning of disease.Tumor originated most commonly in the stomach(41%),small intestine was the second most common location(36%).The mean size of primary tumors was 6.5 cm.The mean duration of follow-up was 60 mo.Multiple parameters were analyzed for their effect on overall survival,but no one reached statistical significance(P = 0.06).Analysis of time to progression/relapse in initially localized disease(univariate analysis),tumor size,mitotic count,Ki-67 and type of d-KIT distribution(cytoplasmic vs membrane/'dot-like') showed statistically significant correlation.In multivariate analysis in the group of patients with localized disease,there were only 2 parameters that have impact on relapse,Ki-67 and SMA(P < 0.0001 and P < 0.034,respectively).Furthermore,Ki-67 was analyzed in localized diseasevs localized with recurrence and metastatic disease.It was shown that there is a strict difference between these 2 groups of patients(median value was 2.5 for localized disease vs 10.0 for recurrent/metastatic disease,P < 0.0001).It was also shown that the cut-off value which is still statistically significant in terms of relapse on the level of 6%.The curves for survival on that cut-off level are significantly different(P < 0.04,Cox F).CONCLUSION:Ki-67 presents a significant prognostic factor for GIST recurrence which could be of great importance in evaluating malignant potential of disease.Borislav Belev Iva Bri Juraj Prejac Zrna Antunac Golubi Damir Vrbanec Jadranka Bozikov Ivan Aleri Marko Boban Jasminka Jaki Razumovi 2013World Journal of Gastroenterology2013,19,4:14
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