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Evaluation of the 8th AJCC staging system for pathologically versus clinically staged pancreatic adenocarcinoma: A time to revisit a dogma?

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 64-69页

作者： Omar abdel-rahman Clinical Oncology Department Faculty of Medicine Ain Shams University

Background: The 8 th edition of the American Joint Committee on Cancer(AJCC) staging system for pancreatic exocrine adenocarcinoma has been released. The current study seeks to assess the 7 th and 8 th editions among patients registered within the surveillance, epidemiology and end results(SEER) ***: SEER database(2010–2013) has been accessed through SEER*Stat program and AJCC 8 th edition stages were reconstructed utilizing the collaborative stage descriptions. Kaplan–Meier analysis of overall survival and pancreatic cancer-specific survival analyses(according to both 7 th and 8 th editions and according to whether pathological or clinical staging were conducted) has been performed. Multivariate analysis of factors affecting pancreatic cancer-specific survival was also conducted through a Cox proportional hazard ***: A total of 18 948 patients with pancreatic adenocarcinoma were identified in the period from 2010–2013. Pancreatic cancer-specific survival among pathologically staged patients and according to the 8 th edition showed significant differences for all pair wise comparisons among different stages(P < 0.0001) except for the comparison between stage IA and stage IB(P = 0.307) and the comparison between stage IB and stage IIA(P = 0.116). Moreover, P value for stage IA vs IIA was 0.014; while pancreatic cancer-specific survival according to the 7 th edition among pathologically staged patients showed significant differences for all pair wise comparisons among different stages(P < 0.0001) except for the comparison between IA and IB(P = 0.072), the comparison between stage IIA and stage IIB(P = 0.065), the comparison between stage IIA and stage Ⅲ(P = 0.059) and the comparison between IIB and Ⅲ(P = 0.595).Among clinically staged patients(i.e. those who did not undergo initial radical surgery), the prognostic performance of both 7 th and 8 th stages for both overall survival and pancreatic cancer-specific survival was ***: Th

关键词： Pancreatic cancer AJCC SEER Prognosis

Hepatitis C comorbidities affecting the course and response to therapy

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World Journal of Gastroenterology 2009年第40期15卷 4993-4999页

作者： abdel-rahman El-Zayadi Tropical Medicine Department Ain Shams University and Cairo Liver Center

Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.

关键词： Comorbidities Chronic hepatitis C Responseto therapy

Outcomes of liver transplantation as an oncologic surgery for different primary liver cancers:A real-world,population-based study

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Hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 88-91页

作者： Omar abdel-rahman Department of Oncology Cross Cancer Institute and the University of AlbertaEdmontonCanada

To the Editor:Although liver transplantation is likely used to treat individuals with end-stage liver disease because of non-neoplastic reasons,the adoption of liver transplantation in the management of primary liver cancer has been expanding in the past decades[1-3].Prior population-based studies for liver transplantation,in the cancer sphere,focused on delineating the outcomes of patients with hepatocellular carcinoma(HCC)treated with transplantation versus other locoregional treatments[4-6].

关键词： liver cancer surgery

Asian Americans have better outcomes of non-metastatic gastric cancer compared to other United States racial groups: A secondary analysis from a randomized study

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World Journal of Gastrointestinal Oncology 2019年第12期11卷 1151-1160页

作者： Omar abdel-rahman Department of Oncology University of Alberta and Cross Cancer Institute

BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western *** is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North *** current study hypothesizes that these differences will present within North American multiethnic *** To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United *** This is a secondary analysis of a randomized controlled trial(CALGB 80101 study)that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric ***-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the *** and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free *** A total of 546 patients were included in the current *** which,73.8%have white race(vs 12.8%black Americans and 8.2% Asian Americans).Using Kaplan-Meier analysis/log-rank testing,Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups(White Americans,Black Americans,and other racial groups)(P=0.011;P=0.010;respectively).Moreover,in an adjusted multivariate model,Asian American race seems to be associated with better overall and disease-free survival(hazard ratio:0.438;95% confidence interval:0.254-0.754),P=0.003;(hazard ratio:0.460;95% confidence interval:0.280-0.755,P=0.002;respectively).CONCLUSION Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United *** preclinical and clinical research is needed to clarif

关键词： Race Asian Americans Survival Prognosis Outcomes

A ROUGH SET APPROACH TO FEATURE SELECTION BASED ON SCATTER SEARCH METAHEURISTIC

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Journal of Systems Science & Complexity 2014年第1期27卷 157-168页

作者： WANG Jue ZHANG Qi abdel-rahman Hedar abdel-MONEM M Ibrahim Center for Forecasting Science Academy of Mathematics and System Science Chinese Academy of ScienceBeijing 100190 China. Department of Computer Science Faculty of Computers and Information Assiut University Assiut 71516Egypt.

Rough set theory is an effective method to feature selection, which has recently fascinated many researchers. The essence of rough set approach to feature selection is to find a subset of the original features. It is, however, an NP-hard problem finding a minimal subset of the features, and it is necessary to investigate effective and efficient heuristic algorithms. This paper presents a novel rough set approach to feature selection based on scatter search metaheuristic. The proposed method, called scatter search rough set attribute reduction （SSAR）, is illustrated by 13 well known datasets from UCI machine learning repository. The proposed heuristic strategy is compared with typical attribute reduction methods including genetic algorithm, ant colony, simulated annealing, and Tabu search. Computational results demonstrate that our algorithm can provide efficient solution to find a minimal subset of the features and show promising and competitive performance on the considered datasets.

关键词： Attribute reduction computational intelligence metaheuristics rough set scatter search.

Hepatic steatosis:A benign disease or a silent killer

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World Journal of Gastroenterology 2008年第26期14卷 4120-4126页

作者： abdel-rahman El-Zayadi Tropical Medicine Department Ain Shams University and Cairo Liver CenterGiza12311Egypt

Steatosis is a common feature of many liver diseases,namely non-alcoholic steatohepatitis(NASH) and hepatitis C virus(HCV) infection,but the pathogenic mechanisms *** resistance(IR),a key feature of metabolic syndrome,is crucial for NASH development,associated with many underlying genetically determined or acquired mitochondrial and metabolic defects and culminates to inflammation and progression to *** may have potential implications for new drug *** HCV-related disease,steatosis impacts both fibrosis progression and response to *** in HCV-related disease relates to both viral factors(HCV genotype 3),and host factors(alcohol consumption,overweight,hyperlipidemia,diabetes).Among others,IR is a recognized *** steatosis is reported to be associated with disturbance in the signaling cascade of interferon and downregulation of its ***,hepatic steatosis should not be considered a benign feature,but rather a silent killer.

关键词： Metabolic steatosis Hepatitis C virussteatosis Insulin resistance Fibrosis progression

Non-alcoholic fatty liver disease:Epidemiology,pathophysiology and an update on the therapeutic approaches

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Asian Pacific Journal of Tropical Biomedicine 2022年第3期12卷 99-114页

作者： Rehab F.abdel-rahman Department of Pharmacology Medical Research and Clinical Studies InstituteNational Research Centre12622-DokkiGizaEgypt

Non-alcoholic fatty liver disease(NAFLD)denotes a spectrum of fatty liver disease in individuals without significant alcohol *** is set to be the most common etiology of serious liver diseases in numerous nations when accompanied by obesity and type 2 *** is further histologically categorized into the non-alcoholic fatty liver(NAFL;steatosis without hepatocellular injury)and non-alcoholic steatohepatitis(NASH)which is characterized by the coexistence of hepatic steatosis and inflammation and is accompanied by hepatocyte injury(ballooning),either with or without *** is considered the benign and reversible stage arising from the excessive accumulation of triglycerides in ***,NASH is a more progressive stage of NAFLD,due to the increased risks of evolving more serious diseases such as cirrhosis,hepatocellular *** concept,however,has been lately challenged by a hypothesis of multiple parallel hits of NAFLD,in which steatosis and NASH are separate entities rather than two points of the NAFLD spectrum,not only from a set of histological patterns but also from a pathophysiological *** current review highlights the epidemiology and pathophysiology of NAFLD,and its progression towards steatohepatitis,with special focus on the novel imminent therapeutic approaches targeting the molecular aspects and the pathogenic pathways involved in the development,and progression of NAFLD.

关键词： Non-alcoholic fatty liver disease Steatosis Insulin sensitizers Glucagon-like peptide-1 analogues Dipeptidyl peptidase-4 inhibitors Farnesoid X receptor agonists

Hepatitis C virus induced insulin resistance impairs response to anti viral therapy

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World Journal of Gastroenterology 2012年第3期18卷 212-224页

作者： abdel-rahman El-Zayadi Mahmoud Anis Tropical Medicine Department Faculty of Medicine Ain-Shams University and Cairo liver center Tropical Medicine Department Faculty of Medicine Tanta University

Hepatitis C virus (HCV) infection is an important risk factor for insulin resistance (IR). The latter is the pathogenic foundation underlying metabolic syndrome, steatosis and cirrhosis, and possibly hepatocellular carcinoma (HCC). The interplay between genetic and environmental risk factors ultimately leads to the development of IR. Obesity is considered a major risk factor, with dysregulation of levels of secreted adipokines from distended adipose tissue playing a major role in IR. HCV-induced IR may be due to the HCV core protein inducing proteasomal degradation of insulin receptor substrates 1 and 2, blocking intracellular insulin signaling. The latter is mediated by increased levels of both tumour necrosis factor-α (TNF-α) and suppressor of cytokine signaling 3 (SOC-3). IR, through different mechanisms, plays a role in the development of steatosis and its progression to steatohepatitis, cirrhosis and even HCC. In addition, IR has a role in impairing TNF signaling cascade, which in turn blocks STAT-1 translocation and interferon stimulated genes production avoiding the antiviral effect of interferon.

关键词： Hepatitis C virus-chronic hepatitis C Insulin resistance Sustained virological response Homeostasis model assessment

Heavy smoking and liver

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World Journal of Gastroenterology 2006年第38期12卷 6098-6101页

作者： abdel-rahman El-Zayadi Department of Tropical Medicine Ain Shams University and Director of Cairo Liver Center Cairo Egypt

Smoking causes a variety of adverse effects on organs that have no direct contact with the smoke itself such as the liver. It induces three major adverse effects on the liver: direct or indirect toxic effects, immunological effects and oncogenic effects. Smoking yields chemical substances with cytotoxic potential which increase necroinflammation and fibrosis. In addition, smoking increases the production of pro-inflammatory cytokines (IL-1, IL-6 and TNF-α) that would be involved in liver cell injury. It contributes to the development of secondary polycythemia and in turn to increased red cell mass and turnover which might be a contributing factor to secondary iron overload disease promoting oxidative stress of hepatocytes. Increased red cell mass and turnover are associated with increased purine catabolism which promotes excessive production of uric acid. Smoking affects both cell-mediated and humoral immune responses by blocking lymphocyte proliferation and inducing apoptosis of lymphocytes. Smoking also increases serum and hepatic iron which induce oxidative stress and lipid peroxidation that lead to activation of stellate cells and development of fibrosis. Smoking yields chemicals with oncogenic potential that increase the risk of hepatocellular carcinoma (HCC) in patients with viral hepatitis and are independent of viral infection as well. Tobacco smoking has been associated with supression of p53 (tumour suppressor gene). In addition, smoking causes suppression of T-cell responses and is associated with decreased surveillance for tumour cells. Moreover, it has been reported that heavy smoking affects the sustained virological response to interferon (IFN) therapy in hepatitis C patients which can be improved by repeated phlebotomy. Smoker’s syndrome is a clinico-pathological condition where patients complain of episodes of facial flushing, warmth of the palms and soles of feet, throbbing headache, fullness in the head, dizziness, lethargy, prickling sensation, p

关键词： Iron overload Interferon response Hepatitis C virus Smoking Fibrosis Hepatocellular carcinoma Polycythemia