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Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

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World Journal of Gastroenterology 2018年第18期24卷 1978-1988页

作者： alba manuel-vázquez Raquel Latorre-Fragua Carmen Ramiro-Pérez Aylhin López-Marcano Roberto De la Plaza-Llamas José manuel Ramia Department of General and Digestive Surgery University Hospital of Guadalajara

The major symptoms of advanced hepatopancreaticbiliary cancer are biliary obstruction, pain and gastric outlet obstruction(GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach. We performed a systematic review of the literature, according PRISMA guidelines, to search for articles on laparoscopic gastrojejunostomy for malignant GOO treatment. We also report our personal series, from 2009 to 2017. A review of the literature suggests that there is no standardized surgical technique either standardized outcomes to report. Most of the studies are case series, so level of evidence is low. Decisionmaking must consider medical condition, nutritional status, quality of life and life expectancy. Evaluation ofthe patient and multidisciplinary expertise are required to select appropriate approach. Given the limited studies and the difficulty to perform prospective controlled trials, no study can answer all the complexities of malignant GOO and more outcome data is needed.

关键词： Duodenal obstruction Gastrojejunostomy Gastroenterosmy Gastric outlet obstruction Gastric bypass Laparoscopy Laparoscopic surgery Sytematic review

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Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis

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World Journal of Gastroenterology 2017年第16期23卷 2972-2977页

作者： alba manuel-vázquez Raquel Latorre-Fragua Carmen Ramiro-Pérez Aylhin López-Marcano Farah Al-Shwely Roberto De la Plaza-Llamas Josémanuel Ramia Department of General and Digestive Surgery University Hospital of Guadalajara19002 GuadalajaraSpain

AIM To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomyrelated complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies. RESULTS We analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of4.99%. Sixty-four point seven nine percent occurred after elective surgery(cholelithiasis or vesicular polyps) and 35.21% after emergency surgery(acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d. CONCLUSION The use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.

关键词： Cholecystectomy 90-d Hospital readmission Readmission rate Cholelithiasis

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Hepatic gastrointestinal stromal tumor: Systematic review of an exceptional location

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World Journal of Meta-Analysis 2019年第5期7卷 224-233页

作者： alba manuel-vázquez Raquel Latorre-Fragua Roberto de la Plaza-Llamas José manuel Ramia General and Digestive Surgery University Hospital of Guadalajara

BACKGROUND A minor subset of primary gastrointestinal stromal tumors(GIST)can also arise outside the gastrointestinal tract,which is known as an extra-GIST(E-GIST).Primary GIST of the liver is an exceptional *** To characterize epidemiological,clinical and pathological features and options of *** We performed a systematic review to search for articles on primary hepatic *** This review shows that right hepatic lobe was the most frequent *** pathological and immunohistochemical features,mitotic count was≥5/50 High Power Fields in more than 50%;and CD117 was negative in only 1 *** than 70%of patients had a lesion with high risk of *** The diagnosis of E-GIST must be considered in a liver *** an accurate diagnosis is a challenge,as well as the confirmation of their primary or metastatic nature.

关键词： Gastrointestinal stromal tumors Extra-gastrointestinal stromal tumor Primary hepatic tumor CD117 Primary hepatic gastrointestinal stromal tumor Primary gastrointestinal stromal tumor of the liver

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The need to develop tailored tools for improving the quality of thematic bibliometric analyses: Evidence from papers published in Sustainability and Scientometrics

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Journal of Data and Information Science 2023年第4期8卷 10-35页

作者： Alvaro Cabezas-Clavijo Yusnelkis Milanés-Guisado Ruben alba-Ruiz Ángel MDelgado-vázquez Universidad Internacional de La Rioja(UNIR) Avenida de la Paz137Logroño26006Spain Universidad Pablo de Olavide Ctra.de UtreraKm 1Sevilla41013Spain Hospital Universitario virgen de las Nieves Avenida de las Fuerzas Armadas2Granada 18014Spain

Purpose: The aim of this article is to explore up to seven parameters related to the methodological quality and reproducibility of thematic bibliometric research published in the two most productive journals in bibliometrics, Sustainability(a journal outside the discipline) and Scientometrics, the flagship journal in the ***/methodology/approach: The study identifies the need for developing tailored tools for improving the quality of thematic bibliometric analyses, and presents a framework that can guide the development of such tools. A total of 508 papers are analysed, 77% of Sustainability, and 23% published in Scientometrics, for the 2019-2021 ***: An average of 2.6 shortcomings per paper was found for the whole sample, with an almost identical number of flaws in both journals. Sustainability has more flaws than Scientometrics in four of the seven parameters studied, while Scientometrics has more shortcomings in the remaining three *** limitations: The first limitation of this work is that it is a study of two scientific journals, so the results cannot be directly extrapolated to the set of thematic bibliometric analyses published in journals from all *** implications: We propose the adoption of protocols, guidelines, and other similar tools, adapted to bibliometric practice, which could increase the thoroughness, transparency, and reproducibility of this type of ***/value: These results show considerable room for improvement in terms of the adequate use and breakdown of methodological procedures in thematic bibliometric research, both in journals in the Information Science area and journals outside the discipline.

关键词： Thematic bibliometric analyses Sustainability Scientometrics Reproducibility Methodological quality

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Site-directed cysteine coupling of disulfide-containing non-antibody carrier proteins(THIOCAPs)

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Science China Materials 2023年第10期66卷 4109-4120页

作者： Ariana Rueda Julian I.Mendoza Lorena alba-Castellon Eloi Parladé Eric voltà-Durán David Paez Anna Avino Ramon Eritja Esther vázquez Antonio villaverde Ramón Mangues Ugutz Unzueta Institut d'Investigació Biomèdica Sant Pau(IIB Sant Pau) Sant Quintí 77-7908041 BarcelonaSpain Josep Carreras Leukaemia Research Institute(IJC Campus Sant Pau) 08041 BarcelonaSpain CIBER de Bioingeniería Biomateriales y NanomedicinaInstituto de Salud Carlos Ⅲ28029 MadridSpain Institut de Biotecnologia i de Biomedicina Universitat Autònoma de Barcelona08193 BellaterraSpain Departament de Genètica i de Microbiologia Universitat Autònoma de Barcelona08193 BellaterraSpain Department of Medical Oncology Hospital de la Santa Creu i Sant Pau.Barcelona08025 BarcelonaSpain CIBER de Enfermedades Raras(CIBERER) Instituto de Salud Carlos Ⅲ28029 MadridSpain Institute for Advanced Chemistry of Catalonia(IQAC) CSIC08034 BarcelonaSpain

The development of a new generation of nonantibody protein drug delivery systems requires site-directed conjugation strategies to produce homogeneous,reproducible and scalable *** that,the genetic addition of cysteine residues into solvent-exposed positions allows the thiol-mediated cysteine coupling of therapeutic drugs into protein-based ***,the high reactivity of unpaired cysteine residues usually reduces protein stability,consequently imposing the use of more methodologically demanding purification *** is especially relevant for disulfide-containing nanocarriers,as previously observed in ***,although many protein scaffolds and targeting ligands are also rich in disulfide bridges,the use of these methodologies over emerging non-antibody carrier proteins has been completely ***,we report the development of a simple and straightforward procedure for a onestep production and site-directed cysteine conjugation of disulfide-containing non-antibody thiolated carrier proteins(THIOCAPs).This method is validated in a fluorescent C-X-C chemokine receptor 4(CXCR4)-targeted multivalent nanocarrier containing two intramolecular disulfide bridges and one reactive cysteine residue strategically placed into a solvent-exposed position(THIO-T22-GFP-H6)for drug conjugation and in a humanized alternative intended for clinical applications(T22-HSNBT-H6).Thus,we produce very stable,homogeneous and fully functional antitumoral nanoconjugates(THIO-T22-GFP-H6-MMAE and T22-HSNBT-H6-MMAE)that selectively eliminate target cancer cells via ***,the developed methodology appears as a powerful tool for the rational engineering of emerging non-antibody,cell-targeted protein nanocarriers that contain disulfide bridges together with a solvent-exposed reactive cysteine(THIOCAP).This should pave the way for the development of a new generation of stable,homogeneous and efficient nanomedicines.

关键词： disulfide directed bridges

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Self-assembling protein nanocarrier for selective delivery of cytotoxic polypeptides to CXCR4^(+) head and neck squamous cell carcinoma tumors

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Acta Pharmaceutica Sinica B 2022年第5期12卷 2578-2591页

作者： Elisa Rioja-Blanco Irene Arroyo-Solera Patriciaálamo Isolda Casanova Alberto Gallardo Ugutz Unzueta Naroa Serna Laura Sánchez-García Miquel Quer Antonio villaverde Esther vázquez Ramon Mangues Lorena alba-Castellón Xavier León Institut d'InvestigacióBiomèdica Sant Pau(IIB-Sant Pau) Barcelona 08041Spain Institut de Recerca contra la Leucèmia Josep Carreras Barcelona 08025Spain CIBER de Bioingeniería Biomateriales y Nanomedicina(CIBER-BBN)Madrid 28029Spain Department of Pathology Hospital de la Santa Creu i Sant PauBarcelona 08041Spain Institut de Biotecnologia i de Biomedicina Universitat Autònoma de BarcelonaBellaterra 08193Spain Departament de Genètica i de Microbiologia Universitat Autònoma de BarcelonaBellaterra 08193Spain Department of Otorhinolaryngology Hospital de la Santa Creu i Sant PauBarcelona 08041Spain

Loco-regional recurrences and distant metastases represent the main cause of head and neck squamous cell carcinoma(HNSCC) mortality. The overexpression of chemokine receptor 4(CXCR4) in HNSCC primary tumors associates with higher risk of developing loco-regional recurrences and distant metastases, thus making CXCR4 an ideal entry pathway for targeted drug delivery. In this context, our group has generated the self-assembling protein nanocarrier T22-GFP-H6, displaying multiple T22 peptidic ligands that specifically target CXCR4. This study aimed to validate T22-GFP-H6 as a suitable nanocarrier to selectively deliver cytotoxic agents to CXCR4^(+)tumors in a HNSCC model. Here we demonstrate that T22-GFP-H6 selectively internalizes in CXCR4^(+)HNSCC cells, achieving a high accumulation in CXCR4^(+)tumors in vivo, while showing negligible nanocarrier distribution in non-tumor bearing organs. Moreover, this T22-empowered nanocarrier can incorporate bacterial toxin domains to generate therapeutic nanotoxins that induce cell death in CXCR4-overexpressing tumors in the absence of histological alterations in normal organs. Altogether, these results show the potential use of this T22-empowered nanocarrier platform to incorporate polypeptidic domains of choice to selectively eliminate CXCR4^(+)cells in HNSCC. Remarkably, to our knowledge, this is the first study testing targeted proteinonly nanoparticles in this cancer type, which may represent a novel treatment approach for HNSCC patients.

关键词： Targeted drug delivery Protein nanoparticles CXCR4 receptor HNSCC Cell targeting Recombinant proteins Nanotoxins Cancer therapy

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Decoupling the adsorption mechanisms of arsenate at molecular level on modified cube-shaped sponge loaded superparamagnetic iron oxide nanoparticles

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Journal of Environmental Sciences 2022年第11期34卷 1-12页

作者： Xiang-Yang Lou Roberto Boada veronica verdugo Laura Simonelli Gustavo Pérez manuel valiente GTS-UAB Research Group Department of ChemistryFacultat de CiènciesUniversitat Autonoma de Barcelona08193 BellaterraSpain alba Synchrotron Carrer de la llum 2-26Cerdanyola del Valles08290 BarcelonaSpain Centro de Excelencia en Nanotecnologia Leitat ChileSantiago 7500724Chile

In this study, a commercial cube-shaped open-celled cellulose sponge adsorbent was modified by in-situ co-precipitation of superparamagnetic iron oxide nanoparticles(SPION) and used to remove As(v) from aqueous solutions. Fe K-edge X-ray absorption spectroscopy(XAS) and TEM identified maghemite as the main iron phase of the SPION nanoparticles with an average size 13 nm. Batch adsorption experiments at 800 mg/L showed a 63% increase of adsorption capacity when loading 2.6 wt.% mass fraction of SPION in the *** determination of the adsorption thermodynamic parameters indicated that the As(v) adsorption on the composite material is a spontaneous and exothermic *** K-edge XAS results confirmed that the adsorption enhancement on the composite can be attributed to the nanoparticles loaded. In addition, adsorbed As(v) did not get reduced to more toxic As(Ⅲ) and formed a binuclear corner-sharing complex with SPION. The advantageous cube-shape of the sponge-loaded SPION composite together with its high affinity and good adsorption capacity for As(v), good regeneration capability and the enhanceddiffusion attributed to its open-celled structure make this adsorbent a good candidate for industrial applications.

关键词： Adsorption Cube composite adsorbent Arsenate removal Regeneration X-ray absorption spectroscopy

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Acquired Hemophilia A Simulating Retropharyngeal Abscess: Importance of Differential Diagnosis of Neck Masses before Surgery

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第4期4卷 282-285页

作者： Isabel López-Sánchez José-Ramón alba-García Cristina vázquez-Romero Miguel Armengot-Carceller ENT Department General and University Hospital Valencia Spain Rhinology Unit ENT Department General and University Hospital.Valencia University Valencia Spain

The coexistence of acquired hemophilia A with a secondary retropharyngeal hematoma is an extremely unusual condition with important clinical implications. The purpose of this paper is to present a case involving a patient whose first clinical manifestation, namely dysphagia, along with specific clinical examination and imaging findings, led to an incorrect initial diagnosis of a retropharyngeal abscess. However, performance of a more thorough clinical examination led to the correct diagnosis of a hematoma secondary to acquired hemophilia A. This allowed surgery to be avoided in a patient at a high risk of bleeding. Conclusions: Acute neck masses require meticulous differential diagnosis assessing the possible presence of various causative systemic diseases before the most appropriate therapy can be determined.

关键词： Dysphagia Cervical Inflammation Coagulopathy Hematoma APTT Parapharyngeal Spaces

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Gluten immunogenic peptide excretion detects dietary transgressions in treated celiac disease patients

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World Journal of Gastroenterology 2019年第11期25卷 1409-1420页

作者： Ana Florencia Costa Emilia Sugai María de la Paz Temprano Sonia Isabel Niveloni Horacio vázquez María Laura Moreno M.Remedios Domínguez-Flores alba Mu?oz-Suano Edgardo Smecuol Juan Pablo Stefanolo Andrea F González Angel Cebolla-Ramirez Eduardo Mauri?o Elena F verdú Julio César Bai Small Bowel Section Department of MedicineDr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1263Argentina Department of Immunology Biomedal S.L.Sevilla 41092Spain Farncombe Family Digestive Health Research Institute McMaster UniversityHamiltonON L8S4L8Canada Research Institutes Universidad del SalvadorBuenos Aires 1050Argentina

BACKGROUND Life-long removal of gluten from the diet is currently the only way to manage celiac disease(CeD). Until now, no objective test has proven useful to objectively detect ingested gluten in clinical practice. Recently, tests that determine consumption of gluten by assessing excretion of gluten immunogenic peptides(GIP) in stool and urine have been developed. Their utility, in comparison with conventional dietary and analytical follow-up strategies, has not been fully *** To assess the performance of enzyme-linked immunosorbent assay(ELISA) and point-of-care tests(PoCTs) for GIP excretion in CeD patients on gluten-free diet(GFD).METHODS We conducted an observational, prospective, cross-sectional study in patients following a GFD for at least two years. Using the Gastrointestinal Symptom Rating Scale questionnaire, patients were classified at enrollment as asymptomatic or symptomatic. Gluten consumption was assessed twice by 3-d dietary recall and GIP excretion(by ELISA in stool and PoCTs(commercial kits for stool and urine) in two consecutive samples. These samples and dietary reports were obtained 10 day apart one from the other. Patients were encouraged to follow their usual GFD during the study *** Forty-four patients were enrolled, of which 19(43.2%) were symptomatic despite being on a GFD. Overall, 83 sets of stool and/or urine samples were *** out of 44 patients(25.0%) had at least one positive GIP test. The occurrence of at least one positive test was 32% in asymptomatic patients compared with 15.8% in symptomatic patients. GIP was concordant with dietary reports in 65.9% of cases(Cohen′s kappa: 0.317). PoCT detected dietary indiscretions. Both ELISA and PoCT in stool were concordant(concomitantly positive or negative) in 67 out of 74(90.5%) samples. Excretion of GIP was detected in 7(8.4%) stool and/or urine samples from patients considered to be strictly compliant with the GFD by dietary *** GIP dete

关键词： Celiac disease Follow-up Gluten-free diet Gluten immunogenic peptide excretion Rapid tests

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Polymorphism AGT2(rs4762)is involved in the development of dermatologic events:Proof-of-concept in hepatocellular carcinoma patients treated with sorafenib

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World Journal of Hepatology 2022年第7期14卷 1438-1458页

作者： víctor Sapena Massimo Iavarone Loreto Boix Floriana Facchetti Maria Guarino Marco Sanduzzi Zamparelli Alessandro Granito Esther Samper Mario Scartozzi Josep Corominas Giorgia Marisi alba Díaz Andrea Casadei-Gardini Laura Gramantieri Pietro Lampertico Filomena Morisco Ferran Torres Jordi Bruix María Reig Barcelona Clinic Liver Cancer Group Liver UnitHospital Clínic de BarcelonaInstitut d'Investigacions Biomèdiques August Pi SunyerCentro de Investigación Biomédica en Red Enfermedades Hepáticas y DigestivasBarcelona 08036Spain Universidad de Barcelona Barcelona 08036Spain Division of Gastroenterology and Hepatology Foundation Istituto di Ricovero e Cura a Carattere Scientifico di Natura Pubblica Ca’Granda Ospedale Maggiore PoliclinicoMilano 20122Italy Department of Clinical Medicine and Surgery Gastroenterology UnitUniversity of Naples Federico IINaples 80131Italy Gastroenterology and Hepatology Unit Fondazione Istituto di Ricovero e Cura a Carattere Scientifico di Natura Pubblica CàGranda Ospedale Maggiore PoliclinicoUniversity of MilanMilan 20100Italy Department of Clinical Medicine and Surgery Gastroenterology UnitUniversity of Naples"Federico II"Napoli 80100Italy Department of Clinical Medicine and Surgery Gastroenterology and HepatologyFederico II University of NaplesNaples 80131Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIstituto di Ricovero e Cura a Carattere Scientifico di Natura Pubblica Azienda Ospedaliero-Universitaria di BolognaBologna 40139Italy Department of Medical and Surgical Sciences University of BolognaBologna 40139Italy Department of Medical Oncology University of CagliariCagliari 45698Italy Biosciences Laboratory Istituto di Ricovero e Cura a Carattere Scientifico di Natura PubblicaIstituto Romagnolo per lo Studio dei Tumori“Dino Amadori”Meldola 47014Italy Department of Pathology Hospital Clínic de BarcelonaUniversitat de BarcelonaBarcelona 08036Spain School of Medicine Vita-Salute San Raffaele UniversityMilan 20132Italy Unit of Oncology UniversitàVita-SaluteIstituto di Ricovero e Cura a Carattere Scientifico di Natura Pubblica-San Raffaele Scientific InstituteMilan 20132Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIstituto di Ricovero e Cura a Carattere Scientifico di Natura Pubblica Aziend

BACKGROUND Dermatologic adverse events(DAEs)are associated with a better outcome in patients with hepatocellular carcinoma(HCC)irrespective of the therapeutic agent *** exact mechanisms associated with the development of DAEs are unknown although several studies point to direct toxicity of tyrosine kinase inhibitors(TKIs)to the skin or an immune-mediated reaction triggered by the oncologic *** is the case in other conditions,individual genetic variants may partially explain a higher risk of *** To evaluate the contribution of several gene variants to the risk of developing DAEs in HCC patients treated with *** We first analyzed 27 single-nucleotide polymorphisms(SNPs)from 12 genes selected as potential predictors of adverse event(AE)development in HCC patients treated with sorafenib[Barcelona Clinic Liver Cancer 1(BCLC1)cohort].Three additional cohorts were analyzed for AGT1(rs699)and AGT2(rs4762)polymorphisms-initially identified as predictors of DAEs:BCLC2(n=79),Northern Italy(n=221)and Naples(n=69)cohorts,*** relation between SNPs and DAEs and death were assessed by univariate and multivariate Cox regression models,and presented with hazard ratios and their 95%confidence intervals(95%CI).RESULTS The BCLC1 cohort showed that patients with arterial hypertension(AHT)(HR=1.61;P value=0.007)and/or AGT SNPs had an increased risk of ***,AGT2(rs4762)AA genotype was found to be linked to a statistically significant increased probability of DAEs(HR=5.97;P value=0.0201,AA vs GG)in the Northern Italy cohort by multivariate analysis adjusted for BCLC stage,ECOG-PS,diabetes and *** value of this genetic marker was externally validated in the cohort combining the BCLC1,BCLC2 and Naples cohorts[HR=3.12(95%CI:1.2-8.14),P value=0.0199,AGT2(rs4762)AA vs AG genotype and HR=2.73(95%CI:1.18-6.32)P value=0.0188,AGT2(rs4762)AA vs GG genotype].None of the other gene variants tested were found to be associated with the risk of D

关键词： HCC Early DAE Single-nucleotide polymorphisms AGT1(rs699) AGT2(rs4762),Tyrosine kinase inhibitors

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