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Diagnostic yield of EUS-FNA of small(≤15 mm) solid pancreatic lesions using a 25-gauge needle

Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 70-74页

作者： Stefano Francesco Crinò Maria Cristina Conti Bellocchi Laura Bernardoni Erminia Manfrin Alice Parisi Antonio Amodio Nicolò De Pretis Luca Frulloni armando gabbrielli Gastroenterology and Digestive Endoscopy Unit The Pancreas Institute University of Verona G.B. Rossi University Hospital Department of Pathology University of Verona G.B. Rossi University Hospital

Background: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.Methods: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups(≤15 mm, 16–25 mm and >25 mm), and the outcomes were compared.Results: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%,81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size(P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor(P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate(P = 0.018, OR = 1.08).Conclusion: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.

关键词： Endoscopic ultrasound Endoscopic ultrasound-guided fine needle aspiration Pancreatic cancer Benign pancreatic tumors Pancreatic neoplasms

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DNA end binding activity and Ku70/80 heterodimer expression in human colorectal tumor

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World Journal of Gastroenterology 2005年第42期11卷 6694-6700页

作者： Paola Mazzarelli Paola Parrella Davide Seripa Emanuela Signori Giuseppe Perrone Carla Rabitti Domenico Borzomati armando gabbrielli Maria Giovanna Matera Carolina Gravina Marco Caricato Maria Luana Poeta Monica Rinaldi Sergio Valeri Roberto Coppola Vito Michele Fazio Laboratory of Molecular Medicine and Biotechnology Interdisciplinary Center for Biomedical Research Università Campus Bio-Medico Rome 00155 Italy Laboratory of Gene Therapy and Oncology IRCCS "Casa Sollievo della Sofferenza" Hospital San Giovanni Rotondo (FG) 71013 Italy Service of Histopathology Università Campus Bio-Medico Rome 00155 Italy Department of General Surgery Università Campus Bio-Medico Rome 00155 Italy Department of Digestive Disease Università Campus Bio-Medico Rome 00155 Italy CNR Gene-Medicine Division Section of Molecular Medicine Institute of Neurobiology and Molecular Medicine Rome 00133 Italy Laboratory of Gene Therapy and Oncology IRCCS "Casa Sollievo della Sofferenza" Hospital San Giovanni Rotondo (FG) 71013 Italy CNR Gene-Medicine Division Section of Molecular Medicine Institute of Neurobiology and Molecular Medicine Rome 00133 Italy

AIM: To determine the DNA binding activity and protein levels of the Ku70/80 heterodimer, the functional mediator of the NHEJ activity, in human colorectal carcinogenesis.METHODS: The Ku70/80 DNA-binding activity was determined by electrophoretic mobility shift assays in 20 colon adenoma and 15 colorectal cancer samples as well as matched normal colonic tissues. Nuclear and cytoplasmic protein expression was determined by immunohistochemistry and Western blot analysis.RESULTS: A statistically significant difference was found in both adenomas and carcinomas as compared to matched normal colonic mucosa (P＜0.00). However,changes in binding activity were not homogenous with approximately 50% of the tumors showing a clear increase in the binding activity, 30% displaying a modest increase and 15% showing a decrease of the activity.Tumors, with increased DNA-binding activity, also showed a statistically significant increase in Ku70 and Ku86nuclear expression, as determined by Western blot and immunohistochemical analyses (P＜0.001). Cytoplasmic protein expression was found in pathological samples,but not in normal tissues either from tumor patients or from healthy subjects.CONCLUSION: Overall, our DNA-binding activity and protein level are consistent with a substantial activation of the NHEJ pathway in colorectal tumors. Since the NHEJ is an error prone mechanism, its abnormal activation can result in chromosomal instability and ultimately lead to tumorigenesis.

关键词： DNA Ku70/80 异质二聚体基因表达结肠癌直肠癌

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ERCP in acute pancreatitis:What takes place in routine clinical practice?

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World Journal of Gastrointestinal Endoscopy 2010年第9期2卷 308-313页

作者： armando gabbrielli Raffaele Pezzilli Generoso Uomo Alessandro Zerbi Luca Frulloni Paolo De Rai Laura Castoldi Guido Costamagna Claudio Bassi Valerio Di Carlo Department of Surgical and Gastroenterological Sciences University of Verona Department of Digestive Diseases and Internal Medicine S.Orsola-Malpighi Hospital Department of Internal Medicine Department of Surgery Humanitas Hospital Department of Emergency Surgery Fondazione IRCCS MaggioreMangiagalli and Regina Elena Hospital Digestive Endoscopy Unit "Agostino Gemelli" University HospitalCatholic University of Rome Rome 00100 Italy Department of Surgery University Vita e Salute

AIM:To evaluate the data from a survey carried out in Italy regarding the endoscopic approach to acute pancreatitis in order to obtain a picture of what takes place after the release of an educational project on acute pancreatitis sponsored by the Italian Association for the Study of the Pancreas.METHODS:Of the 1 173 patients enrolled in our survey,the most frequent etiological category was biliary forms(69.3%) and most patients had mild pancreatitis(85.8%).RESULTS:344/1 173(29.3%) underwent endoscopic retrograde cholangiopancreatography(ERCP).The mean interval between the onset of symptoms and ERCP was 6.7 ± 5.0 d;only 89 examinations(25.9%) were performed within 72 h from the onset of symptoms.The main indications for ERCP were suspicion of common bile duct stones(90.3%),jaundice(44.5%),clini cal worsening of acute pancreatitis(14.2%) and cho langitis(6.1%).Biliary and pancreatic ducts were visua lized in 305 patients(88.7%) and in 93 patients(27.0%) respectively.The success rate in obtaining a cholangio gram was statistically higher(P = 0.003) in patients with mild acute pancreatitis(90.6%) than in patients with severe disease(72.2%).Biliary endoscopic sphinc terotomy was performed in 295 of the 305 patients(96.7%) with no difference between mild and severe disease(P = 0.985).ERCP morbidity was 6.1% and mortality was 1.7%;the mortality was due to the complications of acute pancreatitis and not the endoscopic procedure.CONCLUSION:The results of this survey,as with those carried out in other countries,indicate a lack of compliance with the guidelines for the indications for interventional endoscopy.

关键词： Acute pancreatitis Epidemiology,Endoscopic retrograde cholangiopancreatography Data collection

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对食管下括约肌行内镜下扩张对酸反流性疾病的食管内动力学特征的影响

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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 26-26页

作者： Cicala M. gabbrielli A. Emerenziani S. 陈云茹 Dipto. Malat. Apparato Digerente Università Compus Bio- Medico Vio Longoni 83 00155 Rome Italy Dr.

Background and aims: Improvements in symptoms following endoscopic procedures for gastrooesophageal reflux disease (GORD) are seldom supported by normalisati on of acid exposure time at the distal oesophagus. However, the distribution of gastric acid within the proximal oesophagus is a main determinant of symptom gen eration in GORD patients. In this study, our aim was to assess the effect of end oscopic insertion of hydrogel expandable prostheses into the oesophageal submuco sa on spatiotemporal characteristics of gastro- oesophageal reflux. Methods: Oe sophageal manometry and multichannel ambulatory 24 hour pH monitoring were carri ed out in nine patients before and six months after the endoscopic procedure. Dy namic characteristics of gastro- oesophageal reflux in patients were also compa red with those in 13 asymptomatic controls. Results: Acid exposure time (AET) at the distal oesophagus decreased from 11.7% (95% confidence interval 6.1- 2 1.8) at baseline to 7.7% (3.7- 11.6) at follow up (NS). Of the nine patients, distal AET normalised in three. AET at the middle (7.6% (2.9- 12.3)) and pro ximal (2.4% (0.1- 4.8)) oesophagus decreased significantly in all patients (2 .4% (0.3- 4.5), p < 0.01; 1.2% (0.2- 2.2), p< 0.05 respectively). Proximal extent of acid events significantly decreased in all patients at followup (37.3 % v 9.5% ), reaching values observed in asymptomatic controls. Median GORD he alth related quality of life scores significantly improved from 35.5 at baseline to 9.4. Conclusions: Despite the lack of a significant improvement in tradition al pH variables, endoscopic implant of hydrogel prostheses above the lower oesop hageal sphincter significantly decreases proximal spread of acid reflux into oes ophageal body. This effect would explain the improvement in symptoms in patients six months after therapy.

关键词：食管下括约肌反流性疾病力学特征内动胃食管反流近端远端的假体置入黏膜下层无症状

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