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Risk factors for small intestinal adenocarcinomas that are common in the proximal small intestine

World Journal of Gastroenterology 2022年第39期28卷 5658-5665页

作者： Shunji Fujimori Ryohei Hamakubo Aitoshi Hoshimoto Takayoshi Nishimoto Jun Omori Naohiko Akimoto Shu Tanaka atsushi tatsuguchi Katsuhiko Iwakiri Department of Gastroenterology Chiba Hokusoh HospitalNippon Medical SchoolChiba 270-1694Japan Department of Gastroenterology Nippon Medical SchoolGraduate School of MedicineTokyo 113-8603Japan Department of Gastroenterology Tama-Nagayama HospitalNippon Medical SchoolTokyo 206-0025Japan

The frequency of primary small intestinal adenocarcinoma is increasing but is still *** frequency is approximately 3%of that of colorectal *** that the small intestine occupies 90%of the surface area of the gastrointestinal tract,small intestinal adenocarcinoma is very *** main site of small intestinal adenocarcinoma is the proximal small *** on this characteristic,dietary animal proteins/lipids and bile concentrations are implicated and reported to be involved in *** most nutrients are absorbed in the proximal small intestine,the effect of absorbable intestinal content is a suitable explanation for why small intestinal adenocarcinoma is more common in the proximal small *** proportion of aerobic bacteria is high in the proximal small intestine,but the absolute number of bacteria is *** addition,the length and density of villi are greater in the proximal small ***,the involvement of villi is considered to be low because the number of small intestinal adenocarcinomas is much smaller than that of colorectal *** the other hand,the reason for the low incidence of small intestinal adenocarcinoma in the distal small intestine may be that immune organs reside *** and disease factors increase the likelihood of small intestinal *** carcinogenesis experiments in which the positions of the small and large intestines were exchanged,tumors still occurred in the large intestinal mucosa more *** other words,the influence of the intestinal contents is small,and there is a large difference in epithelial properties between the small intestine and the large *** conclusion,small intestinal adenocarcinoma is rare compared to large intestinal adenocarcinoma due to the nature of the *** is reasonable to assume that diet is a trigger for small intestinal adenocarcinoma.

关键词： Small intestine Large intestine Adenocarcinoma Risk factor Carcinogenesis

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Clinical significance of programmed cell death-ligand expression in small bowel adenocarcinoma is determined by the tumor microenvironment

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World Journal of Gastroenterology 2023年第40期29卷 5566-5581页

作者： Aitoshi Hoshimoto atsushi tatsuguchi Ryohei Hamakubo Takayoshi Nishimoto Jun Omori Naohiko Akimoto Shu Tanaka Shunji Fujimori Tsutomu Hatori Akira Shimizu Katsuhiko Iwakiri Department of Gastroenterology Nippon Medical SchoolTokyo 113-8603Japan Department of Analytic Human Pathology Nippon Medical SchoolTokyo 113-8603Japan Department of Pathology Nippon Medical SchoolChiba Hokusoh HospitalChiba 270-1694Japan

BACKGROUND Comprehensive genomic analysis has shown that small bowel adenocarcinoma(SBA)has different genomic profiles from gastric and colorectal ***,it is essential to establish chemotherapeutic regimens based on SBA *** expression of programmed cell death-ligand 1(PD-L1)and programmed cell death-ligand 2(PD-L2)in SBA is not fully ***-PD-L1/PD-1 therapy uses tumor-infiltrating lymphocytes(TILs);therefore,the status of TILs in the tumor microenvironment(TME)may influence their *** ratio of FoxP3+to CD8+T cells has been reported to be useful in predicting the prognosis of digestive system *** To investigate the clinicopathological significance of PD-L1/2 expression according to the status of TILs in SBA *** We performed immunohistochemical analysis for PD-L1,PD-L2,CD8,FoxP3,and DNA mismatch repair(MMR)proteins using formalin-fixed,paraffin-embedded tissues from 50 patients diagnosed with primary *** immunoreactivities of PD-L1 and PD-L2 were determined separately in tumor cells and tumor-infiltrating immune cells throughout the tumor center and invasive margins,and finally evaluated using the combined positive score(CPS).We assessed CD8+and FoxP3+T cells in the intratumoral and tumor-surrounding ***,we calculated and summed the ratio of FoxP3 to CD8+T cell ***-related cell densities were graded as low or *** results were compared with clinicopathological factors and patient *** distribution of cancer-specific survival(CSS)was estimated using the Kaplan–Meier method,and the log-rank test was used to test for significant differences in CSS.A Cox proportional hazard model was also used to assess the effect of tumor variables on *** PD-L1 expression was positive in 34%in tumor cells(T-PD-L1)and 54%in tumor-infiltrating immune cells(I-PDL1)of the cases examined.T-PD-L2 was positive in 34%and I-PD-L2 was positive in 42%of the ***-L1

关键词： Small bowel adenocarcinoma Programmed cell death-ligand 1 Programmed cell death-ligand 2 Tumor microenvironment Tumor-infiltrating lymphocytes Regulatory T-cells

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