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Artificial intelligence as a noninvasive tool for pancreatic cancer prediction and diagnosis

World Journal of Gastroenterology 2023年第12期29卷 1811-1823页

作者： Alexandra Corina Faur daniela cornelia lazar Laura Andreea Ghenciu Department of Anatomy and Embriology “Victor Babeș”University of Medicine and Pharmacy TimișoaraTimișoara 300041TimișRomania Department V of Internal Medicine I Discipline of Internal Medicine IVUniversity of Medicine and Pharmacy“Victor Babes”TimișoaraTimișoara 300041TimișRomania DepartmentⅢ Discipline of Pathophysiology“Victor Babeș”University of Medicine and PharmacyTimișoara 300041TimișRomania

Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first *** detected,early neoplastic lesions are ideal for surgery,offering the best *** lesions of the pancreas include pancreatic intraepithelial neoplasia and mucinous cystic neoplasms,with intraductal papillary mucinous neoplasms being the most commonly *** study focused on predicting PC by identifying early signs using noninvasive techniques and artificial intelligence(AI).A systematic English literature search was conducted on the PubMed electronic database and other *** obtained a total of 97 studies on the subject of pancreatic *** final number of articles included in our study was 44,34 of which focused on the use of AI algorithms in the early diagnosis and prediction of pancreatic *** algorithms can facilitate diagnosis by analyzing massive amounts of data in a short period of *** can be made through AI algorithms by expanding image and electronic medical records databases,which can later be used as part of a screening program for the general ***-based screening models should involve a combination of biomarkers and medical and imaging data from different *** requires large numbers of resources,collaboration between medical practitioners,and investment in medical infrastructures.

关键词： Pancreatic cancer Early pancreatic lesions Pancreatic neoplasia Artificial intelligence Deep learning Machine learning Radiomics Diagnosis Pancreas

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Predictors of rebleeding and in-hospital mortality in patients with nonvariceal upper digestive bleeding

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World Journal of Clinical Cases 2019年第18期7卷 2687-2703页

作者： daniela cornelia lazar Sorin Ursoniu Adrian Goldis Department of Internal Medicine I University Medical ClinicUniversity of Medicine and Pharmacy "Victor Babes"Timisoara 300041Timis CountyRomania Department of Public Health and Health Management University of Medicine and Pharmacy "Victor Babes"Timisoara 300041Timis CountyRomania Department of Gastroenterology and Hepatology University of Medicine and Pharmacy "Victor Babes"Timisoara 300041Timis CountyRomania

BACKGROUND Nonvariceal upper digestive bleeding (NVUDB) represents a severe emergency condition and is associated with significant morbidity and mortality. Despite a decrease in the incidence due to the widespread use of potent therapy with proton pump inhibitors as well as the implementation of modern endoscopic techniques, the mortality rate associated with NVUDB is still high. AIM To identify the clinical, biological, and endoscopic parameters associated with a poor outcome in patients with NVUDB to allow the stratification of risk, which will lead to the implementation of the most accurate management. METHODS We performed a retrospective study including patients who were admitted to the Gastroenterology Department of Clinical Emergency County Hospital Timisoara, Romania, with a diagnosis of NVUDB between 1 January 2008 and 31 December 2016. All the data were collected from the patient’s records, including demographic data, medication history, hemodynamic status, paraclinical tests, and endoscopic features as well as the methods of hemostasis, rate of rebleeding, need for surgery and death;we also assessed the Rockall score of the patients, length of hospitalization and associated comorbidities. All these parameters were evaluated as potential risk factors associated with rebleeding and death in patients with *** We included a batch of 1581 patients with NVUDB, including 523 (33%) females and 1058 (67%) males with a median age of 66 years. The main cause of NVUDB was peptic ulcer (73% of patients). More than one-third of the patients needed endoscopic treatment. Rebleeding rate was 7.72%;surgery due to failure of endoscopic hemostasis was needed in 3.22% of cases;the in-hospital mortality rate was 8.09%, and the bleeding-episode-related mortality rate was 2.97%. Although our predictive models for rebleeding and death had a low sensitivity, the specificity was very high, suggesting a better discriminative capacity for identifying patients with better out

关键词： Nonvariceal upper digestive bleeding Risk factors Rebleeding Death Outcome

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计算机辅助系统在上消化道内镜质量监测和胃病变评估中的作用

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Gastroenterology Report 2021年第3期9卷 185-204,I0001页

作者： daniela cornelia lazar Mihaela Flavia Avram Alexandra Corina Faur Ioan Romosan Adrian Goldis Department V of Internal Medicine I Discipline of Internal Medicine IV“Victor Babes”University of Medicine and Pharmacy TimisoaraRomaniaTimisoaraRomania Department of Surgery X 1st Surgery Discipline“Victor Babes”University of Medicine and Pharmacy TimisoaraRomaniaTimisoaraRomania Department I Discipline of Anatomy and Embriology“Victor Babes”University of Medicine and Pharmacy TimisoaraRomaniaTimisoaraRomania Department VII of Internal Medicine II Discipline of Gastroenterology and Hepatology“Victor Babes”University of Medicine and Pharmacy TimisoaraRomaniaTimisoaraRomania

本文通过文献综述,对计算机辅助系统在食管胃十二指肠镜质量监测和胃病变评估方面的应用价值进行了分析。目前数据表明,计算机辅助系统能为上消化道内镜检查提供良好的质量控制,并能较为准确地检出胃恶性肿瘤及癌前病变,与经验丰富的内... 详细信息

本文通过文献综述,对计算机辅助系统在食管胃十二指肠镜质量监测和胃病变评估方面的应用价值进行了分析。目前数据表明,计算机辅助系统能为上消化道内镜检查提供良好的质量控制,并能较为准确地检出胃恶性肿瘤及癌前病变,与经验丰富的内镜医师相当,甚至更佳。同时,人工智能(AI)能够为胃癌患者确定最佳治疗策略,即根据肿瘤浸润深度进行内镜或手术切除,从而在保证生活质量和远期预后的同时,避免不必要的手术干预。各种不同算法的AI应用于上消化道内镜检查中,无论是普通的白光内镜,还是一些专业内镜中心所采用的新型内镜技术,都显示出良好的效果。目前在研的一些关于AI及计算机辅助诊断系统嵌入内镜设备的临床试验,其结果值得期待,有望实现AI内镜系统在未来的真实应用,突破当前计算机辅助系统的不足,提高检测效能。这些改进能为胃癌患者提供更好的诊疗策略。而且,将AI算法融入到内镜设备,加之包含内镜图像的大数据,或可进一步拓展上消化道内镜的应用空间,包括远程医疗和疑难病例的会诊。

关键词：上消化道内镜计算机辅助系统胃恶性肿瘤疑难病例胃癌患者内镜中心诊疗策略质量监测

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New advances in targeted gastric cancer treatment

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World Journal of Gastroenterology 2016年第30期22卷 6776-6799页

作者： daniela cornelia lazar Sorina Taban Marioara Cornianu Alexandra Faur Adrian Goldis Department of Gastroenterology and Hepatology University of Medicine and Pharmacy 'Victor Babes' 300041 Timisoara Timis County Romania Department of Pathology University of Medicine and Pharmacy 'Victor Babes' 300041 Timisoara Timis County Romania

Despite a decrease in incidence over past decades,gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours.

关键词： Gastric cancer Helicobacter pylori infection Chemotherapy Targeted therapy Clinical trials New treat

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Malignant hepatic vascular tumors in adults: Characteristics,diagnostic difficulties and current management

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World Journal of Clinical Oncology 2019年第3期10卷 110-135页

作者： daniela cornelia lazar Mihaela Flavia Avram Ioan Romosan Violetta Vacariu Adrian Goldis Marioara Cornianu Department of Internal MedicineⅠ University Medical ClinicUniversity of Medicine and Pharmacy“Victor Babes”Timisoara 300041Romania Department of SurgeryⅩ 1st Surgery ClinicUniversity of Medicine and Pharmacy“Victor Babe?”Timisoara 300041Romania Department of Gastroenterology and Hepatology University of Medicine and Pharmacy“Victor Babes”Timisoara 300041Romania Department of Pathology University of Medicine and Pharmacy“Victor Babes”Timisoara 300041Romania

Malignant vascular tumors of the liver include rare primary hepatic mesenchymal tumors developed in the background of a normal liver parenchyma. Most of them are detected incidentally by the increased use of performing imaging techniques. Their diagnosis is challenging, involving clinical and imaging criteria, with final confirmation by histology and immunohistochemistry. Surgery represents the mainstay of treatment. Liver transplantation(LT) has improved substantially the prognosis of hepatic epithelioid hemangioendothelioma(HEHE), with 5-year patient survival rates of up to 81%, based on the European Liver Intestine Transplantation AssociationEuropean Liver Transplant Registry study. Unfortunately, the results of surgery and LT are dismal in cases of hepatic angiosarcoma(HAS). Due to the disappointing results of very short survival periods of approximately 6-7 mo after LT, because of tumor recurrence and rapid progression of the disease, HAS is considered an absolute contraindication to LT. Recurrences after surgical resection are high in cases of HEHE and invariably present in cases of HAS. The discovery of reliable prognostic markers and the elaboration of prognostic scores following LT are needed to provide the best therapeutic choice for each *** on a few patients have demonstrated the stabilization of the disease in a proportion of patients with hepatic vascular tumors using novel targeted antiangiogenic agents, cytokines or immunotherapy. These new approaches,alone or in combination with other therapeutic modalities, such as surgery and classical chemotherapy, need further investigation to assess their role in prolonging patient survival. Personalized therapeutic algorithms according to the histopathological features, behavior, molecular biology and genetics of the tumors should be elaborated in the near future for the management of patients diagnosed with primary malignant vascular tumors of the liver.

关键词： Hepatic malignant vascular tumors Hepatic small vessel neoplasia Hepaticperivascular epithelioid cell tumor Hepatic hemangiopericytoma Hepatic epithelioidhemangioendothelioma Kaposi sarcoma Hepatic angiosarcoma Diagnostic Prognostic Treatment

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