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Study of preoperative diagnostic modalities in Chinese patients with superficial esophageal squamous cell carcinoma

World Journal of Gastrointestinal Surgery 2022年第9期14卷 986-996页

作者： Ya-Ting Zeng yu-Ying Sun Wen-Cheng Tan Shu-Ai luo Bi-Hui Zou guang-yu luo Chun-yu Huang State Key Laboratory of Oncology in South China Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina Collaborative Innovation Center for Cancer Medicine Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina Department of Endoscopy Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina Cancer Prevention Center Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina

BACKGROUND Endoscopic ultrasonography(EUS)and magnifying endoscopy(ME)reliably determine indications for endoscopic resection in patients with superficial esophageal squamous cell carcinoma(SESCC).ME is widely accepted for predicting the invasion depth of superficial esophageal cancer with satisfying accuracy.However,the addition of EUS is controversial.AIM To evaluate the diagnostic efficiency of ME vs EUS for invasion depth prediction and investigate the influencing factors in patients with SESCC to determine the best diagnostic model in China.METHODS We retrospectively analyzed patients with suspected SESCC who completed both ME and EUS and then underwent endoscopic or surgical resection at Sun Yat-Sen University Cancer Center between January 2018 and December 2021.We evaluated and compared the diagnostic efficiency of EUS and ME according to histological results,and investigated the influencing factors.RESULTS We included 152 lesions from 144 patients in this study.The diagnostic accuracies of ME and EUS in differentiating invasion depth were not significantly different(73.0%and 66.4%,P=0.24);both demonstrated moderate consistency with the pathological results(ME:kappa=0.58,95%confidence interval[CI]:0.48-0.68,P<0.01;EUS:kappa=0.46,95%CI:0.34-0.57,P<0.01).ME was significantly more accurate in the diagnosis of high-grade intraepithelial(HGIN)or carcinoma in situ(odds ratio[OR]=3.62,95%CI:1.43-9.16,P=0.007)subgroups.Using a miniature probe rather than conventional EUS can improve the accuracy of lesion depth determination(82.3%vs 49.3%,P<0.01).Less than a quarter of circumferential occupation and application of a miniature probe were independent risk factors for the accuracy of tumor invasion depth as assessed by EUS(<1/4 circumferential occupation:OR=3.07,95%CI:1.04-9.10;application of a miniature probe:OR=5.28,95%CI:2.41-11.59,P<0.01).Of the 41 lesions(41/152,27.0%)that were misdiagnosed by ME,24 were corrected by EUS(24/41,58.5%).CONCLUSION Preoperative diagnosis of SESCC should be conducted endoscopically u

关键词： Superficial esophageal squamous cell carcinoma Endoscopic ultrasound Magnifying endoscopy Endoscopic resection Japan Esophageal Society classification

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Primary intestinal non-Hodgkin's lymphoma:A clinicopathologic analysis of 81 patients

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World Journal of Gastroenterology 2011年第41期17卷 4625-4631页

作者： Guo-Bao Wang Guo-Liang Xu guang-yu luo Hong-Bo Shan Yin Li Xiao-Yan Gao Jian-Jun Li Rong Zhang Department of Laser Treatment and Endoscopy Sun Yat-Sen University Cancer Center Guangzhou 510060 Guangdong ProvinceChina State Key Laboratory of On-cology in South China Guangzhou 510060 Guangdong Province China

AIM:To analyze the clinicopathologic features and the prognosis of primary intestinal lymphoma.METHODS:Patients were included in the study based on standard diagnostic criteria for primary gastrointesti-nal lymphoma,and were treated at Sun Yat-sen Univer-sity Cancer Centre between 1993 and 2008.RESULTS:The study comprised 81 adults.The most common site was the ileocaecal region.Twenty-two point two percent patients had low-grade B-cell lym-phoma.Fifty-one point nine percent patients had high-grade B-cell lymphoma and 25.9% patients had T-cell lymphoma.Most patients had localized disease.There were more patients and more early stage diseases in the latter period,and the origin sites changed.The ma-jority of patients received the combined treatment,andabout 20% patients only received nonsurgical therapy.The wverall survival and event-free survival rates after 5 years were 71.6% and 60.9% respectively.The mul-tivariate analysis revealed that small intestine and ileo-caecal region localization,B-cell phenotype,and normal lactate dehydrogenase were independent prognostic factors for better patient survival.Surgery based treat-ment did not improve the survival rate.CONCLUSION:Refined stratification of the patients according to the prognostic variables may allow indi-vidualized treatment.Conservative treatment may be an optimal therapeutic modality for selected patients.

关键词：恶性淋巴瘤临床病理原发性患者病理分析小肠 B细胞淋巴瘤综合治疗

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Concurrent chemoradiotherapy combined with enteral nutrition support:a radical treatment strategy for esophageal squamous cell carcinoma patients with malignant istulae

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Chinese Journal of Cancer 2017年第1期36卷 26-33页

作者： Li Ma guang-yu luo yu-Feng Ren Bo Qiu Hong Yang Chun-Xia Xie Song-Ran Liu Shi-Liang Liu Zhao-Lin Chen Qun Li Jian-Hua Fu Meng-Zhong Liu Yong-Hong Hu Wen-Feng Ye Hui Liu Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer Medicine guangdong Esophageal Cancer Research Institute Department of Radiation Oncology Sun Yat-sen University Cancer Center Department of Endoscopy Sun Yat-sen University Cancer Center Department of Radiation Oncology The First Affiliated Hospital of Sun Yat-sen University Department of Thoracic Surgery Sun Yat-sen University Cancer Center Department of Clinical Nutrition Sun Yat-sen University Cancer Center

Background: Concurrent chemoradiotherapy(CCRT) significantly increases the survival rate of esophageal squa?mous cell carcinoma(ESCC) patients with malignant fistulae. Recent clinical evidence has shown the benefits of enteral nutrition for malnourished cancer patients. In this study, we aimed to validate that, with the support of enteral nutrition, ESCC patients who develop malignant fistulae might be able to complete CCRT and achieve long?term survival.Methods: We reviewed the medical records of 652 patients with ESCC who received definitive CCRT at Sun Yat?sen University Cancer Center between January 2010 and December 2012. Treatment outcome and toxicity were ret?rospectively evaluated in 40 ESCC patients with malignant fistulae. All the 40 patients were treated with CCRT and evaluated by clinical nutritionists using nutrition risk screening(NRS) before, during, and after treatment. Twenty?two patients received a nasogastric tube, and 18 underwent percutaneous endoscopic gastrostomy feeding. The median energy intake was 2166 kcal/day. Treatment response was evaluated at 3 months after the completion of CCRT.Results: With a median follow?up of 18 months(range, 3–39 months), patients' 1?year overall survival(OS) rate was 62.5%, and the estimated OS time was 25.5 months. Univariate analysis showed that the NRS score(P n NRS score(P se to treatment(P < 0.001) were sig= 0.003), increase i= 0.024), fistula closure(P = 0.011), and responnifi?cantly associated with OS. Multivariate analysis showed that tumor response(P = 0.044) and increase in NRS score(P = 0.044) were independent predictors of OS. Grade 3 vomiting was observed in 8 patients(20.0%), grade 3 neutro?penia was observed in 11 patients(27.5%), and grade 3 cough was observed in 13 patients(32.5%); 2 patients(5.0%) died of massive bleeding during treatment.Conclusions: CCRT combined with enteral nutrition support is effective for ESCC patients with malignant fistulae. Patients have an increased potential to be cured, especially those who experience complete

关键词： Esophageal squamous cell carcinoma Malignant istula Radiotherapy Concurrent chemotherapy Enteral nutrition support

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Ultrasound-guided fine needle aspiration of retropharyngeal lymph nodes after radiotherapy for nasopharyngeal carcinoma: a novel technique for accurate diagnosis

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Cancer Communications 2018年第1期38卷 229-236页

作者： Long-Jun He Chuanbo Xie Yin Li Lin-Na luo Ke Pan Xiao-Yan Gao Li-Zhi Liu Jian-Ming Gao guang-yu luo Hong-Bo Shan Ming-yuan Chen Chong Zhao Wei-Jun Fan Ping Yang Guo-Liang Xu Jian-Jun Li State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Endoscopy Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Cancer Prevention Research Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Melanoma Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTX 77054USA Department of Imaging and Invention Radiology Sun Yat-sen University Cancer CenterGuangzhou 510060Guang-dongP.R.China Department of Radiation Oncology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Nasopharyngeal Oncology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Pathology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China

Background:Enlarged retropharyngeal lymph nodes(RLNs)are very common in patients with nasopharyngeal carcinoma(NPC)undergoing radiotherapy.The most suitable treatment option for enlarged RLNs depends on the pathological results.However,RLN sampling is difficult and imminent in the clinic setting.We recently developed a novel minimally invasive technique termed endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)for sam-pling RLN tissues sufficient for pathological or cytological diagnosis.Methods:We enrolled 30 post-radiotherapy patients with NPC with suspected RLN metastasis detected via mag-netic resonance imaging(MRI).The EUS probe was introduced into the nasopharynx via the nostrils,and EUS was then used to scan the retropharyngeal space and locate the RLN in the anterior carotid sheath.EUS-FNA was subsequently performed.The safety and efficacy of using EUS-FNA to sample the RLN tissues were assessed.Results:Strips of tissue were successfully sampled from all patients using EUS-FNA.Of the 30 patients,23 were confirmed to have cancer cells in the biopsied tissues via pathology or cytology examinations with 1 EUS-FNA biopsy session.The seven cases without confirmed cancer cells were subsequently reanalyzed by using another EUS-FNA biopsy session,and two more cases were confirmed possessing cancer cells.The other five patients without con-firmed cancer cells were closely followed with MRI every month for 3 months.After follow-up for 3 months,three patients were still considered cancer-free due to the presence of RLNs with stable or shrinking diameters.The rest two patients who showed progressive disease underwent a third EUS-FNA biopsy procedure and were further confirmed to be cancer cell-positive.In the whole cohort reported here,the EUS-FNA procedure was not associated with any severe complications.Conclusion:EUS-FNA is a safe and effective diagnostic approach for sampling tissues from the RLNs in patients with suspected recurrent NPC.

关键词： Fine needle aspiration Endoscopic ultrasonography Retropharyngeal lymph node Nasopharyngeal carcinoma

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Complications of high intensity focused ultrasound in patients with recurrent and metastatic abdominal tumors

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World Journal of Gastroenterology 2007年第19期13卷 2747-2751页

作者： Jian-Jun Li Guo-Liang Xu Mo-Fa Gu guang-yu luo Zhang Rong Pei-Hong Wu Jian-Chuan Xia Department of HIFU Cancer Center Sun Yat-sen University National Key Laboratory of Oncology Guangzhou 510060 Guangdong Province China Department of Radiation Oncology Cancer Center Sun Yat-sen University National Key Laboratory of Oncology Guangzhou 510060 Guangdong Province China Pei-Hong Wu Department of Radiology Cancer Center Sun Yatsen University National Key Laboratory of Oncology Guangzhou 510060 Guangdong Province China Jian-Chuan Xia Biotherapy Center Cancer Center Sun Yat-sen University National Key Laboratory of Oncology Guangzhou 510060 Guangdong Province China

AIM: To analyze the local and systemic complications of high intensity focused ultrasound (HIFU) for patients with recurrent and metastatic abdominal tumors.METHODS: From Aug 2001 to Aug 2004, 17 patients with recurrent and metastatic abdominal tumors were enrolled in this study. Real-time sonography was taken, and vital signs, liver and kidney function, skin burns, local reactions, and systemic effects were observed and recored before, during, and after HIFU. CT and MRI were also taken before and after HIFU.RESULTS: All 17 patients had skin burns and pain in the treatment region; the next common complication was neurapraxia of the stomach and intestines to variable degrees. The other local and systemic complications were relatively rare. Severe complications were present in two patients; one developed a superior mesenteric artery infarction resulting in necrosis of the entire small intestines, and the other one suffered from a perforation in terminal ileum due to HIFU treatment. CONCLUSION: Although HIFU is a one of noninvasive treatments for the recurrent and metastatic abdominal tumors, there are still some common and severe complications which need serious consideration.

关键词：高强度聚焦超声超声波疗法腹部肿瘤复发肿瘤转移并发症

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Methyl-methanesulfonate sensitivity 19 expression is associated with metastasis and chemoradiotherapy response in esophageal cancer

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World Journal of Gastroenterology 2015年第14期21卷 4240-4247页

作者： Jin-Liang Zhang Hui-yun Wang Qing Yang Shi-Yong Lin guang-yu luo Rong Zhang Guo-Liang Xu Department of Endoscopy and Laser State Key Laboratory of Oncology in South ChinaGuangdong Esophageal Cancer InstituteNational Collaborative Innovation Center for Cancer MedicineSun Yat-Sen University Cancer Center Department of Medical Oncology Longhua New District Central Hospital of Shenzhen State Key Laboratory of Oncology in South China Guangdong Esophageal Cancer InstituteNational Collaborative Innovation Center for Cancer MedicineSun Yat-Sen University Cancer Center

AIM: To investigate the clinical significance of methylmethanesulfonate sensitivity 19(MMS19) expression in esophageal squamous cell carcinoma(ESCC).METHODS: Between June 2008 and May 2013, specimens from 103 patients who underwent endoscopic biopsy for the diagnosis of ESCC at the endoscopy center of Sun Yat-Sen University Cancer Center were collected; 52 matched-normal esophageal squamous epithelium samples were biopsied as controls.MMS19 protein expression was measured by immunohistochemistry.Of the 103 cases of ESCC, 49 received radical surgery following neoadjuvant chemoradiotherapy consisting of concurrent radiation in a total dose of 40 Gy and two cycles of chemotherapy with vinorelbine and cisplatin.Relationships between MMS19 expression, clinicopathologic characteristics and chemoradiotherapy response were analyzed.RESULTS: The MMS19 protein could be detected in both the cytoplasm and nucleus of most specimens.High cytoplasmic expression of MMS19 was detected in 63.1% of ESCC samples, whereas high nuclearexpression of MMS19 was found in 35.0%.High cytoplasmic MMS19 expression was associated with regional lymph node metastases(OR = 11.3, 95%CI: 2.3-54.7; P < 0.001) and distant metastases(OR = 13.1, 95%CI: 1.7-103.0; P = 0.002).Furthermore, high cytoplasmic MMS19 expression was associated with a response of ESCC to chemoradiotherapy(OR = 11.5, 95%CI: 3.0-44.5; P < 0.001), with a high cytoplasmic MMS19 expression rates in 79.3% and 25.0% of patients from the good chemoradiotherapy response group and poor response group, respectively.Nuclear MMS19 expression did not show any significant association with clinicopathologic characteristics or chemoradiotherapy response in ESCC.CONCLUSION: The results of our preliminary study suggest that MMS19 may be a potential new predictor of metastasis and chemoradiotherapy response in ESCC.

关键词： Chemoradiotherapy Esophageal squamous cell carcino

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Evaluation of preoperative staging for esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2016年第29期22卷 6683-6689页

作者： Lin-Na luo Long-Jun He Xiao-Yan Gao Xin-Xin Huang Hong-Bo Shan guang-yu luo Yin Li Shi-Yong Lin Guo-Bao Wang Rong Zhang Guo-Liang Xu Jian-Jun Li Department of Endoscopy Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Guangdong Esophageal Cancer Institute Collaborative Innovation Center for Cancer Medicine

Esophageal squamous cell carcinoma(ESCC) is known for its rapid progression and poor outcomes. China has the highest incidence and mortality in the world. Diagnoses made at early stages and accurate staging are associated with better outcomes, all of which can play a significant role in the selection of treatment protocols. ESCC is staged according to the widely accepted TNM system. Common imaging modalities used in staging ESCC before treatment include endoscopy, computed tomography(CT), positron emission tomography(PET) and magnetic resonance imaging(MRI). Endoscopic ultrasound is useful for staging tumor depth and nodal status. Narrow band imaging is valuable for early stage disease assessment. CT and PET provide additional valuable information regarding node and metastasis staging. The ability of MRI to delineate ESCC is continuously being improved and adds information regarding locoregional status to routine examinations.

关键词： Esophageal squamous cell carcinoma Endoscopic ultrasound Computed tomography Positron emission tomog

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The marriage of immunomodulatory,angiogenic,and osteogenic capabilities in a piezoelectric hydrogel tissue engineering scafold for military medicine

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Military Medical Research 2024年第3期11卷 323-344页

作者： Ping Wu Lin Shen Hui-Fan Liu Xiang-Hui Zou Juan Zhao yu Huang yu-Fan Zhu Zhao-yu Li Chao Xu Li-Hua luo Zhi-Qiang luo Min-Hao Wu Lin Cai Xiao-Kun Li Zhou-guang Wang Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research the Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui 323000ZhejiangChina Oujiang Laboratory(Zhejiang Lab for Regenerative Medicine Vision and Brain Health)School of Pharmaceutical ScienceWenzhou Medical UniversityWenzhou 325000ZhejiangChina Department of Spine Surgery and Musculoskeletal Tumor Zhongnan Hospital of Wuhan UniversityWuhan 430071China National Engineering Research Center for Nanomedicine College of Life Science and TechnologyHuazhong University of Science and TechnologyWuhan 430074China Department of Overseas Education College Jimei UniversityXiamen 361021FujianChina School and Hospital of Stomatology Wenzhou Medical UniversityWenzhou 325035ZhejiangChina

Background:Most bone-related injuries to grassroots troops are caused by training or accidental injuries.To establish preventive measures to reduce all kinds of trauma and improve the combat effectiveness of grassroots troops,it is imperative to develop new strategies and scafolds to promote bone regeneration.Methods:In this study,a porous piezoelectric hydrogel bone scafold was fabricated by incorporating polydopamine(PDA)-modified ceramic hydroxyapatite(PDA-hydroxyapatite,PHA)and PDA-modified barium titanate(PDABaTiO3,PBT)nanoparticles into a chitosan/gelatin(Cs/Gel)matrix.The physical and chemical properties of the Cs/Gel/PHA scafold with 0–10 wt%PBT were analyzed.Cell and animal experiments were performed to characterize the immunomodulatory,angiogenic,and osteogenic capabilities of the piezoelectric hydrogel scafold in vitro and in vivo.Results:The incorporation of BaTiO3into the scafold improved its mechanical properties and increased self-generated electricity.Due to their endogenous piezoelectric stimulation and bioactive constituents,the prepared Cs/Gel/PHA/PBT hydrogels exhibited cytocompatibility as well as immunomodulatory,angiogenic,and osteogenic capabilities;they not only effectively induced macrophage polarization to M2 phenotype but also promoted the migration,tube formation,and angiogenic differentiation of human umbilical vein endothelial cells(HUVECs)and facilitated the migration,osteodifferentiation,and extracellular matrix(ECM)mineralization of MC3T3-E1 cells.The in vivo evaluations showed that these piezoelectric hydrogels with versatile capabilities significantly facilitated new bone formation in a rat large-sized cranial injury model.The underlying molecular mechanism can be partly attributed to the immunomodulation of the Cs/Gel/PHA/PBT hydrogels as shown via transcriptome sequencing analysis,and the PI3K/Akt signaling axis plays an important role in regulating macrophage M2 polarization.Conclusion:The piezoelectric Cs/Gel/PHA/PBT hydrogels developed here with favorable immunomodulation,

关键词： Piezoelectric hydrogel Tissue engineering scafold Immunomodulation Angiogenesis Osteogenic differentiation

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Endoscopic ultrasonography for staging of T1a and T1b esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2014年第5期20卷 1340-1347页

作者： Long-Jun He Hong-Bo Shan guang-yu luo Yin Li Rong Zhang Xiao-Yan Gao Guo-Bao Wang Shi-Yong Lin Guo-Liang Xu Jian-Jun Li Department of Endoscopy Sun Yat-sen University Cancer Center Guangdong Esophageal Cancer Institute Department of Endoscopy State Key Laboratory of Oncology in South China Department of Endoscopy Collaborative Innovation Center for Cancer Medicine

AIM: To investigate the accuracy of Endoscopic ultrasound(EUS) in staging and sub-staging T1a and T1b esophageal squamous cell carcinoma(ESCC). METHODS: A retrospective analysis involving 72 patients with pathologically confirmed T1a or T1b ESCC, was undertaken between January 2005 and December 2011 in Sun Yat-sen University Cancer Center. The accuracy and efficiency of EUS for detecting stages T1a and T1b ESCC were examined. RESULTS: The overall accuracy of EUS for detecting stage T1a or T1b ESCC was 70.8%(51/72), and the sensitivity was 74.3%. 77.8%(7/9) of lesions originated in the upper thoracic region, 73.1%(38/52) in the mid-thoracic region and 72.7%(8/11) in the lower thoracic region. Multivariate analysis revealed that the diagnostic accuracy of EUS was closely related to lesion length(F = 4.984, P = 0.029). CONCLUSION: EUS demonstrated median degree of accuracy for distinguishing between stages T1a and T1b ESCC. Therefore, it is necessary to improve EUS for staging early ESCC.

关键词： Endoscopic ultrasound Esophageal cancer Squamous c

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The dual role of striatal interneurons: circuit modulation and trophic support for the basal ganglia

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Neural Regeneration Research 2024年第6期19卷 1277-1283页

作者： Elliot Wegman Marlena Wosiski-Kuhn yu luo Department of Molecular and Cellular Biosciences University of Cincinnati 2. Department of Emergency Medicine at the School of Medicine University of Cincinnati Neuroscience Graduate Program University of Cincinnati

Striatal interneurons play a key role in modulating striatal-dependent behaviors, including motor activity and reward and emotional processing. Interneurons not only provide modulation to the basal ganglia circuitry under homeostasis but are also involved in changes to plasticity and adaptation during disease conditions such as Parkinson’s or Huntington’s disease. This review aims to summarize recent findings regarding the role of striatal cholinergic and GABAergic interneurons in providing circuit modulation to the basal ganglia in both homeostatic and disease conditions. In addition to direct circuit modulation, striatal interneurons have also been shown to provide trophic support to maintain neuron populations in adulthood. We discuss this interesting and novel role of striatal interneurons, with a focus on the maintenance of adult dopaminergic neurons from interneuronderived sonic-hedgehog.

关键词： cholinergic dopamine GABAergic interneuron levodopa-induced dyskinesia parvalbumin sonic hedgehog striatum trophic factor

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