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Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons

World Journal of Gastroenterology 2017年第33期23卷 6172-6180页

作者： Stefanus J van Rooijen Audrey CHM Jongen Zhou-qiao Wu jia-fu ji Gerrit D Slooter Rudi MH Roumen Nicole D Bouvy Department of Surgery Máxima Medical Center NUTRIM School of Nutrition and Translational Research in Metabolism Department of Surgery Maastricht University Medical Center Key laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Ward I of Gastrointestinal Cancer CenterPeking University Cancer Hospital and Institute

AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation',and ‘a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical' leaks as CAL,which partly explains the higher reported Dutch CAL rates.

关键词： Colorectal anastomotic leakage Colorectal surgery Definition Complication

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Over-expression of Metastasis-associated in Colon Cancer-1 (MACC1) Associates with Better Prognosis of Gastric Cancer Patients

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Chinese Journal of Cancer Research 2011年第2期23卷 153-159页

作者： Shao-hua Ge Xiao-jiang Wu Xiao-hong Wang Xiao-fang Xing Lian-hai Zhang Yu-bing Zhu Hong Du Bin Dong Ying Hu jia-fu ji Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） 1Department of Gastrointestinal Surgery Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） Department of Pathology Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） Tissue Bank Peking University School of Oncology Beijing Cancer Hospital ＆ Institute Beijing 100142 China

Objective： The aim of this study was to detect metastasis-associated in colon cancer-1 （MACC1） expression in Chinese gastric cancer and analyze the relationship between MACC1 expression and postoperative survival. Methods： The expression of MACC1 and c-MET protein in a sample of 128 gastric cancer tissues was detected by immunohistochemistry. A retrospective cohort study on the prognosis was carried out and data were collected from medical records. Results： The positive rate of MACC1 protein expression in gastric cancer was 47.66%, higher than that in adjacent noncancerous mucosa （P0.001）. MACC1 protein expression was not related to the clinicopathological variables involved. Kaplan-Meier analysis revealed that the survival of MACC1 positive group tended to be better than that of MACC1 negative group, particularly in patients with stage III carcinoma （P=0.032）. Cox regression analysis revealed that MACC1 protein over-expression in gastric cancer tended to be a protective factor with hazard ratio of 0.621 （P=0.057）. Immunohistochemical analysis showed that the positive rate of c-MET protein expression was much higher in cases with positive MACC1 expression in gastric cancer （P=0.002）, but P53 expression was not associated with MACC1 expression. Conclusion： MACC1 over-expression implies better survival and may be an independent prognostic factor for gastric cancer in Chinese patients.

关键词： MACC1 Gastric cancer Prognosis

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Discovery and validation of prognostic markers in gastric cancer by genome-wide expression profiling

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World Journal of Gastroenterology 2011年第13期17卷 1710-1717页

作者： Yue-Zheng Zhang Lian-Hai Zhang Yang Gao Chao-Hua Li Shu-Qinjia Ni Liu Feng Cheng De-Yun Niu William CS Cho jia-fu ji Chang-Qing Zeng Beijing Institute of Genomics Chinese Academy of Sciences Beijing 100029 China CAS Key Laboratory of Genome Sciences andInformation Chinese Academy of Sciences Beijing Institute ofGenomics Beijing 100029 China Graduate School of ChineseAcademy of Sciences Beijing 100049 China Key Labora-tory of Carcinogenesis and Translational Research (Ministry ofEducation) Department of Surgery Beijing Cancer Hospitaland Institute Peking University School of Oncology Beijing100142 China Department of Clinical Oncology QueenElizabeth Hospital Hong Kong China Laboratory of Cancer Genomics and Personalized Medicine Beijing Institute of Genomics ChineseAcademy of Sciences Beijing 100029 China

AIM: To develop a prognostic gene set that can predict patient overall survival status based on the whole genome expression analysis. METHODS: Using Illumina HumanWG-6 BeadChip followed by semi-supervised analysis, we analyzed the expression of 47 296 transcripts in two batches of gastric cancer patients who underwent surgical resection. Thirty-nine samples in the first batch were used as the training set to discover candidate markers correlated to overall survival, and thirty-three samples in the second batch were used for validation. RESULTS: A panel of ten genes were identified as prognostic marker in the first batch samples and classified patients into a lowand a high-risk group with significantly different survival times (P = 0.000047). This prognostic marker was then verified in an independent validation sample batch (P = 0.0009). By comparing with the traditional Tumor-node-metastasis (TNM) staging system, this ten-gene prognostic marker showed consistent prognosis results. It was the only independent prognostic value by multivariate Cox regression analysis (P = 0.007). Interestingly, six of these ten genes are ribosomal proteins, suggesting a possible association between the deregulation of ribosome related gene expression and the poor prognosis. CONCLUSION: A ten-gene marker correlated with overall prognosis, including 6 ribosomal proteins, was identified and verified, which may complement the predictive value of TNM staging system.

关键词：全基因组预后验证胃癌表达谱标志物核糖体蛋白基因标记

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Integrated approach to colorectal anastomotic leakage: Communication, infection and healing disturbances

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World Journal of Gastroenterology 2016年第32期22卷 7226-7235页

作者： Cloe L Sparreboom Zhou-Qiao Wu jia-fu ji Johan F Lange Department of Surgery Erasmus University Medical Center 3015 CN Rotterdam. The NEthelands Department of Gastrointestinal Surgery Peking University Cancer Hospital and Institute Haidian District Beijing 100142 China

Colorectal anastomotic leakage(CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the available strategies regarding prevention, prediction and intervention of CAL and categorize them into three categories: communication, infection and healing disturbances. These three major factors actively interact during the onset of CAL. We aim to provide an integrated approach to CAL based on its etiology. The intraoperative air leak test, intraoperative endoscopy, radiological examinations and stoma construction mainly aim to detect and to prevent communication between the intra- and extra-luminal content. Other strategies including postoperative drainage, antibiotics, and infectious-parameter evaluation are intended to detect and prevent anastomotic or peritoneal infection. Most currently available interventions for CAL focus on the control of communication and infection, while strategies targeting the healing disturbances such as lifestyle changes, oxygen therapy and evaluation of metabolic biomarkers still lack wide clinical application. This simplified categorization may contribute to an integrated understanding of CAL. We strongly believe that this integrated approach should be taken into consideration during clinical practice. An integrated approach to CAL could contribute to a better understanding of the etiology of CAL and eventually better patient outcome.

关键词： Colorectal anastomotic leakage Integrated approach Prevention Prediction Intervention

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为局部地先进的胃的癌症的 Neoadjuvant 化疗: 与或没有放射

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World Journal of Gastrointestinal Surgery 2012年第2期4卷 27-31页

作者： Ai-Wen Wu jia-fu ji Ai-Wen Wu Jia-Fu Ji Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Department of Gastrointestinal Surgery Peking University Cancer Hospital Beijing Cancer Hospital and Institute Beijing 100142 China.

The role of perioperative chemotherapy for gastric cancer has been established for gastric cancers in their advanced stage.In most parts of the world,even in Japan and Korea,local recurrence of gastric cancer following curative resection remains a problem.Should radiation be added to chemotherapy to achieve better local and regional control? What is the current evidence? What are the concerns regarding neoadjuvant chemoradiation in terms of safety,efficacy and survival benefit? After a serious review of the literature,the authors conclude that it is still too early to get a definitive answer but radiation seems promising.It may bring a higher pathological response rate.Rationally,more high level clinical trials are needed to confirm the role of radiotherapy in the neoadjuvant setting or to ascertain subsets of patients who may benefit from it.It is of note that surgeons should pay attention to possible complicated circumstances following radiotherapy,maintain proper nutrition status and minimize the occurrence of postoperative complications.As few data are available in Japan and Korea,interpretation and implementation of neoadjuvant radiation or chemoradiation should be done with caution.

关键词： Stomach Neoplasm Treatment Radiation Neoadjuvant

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Prognosis of patients with gastric cancer and solitary lymph node metastasis

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World Journal of Gastroenterology 2013年第46期19卷 8611-8618页

作者： Chun-Qiu Chen Xiao-jiang Wu Zhen Yu Zhao-De Bu Ke-Qiang Zuo Zi-Yu Li jia-fu ji Department of General Surgery Tenth People’s Hospital of Shanghai Tongji University School of Medicine Department of Surgery Beijing Cancer Hospital Peking University School of Oncology

AIM:To investigate the relationship of solitary lymph node metastasis(SLNM)and age with patient survival in gastric cancer(GC).METHODS:The medical records databases of China’s Beijing Cancer Hospital at the Peking University School of Oncology and Shanghai Tenth People’s Hospital affiliated to Tongji University were searched retrospectively to identify patients with histologically proven GC and SLNM who underwent surgical resection between October 2003 and December 2012.Patients with distant metastasis or gastric stump carcinoma following resection for benign disease were excluded from the analysis.In total,936 patients with GC+SLNM were selected for analysis and the recorded parameters of clinicopathological disease and follow-up(range:13-2925 d)were collected.The Kaplan-Meier method was used to stratify patients by age(≤50 years-old,n=198;50-64 years-old,n=321;≥65 years-old,n=446)and by metastatic lymph node ratio[MLR<0.04(1/25),n=180;0.04-0.06(1/25-1/15),n=687;≥0.06(1/15),n=98]for 5-year survival analysis.The significance of intergroup differences between the survival curves was assessed by a log-rank test. RESULTS:The 5-year survival rate of the entire GC+SLNM patient population was 49.9%.Stratification analysis showed significant differences in survival time(post-operative days)according to age:≤50 yearsold:950.7±79.0 vs 50-64 years-old:1697.8±65.9 vs≥65 years-old:1996.2±57.6,all P<0.05.In addition,younger age(≤50 years-old)correlated significantly with mean survival time(r=0.367,P<0.001).Stratification analysis also indicated an inverse relationship between increasing MLR and shorter survival time:<0.04:52.8%and 0.04-0.06:51.1%vs≥0.06:40.5%,P<0.05.The patients with the shortest survival times and rates were younger and had a high MLR(≥0.06):≤50 years-old:496.4±133.0 and 0.0%vs 50-65 years-old:1180.9±201.8 and 21.4%vs≥65 years-old:1538.4±72.4 and 37.3%,all P<0.05.The same significant trend in shorter survival times and rates for younger patients was seen with the mid-range MLR group(0.04-0.06),but the differ

关键词： Gastric cancer Solitary lymph node metas-tasis Age Metastatic lymph node ratio Survival

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Oncogenic potential of IDH1R132C mutant incholangiocarcinoma development in mice

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World Journal of Gastroenterology 2016年第6期22卷 2071-2080页

作者： Ning Ding Li Che Xiao-Lei Li Yan Liu Li-jie jiang Biao Fan Jun-Yan Tao Xin Chen jia-fu ji Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Department of Gastrointestinal SurgeryPeking University Cancer Hospital and InstituteBeijing 100142China Department of Bioengineering and Therapeutic Sciences Liver CenterUniversity of CaliforniaSan FranciscoCA 94143United States Department of Hepatobiliary Surgery Xijing HospitalThe Fourth Military Medical UniversityXi’an 710032Shanxi ProvinceChina School of Pharmacy Hubei University of Chinese MedicineWuhan 430065Hubei ProvinceChina

AIM: To investigate whether IDH1R132 C mutant in combination with loss of p53 and activated Notch signaling promotes intrahepatic cholangiocarcinoma(ICC) development.METHODS: We applied hydrodynamic injection and sleeping beauty mediated somatic integration to induce loss of p53(via sh P53), activation of Notch [via intracellular domain of Notch1(NICD)] and/or overexpression of IDH1R132 C mutant together with the sleeping beauty transposase into the mouse liver. Specifically, we co-expressed sh P53 and NICD(sh P53/NICD, n = 4), sh P53 and IDH1R132C(sh P53/IDH1R132 C, n = 3), NICD and IDH1R132C(NICD/IDH1R132 C, n = 4), as well as NICD, sh P53 and IDH1R132C(NICD/sh P53/IDH1R132 C, n = 9) in mice. Mice were monitored for liver tumor development and euthanized at various time points. Liver histology was analyzed by hematoxylin and eosin staining. Molecular features of NICD/sh P53/IDH1R132 C ICC tumor cells were characterized by Myc tag, Flag tag, Ki-67, p-Erk and p-AKT immunohistochemical staining. Desmoplastic reaction in tumor tissues was studied by Picro-Sirius red staining.RESULTS: We found that co-expression of sh P53/NICD, sh P53/IDH1R132 C or NICD/IDH1R132 C did not lead to liver tumor formation. In striking contrast, coexpression of NICD/sh P53/IDH1R132 C resulted in ICC development in mice(P < 0.01). The tumors could be identified as early as 12 wk post hydrodynamic injection. Tumors rapidly progressed, and by 18 wk post hydrodynamic injection, multiple cystic lesions could be identified on the liver surface. NICD/sh P53/IDH1R132 C liver tumors shared multiple histological features of human ICCs, including hyperplasia of irregular glands. Importantly, all tumor cells were positive for the biliary epithelial cell marker cytokeratin 19. Extensive collagen fibers could be visualized in tumor tissues using Sirus red staining, duplicating the desmoplastic reaction observed in human ICC. Tumors were highly proliferative and expressed ectopically injected genes. Together these studies supported that NICD/sh P53/IDH

关键词： IDH1 mutant Notch pathway Intrahepaticcholangiocarcinoma Mouse liver cancer p53

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疫情期间胃肠外科的应对策略与诊疗推荐:中国外科医师的经验分享

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Gastroenterology Report 2020年第3期8卷 167-174,I0001页

作者： jia Ke Nan Lan Ting Wang jin-jie Wu Zhen He Xiao-Sheng He Kai-Xiong Tao Qun Qian Ping-Hong Zhou Guo-Xin Li Min-Hua Zheng Zhong-Tao Zhang jia-fu ji Ping Lan Department of Colorectal Surgery The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhouGuangdongP.R.China Department of Gastrointestinal Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP.R.China Department of General Surgery Zhongnan Hospital of Wuhan UniversityWuhanHubeiP.R.China Endoscopy Center Zhongshan HospitalFudan UniveristyShanghaiP.R.China Department of General Surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongP.R.China Department of Gastrointestinal Surgery Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiP.R.China Department of General Surgery Beijing Friendship HospitalCapital Medical UniversityNational Clinical Research Center for Digestive DiseasesBeijingP.R.China Department of Gastrointestinal Cancer Center Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital&InstituteBeijingP.R.China

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的COVID-19正在全球暴发。尽管SARS-CoV-2被认为主要是通过呼吸道飞沫传播,但最新研究发现其也可以通过粪/口途径传播,这也引起了大家对胃肠道病毒传播的担忧。因此,作为抗疫一线的中国... 详细信息

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的COVID-19正在全球暴发。尽管SARS-CoV-2被认为主要是通过呼吸道飞沫传播,但最新研究发现其也可以通过粪/口途径传播,这也引起了大家对胃肠道病毒传播的担忧。因此,作为抗疫一线的中国胃肠外科医师,我们愿意分享一些抗疫期间的经验和教训。在疫情期间建立一个科学、合理的应对策略是非常必要的。本文中,我们就如何在继续提供胃肠外科医疗服务的同时尽可能从各个方面减少病毒传播,取得了中国多家机构的共识,包括胃肠外科门诊防护、胃肠外科病房防护、胃肠内镜中心防护以及围手术期管理模式的优化。我们的经验分享和诊治推荐或有助于全球仍处于疫区的胃肠外科建立自己的病毒防控策略。

关键词： gastroenterological surgery novel coronavirus disease-2019 perioperative care severe acute respiratory syndrome coronavirus 2

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The Chinese Society of Clinical Oncology(CSCO):clinical guidelines for the diagnosis and treatment of gastric cancer

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Cancer Communications 2019年第1期39卷 75-105页

作者： Feng-Hua Wang Lin Shen jin Li Zhi-Wei Zhou Han Liang Xiao-Tian Zhang Lei Tang Yan Xin jing jin Yu-jing Zhang Xiang-Lin Yuan Tian-Shu Liu Guo-Xin Li Qi Wu Hui-Mian Xu jia-fu ji Yuan-Fang Li Xin Wang Shan Yu Hao Liu Wen-Long Guan Rui-Hua Xu Department of Medical Oncology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060GuangdongP.R.China Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Department of Gastrointestinal OncologyPeking University Cancer Hospital and InstituteBeijing 100142P.R.China Department of Oncology Shanghai East HospitalTongji University School of MedicineShanghai 200120P.R.China Department of Gastric Surgery Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060GuangdongP.R.China Department of Gastric Cancer Tianjin Medical University Cancer Institute&HospitalNational Clinical Research Center of CancerTianjin’s Clinical Research Cancer for CancerKey Laboratory of Cancer Prevention and TherapyTianjin 300060P.R.China Medical Imaging Department Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Department of Gastrointestinal OncologyPeking University Cancer Hospital and InstituteBeijing 100142P.R.China Pathology Laboratory of Gastrointestinal Tumor The First Hospital of China Medical UniversityShenyang 110001LiaoningP.R.China Department of Radiation Oncology National Cancer CenterChina and Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021P.R.China Department of Radiotherapy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060GuangdongP.R.China Department of Medical Oncology Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430030HubeiP.R.China Department of Medical Oncology Zhongshan Hospital Affiliated to Fudan UniversityShanghai 200032P.R.China Department of General Surgery Nanfang Hospital Affi

China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.

关键词： Chinese Society of Clinical Oncology(CSCO) Gastric cancer Diagnosis Surgery Neoadjuvant Adjuvant Radiotherapy Chemotherapy Targeted therapy Immunotherapy

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The emerging tumor microbe microenvironment: From delineation to multidisciplinary approach-based interventions

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Acta Pharmaceutica Sinica B 2024年第4期14卷 1560-1591页

作者： Yu fu jia Li Wenyun Cai Yulan Huang Xinlong Liu Zhongyi Ma Zhongjie Tang Xufei Bian ji Zheng jiayun jiang Chong Li Medical Research Institute College of Pharmaceutical SciencesSouthwest UniversityChongqing 400715China Institute of Hepatobiliary Surgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Department of Urology Urologic Surgery CenterXinqiao HospitalThird Military Medical University(Army Medical University)Chongqing 400037China

Intratumoral microbiota has become research hotspots,and emerges as a non-negligent new component of tumor microenvironments(TME),due to its powerful infuence on tumor initiation,metas-tasis,immunosurveillance and prognosis despite in low-biomass.The accumulations of microbes,and their related components and metabolites within tumor tissues,endow TME with additional pluralistic features which are distinct from the conventional one.Therefore,it's definitely necessary to comprehen-sively delineate the sophisticated landscapes of tumor microbe microenvironment,as well as their func-tions and related underlying mechanisms.Herein,in this review,we focused on the fields of tumor microbe microenvironment,including the heterogeneity of intratumor microbiota in different types of tu-mors,the controversial roles of intratumoral microbiota,the basic features of tumor microbe microenvi-ronment(i.e.,pathogen-associated molecular patterns(PAMPs),typical microbial metabolites,autophagy,infammation,multi-faceted immunomodulation and chemoresistance),as well as the multi-disciplinary approach-based intervention of tumor microbiome for cancer therapy by applying wild-type or engineered live microbes,microbiota metabolites,antibiotics,synthetic biology and rationally de-signed biomaterials.We hope our work will provide valuable insight to deeply understand the interplay of cancer-immune-microbial,and facilitate the development of microbes-based tumor-specific treatments.

关键词： Tumor microbe microenvironment Microbiota metabolites Immunomodulation Chemoresistance Multidisciplinary approach Genetically engineered microbiota Autophagy Outer membrane vesicles

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