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Personalized treatment of well-differentiated gastric neuroendocrine tumors based on clinicopathological classification and grading:A multicenter retrospective study

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Chinese Medical Journal 2024年第6期137卷 720-728页

作者： Ju Huang Huimin liu Dekun Yang Tianming Xu Jing Wang jingnan li Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China Key Laboratory of Gut Microbiota Translational Medicine Research Chinese Academy of Medical SciencesBeijing 100730China Department of Gastroenterology Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical CollegeYantaiShandong 264000China Department of Gastroenterology Beijing Zhong-Neng-Jian HospitalBeijing 102401China

Background:The incidence of well-differentiated gastric neuroendocrine tumors(G-NET)is increasing annually,and while they have a good prognosis and low mortality rate,their high recurrence rate makes treatment options controversial.This study aims to determine the relationship between individualized treatment plans and the recurrence of G-NET.Methods:We performed a multicenter,retrospective study of 94 patients with highly differentiated G-NET and treated at Peking Union Medical College Hospital,Yantai Yuhuangding Hospital,and Beijing Zhong-Neng-Jian Hospital from November 2015 to September 2023.Risk factors for recurrence of G-NETs were investigated using chi-squared test and multifactorial logistic regression analysis.Results:After a median follow-up of 49 months,the overall recurrence rate among the 94 G-NET patients was 14%(13/94).The recurrence rates of endoscopic mucosal resection(EMR),endoscopic submucosal dissection(ESD),somatostatin analog(SSA)therapy,and surgery were 43%(6/14),10%(5/49),5%(1/22),and 11%(1/9),respectively.Post-treatment recurrence rates were significantly different(P=0.014)among four treatments(EMR,ESD,SSA,and surgery),and further subgroup comparisons revealed lower recurrence rates in the ESD and SSA groups than in the EMR group.From the second month onward,SSA therapy considerably reduced the gastrin levels from 1081.0(571.5,2472.8)pg/mL to 461.5(255.3,795.0)pg/mL(Z=-3.521,Plinicopathological parameters studied,only the pre-treatment gastrin level(P=0.018 and 0.005)and the type of treatment(P=0.014 and 0.017)were significantly associated with G-NET recurrence.Conclusions:Individualized treatment strategies may reduce the risk of relapse after G-NET treatment.Long-term SSA therapy may be a secure and efficacious treatment option for type 1 G-NET with more than six lesions,and it substantially decreases the incidence of post-treatment recurrence.

关键词： Well-differentiated G-NET Serum gastrin Personalized treatment Endoscopic submucosal dissection Endoscopic mucosal resection Somatostatin analog therapy Surgical resection Recurrence

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Home cryopreservation of fecal samples:an effective strategy for longitudinal studies using multi-omics approaches

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Chinese Medical Journal 2022年第9期135卷 1102-1104页

作者： Pengguang Yan Mingjie Luo Fei liu jingnan li Department of Gastroenterology Peking Union Medical College HospitalBeijing 100730China School of Medicine Tsinghua UniversityBeijing 100089China Institute of Microbiology Chinese Academy of SciencesBeijing 100101China

To the Editor:Accumulating evidence has shown that gut microbiota–host interactions play vital roles in human health and disease.However,the dynamic equilibria between microbes and their hosts limit the utility of single strains or microbial signatures as markers for disease risk prediction and outcome assessment.[1]Analysis of changes in the gut microenvironment using multi-omics approaches has now become routine.[2]In inflammatory bowel disease,and especially during the acute phase,a significant shift in the gut microenvironment occurs within 2 weeks.Therefore,effective strategies to obtain fecal samples every 2 to 3 days are needed.However,challenges in specimen storage,transport,and handling limit long-term sampling ability.The microbial composition of fecal samples stored at room temperature for>24 h is significantly altered.Storage of fecal specimens at−80°C immediately after evacuation is standard procedure but is impractical in real-life situations.An alternative is a storage at−20°C for up to 1 month followed by sample transport and laboratory analysis.The objective of this study was to evaluate whether the gut microenvironment in fecal specimens collected every 2 to 3 days and stored at home at−20°C for up to 1 month could be preserved.

关键词： routine limit signature

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Clinicopathological features,endoscopic features,and treatment analysis of gastric neuroendocrine neoplasms

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Chinese Medical Journal 2022年第20期135卷 2497-2499页

作者： Ju Huang Xi Wu Tianming Xu jingnan li Peking Union Medical College Chinese Academy of Medical ScienceBeijing 100730China Department of Gastroenterology Peking Union Medical College HospitalBeijing 100730China

To the Editor:Gastric neuroendocrine neoplasms(gNENs)are highly heterogeneous tumors derived from different neuroendocrine cells in the stomach.Recent epidemiological evidence has indicated that gNENs account for 0.3%to 1.8%of all gastric malignancies.[1]However,few research data are available on gNENs in Chinese patients,but Chinese doctors need to improve their knowledge about this disease.

关键词： neoplasms neuroendocrine stomach

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Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

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Chinese Medical Journal 2023年第8期136卷 899-909页

作者： Kaiwen li Gechong Ruan Shuang liu Tianming Xu Kai Guan Ji li jingnan li Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100005China Key Laboratory of Gut Microbiota Translational Medicine Research Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100005China Department of Allergy Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100005China

Eosinophilic gastroenteritis(EGE)is a gastrointestinal disorder of unclear etiology that is characterized by eosinophilic infiltration of the stomach and small intestine,and consists of mucosal,muscular,and serosal subtypes.Eosinophilic infiltration of the gastrointestinal tract is a fundamental histopathological characteristic of EGE and is driven by several T-helper type 2(Th2)-dependent cytokines and induced by food allergy.Due to the lack of a diagnostic gold standard,EGE has a high rate of delayed diagnosis or misdiagnosis.However,several new diagnostic strategies have been developed,such as novel genetic biomarkers and imaging tests.Although dietary therapy and corticosteroids remain the common choices for EGE treatment,recent decades have seen the emergence of novel treatment alternatives,such as biologics that target particular molecules involved in the pathogenic process.Preliminary investigations and clinical trials have demonstrated the efficacy of biologics and provided additional insights for the era of refractory or corticosteroid-dependent EGE biologics.

关键词： Eosinophilic gastroenteritis Pathogenesis Diagnosis Treatment

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Single-atom skeletal editing of 2H-indazoles enabled by difluorocarbene

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Science China Chemistry 2023年第7期66卷 1975-1981页

作者： Yao Zhou Fuling Chen Ziru li Junjie Dong jingnan li Bohao Zhang Qiuling Song Hubei Key Laboratory of Pollutant Analysis&Reuse Technology College of Chemistry and Chemical EngineeringHubei Normal UniversityHuangshi 435002China Key Laboratory of Molecule Synthesis and Function Discovery Fujian Province UniversityCollege of Chemistry at Fuzhou University Fuzhou 350108China

A novel difluorocarbene promoted single-atom skeletal editing of 2H-indazoles is demonstrated herein.Ethyl bromodifluoroacetate was severed as the difluorocarbene source in the current protocol,facilitating the cleavage of the N-N bond via carbon atom insertion.This metal-free ring expansion reaction enables the late-stage diversification of indazole skeletons,assembling a diverse array of functionalized quinazolin-4(3H)-ones in decent yields with excellent functional group compatibility.

关键词： indazoles skeletal editing difluorocarbene N-N bond cleavage quinazolin-4(3H)-ones

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Chemoprevention of colorectal cancer in general population and high-risk population: a systematic review and network meta-analysis

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Chinese Medical Journal 2023年第7期136卷 788-798页

作者： Ye Ma Wen You Yang Cao Xuxia He Jing Wang Yuelun Zhang Ji li jingnan li Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Key Laboratory of Gut Microbiome and Translational Medicine Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China

Background:Many nutritional supplements and pharmacological agents have been reported to show preventive effects on colorectal adenoma and colorectal cancer(CRC).We performed a network meta-analysis to summarize such evidence and assess the efficacy and safety of these agents.Methods:We searched PubMed,Embase,and the Cochrane library for studies published in English until October 31,2021 that fit our inclusion criteria.We performed a systematic review and network meta-analysis to assess the comparative efficacy and safety of candidate agents(low-dose aspirin[Asp],high-dose Asp,cyclooxygenase-2 inhibitors[coxibs],calcium,vitamin D,folic acid,ursodeoxycholic acid[UDCA],estrogen,and progesterone,alone or in combination)for preventing colorectal adenoma and CRC.Cochrane risk-of-bias assessment tool was employed to evaluate the quality of each included study.Results:Thirty-two randomized controlled trials(278,694 participants)comparing 13 different interventions were included.Coxibs significantly reduced the risk of colorectal adenoma(risk ratio[RR]:0.59,95%confidence interval[CI]:0.44–0.79,six trials involving 5486 participants),advanced adenoma(RR:0.63,95%CI:0.43–0.92,four trials involving 4723 participants),and metachronous adenoma(RR:0.58,95%CI:0.43–0.79,five trials involving 5258 participants)compared with placebo.Coxibs also significantly increased the risk of severe adverse events(RR:1.29,95%CI:1.13–1.47,six trials involving 7109 participants).Other interventions,including Asp,folic acid,UDCA,vitamin D,and calcium,did not reduce the risk of colorectal adenoma in the general and high-risk populations compared with placebo.Conclusions:Considering the balance between benefits and harms,regular use of coxibs for prevention of colorectal adenoma was not supported by the current evidence.Benefit of low-dose Asp for chemoprevention of colorectal adenoma still requires further evidence.

关键词： Chemoprevention Colorectal adenoma Colorectal cancer Cyclooxygenase-2 inhibitors Low-dose aspirin

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基于匹配追踪算法的地震数据提高分辨率方法

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石油物探 2024年第3期63卷 571-577页

作者：李京南中石化石油物探技术研究院有限公司江苏南京211103

提高地震数据的分辨率对于薄储层的识别与表征具有重要意义。常规的反褶积、反Q滤波等提高地震分辨率处理方法,存在假设条件多、信噪比较低、算法不稳定等不足,使得方法的应用效果和适用性受限。提出了一种新的基于匹配追踪算法的地震... 详细信息

提高地震数据的分辨率对于薄储层的识别与表征具有重要意义。常规的反褶积、反Q滤波等提高地震分辨率处理方法,存在假设条件多、信噪比较低、算法不稳定等不足,使得方法的应用效果和适用性受限。提出了一种新的基于匹配追踪算法的地震数据提高分辨率方法,可以在保持较高信噪比的同时提高地震数据分辨率。首先,根据地震信号特点,利用频率加权指数函数计算基准子波,并由此构建子波字典,频率加权指数函数可以很好地拟合不同形状的频谱,更好地适应不同的工区。然后,利用匹配追踪算法将原始地震数据分解为一系列子波的线性叠加,增加较高信噪比的高频匹配子波的振幅。最后对地震数据进行重构,获得高分辨率的地震数据。应用结果表明,该方法可有效提高地震分辨率,具有较高的信噪比,并且提高分辨率处理的结果与测井合成地震记录有很好的吻合性,证明方法是可靠的,且处理结果有利于后续薄储层识别与描述。

关键词：匹配追踪高分辨率地震数据分解子波字典薄层识别

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Discriminating endoscopic features of sessile serrated lesions

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Chinese Medical Journal 2023年第10期136卷 1237-1239页

作者： Wen Shi Yuelun Zhang Hanyue Ding Feng Xie Yang Chen Martin CSWong jingnan li Dong Wu Department of Gastroenterology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Medical Research Center Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College HospitalBeijing 100730China Department of Epidemiology and Biostatistics School of Population Medicine and Public HealthPeking Union Medical CollegeChinese Academy and Medical SciencesBeijing 100730China Department of Family Medicine and Primary Care JC School of Public Health and Primary CareFaculty of MedicineChinese University of Hong KongHong Kong 999077China Department of Health Research Methods Evidence and ImpactMcMaster UniversityHamiltonOntario L8S4L8Canada Centre for Health Economics and Policy Analysis McMaster UniversityHamiltonOntario L8S4L8Canada Clinical Epidemiology Unit International Clinical Epidemiology NetworkBeijing 100730China

To the Editor:Colorectal cancer(CRC)remains a leading cause of cancer-related death worldwide.[1]In addition to the classical adenoma-to-carcinoma model of colorectal carcinogenesis,the serrated neoplastic pathway accounts for 20%–30%of CRCs.Sessile serrated lesions(SSLs),the most common premalignant serrated polyp subtype,share many of the genomic characteristics of post-colonoscopy CRCs and are thus recognized as their precursor lesions.However,SSLs can be easily missed due to their flat shape and subtle endoscopic features.Sometimes they can also be difficult to distinguish from other types of polyps,especially hyperplastic polyps(HPs),which are believed to have no malignant potential.[2]Approximately 10%of polyps initially diagnosed as HPs endoscopically are reclassified as SSLs after histopathological examination,reflecting diagnostic difficulties in colonoscopy.[3,4]Current guidelines recommend“diagnose-and-leave”and“resect-and-discard”strategies for diminutive polyps,which might lead to SSLs being left in situ or diagnoses being missed,[5]raising the risk of recurrence and post-colonoscopy cancers.Furthermore,it remains debatable in the gastrointestinal community whether the risks of resecting SSLs outweigh the reduction in cancer risk.Any strategy that improves the diagnostic accuracy of SSLs could have a meaningful clinical impact.

关键词： lesions endoscopic meaningful

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胃肠胰神经内分泌肿瘤领域近十年的研究进展和热点问题

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中华内科杂志 2024年第7期63卷 641-644页

作者：徐天铭李景南中国医学科学院北京协和医学院北京协和医院消化内科北京

胃肠胰神经内分泌肿瘤(GEP-NENs)是一类具有神经内分泌系统标志物, 并且能够合成生物活性胺和/或多肽类激素的异质性较高的肿瘤。近十年来, GEP-NENs临床诊治取得了明显进展, 不论是流行病学、诊断方法、治疗手段均取得长足进步。目前,... 详细信息

胃肠胰神经内分泌肿瘤(GEP-NENs)是一类具有神经内分泌系统标志物, 并且能够合成生物活性胺和/或多肽类激素的异质性较高的肿瘤。近十年来, GEP-NENs临床诊治取得了明显进展, 不论是流行病学、诊断方法、治疗手段均取得长足进步。目前, 围绕GEP-NENs仍有不少问题需要未来进一步研究解决。

关键词：神经内分泌瘤胃肠肿瘤胰腺肿瘤消化系统疾病

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Probiotic mixture VSL#3 prevents ulcerative colitis-associated carcinogenesis in mice and cells by regulating the inflammatory and Wnt/β-catenin pathway

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Chinese Medical Journal 2022年第19期135卷 2357-2359页

作者： Wenbin li Yanan Wang Chunsaier Wang Hongying Wang Yiming Ma Hong Yang Xinhua Zhao Xiaomin Hu John Y.Kao Jiaming Qian Chung Owyang jingnan li Department of Gastroenterology Key Laboratory of Gut Microbiota Translational Medicine ResearchPeking Union Medical Cllege HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBejing 100730China Department of Gastroenterology Bejing HospitalNational Center of GerontologyInstitute of Geriatic MedicineChinese Academy of Medical ScienceBejing 100730China National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBejing 100021China Department of Central Laboratory Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CllegeBejing 100730China Department of Internal Medicine Division of GastroenterologyUniversity of Michigan Health SystemAnn ArborMIUSA.

To the Editor:Increasing attention is being paid to preventing ulcerative colitis(UC)-associated carcinogenesis.The intestinal microbiota plays an important role in maintaining the intestinal barrier and immune function.Probiotic mixture VSL#3,that was bought from Sigma-Tau pharmaceuticals(De Simone Formulation)in May 2015,is a mixture of Lactobacillus casei,L.plantarum,L.acidophilus,L.delbrueckii subsp.bulgaricus,Bifidobacterium longum,B.breve,B.infantis and Streptococcus salivarius andcontains 4.5 billion live bacterialcolonies.i Previous studies have shown that VSL#3 can help induce and maintain UC remission.The effects of probiotics on UC-associated carcinogenesis are difficult to observe clinically;therefore,mouse models are often used to study this disease.Previous studies have shown that azoxymethane(AOM)combined with dextran sulfate sodium(DSS)can quickly induce a UC-associated carcinogenesis model.

关键词： carcinogenesis function. mixture

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