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Robotic versus laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: A propensity score-matched analysis

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 154-159页

作者： Dakyum Shin Jaewoo Kwon Jae Hoon Lee Seo Young Park Yejong Park Woohyung Lee ki byung song Dae Wook Hwang song Cheol kim Division of Hepato-Biliary and Pancreatic Surgery Department of SurgeryAsan Medical CenterUniversity of Ulsan College of Medicine88 Olympic-ro 43-gilSongpa-guSeoul 05505Korea Department of Surgery Kangbuk Samsung HospitalSungkyunkwan University School of Medicine29 Saemunan-roJongno-guSeoul 03181Korea Department of Statistics and Data Science Korea National Open University86 Daehak-roJongno-guSeoul 03087Korea

Background: Minimally invasive surgery is becoming increasingly popular in the field of pancreatic surgery. However, there are few studies of robotic distal pancreatectomy(RDP) for pancreatic ductal adenocarcinoma(PDAC). This study aimed to investigate the efficacy and feasibility of RDP for PDAC. Methods: Patients who underwent RDP or laparoscopic distal pancreatectomy(LDP) for PDAC between January 2015 and September 2020 were reviewed. Propensity score matching analyses were performed. Results: Of the 335 patients included in the study, 24 underwent RDP and 311 underwent LDP. A total of 21 RDP patients were matched 1:1 with LDP patients. RDP was associated with longer operative time(209.7 vs. 163.2 min;P = 0.003), lower open conversion rate(0% vs. 4.8%;P < 0.001), higher cost(15 722 vs. 12 699 dollars;P = 0.003), and a higher rate of achievement of an R0 resection margin(90.5% vs. 61.9%;P = 0.042). However, postoperative pancreatic fistula grade B or C showed no significant intergroup difference(9.5% vs. 9.5%). The median disease-free survival(34.5 vs. 17.3 months;P = 0.588) and overall survival(37.7 vs. 21.9 months;P = 0.171) were comparable between the groups. Conclusions: RDP is associated with longer operative time, a higher cost of surgery, and a higher likelihood of achieving R0 margins than LDP.

关键词： Minimally invasive surgery Robotic distal pancreatectomy Laparoscopic distal pancreatectomy Pancreatic ductal adenocarcinoma Propensity score matching

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Metastatic stomach lymphoepithelioma-like carcinoma and immune checkpoint inhibitor therapy:A case report

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1436-1442页

作者： Guo-Feng Chen Jun Wang Yu Yan song Xu Jian Chen Department of Gastroenterology Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina Cancer Center Zhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of Pathology The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina Department of Gastroenterology The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina

BACKGROUND Pulmonary lymphoepithelioma-like carcinoma(PLELC)is a rare type of nonsmall-cell lung cancer.Stomach lymphoepithelioma-like carcinoma(LELC)metastasis secondary to PLELC has not been reported recently.CASE SUMMARY A 64-year-old female was admitted to our hospital for a regular gastroscopy examination with a 6-year history of surgical resection for left PLELC.Positron emission tomography/computed tomography suggested high accumulation of 18F-fludeoxyglucose in the gastric cardia region.Upper gastrointestinal endoscopy confirmed a large mass at the stomach fundus.Immunohistochemistry(IHC)of the biopsy suggested metastatic stomach LELC.Proximal gastrectomy showed that this 6.5 cm×5.0 cm mass was located in the stomach fundus near the cardia.Histopathological examination showed a poorly differentiated carcinoma with prominent lymphoplasmacytic infiltration.IHC demonstrated that the tumor was positive for CK(AE1/AE3),p63,p40,p53,ki-67(70%),and EGFR(3+)and negative for CK7,CK20,Her2,and CD10.In situ hybridization analysis showed positive staining Epstein-Barr virus-encoded RNA.Tumor programmed cell death ligand 1(PD-L1)expression score was 98%,and the combined positive score was 100,with no evidence of microsatellite instability.Thus,the patient was unequivocally diagnosed with metastatic stomach LELC secondary to pulmonary LELC.After discharge,this patient underwent PD-1 inhibitor treatment(toripalimab,240 mg)every 3 wk for ten cycles,and she has had no tumor recurrence.CONCLUSION For gastric LELC metastasis,PD-1 inhibitor therapy could become a new therapeutic approach,though there is still no evidence from large data sets to support this.

关键词： Stomach neoplasm Pulmonary lymphoepithelioma-like carcinoma Metastasis Immune checkpoint inhibitor Case report

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Marker ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts

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World Journal of Clinical Cases 2024年第1期12卷 32-41页

作者： Zhen song Qi Zhou Jiang-Lei Zhang Jun Ouyang Zhi-Yu Zhang Department of Urology Taixing People’s HospitalTaizhou 225400Jiangsu ProvinceChina Department of Urology The First Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina Department of Reproductive Medicine Center The First Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND Prostate cancer(PCa)is a widespread malignancy,predominantly affecting elderly males,and current methods for diagnosis and treatment of this disease continue to fall short.The marker ki-67(Mki67)has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells,including those of PCa.Hence,verifying the association between Mki67 and the diagnosis and prognosis of PCa,using bioinformatics databases and clinical data analysis,carries significant clinical implications.AIM To explore the diagnostic and prognostic efficacy of antigens identified by Mki67 expression in PCa.METHODS For cohort 1,the efficacy of Mki67 diagnosis was evaluated using data from The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases.For cohort 2,the diagnostic and prognostic power of Mki67 expression was further validated using data from 271 patients with clinical PCa.RESULTS In cohort 1,Mki67 expression was correlated with prostate-specific antigen(PSA),Gleason Score,T stage,and N stage.The receiver operating characteristic(ROC)curve showed a strong diagnostic ability,and the Kaplan-Meier method demonstrated that Mki67 expression was negatively associated with the progression-free interval(PFI).The time-ROC curve displayed a weak prognostic capability for Mki67 expression in PCa.In cohort 2,Mki67 expression was significantly related to the Gleason Score,T stage,and N stage;however,it was negatively associated with the PFI.The time-ROC curve revealed the stronger prognostic capability of Mki67 in patients with PCa.Multivariate COX regression analysis was performed to select risk factors,including PSA level,N stage,and Mki67 expression.A nomogram was established to predict the 3-year PFI.CONCLUSION Mki67 expression was positively associated with the Gleason Score,T stage,and N stage and showed a strong diagnostic and prognostic ability in PCa.

关键词： Marker ki-67 Prostate cancer Biomarker Diagnosis Prognosis

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Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1423-1435页

作者： Sarang Hong ki byung song Dae Wook Hwang Jae Hoon Lee Woohyung Lee Eunsung Jun Jaewoo Kwon Yejong Park Seo Young Park Naru kim Dakyum Shin Hyeyeon kim Minkyu Sung Yunbeom Ryu song Cheol kim Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryAsan Medical CenterSeoul 05505South Korea Department of Surgery Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 03181South Korea Department of Statistics and Data Science Korea National Open UniversitySeoul 03087South Korea Department of Surgery Uijeongbu St.Mary's HospitalCollege of MedicineGyeonggido 11765South Korea

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience recurrence.Thus,it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIM To evaluate the predictive factors associated with the early recurrence of earlystage PDAC.METHODS This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016.Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery.The optimal cutoff values were determined by receiver operating characteristic(ROC)analyses.Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTS Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant sites.In total,253(62.2%)patients received adjuvant chemotherapy.On ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,respectively.Of the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage PDAC.CONCLUSION Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage PDAC.As adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.

关键词： Pancreatic ductal adenocarcinoma Early recurrence Upfront surgery Carbohydrate antigen 19-9 Adjuvant chemotherapy

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Prognostic significance of grade of malignancy based on histopathological differentiation and ki-67 in pancreatic ductal adenocarcinoma

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Cancer Biology & Medicine 2024年第5期21卷 416-432页

作者： Yuexiang Liang Guannan Sheng Yu Guo Yiping Zou Hanhan Guo Zhifei Li Shaofei Chang Quan Man song Gao Jihui Hao Department of Pancreatic Cancer Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and TherapyTianjin Tianjin's Clinical Research Center for Cancer Department of Gastrointestinal Oncology The First Affiliated Hospital of Hainan Medical University Department of Gastrointestinal Pancreatic Surgery Shanxi Provincial People's Hospital

Objective: Tumor cell malignancy is indicated by histopathological differentiation and cell proliferation. ki-67, an indicator of cellular proliferation, has been used for tumor grading and classification in breast cancer and neuroendocrine tumors. However, its prognostic significance in pancreatic ductal adenocarcinoma(PDAC) remains uncertain.Methods: Patients who underwent radical pancreatectomy for PDAC were retrospectively enrolled, and relevant prognostic factors were examined. Grade of malignancy(GOM), a novel index based on histopathological differentiation and ki-67, is proposed, and its clinical significance was evaluated.Results: The optimal threshold for ki-67 was determined to be 30%. Patients with a ki-67 expression level > 30% rather than ≤ 30% had significantly shorter 5-year overall survival(OS) and recurrence-free survival(RFS). In multivariate analysis, both histopathological differentiation and ki-67 were identified as independent prognostic factors for OS and RFS. The GOM was used to independently stratify OS and RFS into 3 tiers, regardless of TNM stage and other established prognostic factors. The tumor-nodemetastasis-GOM stage was used to stratify survival into 5 distinct tiers, and surpassed the predictive performance of TNM stage for OS and RFS.Conclusions: ki-67 is a valuable prognostic indicator for PDAC. Inclusion of the GOM in the TNM staging system may potentially enhance prognostic accuracy for PDAC.

关键词： ki-67 Pancreatic ductal adenocarcinoma TNM stage differentiation prognosis

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Neuroendocrine carcinoma of the common hepatic duct coexisting with distal cholangiocarcinoma:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1449-1460页

作者： Fei Chen Wei-Wei Li Juan-Fen Mo Min-Jie Chen Su-Hang Wang Shu-Ying Yang Zheng-Wei song Department of Hepatobiliary Surgery The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Graduate School Bengbu Medical CollegeBengbu 233000Anhui ProvinceChina The Key Laboratory The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Department of Pathology The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Department of Intensive Medicine The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina

BACKGROUND Neuroendocrine carcinoma(NEC)of the extrahepatic bile duct is very rare,and the treatment and prognosis are unclear.Herein,we report the case of a middleaged female with primary large cell NEC(LCNEC)of the common hepatic duct combined with distal cholangiocarcinoma(dCCA).Additionally,after a review of the relevant literature,we summarize and compare mixed neuroendocrine-nonneuroendocrine neoplasm(MiNEN)and pure NEC to provide a reference for selecting the appropriate treatment and predicting the prognosis of this rare disease.CASE SUMMARY A 62-year-old female presented to the hospital due to recurrent abdominal pain for 2 months.Physical examination showed mild tenderness in the upper abdomen and a positive Courvoisier sign.Blood tests showed elevated liver transaminase and carbohydrate antigen 199 levels.Imaging examination revealed node dissection was performed,and hepatic duct tumours were unexpectedly found during surgery.Pathology suggested poorly differentiated LCNEC(approximately 0.5 cm×0.5 cm×0.4 cm),ki-67(50%),synaptophysin+,and chromogranin A+.dCCA pathology suggested moderately differentiated adenocarcinoma.The patient eventually developed lymph node metastasis in the liver,bone,peritoneum,and abdominal cavity and died 24 months after surgery.Gene sequencing methods were used to compare gene mutations in the two primary bile duct tumours.CONCLUSION The prognosis of MiNEN and pure NEC alone is different,and the selection of treatment options needs to be differentiated.

关键词： Neuroendocrine carcinoma Mixed neuroendocrine-non-neuroendocrine neoplasm Cholangiocarcinoma Extrahepatic bile duct Case report

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Repair of a large patellar cartilage defect using human umbilical cord blood-derived mesenchymal stem cells:A case report

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World Journal of Clinical Cases 2022年第34期10卷 12665-12670页

作者： Jun-Seob song ki-Taek Hong ki Jeon song Seok Jung kim Department of Orthopedic Surgery Gangnam JS HospitalSeoul 06053South Korea Department of Orthopedic Surgery Uijeongbu Street Mary’s HospitalCollege of MedicineThe Catholic University of KoreaUijeongbu 11765GyeonggidoSouth Korea

BACKGROUND Patellar dislocation may cause cartilage defects of various sizes.Large defects commonly require surgical treatment;however,conventional treatments are problematic.CASE SUMMARY A 15-year-old male with a large patellar cartilage defect due to patellar dislocation was treated via human umbilical cord blood-derived mesenchymal stem cell(hUCB-MSC)implantation.To our knowledge,this is the first report of this treatment for this purpose.The patient recovered well as indicated by good visual analog scale,International Knee Documentation Committee and McMaster Universities Osteoarthritis Index scores.Magnetic resonance imaging showed cartilage regeneration 18 mo postoperatively.CONCLUSION Umbilical cord blood-derived hUCB-MSCs may be a useful treatment option for the repair of large patellar cartilage defects.

关键词： Cartilage defect Umbilical cord Mesenchymal stem cells Patellar dislocation Magnetic resonance imaging Case report

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Emerging nanoformulation strategies for phytocompounds and applications from drug delivery to phototherapy to imaging

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Bioactive Materials 2022年第8期7卷 182-205页

作者： Hwa Seung Han song Yi Koo ki Young Choi Natural Product Informatics Research Center Korea Institute of Science and Technology(KIST)Gangneung25451Republic of Korea Division of Bio-Medical Science and Technology KIST SchoolUniversity of Science and Technology(UST)Seoul02792Republic of Korea

Over thousands of years,natural bioactive compounds derived from plants(bioactive phytocompounds,BPCs)have been used worldwide to address human health issues.Today,they are a significant resource for drug discovery in the development of modern medicines.Although many BPCs have promising biological activities,most of them cannot be effectively utilized in drugs for therapeutic applications because of their inherent limitations of low solubility,structural instability,short half-life,poor bioavailability,and non-specific distribution to organs.Researchers have utilized emerging nanoformulation(NF)technologies to overcome these limitations as they have demonstrated great potential to improve the solubility,stability,and pharmacokinetic and pharmacodynamic characteristics of BPCs.This review exemplifies NF strategies for resolving the issues associated with BPCs and summarizes recent advances in their preclinical and clinical applications for imaging and therapy.This review also highlights how innovative NF technologies play a leading role in next-generation BPC-based drug development for extended therapeutic applications.Finally,this review discusses the opportunities to take BPCs with meaningful clinical impact from bench to bedside and extend the patent life of BPC-based medicines with new formulations or application to new adjacent diseases beyond the primary drug indications.

关键词： Natural products Phytocompound Nanoformulation Drug delivery Phototherapy

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Heat Storage/Heat Release of Phase-Change Filling Body with Casing Heat Exchanger for Extracting Geothermal Energy

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Journal of Thermal Science 2023年第3期32卷 1171-1189页

作者： ZHANG Xiaoyan XU Muyan LIU Lang YANG Qixing ki-IL song Energy School Xi'an University of Science and TechnologyXi'an 710054China Key Laboratory of Western Mines and Hazards Prevention Ministry of Education of ChinaXi'an 710054China Department of Civil Engineering Inha UniversityIncheon 402-751South Korea

Arranging heat exchanger in filling body to extract geothermal energy is an effective way to alleviate the problems of high ground pressure and high ground temperature in deep resource exploitation.Filling body with casing heat exchanger was acted as research object,encapsulating phase change materials(PCMs)in annular space.During heat storage and heat release process,the effects of different PCMs on temperature distribution,phase-change process and heat transfer performance were studied.The result indicates:During heat storage process,the temperature increases rapidly and the melting process is accelerated for the position closer surrounding rock.CaCl_(2)·6H_(2)O/EG can make filling body complete heat storage process in the shortest time because of its good thermal diffusivity.The heat storage capacity of PCMs backfill is significantly higher than that of ordinary backfill;it increases by 36.6%-67.3%at heat storage of 10 h.During heat release process,the closer to the heat exchange tube,the greater the temperature drop in filling body.The maximum value of heat release rate and heat release capacity is in CaCl_(2)·6H_(2)O/EG backfill,it can release 116.4%more heat than RT35backfill after heat release of 12 h,the maximum value of effectiveness and its heat transfer rate also is in CaCl_(2)·6H_(2)O/EG backfill.This paper provides the basic data for the selection of PCMs in phase-change thermal storage filling body.

关键词： flling body heat exchanger phase change material heat storage/heat release

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Injectable polymeric nanoparticle hydrogel system for long-term anti-inflammatory effect to treat osteoarthritis

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Bioactive Materials 2022年第1期7卷 14-25页

作者： Bo-Bae Seo Youngjoong Kwon Jun kim ki Hyun Hong Sung-Eun kim Hae-Ryong song Young-Min kim Soo-Chang song Center for Biomaterials Korea Institute of Science&TechnologySeoul02792South Korea Division of Bio-Medical Science and Technology KIST SchoolKorea University of Science and TechnologySeoul02792South Korea Department of Orthopedic Surgery and Rare Diseases Institute Korea University Medical College Guro HospitalSeoul08308South Korea

Treatment of osteoarthritis(OA)by administration of corticosteroids is a commonly used method in clinics using anti-inflammatory medicine.Oral administration or intra-articular injection of corticosteroids can reduce the pain and progress of cartilage degeneration,but they are usually insufficient to show local and long-term anti-inflammatory effects because of their fast clearance in the body.In this study,we suggest an injectable anti-OA drug depot system for sustained drug release that provides long-term effective therapeutic advantages.Amphiphilic poly(organophosphazene),which has temperature-dependent nanoparticle forming and sol-gel transition behaviors when dissolved in aqueous solution,was synthesized for triamcinolone acetonide(TCA)delivery.Because hydrophobic parts of the polymer can interact with hydrophobic parts of the TCA,the TCA was encapsulated into the self-assembled polymeric nanoparticles.The TCA-encapsulated polymeric nanoparticles(TePNs)were well dispersed in an aqueous solution below room temperature so that they can be easily injected as a sol state into an intra-articular region.However,the TePNs solution transforms immediately to a viscose 3D hydrogel like a synovial fluid in the intra-articular region via the conducted body temperature.An in vitro TCA release study showed sustained TCA release for six weeks.One-time injection of the TePN hydrogel system in an early stage of OA-induced rat model showed a great inhibition effect against further OA progression.The OA-induced knees completely recovered as a healthy cartilage without any abnormal symptoms.

关键词： Thermosensitive hydrogel Triamcinolone acetonide Polymer nanoparticle Osteoarthritis Sustained release

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