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Comparison of outcomes with stapler versus hand-sewn closure of the pancreatic stump following minimally invasive distal pancreatectomy: a retrospective cohort study

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胰腺病学杂志(英文) 2024年第2期07卷 106-110页

作者： Qian Tao Huang Kaiquan Chen Wen Bai Xueli Gao Shunliang Shen Yan Zhang Min Wu Jian Yu Jun Ma Tao liang tingbo Department of Hepatobiliary and Pancreatic Surgery the First Affiliated Hospital of Zhejiang University School of Medicine Hangzhou China Innovation Center for the Study of Pancreatic Diseases of Zhejiang Province Hangzhou China Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases Hangzhou China Zhejiang Provincial Key Laboratory of Pancreatic Disease Hangzhou China Cancer Center Zhejiang University Hangzhou China

Background: Pancreatic fistula after distal pancreatectomy is a common and potentially lethal complication. The optimal closure method for the pancreatic remnant during minimally invasive distal pancreatectomy (MDP) remains ***: Data of consecutive patients who underwent MDP in our institution between July 2018 and June 2021 were collected. The outcomes of MDP with stapler and hand-sewn closure were compared. The primary outcome was clinically relevant postoperative pancreatic fistula (CR-POPF) per the International Study Group of Pancreatic Surgery ***: Of the 384 patients (stapler closure, 339; hand-sewn closure, 45) enrolled, 249 developed CR-POPF (grades B and C: 242 and 7 patients, respectively). The rates of grade B and grade C POPF in the stapler group were similar to the corresponding rates in the hand-sewn group (64.6% and 1.5% vs 51.1% and 4.4%,P = .078 andP = .223, respectively). No differences between the stapler and hand-sewn groups were observed regarding the median operation time (207 vs 222 minutes,P = .139), incidence of major complications (16.5% vs 20.0%,P = .559), and mortality (0.2% vs 0%,P = 1.000). The independent risk factors of CR-POPF were abdominal abscess, prolonged operation time, and transection site (P = .004, .006, and .001, respectively).Conclusion: The incidence and severity of CR-POPF by stapler closure of the pancreatic stump were comparable to those associated with hand-sewn closure in MDP in this retrospective cohort. Randomized controlled trials are needed to verify this finding.

关键词： Distal pancreatectomy Minimally invasive surgery Outcome Postoperative pancreatic fistula Stapler closure

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机器人辅助保留功能胰腺手术治疗新进展

中华消化外科杂志 2024年第1期23卷 102-108页

作者：白雪莉洪一帆张晓雨杨加琦梁廷波浙江大学医学院附属第一医院肝胆胰外科杭州310003

保留功能胰腺手术作为一种限制性切除技术,应用于胰腺良性、交界性或低度恶性病变,能显著改善患者术后短期和长期生命质量。与传统腹腔镜手术比较,机器人手术系统在胰腺手术中更高效、精确,其安全性与可靠性在医学界也得到广泛认可。然... 详细信息

保留功能胰腺手术作为一种限制性切除技术,应用于胰腺良性、交界性或低度恶性病变,能显著改善患者术后短期和长期生命质量。与传统腹腔镜手术比较,机器人手术系统在胰腺手术中更高效、精确,其安全性与可靠性在医学界也得到广泛认可。然而,目前对于机器人系统在保留功能胰腺手术中的应用研究仍然较少。因此,笔者总结分析机器人辅助保留功能胰腺手术的最新进展,重点介绍手术范围、手术方式及相关预后情况。

关键词：胰腺肿瘤机器人手术保留功能胰腺手术手术方式进展

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Genetic alterations and tumor mutation burden predict chemosensitivity of pancreatic cancer: a retrospective study

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胰腺病学杂志(英文) 2024年第3期07卷 171-180页

作者： Hu Manyi Xu Yiting Wang Yangyang Chen Cao He Junjun Sun Ke Zhang Qi liang tingbo Department of Hepatobiliary and Pancreatic Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Zhejiang Provincial Key Laboratory of Pancreatic Disease the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Department of Pathology the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases Hangzhou China The Innovation Center for the Study of Pancreatic Diseases of Zhejiang Province Hangzhou China Zhejiang University Cancer Center Hangzhou China

Background: Chemotherapy stands as a recommended approach for all stages of pancreatic cancer. However, its efficacy stratification remains obscure. Genomic sequencing is extensively applied across diverse diseases. This study aims to explore the potential genomic markers in relation to the decision-making of ***: A total of 140 patients with pancreatic cancer were categorized into chemotherapy-first group and adjuvant chemotherapy group. The genomic alterations were detected from the next-generation sequencing using surgical or fine-needle-biopsy specimens. Chemotherapy response was defined according to objective response based on the RECIST criteria (version 1.1).Results: In the chemotherapy-first group, the patients who harbored higher tumor mutation burden (TMB) levels had significant shorter progress-free survival (PFS) than that with low TMB levels (hazard ratio [HR] = 30.362,P = .002). No independent risk factors were found to be correlated with chemoresistance in patients receiving chemotherapy at first (allP > .05). In the adjuvant chemotherapy group, the increased carbohydrate antigen 125 (CA125) level of more than 35 U/mL potentially elucidated a shorter period of DFS (HR = 3.695,P = .020).Conclusion: Our study indicated that a high level of TMB may predict earlier tumor progression in pancreatic cancer patients received chemotherapy at first. The elevation of CA125 presents itself as a predictive indicator for postoperative chemotherapy patients’ tumor recurrence, whereas gene mutations remain unrelated to this phenomenon.

关键词： Chemotherapy response Genomic alteration Pancreatic cancer Predictive markers TMB

Oncolytic virotherapy:basic principles,recent advances and future directions

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Signal Transduction and Targeted Therapy 2023年第5期8卷 2180-2208页

作者： Danni Lin Yinan Shen tingbo liang Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang Provincial Key Laboratory of Pancreatic Disease The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases HangzhouZhejiangChina The Innovation Center for the Study of Pancreatic Diseases of Zhejiang Province HangzhouZhejiangChina Cancer Center Zhejiang UniversityHangzhouZhejiangChina

Oncolytic viruses(OVs)have attracted growing awareness in the twenty-first century,as they are generally considered to have direct oncolysis and cancer immune *** the progress in genetic engineering technology,OVs have been adopted as versatile platforms for developing novel antitumor strategies,used alone or in combination with other *** studies have yielded eye-catching results that delineate the promising clinical outcomes that OVs would bring about in the *** this review,we summarized the basic principles of OVs in terms of their classifications,as well as the recent advances in OV-modification strategies based on their characteristics,biofunctions,and cancer *** OVs are expected to be designed as“qualified soldiers”first by improving target fidelity and safety,and then equipped with“cold weapons”for a proper cytocidal effect,“hot weapons”capable of activating cancer immunotherapy,or“auxiliary weapons”by harnessing tactics such as anti-angiogenesis,reversed metabolic reprogramming and decomposing extracellular matrix around *** with other cancer therapeutic agents have also been elaborated to show encouraging antitumor *** results from clinical trials using OV as a treatment congruously suggested its significance in future application directions and challenges in developing OVs as novel weapons for tactical decisions in cancer treatment.

关键词： directions reversed summarized

Pancreatic tumor initiation: the potential role of IL-33

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Signal Transduction and Targeted Therapy 2021年第6期6卷 1636-1637页

作者： Xing Huang Gang Zhang tingbo liang Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang Provincial Key Laboratory of Pancreatic Disease the First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina

A recent report published in Nature by Alonso-Curbelo et al.1 revealed epigenetic reprogramming in pancreatic cancer initiation caused by the cooperative effects of KRAS mutation and environmental damage.

关键词： al. damage KRAS

Eating self for not be eaten:Pancreatic cancer suppresses selfimmunogenicity by autophagy-mediated MHC-I degradation

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Signal Transduction and Targeted Therapy 2020年第1期5卷 1626-1627页

作者： Xing Huang Xiaozhen Zhang Xueli Bai tingbo liang Zhejiang Provincial Key Laboratory of Pancreatic Disease the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003 ZhejiangChina Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003 ZhejiangChina

In a recent study in Nature,1 Yamamoto et *** that MHC-I is a selective substrate of autophagy in tumor immune ***,it was reported that autophagy-mediated lysosomal degradation of MHC-I suppresses pancreatic cancer immunogenicity and the effectiveness of *** findings indicate the potential of autophagy inhibition as a strategy to activate anti-pancreatic cancer immunity.

关键词： cancer al mediated

mRNA vaccines in disease prevention and treatment

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Signal Transduction and Targeted Therapy 2023年第10期8卷 4669-4698页

作者： Gang Zhang Tianyu Tang Yinfeng Chen Xing Huang tingbo liang Zhejiang Provincial Key Laboratory of Pancreatic Disease The First Affliated HospitalZhejiang University School of Medicine310oo9 HangzhouZhejiangChina Department of Hepatobiliary and Pancreatic Surgery The First Affliated HospitalZhejiang University School of Medicine310003 HangzhouZhejiangChina Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases 310003 HangzhouZhejangChina The Innovation Center for the Study of Pancreatic Diseases of Zhejiang Province 310009 HangzhouZhejiangChina Cancer Center Zhejiang University310058 HangzhouZhejiangChina

mRNA vaccines have emerged as highly effective strategies in the prophylaxis and treatment of diseases,thanks largely although not totally to their extraordinary performance in recent years against the worldwide plagu... 详细信息

关键词： prevention vaccines treatment

Multiplex imaging reveals the architecture of the tumor immune microenvironment

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Cancer Biology & Medicine 2021年第4期18卷 949-954页

作者： Junlei Zhang Jinyuan Song Jianpeng Sheng Xueli Bai tingbo liang Department of Hepatobiliary and Pancreatic Surgery Zhejiang Provincial Key Laboratory of Pancreatic Diseasethe First Affiliated HospitalZhejiang University School of MedicineZhejiang University Cancer CentreZhejiang UniversityHangzhou 310002China

The tumor immune microenvironment(TME)is composed of a variety of components,such as tumor cells,immune cells,and the extracellular *** TME has been studied through transcriptomic,proteomic,metabolomic,and phosphoprot... 详细信息

关键词： immune tumor microenvironment

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Computed tomography-based delta radiomics of tumor coreedge combination for systemic treatment response evaluation in pancreatic cancer

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胰腺病学杂志(英文) 2024年第3期07卷 181-190页

作者： Li Xiang Lu Na Hu Peijun Chen Yiwen Liu Liying Liu Xinyuan Guo Chengxiang Xiao Wenbo Sun Ke Li Jingsong Bai Xueli liang tingbo Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Zhejiang Provincial Key Laboratory of Pancreatic Disease Hangzhou China Research Center for Healthcare Data Science Zhejiang Lab Hangzhou China Department of Radiology The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Department of Pathology The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Key Laboratory for Biomedical Engineering of Ministry of Education College of Biomedical Engineering and Instrument Science Zhejiang University Hangzhou China Zhejiang University Cancer Center Hangzhou China

Background: As a systemic disease, pancreatic cancer （PC） can be treated systemically to raise the R0 resection rate and enhance patient prognosis. The best ways to assess the treatment response to systemic treatment of patients with PC are still ***: A total of 122 PC patients were enrolled; 25 of these patients were used as an independent testing set. According to the pathologic response, PC patients were classified into the responder and nonresponder groups. The whole tumor, core, edge, and peritumoral were segmented from the enhanced computed tomography （CT） images. Machine-learning models were created by extracting the variations in radionics features before and after therapy （delta radiomics features）. Finally, we compared the performance of models based on radiomics features, changes in tumor markers, and radiologic ***: The model based on the core （area under curve [AUC] = 0.864） and edge features （AUC = 0.853） showed better performance than that based on the whole tumor （AUC = 0.847） or peritumoral area （AUC = 0.846）. Moreover, the tumor coreedge combination model （AUC = 0.899） could better increase confidence in treatment response than using either of them alone. The accuracies of models based on changes in tumor markers and radiologic evaluation were relatively poorer than of the radiomics model. Moreover, Patients predicted to respond to therapy using the radiomics model showed a relatively longer overall survival （43 vs 27 months）, although there were no significant differences （P = .063）.Conclusions: The tumor coreedge combination delta radiomics model is an effective approach to evaluate pathologic response in PC patients with systemic treatment.

关键词： Computed tomography Delta radiomics Pancreatic cancer Pathologic response Systemic treatment