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Combined and intraoperative risk modelling for oesophagectomy:A systematic review

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World Journal of Gastrointestinal Surgery 2023年第7期15卷 1485-1500页

作者： James paul Grantham Amanda Hii Jonathan Shenfine Department of General Surgery Modbury HospitalModbury 5092South AustraliaAustralia Department of General Surgical Unit Jersey General HospitalSaint Helier JE13QSJerseyUnited Kingdom

BACKGROUND Oesophageal cancer is the eighth most common malignancy worldwide and is associated with a poor *** remains the best prospect for a cure if diagnosed in the early disease ***,the procedure is associated with significant morbidity and mortality and is undertaken only after careful *** patient selection,counselling and resource allocation is *** risk models have been devised to guide surgeons in making these *** To evaluate which multivariate risk models,using intraoperative information with or without preoperative information,best predict perioperative oesophagectomy *** A systematic review of the MEDLINE,EMBASE and Cochrane databases was undertaken from *** search terms used were[(Oesophagectomy)AND(Model OR Predict OR Risk OR score)AND(Mortality OR morbidity OR complications OR outcomes OR anastomotic leak OR length of stay)].Articles were included if they assessed multivariate based tools incorporating preoperative and intraoperative variables to forecast patient outcomes after *** were excluded if they only required preoperative or any post-operative *** appraising univariate risk predictors such as preoperative sarcopenia,cardiopulmonary fitness and American Society of Anesthesiologists score were also *** review was conducted following the preferred reporting items for systematic reviews and meta-analyses *** captured risk models were appraised for clinical credibility,methodological quality,performance,validation and clinical *** Twenty published studies were identified which examined eleven multivariate risk *** of these combined preoperative and intraoperative data and the remaining three used only intraoperative *** two risk models were identified as promising in predicting mortality,namely the Portsmouth physiological and operative severity score for the enumeration o

关键词： Oesophagectomy Risk model Oesophageal cancer Preoperative Intraoperative Morbidity Mortality

Preoperative risk modelling for oesophagectomy: A systematic review

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World Journal of Gastrointestinal Surgery 2023年第3期15卷 450-470页

作者： James paul Grantham Amanda Hii Jonathan Shenfine Department of General Surgery Modbury HospitalAdelaide 5092South AustraliaAustralia General Surgical Unit Jersey General HospitalSaint Helier JE13QSJerseyUnited Kingdom

BACKGROUND Oesophageal cancer is a frequently observed and lethal malignancy *** resection remains a realistic option for curative intent in the early stages of the ***,the decision to undertake oesophagectomy is significant as it exposes the patient to a substantial risk of morbidity and ***,appropriate patient selection,counselling and resource allocation is *** tools have been developed to aid surgeons in appropriate *** To examine all multivariate risk models that use preoperative and intraoperative information and establish which have the most clinical *** A systematic review of the MEDLINE,EMBASE and Cochrane databases was conducted from *** search terms applied were((Oesophagectomy)AND(Risk OR predict OR model OR score)AND(Outcomes OR complications OR morbidity OR mortality OR length of stay OR anastomotic leak)).The applied inclusion criteria were articles assessing multivariate based tools using exclusively preoperatively available data to predict perioperative patient outcomes following *** exclusion criteria were publications that described models requiring intra-operative or post-operative data and articles appraising only univariate predictors such as American Society of Anesthesiologists score,cardiopulmonary fitness or pre-operative *** that exclusively assessed distant outcomes such as long-term survival were excluded as were publications using cohorts mixed with other surgical *** articles generated from each search were collated,processed and then reported in accordance with PRISMA *** risk models were appraised for clinical credibility,methodological quality,performance,validation,and clinical *** The initial search of composite databases yielded 8715 articles which reduced to 5827 following the deduplication *** title and abstract screening,197 potentially relevant texts were

关键词： Oesophagectomy Risk model Oesophageal cancer Preoperative Morbidity Mortality

Two novel compounds, ergosterol and ergosta-5,8-dien-3-ol, from Termitomyces heimii Natarajan demonstrate promising antihepatocarcinoma activity

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Journal of Traditional Chinese Medical Sciences 2022年第4期9卷 443-453页

作者： Ribhu Ray Saparja Saha Santanu paul Laboratory of Cell and Molecular Biology Department of BotanyUniversity of CalcuttaKolkata700019West BengalIndia

Background:Mushroom-derived components have immense potential to become a safe alternative in identifying lead anti-cancer *** heimii Natarajan(***)is a traditionally used edible mushroom with no previous record of anti-hepatocarcinoma ***:The anti-proliferative efficacy of the mushroom ethyl acetate extract was screened against a panel of seven cancer cell lines,namely Hep G2,MCF-7,MDA-MB-231,MAD-MB-436,MOLT-4,Reh,and K-562,and against peripheral blood mononuclear cells isolated from normal healthy donors by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction *** impact of the extract on nuclear morphology was examined by 40,6-diamidino-2-phenylindole staining and the apoptotic potential of the extract was evaluated through flow cytometry and Annexin v-PI dual staining,followed by an in vitro scratch assay to elucidate the anti-migratory potential of the *** apoptotic and antimigratory effects were further validated using in silico molecular docking with four compounds,ergosterol,ergosta-5,8-dien-3-ol,lanosterol,and eburicol,against two anti-apoptotic proteins,Bcl-2 and Bcl-XL,and two angiogenic receptors,vEGFR-1 and ***:The screening data revealed that ethyl acetate extract exhibited remarkable anti-proliferative efficacy against Hep G2 cells,with a half maximal inhibitory concentration(IC50)value of 263.53(8.09)mg/mL,followed by MCF-7 cell lines and showed a negligible effect on peripheral blood mononuclear cells.A clear alteration of the cellular and nuclear morphology was concentration-dependently observed in Hep G2 *** extract induced robust apoptosis and a significant concentrationdependent increase in the scratch *** results of in silico docking revealed that compared to standard drug sunitinib,both ergosterol and ergosta-5,8-dien-3-ol displayed lower binding energy,and satisfactory drugability and absorption,distribution,metabolism,excretion,and toxicity properties.

关键词： Termitomyces heimii Natarajan Ergosterol In silico docking Hepatocarcinoma

Rare case of entero-enteric intussusception caused by small bowel metastasis from a cardiac liposarcoma

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World Journal of Gastrointestinal Oncology 2016年第3期8卷 326-329页

作者： Gustavo Gomez Mohammad Bilal paul Klepchick Kofi Clarke Department of Gastroenterology Hepatology and Nutrition Allegheny General Hospital Department of Internal Medicine Allegheny General Hospital Department of Radiology Allegheny General Hospital

Primary cardiac liposarcoma is exceedingly rare and its metastatic potential varies based on the actual tumor subclass. Intestinal intussusception is also an uncommon cause of abdominal pain and bowel obstruction in adults and it usually generates at a malignant lead point in this age group. We report a case of a primary cardiac dedifferentiated liposarcoma in a pregnant woman causing small bowel seeding leading to bowel intussusception.

关键词： Liposarcoma Intussusception Small bowel metastasis Enteroenteric Cardiac

Psychosocial factors and their association with reflux oesophagitis,Barrett's oesophagus and oesophageal adenocarcinoma

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World Journal of Gastroenterology 2013年第11期19卷 1770-1777页

作者： paul Denver Michael Donnelly Liam J Murray Lesley A Anderson Centre for Public Health Queen's University BelfastBelfast BT12 6BJNorthern IrelandUnited Kingdom

AIM:To investigate the role of psychological characteristics as risk factors for oesophageal adenocarcinoma(OAC),as well as the reflux-mediated precursor ***:An all-Ireland population-based case-control study recruited 230 reflux oesophagitis(RO),224 Barrett's oesophagus(BO) and 227 OAC patients and 260 *** case/control group completed measures of stress,depression,self-efficacy,self-esteem,repression and social support.A comparative analysis was undertaken using polytomous logistic regression adjusted for potential ***:Compared to controls,OAC patients were almost half as likely to report high stress levels over their lifetime(P = 0.010,OR 0.51;95%CI:0.29-0.90)and 36% less likely to report having experienced depression(OR 0.64;95%CI:0.42-0.98).RO patients reported significantly higher stress than controls particularly during middle-and senior-years(P for trends ving been highly emotionally repressed(OR 0.63;95%CI:0.41-0.95).All case groups(OAC,RO and BO) were more likely than controls to report having had substantial amounts of social support(OR 2.84;95%CI:1.63-4.97;OR 1.97;95%CI:1.13-3.44 and OR 1.83;95%CI:1.03-3.24,respectively).CONCLUSION:The improved psychological profile of OAC patients may be explained by response *** role of psychological factors in the development of OAC requires further investigation.

关键词： Reflux oesophagitis Barrett’s oesophagus Oesophageal adenocarcinoma Adjustment Psychological Psychosocial factors

Determining the role for uric acid in non-alcoholic steatohepatitis development and the utility of urate metabolites in diagnosis:An opinion review

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World Journal of Gastroenterology 2020年第15期26卷 1683-1690页

作者： paul Brennan Kathleen Clare Jacob George John F Dillon Department of Molecular and Clinical Medicine University of DundeeNinewells Hospital and Medical SchoolDundee DD19SYUnited Kingdom Department of Neurology Queen Elizabeth HospitalGlasgow G514TFUnited Kingdom

There has long been a recognised association between non-alcoholic fatty liver disease(NAFLD)and the composite aspects of the metabolic *** of this association highlighted the supposed co-existence of elevated uric acid levels in those with *** is interest in exploitation of this as a putative diagnostic and prognostic biomarker in *** the increased economic and health burden associated with the NAFLD epidemic,improved methods of population-based,minimally-invasive methods and biomarkers are clearly highly sought and *** this opinion review we review the proposed role of uric acid in the pathogenesis of NAFLD and its potential utilisation in the diagnosis and monitoring of the disease process.

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Uric acid Urate Non-invasive fibrosis markers Fatty liver index

Abnormally activated wingless/integrated signaling modulates tumor-associated macrophage polarization and potentially promotes hepatocarcinoma cell growth

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World Journal of Gastroenterology 2024年第41期30卷 4490-4495页

作者： Wei-Lu Wang paul Kwong Hang Tam Yan Chen School of Pharmacy Faculty of MedicineMacao University of Science and TechnologyMacao 999078China

In this article,we comment on the article by Huang et *** urgent development of new therapeutic strategies targeting macrophage polarization is critical in the fight against liver ***-associated macrophages(TAMs),primarily of the M2 subtype,are instrumental in cellular communication within the tumor microenvironment and are influenced by various signaling pathways,including the wingless/integrated(Wnt)*** of the Wnt signaling pathway is pivotal in promoting M2 TAMs polarization,which in turn can exacerbate hepatocarcinoma cell proliferation and *** manuscript emphasizes the burgeoning significance of the Wnt signaling pathway and M2 TAMs polarization in the pathogenesis and progression of liver cancer,highlighting the potential therapeutic benefits of inhibiting the Wnt ***,we point out areas in Huang et al’s study that require further research,providing guidance and new directions for similar studies.

关键词： Liver cancer Hepatocarcinoma cell Wingless/integrated signaling pathway M2 tumor-associated macrophages Polarization

Screening strategy for gastrointestinal and hepatopancreatobiliary cancers in cystic fibrosis

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World Journal of Gastrointestinal Oncology 2021年第9期13卷 1121-1131页

作者： Brett Hoskins paul Wasuwanich Ann O Scheimann Wikrom Karnsakul Division of Pediatric Gastroenterology Hepatologyand NutritionDepartment of PediatricsThe Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Medicine University of Florida College of MedicineGainesvilleFL 32610United States

Based on systematic review and meta-analysis,the risk for developing cancers in patients with cystic fibrosis(CF)is known to be significantly greater than in the general population,including site-specific cancers of the esophagus,small bowel,colon,liver,biliary tract,and *** even higher risk has been found in patients who have severe CF transmembrane conductance regulator(CFTR)genotypes or who have undergone organ transplantation and are *** risk continues to rise as life expectancies steadily climb due to advancements in medical care and treatment for *** colorectal cancer risk is at such a high level that CF has now been declared a hereditary colon cancer syndrome by the Cystic Fibrosis *** CFTR gene has been stronglyassociated with the development of gastrointestinal(GI)cancers and mortality in the CF *** CF carriers have shown an increased rate of GI cancers compared to the general *** limitations exist with the reported guidelines for screening of GI and hepatopancreatobiliary cancers in the CF population,which are largely universal and are still *** is a need for more precise screening based on specific risk factors,including CFTR mutation,medical co-morbidities(such as gastroesophageal reflux disease,distal intestinal obstruction syndrome,and diabetes mellitus),familial risks for each cancer,gender,age,and other *** this review,we propose changes to the guidelines for GI screening of patients with *** the development of CFTR modulators,additional studies are necessary to elucidate if there is an effect on cancer risk.

关键词： Colorectal cancer CFTR gene Cystic fibrosis Gastrointestinal cancer Hepatopancreatobiliary cancer Screening

Involvement of eicosanoids in the pathogenesis of pancreatic cancer: the roles of cyclooxygenase-2 and 5-lipoxygenase

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World Journal of Gastroenterology 2014年第31期20卷 10729-10739页

作者： Lawrence M Knab paul J Grippo David J Bentrem Department of Surgery Northwestern University Feinberg School of Medicine Robert H Lurie Comprehensive Cancer Center Northwestern University Jesse Brown vA Medical Center

The interplay between inflammation and cancer progression is a growing area of research. A combination of clinical, epidemiological, and basic science investigations indicate that there is a relationship between inflammatory changes in the pancreas and neoplastic progression. Diets high in ω-6 polyunsaturated fatty acids provide increased substrate for arachidonic acid metabolism by cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) to form eicosanoids. These eicosanoids directly contribute to pancreatic cancer cell proliferation. Both COX-2 and 5-LOX are upregulated in multiple cancer types, including pancreatic cancer. In vitro studies using pancreatic cancer cell lines have demonstrated upregulation of COX-2 and 5-LOX at both the mRNA and protein levels. When COX-2 and 5-LOX are blocked via a variety of mechanisms, cancer cell proliferation is abrogated both in vitro and in vivo. The mechanism of COX-2 has been shown to include effects on apoptosis as well as angiogenesis. 5-LOX has been implicated in apoptosis. The use of COX-2 and 5-LOX inhibitors in clinical studies in patients with pancreatic cancer has been limited. Patient enrollment has been restricted to those with advanced disease which makes evaluation of these drugs as chemopreventive agents difficult. COX-2 and 5-LOX expression have been shown to be present during the early neoplastic changes of pancreatic cancer, well before progression to invasive disease. This indicates that the ideal role for these interventions is early in the disease process as preventive agents, perhaps in patients with chronic pancreatitis or hereditary pancreatitis.

关键词： Arachidonic acid Eicosanoid Cyclooxygenase-2 5-lipoxygenase Pancreatic cancer Inflammation