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World Journal of Gastroenterology 2017年第2期23卷 197-203页

作者： Simona Deiana tommaso gabbani Vito Annese Division of Gastroenterology AOU Careggi University Hospital50139 FirenzeItaly

Biologic compounds are obtained from living organisms or cell cultures by means of biotechnology methods. A similar biologic drug, commonly called biosimilar, is a product copied by a native approved biologic drug whose license has expired. Biosimilar drugs usually are marketed at a lower price and provide important financial savings for public healthcare systems. Some differences between biosimilars and original biologic drugs might exist but they are acceptable if they fall within defined “boundaries of tolerance”: differences in some features between the two molecules are considered important only if clinical relevant. Considering that the efficacy of the innovator biologic drug has already been established, the clinical studies required for approval of a biosimilar could be reduced compared with those required for the approval of the originator. In this review, real life data available in inflammatory bowel disease patients treated with biosimilars are reported, documenting in general satisfactory outcomes, sustained efficacy and no sign of increased immunogenicity, although, further controlled data are awaited.

关键词： Adalimumab biosimilar CTP-13 ZRC-3197 Infliximab biosimilars Biologic drugs

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Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies:A pilot study

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World Journal of Hepatology 2016年第17期8卷 731-738页

作者： Maria Marsico tommaso gabbani Lorenzo Livi Maria Rosa Biagini Andrea Galli Integrate Activity Department 1 Gastroen-terology AOU Modena University Hospital Oncology Department Clinical Gastroenterology AOU CareggiFlorence University Hospital Oncology Department Radiotherapy SOD AOU Careggi Florence University Hospital

AIM: To assess how the application of different types of markers affects the tracking accuracy of Cyber Knife'***: Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers. Two different type of needles 25 gauge(G) and 17 G containing two different fiducial marker, gold notched flexible anchor wire 0.28 mm × 10 mm(25 G needle) and gold cylindrical grain 1 mm × 4 mm(17 G), were used. Seven days after the procedure, a Cyber Knife planning computed tomography(CT) for the simulation of radiation treatment was performed on all patients.A binary CT score was assigned to the fiducial markers visualization. Also, the CT number was calculated for each fiducial and the values compared with a specific ***: For each patient from 1 to 5, intra-hepatic markers were placed(one in 2 patients, three in 8 patients, four in 3 patients, and five in 2 patients). A total of 48 needles were used(thirty-two 17 G and sixteen 25 G) and 48 gold markers were placed(32 Grain shaped markers and 16 Gold Anchor). The result showed that the CT visualization of the grain markers was better than the anchor markers(P = 5 × 10^(-9)). Furthermore, the grain markers were shown to present minor late complications(P = 3 × 10^(-6)), and the best CT threshold number(P = 0.0005). CONCLUSION: The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complications and low visualization by the CT.

关键词： Robotic radiosurgery Fiducial markers Liver malignancies Cyber Knife Radiation therapy Stereotactic radiosurgery

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New endoscopic imaging techniques in surveillance of inflammatory bowel disease

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World Journal of Gastrointestinal Endoscopy 2015年第3期7卷 230-236页

作者： tommaso gabbani Natalia Manetti Andrea Giovanni Bonanomi Antonio Luca Annese Vito Annese Department of Emergency Division of Gastroenterology Florence University Hospital AOU Careggi 50134 Florence Italy School of Medicine Florence University Hospital

Endoscopy plays a crucial role in the management of inflammatory bowel disease(IBD). Advancesimaging techniques allow visualization of mucosal details, tissue characteristics and cellular alteration. In particular chromoendoscopy, magnification endoscopy, confocal laser endomicroscopy and endocytoscopy seem to have the possibility to radically modify the approach to surveillance and decision making. Dyebased chromoendoscopy(DBC) and magnification chromoendoscopy improve detection of dysplasia, and evaluation of inflammatory activity and extension of ulcerative colitis and are thus considered the standard of care. Dye-less chromoendoscopy could probably replace conventional DBC for surveillance. Narrow band imaging and i-scan have shown to improve activity and extent assessment in comparison to white-light endoscopy. Confocal laser endomicroscopy(CLE) can detect more dysplastic lesions in surveillance colonoscopy and predict neoplastic and inflammatory changes with high accuracy compared to histology. This technology is best used in conjunction with chromoendoscopy, narrow-band imaging, or autofluorescence because of its minute scanning area. This combination is useful for appropriate tissue classification of mucosal lesions already detected by standard or optically enhanced endoscopy. The best combination for IBD surveillance appear to be chromoendoscopy for identification of areas of suspicion, with further examination with CLE to detect intraepithelial neoplasia. However cost, availability, and experience are still an issue.

关键词： Ulcerative colitis Crohn's disease Endoscopy Surveillance Colorectal cancer

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