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A new era for hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 135-136页

作者： Riccardo Memeo antonio Rosario pisani Michele Ammendola Nicola de’Angelis Riccardo Inchingolo Division of Hepato-Pancreato-Biliary Surgery “F.Miulli”General HospitalAcquaviva delle FontiBariItaly Nuclear Medicine Unit Interdisciplinary Department of MedicineUniversity of Bari‘Aldo Moro’BariItaly Science of Health Department Digestive Surgery UnitUniversity“Magna Graecia”Medical SchoolCatanzaroItaly Unit of Colorectal and Digestive Surgery DIGEST DepartmentBeaujon University Hospital(AP-HP)University Paris CiteClichyFrance Interventional Radiology Unit “F.Miulli”Regional General HospitalAcquaviva Delle FontiBariItaly

Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic *** represents most common primary malignancy of the liver,developing in 90%of cases of un underlying liver disease(1)[chronic HBV and HCV hepatitis,dysmetabolic liver disease].

关键词： Hepatocellular carcinoma(HCC) guidelines Consensus statement Japan Society of Hepatology

Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

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World Journal of Gastroenterology 2024年第18期30卷 2379-2386页

作者： Riccardo Inchingolo Francesco Cortese antonio Rosario pisani Fabrizio Acquafredda Roberto Calbi Riccardo Memeo Fotis Anagnostopoulos Stavros Spiliopoulos Unit of Interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy Interdisciplinary Department of Medicine Section of Nuclear MedicineUniversity of Bari“Aldo Moro”Bari 70121Italy Department of Radiology General Regional Hospital“F.Miulli”Acquaviva delle Fonti 70021Italy Unit of Hepato-Pancreatic-Biliary Surgery “F.Miulli”Regional General HospitalBari 70021Italy The Second Radiology Department National and Kapodistrian University of AthensChaidari Athens 12461Greece

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of *** percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the *** employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation *** latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not *** segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy *** research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.

关键词： Transarterial radioembolization Selective internal radiation therapy Radiation segmentectomy Hepatocellular carcinoma Primary liver malignancies Personalised dosimetry

Noninvasive molecular analysis of Helicobacter pylori : Is it time for tailored first-line therapy?

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World Journal of Gastroenterology 2017年第14期23卷 2453-2458页

作者： Enzo Ierardi Floriana Giorgio Andrea Iannone Giuseppe Losurdo Mariabeatrice Principi Michele Barone antonio pisani Alfredo Di Leo Gastroenterology Section Department of Emergency and Organ Transplantation University of Bari

The main problem of Helicobacter pylori(H. pylori) infection management is linked to antibiotic resistances. This phenomenon has grown in the last decade, inducing a dramatic decline in conventional regimen effectiveness. The causes of resistance are point mutations in bacterial DNA, which interfere with antibiotic mechanism of action, especially clarithromycin and levofloxacin. Therefore, international guidelines have recently discouraged their use in areas with a relevant resistance percentage, suggesting first-line schedules with expected high eradication rates, i.e., bismuth containing or non-bismuth quadruple therapies. These regimens require the daily assumption of a large number of tablets. Consequently, a complete adherence is expected only in subjects who may be motivated by the presence of major disorders. However, an incomplete adherence to antibiotic therapies may lead to resistance onset, since sub-inhibitory concentrations could stimulate the selection of resistant mutants. Of note, a recent meta-analysis suggests that susceptibility tests may be more useful for the choice of first than second-line or rescue treatment. Additionally, susceptibility guided therapy has been demonstrated to be highly effective and superior to empiric treatments by both meta-analyses and recent clinical studies. Conventional susceptibility test is represented by culture and antibiogram. However, the method is not available everywhere mainly for methodology-related factors and fails to detect hetero-resistances. Polymerase chain reaction(PCR)-based, culture-free techniques on gastric biopsy samples are accurate in finding even minimal traces of genotypic resistant strains and hetero-resistant status by the identification of specific point mutations. The need for an invasive endoscopic procedure has been the most important limit to their spread. A further step has, moreover, been the detection of point mutations in bacterial DNA fecal samples. Few studies on clarithromycin su

关键词： Helicobacter pylori Antibiotic resistance Noninvasive molecular test Tailored therapy Stool

phytoestrogens/insoluble fibers and colonic estrogen receptor β: randomized, double-blind, placebo-controlled study

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World Journal of Gastroenterology 2013年第27期19卷 4325-4333页

作者： Mariabeatrice Principi Alfredo Di Leo Maria Pricci Maria Principia Scavo Raffaella Guido Sabina Tanzi Domenico Piscitelli antonio pisani Enzo Ierardi Maria Cristina Comelli Michele Barone Gastroenterology Unit Department of Emergency and Organ Transplantation University of Bari Pathology Unit Department of Emergency and Organ TransplantationUniversity of Bari Gastroenterology Unit Department of Medical SciencesUniversity of Foggia R and D CMD Pharma Limited

AIM:To assess the safety and effect of the supplementation of a patented blend of dietary phytoestrogens and insoluble fibers on estrogen receptor (ER)-β and biological parameters in sporadic colonic adenomas. METHODS:A randomized, double-blind placebo-controlled trial was performed. Patients scheduled to undergo surveillance colonoscopy for previous sporadic colonic adenomas were identified, and 60 eligible patients were randomized to placebo or active dietary intervention (ADI) twice a day, for 60 d before surveillance colonoscopy. ADI was a mixture of 175 mg milk thistle extract, 20 mg secoisolariciresinol and 750 mg oat fiber extract. ER-β and ER-α expression, apoptosis and proliferation (Ki-67 LI) were assessed in colon samples. RESULTS:No adverse event related to ADI was recorded. ADI administration showed a significant increases in ER-β protein (0.822 ± 0.08 vs 0.768 ± 0.10, P = 0.04) and a general trend to an increase in ER-β LI (39.222 ± 2.69vs 37.708 ± 5.31,P = 0.06), ER-β/ER-α LI ratio (6.564 ± 10.04 vs 2.437 ± 1.53, P = 0.06), terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (35.592 ± 14.97 vs 31.541 ± 11.54, P = 0.07) and Ki-67 (53.923 ± 20.91 vs 44.833 ± 10.38, P = 0.07) approximating statistical significance. A significant increase of ER-β protein (0.805 ± 0.13 vs 0.773 ± 0.13,P = 0.04), mRNA (2.278 ± 1.19vs 1.105 ± 1.07, P < 0.02) and LI (47.533 ± 15.47 vs 34.875 ± 16.67,P < 0.05) and a decrease of ER-α protein (0.423 ± 0.06vs 0.532 ± 0.11,P < 0.02) as well as a trend to increase of ER-β/ER-α protein in ADI vs placebo group were observed in patients without polyps (1.734 ± 0.20 vs 1.571 ± 0.42, P = 0.07). CONCLUSION:The role of ER-β on the control of apoptosis, and its amenability to dietary intervention, are supported in our study.

关键词： Estrogen receptor-β Estrogen receptor-α Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling Sporadic adenomatous polyposis Phytoestrogens Insoluble fibers

Radiomics in colorectal cancer patients

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World Journal of Gastroenterology 2023年第19期29卷 2888-2904页

作者： Riccardo Inchingolo Cesare Maino Roberto Cannella Federica Vernuccio Francesco Cortese Michele Dezio antonio Rosario pisani Teresa Giandola Marco Gatti Valentina Giannini Davide Ippolito Riccardo Faletti Unit of Interventional Radiology F.Miulli HospitalAcquaviva delle Fonti 70021Italy Department of Radiology Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy Department of Biomedicine Neuroscience and Advanced Diagnostics(BiND)University of PalermoPalermo 90127Italy Institute of Radiology University Hospital of PadovaPadova 35128Italy Interdisciplinary Department of Medicine Section of Nuclear MedicineUniversity of Bari“Aldo Moro”Bari 70121Italy Department of Surgical Sciences University of TurinTurin 10126Italy

The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic ***,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is *** images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence *** is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and *** efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene ***,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different *** published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant *** status is the main determinant of adjuvant ***,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been *** studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant *** colorectal liver metastase

关键词： Colorectal cancer Radiomics Artificial intelligence Liver metastases Magnetic resonance imaging Computed tomography Positron emission tomography/computed tomography

Indications and outcomes of endoscopic resection for nonpedunculated colorectal lesions:A narrative review

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 275-295页

作者： Endrit Shahini Diogo Libanio Giacomo Lo Secco antonio pisani Alberto Arezzo Department of Gastroenterology and Digestive Endoscopy Unit National Institute of Research“Saverio De Bellis”Castellana Grotte(Bari)70013Italy Department of Gastroenterology Portuguese Oncology InstitutePorto 4200-072Portugal Department of Surgical Sciences University of TorinoTurin 10126Italy

In the last years,endoscopic techniques gained a crucial role in the treatment of colorectal flat *** the same time,the importance of a reliable assessment of such lesions to predict the malignancy and the depth of invasion of the colonic wall *** current unsolved dilemma about the endoscopic excision techniques concerns the necessity of a reliable submucosal invasive cancer assessment system that can stratify the risk of the post-procedural need for ***,this narrative literature review aims to compare the available diagnostic strategies in predicting malignancy and to give a guide about the best techniques to *** performed a literature search using electronic databases(MEDLINE/PubMed,EMBASE,and Cochrane Library).We collected all articles about endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)registering the ***,we analyzed all meta-analyses comparing EMR vs ESD outcomes for colorectal sessile or nonpolypoid lesions of any size,preoperatively estimated as *** meta-analysis studies,mainly Eastern,were included in the analysis comparing 124 studies and overall 22954 patients who underwent EMR and ESD *** these,eighty-two were retrospective,twenty-four perspective,nine casecontrol,and six cohorts,while three were randomized clinical trials.A total of 18118 EMR and 10379 ESD were completed for a whole of 28497 colorectal sessile or non-polypoid lesions>5-10 mm in *** conclusion,it is crucial to enhance the preoperative diagnostic workup,especially in deciding the most suitable endoscopic method for radical resection of flat colorectal lesions at risk of underlying ***,the ESD necessitates further improvement because of the excessively time-consuming as well as the intraprocedural technical hindrances and related *** found a higher rate of en bloc resections and R0 for ESD than EMR for non-pedunculated colorectal ***,d

关键词： Colorectal cancer Adenoma detection High-resolution colonoscopy Chromoendoscopy Pit pattern Dysplasia

Hepatitis C and double-hit B cell lymphoma successfully treated by antiviral therapy

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World Journal of Hepatology 2016年第29期8卷 1244-1250页

作者： Giovanni Galati Lorenzo Rampa Umberto Vespasiani-Gentilucci Mirella Marino Francesco pisani Carlo Cota Alessandro Guidi antonio Picardi Unit of Internal Medicine and Hepatology Department of Medicine Università Campus Bio-Medico di Roma Department of Pathology Regina Elena National Cancer Institute Hematology and Stem Cell Transplant Unit Regina Elena National Cancer Institute Dermopahology Unit San Gallicano Dermatological Institute IRCCS

B cells lymphoma is one of the most challenging extrahepatic manifestations of hepatitis C virus(HCV). Recently, a new kind of B-cell lymphoma, named doublehit B(DHL), was characterized with an aggressive clinical course whereas a potential association with HCV was not investigated. The new antiviral direct agents(DAAs) against HCV are effective and curative in the majority of HCV infections. We report the first case, to our knowledge, of DHL and HCV-infection successfully treated by new DAAs. According to our experience, a DHL must be suspected in case of HCV-related lymphoma, and an early diagnosis could direct towards a different hematological management because a worse prognosis might be expected. A possible effect of DAAs on DHL regression should be investigated, but eradicating HCV would avoid life-threatening reactivation of viral hepatitis during pharmacological immunosuppression in oncohaematological diseases.

关键词： Hepatitis C Lymphoma Direct antiviral agents Double hit lymphoma Chronic hepatitis C

Detection of anti-aquaporin-4 autoantibodies in the sera of Chinese neuromyelitis optica patients

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Neural Regeneration Research 2013年第8期8卷 708-713页

作者： Miao Li Weiheng Su Jie Wang Francesco pisani antonio Frigeri Tonghui Ma Membrane Channel Research Laboratory Northeast Normal University Department of Neurosurgery China-Japan Union HospitalJilin University National Engineering Laboratory for AIDS Vaccine College of Life ScienceJilin University Department of General and Environmental Physiology and Centre of Excellence in Comparative Genomics (CEGBA) University of Bari

In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast （V79） cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica.

关键词： neural regeneration neurodegenerative diseases neuromyelitis optica multiple sclerosis aquaporin-4 autoimmune disease autoantibody immunofluorescence Expanded Disability StatusScale grants-supported paper photographs-containing paper neuroregeneration

Sonographic markers for early diagnosis of fetal malformations

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World Journal of Radiology 2013年第10期5卷 356-371页

作者： Maria Daniela Renna Paola pisani Francesco Conversano Emanuele Perrone Ernesto Casciaro Gian Carlo Di Renzo Marco Di Paola antonio Perrone Sergio Casciaro National Council of Research Institute of Clinical Physiology c/o Campus Universitario Ecotekne Department of Ob-stetrics and Gynecology University of Perugia Santa Maria della Misericordia University Hospital Obstetrics and Gynecology Department "Vito Fazzi" Hospital Piazza Filippo Muratore

Fetal malformations are very frequent in industrialized *** advanced maternal age may affect pregnancy outcome adversely,80%-90%of fetal malformations occur in the absence of a specific risk factor for *** only effective approach for prenatal screening is currently represented by an ultrasound ***,ultrasound methods present two important limitations:the substantial absence of quantitative parameters and the dependence on the sonographer *** recent years,together with the improvement in transducer technology,quantitative and objective sonographic markers highly predictive of fetal malformations have been *** markers can be detected at early gestation(11-14 wk)and generally are not pathological in themselves but have an increased incidence in abnormal ***,prenatal ultrasonography during the second trimester of gestation provides a"genetic sonogram",including,for instance,nuchal translucency,short humeral length,echogenic bowel,echogenic intracardiac focus and choroid plexus cyst,that is used to identify morphological features of fetal Down’s syndrome with a potential sensitivity of more than 90%.Other specific and sensitive markers can be seen in the case of cardiac defects and skeletal *** the future,sonographic markers could limit even more the use of invasive and dangerous techniques of prenatal diagnosis(amniocentesis,etc.).

关键词： Prenatal diagnosis Prenatal sonography Chromosome abnormalities nuchal translucency Fetal echocardiography Skeletal dysplasia