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Risk of lymph node metastases in patients with T1b oesophageal adenocarcinoma: A retrospective single centre experience

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World Journal of Gastroenterology 2018年第41期24卷 4698-4707页

作者： David Graham Nejc Sever Cormac Magee William Waddingham Matthew Banks Rami Sweis Hannah Al-Yousuf Miriam Mitchison Durayd Alzoubaidi Manuel Rodriguez-Justo Laurence Lovat marco novelli Marnix Jansen Rehan Haidry GI Services University College London Hospital Division of Surgery and Science University College London Gastroenterology Department University Medical Center Ljubljana Department of Metabolism and Experimental Therapeutics University College London

AIM To assess clinical outcomes for submucosal (T1b) oesophageal adenocarcinoma (OAC) patients managed with either surgery or endoscopic eradication *** Patients found to have T1b OAC following endoscopic resection between January 2008 to February 2016 at University College London Hospital were retrospectively analysed. Patients were split into low-risk and high-risk groups according to established histopathological criteria and were then further categorised according to whether they underwent surgical resection or conservative management. Study outcomes include the presence of lymphnode metastases, disease-specific mortality and overall survival. RESULTS A total of 60 patients were included; 22 patients were surgically managed (1 low-risk and 21 high-risk patients) whilst 38 patients were treated conservatively (12 low-risk and 26 high-risk). Overall, lymph node metastases (LNM) were detected in 10 patients (17%); six of these patients had undergone conservative management and LNM were detected at a median of 4 mo after endoscopic mucosal resection (EMR). All LNM occurred in patients with highrisk lesions and this represented 21% of the total high-risk lesions. Importantly, there was no statistically significant difference in tumor-related deaths between those treated surgically or conservatively (P = 0.636) and disease-specific survival time was also comparable between the two treatment strategies (P = 0.376).CONCLUSION T1b tumours without histopathological high-risk markers of LNM can be treated endoscopically with good outcomes. In selected patients, endoscopic therapy may be appropriate for high-risk lesions.

关键词： Oesophageal adenocarcinoma Submucosal invasion T1b Lymph node metastasis Risk prediction Endoscopy

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Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

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World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman marco novelli Laurence B Lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia Oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation

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英国胃肠病学会关于胃癌风险患者的诊断和管理指南

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中华胃肠内镜电子杂志 2020年第2期7卷 49-83页

作者： Matthew Banks David Graham Marnix Jansen TakujiGotoda Sergio Coda Massimiliano di Pietro NoriyaUedo Pradeep Bhandari D Mark Pritchard Ernst J Kuipers Manuel Rodriguez-Justo marco R novelli KrishRagunath Neil Shepherd Mario Dinis-Ribeiro 乌雅罕(译) 张冬雪(译) 牛占岳(校) 刘鑫(校) 丁士刚(译/校) 伦敦大学学院医院伦敦大学学院医院NHS基金会英国伦敦目标干预研究部伦敦大学学院英国伦敦外科与介入科学部伦敦大学学院生物科学部英国伦敦伦敦大学学院病理学系英国伦敦日本大学医学院医学研究所消化科日本东京板桥区健康集团内镜英国伦敦医学研究委员会癌症中心剑桥大学英国剑桥剑桥大学医院NHS基金会消化科英国剑桥内镜训练和学习中心大阪癌症及心血管疾病医学中心胃肠肿瘤科日本大阪朴茨茅斯大学英国朴茨茅斯转化医学研究所利物浦大学英国利物浦伊拉斯谟大学医学中心荷兰鹿特丹诺丁汉消化疾病中心诺丁汉大学医院英国诺丁汉格洛斯特郡大学细胞病理实验室切尔滕纳姆综合医院英国切尔滕纳姆波尔多葡萄牙肿瘤学研究所消化科葡萄牙波尔多北京大学第三医院消化科北京100191 不详

胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(***,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生... 详细信息

胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(***,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生存率的关键是在内镜检查前以非侵入性方式识别高危人群。然而,尽管生物标志物可能有助于检测慢性萎缩性胃炎,但尚无足够的证据支持其用于人群筛查。高质量内镜检查是胃癌早期发现的重要组成部分,图像增强内镜结合组织病理学活检是GA和GIM最佳的诊断方法,并能准确进行风险分层。按照悉尼标准从胃窦、角切迹、小弯和大弯进行活检,既能明确诊断,也能对胃癌进行风险分层。理想状态应当是在高质量内镜检查中对GA或GIM区域活检。英国属于低危地区,可根据需要接受常规诊断性胃镜检查,但没有足够证据支持筛查,对于广泛GA或GIM的患者,每3年检查内镜。对于胃异型增生和早期癌,只要满足标准,内镜下黏膜切除术或内镜黏膜下剥离术的治疗有效,成功率高,复发率低。

关键词：慢性萎缩性胃炎内镜检查内镜黏膜下剥离术恶性贫血常规诊断角切迹早期癌胃肠病学

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Assessment of chicken breast shelf life based on bench-top and portable near-infrared spectroscopy tools coupled with chemometrics

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Food Quality and Safety 2021年第1期5卷 31-41页

作者： llaria Lanza Daniele Conficoni Stefania Balzan marco Cullere Luca Fasolato Lorenzo Servap Barbara Contiero Angela Trocino Giorgio Marchesini Gerolamo Xiccato Enrico novelli Severino Segato Department of Animal Medicine Productions and HealthUniversity of PadovaLegnaroItaly Department of Comparative Biomedicine and Food Science University of PadovaLegnaroItaly Department of Agronomy FoodNatural ResourcesAnimals and EnvironmentUniversity of PadovaLegnaroItaly

Objectives:Near-infra red(NIR)spectroscopy is a rapid technique able to assess meat quality even if its capability to determine the shelf life of chicken fresh cuts is still debated,especially for portable *** aim of the study was to compare bench-top and portable NIR instruments in discriminating between four chicken breast refrigeration times(RT),coupled with multivariate classifier *** and Methods:Ninety-six samples were analysed by both NIR tools at 2,6,10 and 14 days post *** data were subsequently submitted to partial least squares discriminant analysis(PLS-DA)and canonical discriminant analysis(CDA).The latter was preceded by double feature selection based on Boruta and Stepwise ***:PLS-DA sorted moderate separation of RT theses,while shelf life assessment was more accurate on application of ***-top tool had better performance than portable one,probably because it captured more informative spectral data as shown by the variable importance in projection(VIP)and restricted pool of Stepwise-CDA predictive scores(SPS).Conclusions:NIR tools coupled with a multivariate model provide deep insight into the physicochemical processes occurring during *** showed reliable effectiveness to recognise a 7-day shelf life threshold of breasts,suitable for routine at-line application for screening of meat quality.

关键词： shelf life chicken breast Near-infrared(NIR)spectroscopy bench-top NIR portable NIR canonical discriminant analysis

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