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Neoadjuvant strategies for pancreatic cancer

World Journal of Gastroenterology 2014年第28期20卷 9374-9383页

作者： Francesco Polistina Giuseppe Di Natale Giorgio Bonciarelli Giovanni Ambrosino mauro frego Department of General Surgery Monselice Hospital Rome University "La Sapienza" School of Surgery Piazzale Aldo Moro Department of Clinical Oncology Monselice Hospital Department of Surgery Malzoni Hospital

Pancreatic cancer(PC)is the fourth cause of cancer death in Western countries,the only chance for long term survival is an R0 surgical resection that is feasible in about 10%-20%of all *** years cumulative survival is less than 5%and rises to 25%for radically resected *** 40%has locally advanced in PC either borderline resectable(BRPC)or unresectable locally advanced(LAPC).Since LAPC and BRPC have been recognized as a particular form of PC neoadjuvant therapy(NT)has increasingly became a valid treatment *** aim of NT is to reach local control of disease but,also,it is recognized to convert about40%of LAPC patients to R0 resectability,thus providing a significant improvement of prognosis for responding *** R0 resection is achieved,survival is comparable to that of early stage PCs treated by upfront *** it is crucial to look for a proper patient *** strategies are multiples and include neoadjuvant chemotherapy(nCT),and the association of nCT with radiotherapy(nCRT)given as either a combination of a radio sensitizing drug as gemcitabine or capecitabine or and concomitant irradiation or as upfront nCT followed by nRT associated to a radio sensitizing *** latter seem to be most promising as it may select patients who do not go on disease progression during initial treatment and seem to have a better *** clinical relevance of nCRT may be enhanced by the application of higher active protocols as FOLFIRINOX.

关键词： Pancreatic cancer Neoadjuvant Chemotherap Radiotherapy Chemoradiation

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Persistence of high CD40 and CD40L expression after restorative proctocolectomy for ulcerative colitis

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World Journal of Gastroenterology 2005年第34期11卷 5303-5308页

作者： Lino Polese Imerio Angriman Giuseppe De Franchis Attilio Cecchetto Giacomo C.Sturniolo Renata D'Incà Marco Scarpa Cesare Ruffolo Lorenzo Norberto mauro frego Davide F D'Amico Department of Gastroenterological and Surgical Sciences. Surgical Unit University of Padova Italy Department of Laboratory Medicine University of Padova Italy Department of Pathology University of Padova Italy Department of Gastroenterological and Surgical Sciences Gastroenterological Unit University of Padova Italy

AIM： To focus on the role of CD40 and CD40L in their pathogenesis. METHODS： We analyzed by immunohistochemistry the CD40 and CD40L expression in the pouch mucosa of 28 patients who had undergone RPC for UC, in the terminal ileum of 6 patients with UC and 11 healthy subjects. We also examined by flow cytometry the expression of CEH0 by B lymphoo/tes and monocytes in the peripheral blood of 20 pouch patients, 15 UC patients and 11 healthy controls. RESULTS： Ileal pouch mucosa leukocytes presented a significantly higher expression of CD40 and CD40L as compared to controls. This alteration correlated with pouchitis, but was also present in the healthy pouch and in the terminal ileum of UC patients. CD40 expression of peripheral B lymphocytes was significantly higher in patients with UC and pouch, respect to controls. Increased CD40 levels in blood B cells of pouch patients correlated with the presence of spondyloarthropathy, but not with pouchitis, or inflammatory indices. CONCLUSION： High CD40 expression in the ileal pouch mucosa could be implied in the pathogenesis of pouchitis following proctocolectomy for UC, whereas its increased levels on peripheral blood B lymphocytes are associated with the presence of extraintestinal manifestations.

关键词： Ulcerative colitis Pouchitis Spondyloarthropathy CD40 CD4OL Arthritis

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Accuracy of magnetic resonance cholangiography compared to operative endoscopy in detecting biliary stones, a single center experience and review of literature

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World Journal of Radiology 2015年第4期7卷 70-78页

作者： Francesco A Polistina mauro frego Marco Bisello Emy Manzi Antonella Vardanega Bortolo Perin Department of General Surgery Suor Maria Teresa di CalcuttaPadova sud Hospital Department of General Surgery and Service of Endoscopy Suor Maria Teresa di CalcuttaPadova sud Hospital School of Surgery La Sapienza University Department of Radiology Suor Maria Teresa di CalcuttaPadova sud Hospital

AIM: To compare diagnostic sensitivity, specificity and accuracy of magnetic resonance cholangiopancreatography(MRCP) without contrast medium and endoscopic ultrasound(EUS)/endoscopic retrograde cholangiopancreatography(ERCP) for biliary calculi. METHODS: From January 2012 to December 2013, two-hundred-sixty-three patients underwent MRCP at our institution, all MRCP procedure were performed with the same machinery. In two-hundred MRCP was done for pure hepatobiliary symptoms and these patients are the subjects of this study. Among these two-hundred patients, one-hundred-eleven(55.5%) underwent ERCP after MRCP. The retrospective study design consisted in the systematic revision of all images from MRCP and EUS/ERCP performed by two radiologist with a long experience in biliary imaging, an experienced endoscopist and a senior consultant in Hepatobiliopancreatic surgery. A false positive was defined an MRCP showing calculi with no findings at EUS/ERCP; a true positive was defined as a concordance between MRCP and EUS/ERCP findings; a false negative was defined as the absence of images suggesting calculi at MRCP with calculi localization/extraction at EUS/ERCP and a true negative was defined as a patient with nocalculi at MRCP ad at least 6 mo of asymptomatic followup. Biliary tree dilatation was defined as a common bile duct diameter larger than 6 mm in a patient who had an in situ gallbladder. A third blinded radiologist who examined the MRCP and ERCP data reviewed misdiagnosed cases. Once obtained overall data on sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) we divided patients in two groups composed of those having concordant MRCP and EUS/ERCP(Group A, 72 patients) and those having discordant MRCP and EUS/ERCP(Group B, 20 patients). Dataset comparisons had been made by the Student's t-test and χ2 when ***: Two-hundred patients(91 men, 109 women, mean age 67.6 years, and range 25-98 years) underwe

关键词： Biliary strictures Magnetic resonance cholangiopancreatography Biliary stones Endoscopic retrograde cholangiopancreatography Endoscopic ultrasound

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