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New common bile duct morphological subtypes:Risk predictors of common bile duct stone recurrence

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World Journal of Gastrointestinal Surgery 2022年第3期14卷 236-246页

作者： Xu Ji Zhuo Yang Shu-Ren Ma Wen Jia Qian Zhao Lu Xu Ying Kan Yang Cao Yao Wang Bao-Jun Fan Department of Digestive Endoscopy General Hospital of Northern Theater CommandShenyang 110840Liaoning ProvinceChina Postgraduate College Dalian Medical UniversityDalian 116044Liaoning ProvinceChina

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the primary treatment for removing common bile duct(CBD)stones.The risk factors for CBD stone recurrence after ERCP have been discussed for many years.However,the influence of CBD morphology has never been noticed.AIM To evaluate CBD morphology and other predictors affecting CBD stone recurrence in average patients.METHODS A retrospective analysis of 502 CBD stone patients who underwent successful therapeutic ERCP for stone extraction at our centre from February 2020 to January 2021 was conducted.CBD morphology and other predictors affecting CBD stone recurrence were examined by univariate analysis and multivariate logistic regression analysis.RESULTS CBD morphology(Precurrence.Furthermore,the recurrence rate of patients with the S type was 6.61-fold that of patients with the straight type(OR=6.61,95%CI:2.61-16.77,Precurrence rate of patients with the polyline type was 2.45-fold that of patients with the straight type(OR=2.45,95%CI:1.14-5.26,P=0.02).The recurrence rate of S type patients was 2.70-fold that of patients with the polyline type(OR=2.70,95%CI:1.08-6.73,P=0.03).Compared with no-ESBD,ESBD could decrease the risk of recurrence.CONCLUSION CBD diameter≥1.5 cm and CBD morphology,especially S type and polyline type,were associated with increased recurrence of CBD stones.In addition,ESBD was related to decreased recurrence.Patients with these risk factors should undergo periodic surveillance and standard prophylactic therapy.

关键词： Endoscopic retrograde cholangiopancreatography Common bile duct stones recurrence Common bile duct morphology Risk factors

Risk factors for stroke recurrence in young patients with first-ever ischemic stroke:A meta-analysis

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世界临床病例杂志 2023年第26期11卷 6122-6131页

作者： Yu Xia Han Liu Rui Zhu Department of Neurology The Third People’s Hospital of Hefei(The Third Clinical College of Anhui Medical University)Hefei 230022Anhui ProvinceChina Department of Neurology The First Affiliated Hospital of Anhui Medical University(Anhui Public Health Clinical Center)Hefei 230041Anhui ProvinceChina

BACKGROUND At present,the incidence rate of ischemic stroke in young people is increasing yearly,and the age of onset is increasingly young.Therefore,primary and secondary prevention of ischemic stroke in young people,especially secondary prevention,is particularly crucial.AIM We aimed to comprehensively evaluate risk factors for stroke recurrence in firstever young ischemic stroke(YIS)patients.METHODS The meta-analysis was used to quantitatively analyze the research results on risk factors for stroke recurrence in first-ever YIS patients both domestically and internationally.Stata12.0 software was used for heterogeneity testing,publication bias analysis,sensitivity analysis,and the calculation of combined odds ratios and 95%confidence intervals.RESULTS The odds ratio(OR)values of the relationship between hypertension and hyperlipidemia and recurrence of first-ever YIS were 1.54(1.05-2.26)and 1.12(1.00-1.25),respectively.The OR values of male sex,type 2 diabetes,smoking,drinking and YIS recurrence were 1.66(0.98-2.79),1.01(0.64-1.59),1.21(0.83-1.76),and 1.28(0.82-2.53),respectively.The relationship between male sex,type 2 diabetes,smoking,drinking and YIS recurrence was ambiguous.CONCLUSION Hypertension and hyperlipidemia are important risk factors for stroke recurrence in first-ever YIS patients,and active intervention should be taken.

关键词： Young ischemic stroke First-ever Risk factors recurrence Meta-analysis

Predictors and long-term prognosis of early and late recurrence for patients undergoing hepatic resection of hepatocellular carcinoma: a large-scale multicenter study

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 155-168,I0001页

作者： Wen-Tao Yan Chao Li Lan-Qing Yao Hai-Bo Qiu Ming-Da Wang Xin-Fei Xu Ya-Hao Zhou Hong Wang Ting-Hao Chen Wei-Min Gu Jian-Hong Zhong Han Wu Timothy M.Pawlik Wan Yee Lau Feng Shen Tian Yang Department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)ShanghaiChina Graduate School Second Military Medical University(Navy Medical University)ShanghaiChina Department of Anesthesiology Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)ShanghaiChina Department of Hepatobiliary Surgery Pu’er People’s HospitalPu’erChina Department of General Surgery Liuyang People’s HospitalLiuyangChina Department of General Surgery Ziyang First People’s HospitalZiyangChina The First Department of General Surgery the Fourth Hospital of HarbinHarbinChina Department of Hepatobiliary Surgery Affiliated Tumor Hospital of Guangxi Medical UniversityNanningChina Department of Surgery Ohio State UniversityWexner Medical CenterColumbusOHUSA Faculty of Medicine the Chinese University of Hong KongShatinNew TerritoriesHong KongChina

recurrence is common among patients undergoing hepatic resection for hepatocellular carcinoma(HCC),which greatly limits long-term survival.We aimed to identify predictors and long-term prognosis of early and late recurrence after HCC resection.Methods:Multicenter data of patients who underwent HCC resection between 2002 and 2016 were analyzed.recurrence was divided into early(≤2 years)and late recurrence(>2 years after surgery).Predictors of early and late recurrence,and prognostic factors of post-recurrence survival(PRS)were identified by univariate and multivariate analyses.Results:Among 1,426 patients,554(38.8%)and 348(24.4%)developed early and late recurrence,respectively.Independent predictors associated with early recurrence included preoperative alpha-fetoprotein level>400μg/L,resection margin5.0 cm,multiplicity,macrovascular and microvascular invasion,and satellites of the initial tumor at the first diagnosis of HCC;independent predictors associated with late recurrence included male,cirrhosis,and tumor size>5.0 cm,multiplicity,macrovascular and microvascular invasion,and satellites of the initial tumor.Patients with early recurrence had a lower likelihood of undergoing potentially curative treatments for recurrence(37.2%vs.48.0%,Precurrence.Multivariate analysis revealed that early recurrence and irregular postoperative surveillance were independently associated with worse PRS[hazard ratio(HR)=1.250,95%CI:1.016-1.538,P=0.035;and HR=1.983,95%CI:1.677-2.345,Precurrence after curative resection for patients with HCC were generally same,although several did differ.Patients with late recurrence had better long-term survival than patients with early recurrence.

关键词： Hepatocellular carcinoma(HCC) recurrence predictor prognosis hepatectomy

Risk prediction of common bile duct stone recurrence based on new common bile duct morphological subtypes

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World Journal of Gastrointestinal Surgery 2022年第8期14卷 874-876页

作者： Hirokazu Saito Shuji Tada Department of Gastroenterology Kumamoto City HospitalKumamoto 862-8505Japan

Stones in the common bile duct(CBD) are reported worldwide, and this condition is majorly managed through endoscopic retrograde cholangiopancreatography(ERCP). CBD stone recurrence is an important issue after endoscopic stone removal. Therefore, it is essential to identify its risk factors to determine the necessity of regular follow-up in patients who underwent endoscopic removal of CBD stones. The authors identified that the S and polyline morphological subtypes of CBD were associated with increased stone recurrence. New morphological subtypes of CBD presented by the authors can be important risk predictors of recurrence after endoscopic stone removal. Furthermore, the new morphological subtypes of CBD may predict the risk of residual CBD stones or technical difficulty in CBD stone removal. Further studies with a large sample size and longer follow-up durations are warranted to examine the usefulness of the newly identified morphological subtypes of CBD in predicting the outcomes of ERCP for CBD stone removal.

关键词： Endoscopic retrograde cholangiopancreatography Common bile duct stone Stone removal recurrence Common bile duct morphology Risk prediction

Recent progress in molecular mechanisms of postoperative recurrence and metastasis of hepatocellular carcinoma

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World Journal of Gastroenterology 2022年第46期28卷 6433-6477页

作者： Zhao-Shan Niu Wen-Hong Wang Xiao-Jun Niu Laboratory of Micromorphology School of Basic MedicineQingdao UniversityQingdao 266071Shandong ProvinceChina Department of Pathology School of Basic MedicineQingdao UniversityQingdao 266071Shandong ProvinceChina Department of Internal Medicine Qingdao Shibei District People's HospitalQingdao 266033Shandong ProvinceChina

Hepatectomy is currently considered the most effective option for treating patients with early and intermediate hepatocellular carcinoma(HCC).Unfortunately,the postoperative prognosis of patients with HCC remains unsatisfactory,predominantly because of high postoperative metastasis and recurrence rates.Therefore,research on the molecular mechanisms of postoperative HCC metastasis and recurrence will help develop effective intervention measures to prevent or delay HCC metastasis and recurrence and to improve the long-term survival of HCC patients.Herein,we review the latest research progress on the molecular mechanisms underlying postoperative HCC metastasis and recurrence to lay a foundation for improving the understanding of HCC metastasis and recurrence and for developing more precise prevention and intervention strategies.

关键词： Hepatocellular carcinoma recurrence Metastasis Mechanisms Postoperation Intervention

Hepatocellular carcinoma recurrence:Predictors and management

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Liver Research 2023年第4期7卷 321-332页

作者： Walaa Abdelhamed Mohamed El-Kassas Endemic Medicine Department Sohag UniversitySohagEgypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairoEgypt

Hepatocellular carcinoma(HCC),the sixth most common cancer globally,is associated with high mortality rates and more than 830,000 annual deaths.Despite advances in the available management options including surgical resection and local ablative therapies,recurrence rates after the initial treatment exceed 50%,even among patients who have undergone curative-intent therapy.Moreover,postsurgical HCC recurrence occurs in about 70%of cases five years postoperatively.The management of recurrent HCC remains undefined.This review discusses different predictors for HCC recurrence after each treatment modality and different approaches available to stratify these patients.More specific guidelines for managing HCC recurrence and strict surveillance protocols for such recurrence after initial HCC management are needed.

关键词： Hepatocellular carcinoma(HCC) recurrence Ablation Liver resection Liver transplantation

Saccharomyces cerevisiae prevents postoperative recurrence of Crohn's disease modeled by ileocecal resection in HLA-B27 transgenic rats

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World Journal of Gastroenterology 2023年第5期29卷 851-866页

作者： Caroline Valibouze Silvia Speca Caroline Dubuquoy Florian Mourey Lena M'Ba Lucil Schneider Marie Titecat Benoît Foligné Michaël Genin Christel Neut Philippe Zerbib Pierre Desreumaux Department of Digestive Surgery and Transplantation Lille University HospitalLille 59037France U1286-INFINITE-Institute for Translational Research in Inflammation Univ.LilleInsermCHU LilleLille 59000France Intestinal Biotech Development Lille 59045France Department of Research and Applications Gnosis by LesaffreLesaffre GroupMarcq-en-Baroeul 59700France ULR 2694-METRICS:Évaluation des Technologies de Santéet des Pratiques Médicales University of LilleLille University HospitalLille 59000France Department of Hepato-Gastroenterology Lille University HospitalLille 59037France

BACKGROUND Postoperative recurrence(POR)after ileocecal resection(ICR)affects most Crohn's disease patients within 3-5 years after surgery.Adherent-invasive Escherichia coli(AIEC)typified by the LF82 strain are pathobionts that are frequently detected in POR of Crohn's disease and have a potential role in the early stages of the disease pathogenesis.Saccharomyces cerevisiae CNCM I-3856 is a probiotic yeast reported to inhibit AIEC adhesion to intestinal epithelial cells and to favor their elimination from the gut.AIM To evaluate the efficacy of CNCM I-3856 in preventing POR induced by LF82 in an HLA-B27 transgenic(TgB27)rat model.METHODS Sixty-four rats[strain F344,38 TgB27,26 control non-Tg(nTg)]underwent an ICR at the 12th wk(W12)of life and were sacrificed at the 18th wk(W18)of life.TgB27 rats were challenged daily with oral administration of LF82(109 colony forming units(CFUs)/day(d),n=8),PBS(n=5),CNCM I-3856(109 CFUs/d,n=7)or a combination of LF82 and CNCM I-3856(n=18).nTg rats receiving LF82(n=5),PBS(n=5),CNCM I-3856(n=7)or CNCM I-3856 and LF82(n=9)under the same conditions were used as controls.POR was analyzed using macroscopic(from 0 to 4)and histologic(from 0 to 6)scores.Luminal LF82 quantifications were performed weekly for each animal.Adherent LF82 and inflammatory/regulatory cytokines were quantified in biopsies at W12 and W18.Data are expressed as the median with the interquartile range.RESULTS nTg animals did not develop POR.A total of 7/8(87%)of the TgB27 rats receiving LF82 alone had POR(macroscopic score≥2),which was significantly prevented by CNCM I-3856 administration[6/18(33%)TgB27 rats,P=0.01].Macroscopic lesions were located 2 cm above the anastomosis in the TgB27 rats receiving LF82 alone and consisted of ulcerations with a score of 3.5(2-4).Seven out of 18 TgB27 rats(39%)receiving CNCM I-3856 and LF82 had no macroscopic lesions.Compared to untreated TgB27 animals receiving LF82 alone,coadministration of CNCM I-3856 and LF82 significantly reduced the macroscopic[3.5(2-4)vs 1(0-3),P=0.002]a

关键词： Crohn's disease recurrence Escherichia coli Probiotic Saccharomyces cerevisiae Colorectal surgery

Definition and verification of novel metastasis and recurrence related signatures of ccRCC: A multicohort study

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Cancer Innovation 2022年第2期1卷 146-167页

作者： Aimin Jiang Qingyang Pang Xinxin Gan Anbang Wang Zhenjie Wu Bing Liu Peng Luo Le Qu Linhui Wang Department of Urology Changhai HospitalNaval Medical University(Second Military Medical University)ShanghaiChina Department of Urology Changzheng HospitalNaval Medical University(Second Military Medical University)ShanghaiChina Department of Urology The Third Affiliated HospitalNaval Medical University(Second Military Medical University)ShanghaiChina Department of Oncology Zhujiang HospitalSouthern Medical UniversityGuangzhouChina Department of Urology Affiliated Jinling HospitalMedical School of Nanjing UniversityNanjingChina

Background:Cancer metastasis and recurrence remain major challenges in renal carcinoma patient management.There are limited biomarkers to predict the metastatic probability of renal cancer,especially in the early-stage subgroup.Here,our study applied robust machine-learning algorithms to identify metastatic and recurrence-related signatures across multiple renal cancer cohorts,which reached high accuracy in both training and testing cohorts.Methods:Clear cell renal cell carcinoma(ccRCC)patients with primary or metastatic site sequencing information from eight cohorts,including one outhouse cohort,were enrolled in this study.Three robust machine-learning algorithms were applied to identify metastatic signatures.Then,two distinct metastatic-related subtypes were identified and verified;matrix remodeling associated 5(MXRA5),as a promising diagnostic and therapeutic target,was investigated in vivo and in vitro.Results:We identified five stable metastasis-related signatures(renin,integrin subunit beta-like 1,MXRA5,mesenchyme homeobox 2,and anoctamin 3)from multicenter cohorts.Additionally,we verified the specificity and sensibility of these signatures in external and out-house cohorts,which displayed a satisfactory consistency.According to these metastatic signatures,patients were grouped into two distinct and heterogeneous ccRCC subtypes named metastatic cancer subtype 1(MTCS1)and type 2(MTCS2).MTCS2 exhibited poorer clinical outcomes and metastatic tendencies than MTCS1.In addition,MTCS2 showed higher immune cell infiltration and immune signature expression but a lower response rate to immune blockade therapy than MTCS1.The MTCS2 subgroup was more sensitive to saracatinib,sunitinib,and several molecular targeted drugs.In addition,MTCS2 displayed a higher genome mutation burden and instability.Furthermore,we constructed a prognosis model based on subtype biomarkers,which performed well in training and validation cohorts.Finally,MXRA5,as a promising biomarker,significantly suppressed malignant ability,including the ce

关键词： clear cell renal cell carcinoma metastasis recurrence machine learning multiple omics single‐cell sequencing

Lessons learned from hepatocellular carcinoma may cause a paradigm shift in intraductal papillary mucinous neoplasms:a narrative review and discussion of conceptual similarities in tumor progression and recurrence

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Journal of Pancreatology 2022年第1期5卷 36-40页

作者： Georgios Antonios Margonis Nikolaos Andreatos Jane Wang Matthew J.Weiss Christopher L.Wolfgang Department of Surgery Memorial Sloan Kettering Cancer CenterNew YorkNY Department of Internal Medicine and Taussig Cancer Institute Cleveland ClinicClevelandOH Department of Surgery University of California San FranciscoSan FranciscoCA Department of Surgery Northwell Health Cancer Institute and Zucker School of Medicine at HofstraL ake Success Department of Surgery NYU Grossman School of MedicineNew YorkNYUSA

Although the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality ( "field defect" ) in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic "field defect" may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression;thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.

关键词： Field defect Hepatocellular carcinoma Intraductal papillary mucinous neoplasm Progression recurrence