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peritoneal dissemination of pancreatic cancer caused by endoscopic ultrasound-guided fine needle aspiration:A case report and literature review

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World Journal of Gastroenterology 2021年第3期27卷 294-304页

作者： Hideaki Kojima Minoru Kitago Eisuke Iwasaki Yohei Masugi Yohji Matsusaka Hiroshi Yagi Yuta Abe Yasushi Hasegawa Shutaro Hori Masayuki Tanaka Yutaka Nakano Yusuke Takemura Seiichiro Fukuhara Yoshiyuki Ohara Michiie Sakamoto Shigeo Okuda Yuko Kitagawa Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineTokyo 160-8582Japan Department of Pathology Keio University School of MedicineTokyo 160-8582Japan Department of Radiology Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)is a biopsy technique widely used to diagnose pancreatic tumors because of its high sensitivity and *** needle-tract seeding caused by EUS-FNA has been recently reported,dissemination of pancreatic cancer cells is generally considered to be a rare complication that does not affect patient ***,the frequency of dissemination and needle-tract seeding appears to have been *** present a case of peritoneal dissemination of pancreatic cancer due to preoperative *** SUMMARY An 81-year-old man was referred to the Department of Surgery of our hospital in Japan owing to the detection of a pancreatic mass on computed tomography during medical ***-gastric EUS-FNA revealed that the mass was an adenocarcinoma;hence laparoscopic distal pancreatectomy with lymphadenectomy was *** intraoperative peritoneal dissemination and liver metastasis were visually detected,and pelvic lavage cytology was negative for carcinoma *** postoperative surgical specimen was negative for carcinoma cells at the dissected margin and the cut end margin;however,pathological findings revealed adenocarcinoma cells on the peritoneal surface proximal to the needle puncture site,and the cells were suspected to be disseminated via ***,the patient received adjuvant therapy with S-1(tegafur,gimeracil,and oteracil potassium);however,computed tomography performed 5 mo after surgery revealed liver metastasis and cancerous *** patient received palliative therapy and died 8 mo after the *** The indications of EUS-FNA should be carefully considered to avoid iatrogenic dissemination,especially for cancers in the pancreatic body or tail.

关键词： Case report Pancreatic carcinoma Endoscopic ultrasound-guided fine needle aspiration peritoneal dissemination Cancerous peritonitis Biopsy

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Prognostic nutritional index is an independent prognostic factor for gastric cancer patients with peritoneal dissemination

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Chinese Journal of Cancer Research 2016年第6期28卷 570-578页

作者： Runcong Nie Shuqiang Yuan Shi Chen Xiaojiang Chen Yongming Chen Baoyan Zhu Haibo Qiu Zhiwei Zhou Junsheng Peng Yingbo Chen Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Department of Gastrointestinal Surgery the Sixth Affiliated Hospital Sun Yat-sen University

Objective： The predictive and prognostic role of prognostic nutritional index（PNI） in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal ***： A total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yatsen University were retrospectively analyzed. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal dissemination were ***： Compared with PNI-high group, PNI-low group was correlated with advanced age（P=0.036）, worse performance status（P0.001）, higher frequency of ascites（P0.001） and higher frequency of multisite distant metastasis（P0.001）. Kaplan-Meier survival curves showed that PNI-high group had a significantly longer median overall survival than PNI-low group（13.13 vs. 9.03 months, P0.001）. Multivariate survival analysis revealed that Borrmann type IV（P=0.014）, presence of ascites（P=0.017） and lower PNI（P=0.041） were independent poor prognostic factors, and palliative surgery（P0.001） and first-line chemotherapy（P0.001） were good prognostic factors. For patients receiving palliative surgery, the postoperative morbidity rates in the PNI-low group and PNIhigh group were 9.1% and 9.9%, respectively（P=0.797）. The postoperative mortality rate was not significantly different between PNI-low and PNI-high groups（2.3% vs. 0.9%, P=0.362）.Conclusions： PNI is a useful and practical tool for evaluating the nutritional status of gastric cancer patients with peritoneal dissemination, and is an independent prognostic factor for these patients.

关键词： Prognostic nutritional index(PNI) gastric cancer peritoneal dissemination survival

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Primary rectal signet ring cell carcinoma with peritoneal dissemination and gastric secondaries

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World Journal of Gastroenterology 2008年第13期14卷 2118-2120页

作者： Hsien-Lin Sim Kok-Yang Tan Pak-Leng Poon Anton Cheng Department of Surgery Alexandra Hospital 378 Alexandra Road 159964 Singapore

Disseminated signet ring cell carcinomas frequently arise from the stomach. However, primaries in the colon and rectum have also been reported. We present a 68 year old lady who presented with a change in her bowel habit. Colonoscopy showed a stenosing rectal tumour at 7 cm to 8 cm from the anal verge. Multiple scattered ulcers were also noted along the entire length of the colon. Biopsy of the lesions revealed signet ring cell adenocarcinoma. Gastroscopy showed multiple nodules with ulceration over several areas of the stomach which were similar in appearance to the colonic lesions. However, no primary tumour of the stomach was seen. Biopsy of the gastric lesions also showed signet ring cell adenocarcinoma. Computed tomography scan of the abdomen and pelvis revealed circumferential tumour at the rectosigmoid junction with possible invasion into the left ischiorectal fossa. The overall picture was that of a primary rectal signet ring cell carcinoma with peritoneal dissemination. The patient was referred for palliative chemotherapy in view of the disseminated disease. In the present report, we discuss this interesting pathological entity and review the role of various histolological techniques in helping to identify the primary tumor.

关键词： Signet ring cell carcinoma Colorectal tumour peritoneal dissemination Gastric secondaries

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A nomogram to predict prognosis for gastric cancer with peritoneal dissemination

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Chinese Journal of Cancer Research 2018年第4期30卷 449-459页

作者： Shi Chen Xijie Chen Runcong Nie Liying Ou Yang Aihong Liu Yuanfang Li Zhiwei Zhou Yingbo Chen Junsheng Peng Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases the Sixth Affiliated Hospital of Sun Yat-sen University Department of Gastrointestinal Surgery the Sixth Affiliated Hospital of Sun Yat-sen University Department of Gastropancreatic Surgery Sun Yat-sen University Cancer Center Department of Intensive Care Sun Yat-sen University Cancer Center

Objective： To identify independent prognostic factors to be included in a nomogram to predict the prognosis ofgastric cancer patients with peritoneal ***： This is a retrospective study on 684 patients with a histological diagnosis of gastric cancer withperitoneal dissemination from the Sun Yat-sen University Cancer Center as the development set, and 62 gastriccancer patients from the Sixth Affiliated Hospital of Sun Yat-sen University as the validation group. Chi-square testand Cox regression analysis were used to compare the clinicopathological variables and the prognosis of gastriccancer patients with peritoneal dissemination. The Harrell＇s concordance index （C-index） and calibration curvewere determined for comparisons of predictive ability of the ***： Univariate and multivariate analyses showed that serum carcinoembryonic antigen （CEA） level（P=0.032）, ascites grading （P=0.008）, presence of extraperitoneal metastasis （P〈0.001）, seeding status （P=0.016） andperformance status （P=0.009） were independent prognostic factors for gastric cancer patients with peritonealdissemination in the development set. The nomogram model was constructed using these five factors. Internalvalidation showed that the C-index of the model was 0.641. For the external validation, the C-index of this modelwas ***： We developed and validated a nomogram to predict the prognosis for gastric cancer patients withperitoneal dissemination. This nomogram may play an important clinical role in guiding palliative therapy for thesetypes of patients, although it may need more data for optimization.

关键词： Gastric cancer prognosis peritoneal dissemination nomogram

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Analysis and external validation of a nomogram to predict peritoneal dissemination in gastric cancer

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Chinese Journal of Cancer Research 2020年第2期32卷 197-207页

作者： Xijie Chen Shi Chen Xinyou Wang Runcong Nie Dongwen Chen Jun Xiang Yijia Lin Yingbo Chen Junsheng Peng Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655China Guangdong Institute of Gastroenterology Guangzhou 510655China departm ent of Gastrointestinal Surgery The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655China Department of Gastric Surgery Sun Yat-sen University Cancer CenterGuangzhou 510060China

Objective:peritoneal dissemination is difficult to diagnose by conventional imaging *** aimed to construct a nomogram to predict peritoneal dissemination in gastric cancer(GC)***:We retrospectively analyzed 1,112 GC patients in Sun Yat-sen University Cancer Center between2001 and 2010 as the development set and 474 patients from The Sixth Affiliated Hospital,Sun Yat-sen University between 2010 and 2016 as the validation *** clinicopathological variables associated with gastric cancer with peritoneal dissemination(GCPD)were *** used logistic regression analysis to identify independent risk factors for peritoneal ***,we constructed a nomogram for the prediction of GCPD and defined its predictive value with a receiver operating characteristic(ROC)*** validation was performed to validate the applicability of the ***:In total,250 patients were histologically identified as having peritoneal *** regression analysis demonstrated that age,sex,tumor location,tumor size,signet-ring cell carcinoma(SRCC),T stage,N stage and Borrmann classification IV(Borrmann IV)were independent risk factors for peritoneal *** constructed a nomogram consisting of these eight factors to predict GCPD and found an optimistic predictive capability,with a C-index of 0.791,an area under the curve(AUC)of 0.791,and a 95%confidence interval(95%CI)of *** results found in the external validation set were also ***:We constructed a highly sensitive nomogram that can assist clinicians in the early diagnosis of GCPD and serve as a reference for optimizing clinical management strategies.

关键词： Gastric cancer peritoneal dissemination nomogram

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Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation:A case report

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World Journal of Clinical Oncology 2021年第11期12卷 1083-1088页

作者： Shinpei Ogino Tatsuya Matsumoto Yosuke Kamada Noriaki Koizumi Hiroshi Fujiki Kenji Nakamura Takeshi Yamano Chouhei Sakakura Department of Surgery Akashi City HospitalAkashi 673-8501HyogoJapan Department of Pathology Akashi City HospitalAkashi 673-8501HyogoJapan

BACKGROUND Foreign body granuloma(FBG)is a well-known type of granulomatous formation,and intraabdominal FBG(IFBG)is primarily caused by surgical *** IFBGs caused by gastrointestinal perforation is an extremely rare and interesting clinicopathological condition that resembles peritoneal ***,we present a case of IFBGs mimicking peritoneal dissemination caused by bowel perforation and describe the value of intraoperative pathological examinations for rapid IFBG *** SUMMARY An 86-year-old woman with an incarcerated femoral hernia was admitted to the hospital and underwent *** the operation,the incarcerated ileum was perforated during repair due to hemorrhage necrosis,and a small volume of enteric fluid leaked from the *** incarcerated ileum was resected,and the femoral hernia was repaired without *** months later,a second operation was performed for an umbilical incisional *** the second operation,multiple small,white nodules were observed throughout the abdominal cavity,resembling peritoneal *** results of peritoneal washing cytology in Douglas’pouch and the examination of frozen nodule sections were compatible with IFBG diagnosis,and incisional hernia repair was *** IFBGs can mimic *** pathological examinations and operation history are valuable for the rapid diagnosis to avoid excessive treatments.

关键词： Foreign body granuloma peritoneal dissemination peritoneal seeding Perforation Operation Case report

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Molecular mechanism of peritoneal dissemination in gastric cancer

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 451-458页

作者： Qing-Jiang Hu Shuhei Ito Kazuyoshi Yanagihara Koshi Mimori Department of Surgery Kyushu University Beppu HospitalBeppu 874-0838Japan Department of Surgery and Science Kyushu University HospitalFukuoka 812-8582Japan Division of Biomarker Discovery Exploratory Oncology Research&Clinical Trial CenterNational Cancer CenterKashiwa 277-8577Japan

peritoneal dissemination(PD)is the most common cause of metastasis in gastric cancer(GC).Because there are no standard treatments for PD,it is associated with a poor *** clinicians have performed intraperitoneal chemotherapy for GC with PD,the outcome remains ***,the development of novel treatments and diagnostic tools for PD is expected to improve the prognosis of GC patients with ***,it is essential to elucidate the molecular mechanisms involved in the development of PD in *** this review,the molecular mechanisms of PD(three steps:detachment from the primary tumor,adaptation to the microenvironment of the peritoneal cavity,and attachment to peritoneal mesothelial cells)and new topics in GC are highlighted.

关键词： Gastric cancer peritoneal dissemination molecular mechanism

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Depth of tumor invasion and tumor-occupied portions of stomach are predictive factors of intra-abdominal metastasis

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Chinese Journal of Cancer Research 2017年第2期29卷 109-117页

作者： Ziyu Li Zhemin Li Shuqin Jia Zhaode Bu Lianhai Zhang Xiaojiang Wu Shuangxi Li Fei Shan Xin Ji Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Center of Gastrointestinal Surgery Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Center for Molecular Diagnostics Peking University Cancer Hospital & Institute Beijing 100142 China

Objective： Diagnostic laparoscopy is recommended for the pretherapeutic staging of gastric cancer to detect any unexpected or unconfirmed intra-abdominal metastasis. The aim of this study was to evaluate the role and indications of diagnostic laparoscopy in the detection of intra-abdominal metastasis. Methods： Standard diagnostic laparoscopy with peritoneal cytology examination was performed prospectively on patients who were clinically diagnosed with primary local advanced gastric cancer （CT≥2M0）. We calculated the rate of intra-abdominal metastases identified by diagnostic laparoscopy, and examined the relationship between peritoneal dissemination （P） and cytology results （CY）. Split-sample method was applied to find clinical risk factors for intra-abdominal metastasis. Multivariate logistic regression analysis and receiver-operator characteristic （ROC） analysis were performed in training set to find out risk factors ofintra-abdominal metastasis, and then validate it in testing set. Results： Out of 249 cM0 patients, 51 （20.5%） patients with intra-abdominal metastasis were identified by diagnostic laparoscopy, including 20 （8.0%） P1CY1, 17 （6.8%） POCY1 and 14 （5.6%） P1CY0 patients. In the training set, multivariate logistic regression analysis and ROC analysis showed that the depth of tumor invasion on computer tomography （CT） scan ≥21 mm and tumor-occupied 〉2 portions of stomach are predictive factors of metastasis. In the testing set, when diagnostic laparoscopy was performed on patients who had one or two of these risk factors, the sensitivity and positive predictive value for detecting intra-abdominal metastasis were 90.0% and 32.1%, respectively. Conclusions： According to our results, depth of tumor invasion and tumor-occupied portions of stomach are predictive factors ofintra-abdominal metastasis.

关键词： Gastric cancer diagnostic laparoscopy peritoneal dissemination intra-peritoneal free cancer cells pretherapeutic staging

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