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Prediction of tumor biological characteristics in different colorectal cancer liver metastasis animal models using^(18)F-FDG and^(18)F-FLT

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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 140-148页

作者： Hai-Long Xu Man Li Rong-Jun Zhang Hui-Jie Jiang Ming-Yu Zhang Xin Li Yi-Qiao Wang Wen-Bin Pan Department of Radiology the Second Affiliated Hospital of Harbin Medical University endoscopy Center the Third Affiliated Hospital of Harbin Medical University Key Laboratory of Nuclear Medicine of the Ministry of Health Jiangsu Key Laboratory of Molecular Nuclear Medicine

Background: Positron emission tomography(PET) is a noninvasive method to characterize different metabolic activities of tumors, providing information for staging, prognosis, and therapeutic response of patients with cancer. The aim of this study was to evaluate the feasibility of18F-fludeoxyglucose(18F-FDG) and 3’-deoxy-3’-18F-fluorothymidine(18F-FLT) PET in predicting tumor biological characteristics of colorectal cancer liver ***: The uptake rate of18F-FDG and18F-FLT in SW480 and SW620 cells was measured via an in vitro cell uptake assay. The region of interest was drawn over the tumor and liver to calculate the maximum standardized uptake value ratio(tumor/liver) from PET images in liver metastasis model. The correlation between tracer uptake in liver metastases and VEGF, Ki67 and CD44 expression was evaluated by linear ***: Compared to SW620 tumor-bearing mice, SW480 tumor-bearing mice presented a higher rate of liver metastases. The uptake rate of18F-FDG in SW480 and SW620 cells was 6.07% ± 1.19% and2.82% ± 0.15%, respectively(t = 4.69, P = 0.04); that of18F-FLT was 24.81% ± 0.45% and 15.57% ± 0.66%, respectively(t = 19.99, P < 0.001). Micro-PET scan showed that all parameters of FLT were significantly higher in SW480 tumors than those in SW620 tumors. A moderate relationship was detected between metastases in the liver and18F-FLT uptake in primary tumors(r = 0.73, P = 0.0019).18F-FLT uptake was also positively correlated with the expression of CD44 in liver metastases(r = 0.81, P = 0.0049).Conclusions: The uptake of18F-FLT in metastatic tumor reflects different biological behaviors of colon cancer cells.18F-FLT can be used to evaluate the metastatic potential of colorectal cancer in nude mice.

关键词： Liver metastasis model Tumor biology Positron emission tomography

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Pancreatoscopy: An update

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World Journal of Gastrointestinal endoscopy 2019年第1期11卷 22-30页

作者： Luca De Luca Alessandro Repici Adea Ko?ollari Francesco Auriemma Mario Bianchetti Benedetto Mangiavillano Gastroenterology and Digestive endoscopy Unit Ospedali Riuniti Marche Nord Digestive endoscopy Unit Division of Gastroenterology Humanitas Research Hospital Humanitas University Gastroenterology Unit University Medical Center "Mother Theresa" Hospital Gastrointestinal endoscopy Unit Humanitas Mater Domini

Per-oral pancreatoscopy(POPS) is an endoscopic procedure to visualize the main pancreatic duct. POPS specifically has the advantage of direct visualization of the pancreatic duct, allowing tissue acquisition and directed therapies such as stones lithotripsy. The aim of this review is to analyze and summarize the literature around pancreatoscopy. Pancreatoscopy consists of the classic technique of the mother-baby method in which a mini-endoscope is passed through the accessory channel of the therapeutic duodenoscope. Pancreatoscopy has two primary indications for diagnostic purpose. First, it is used for visualization and histological diagnosis of intraductal papillary mucinous neoplasms. In these cases, POPS is very useful to assess the extent of malignancy and for the study of the intraductal papillary mucinous neoplasm in order to guide the surgery resection margins. Second, it is used to determine pancreatic duct strictures,particularly important in cases of chronic pancreatitis, which is associated with both benign and malignant strictures. Therefore POPS allows differentiation between benign and malignant disease and allows mapping the extent of the tumor prior to surgical resection. Also tissue sampling is possible, but it can be technically difficult because of the limited maneuverability of the biopsy forceps in the pancreatic ducts. Pancreatoscopy can also be used for therapeutic purposes, such as pancreatoscopy-guided lithotripsy in chronic painful pancreatitis with pancreatic duct stones. The available data for the moment suggests that, in selected patients, pancreatoscopy has an important and promising role to play in the diagnosis of indeterminate pancreatic duct strictures and the mapping of main pancreatic duct intraductal papillary mucinous neoplasms. However, further studies are necessary to elucidate and validate the pancreatoscopy role in the therapeutic algorithm of chronic pancreatitis.

关键词： Pancreatoscopy Per-oral pancreatoscopy Endoscopic retrograde cholangiopancreatography SpyGlass

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Diagnosis and management of primary sclerosing cholangitis-perspectives from a therapeutic endoscopist

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World Journal of Hepatology 2015年第5期7卷 799-805页

作者： Kunjam Modha Udayakumar Navaneethan Digestive Disease Institute the Cleveland ClinicClevelandOH 44195United States Center for Interventional endoscopy Florida HospitalOrlandoFL 32803United States

Primary sclerosing cholangitis(PSC) is a chronic,cholestatic liver condition characterized by inflammation,fibrosis,and destruction of the intra-and extrahepatic bile *** therapeutic endoscopist plays a key role in the diagnosis and management of *** patients presenting with a cholestatic profile,endoscopic retrograde cholangiopancreatography(ERCP) is warranted for a definite diagnosis of *** strictures of the bile duct occur in 36%-57% of PSC *** balloon dilatation with or without stenting have been employed in the management of dominant *** addition,PSC patients are at increased risk of developing cholangiocarcinoma with a 20% lifetime *** cytology obtained during ERCP and use of fluorescence in situ hybridization forms the initial diagnostic step in the investigation of patients with dominant biliary *** review aims to summarize the current evidence supporting the role of a therapeutic endoscopist in the management of PSC patients.

关键词：内视镜检查法治疗学的内视镜检查法主要 sclerosing 胆管炎胆汁主导的苛评

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Current updates and future directions in diagnosis and management of gastroenteropancreatic neuroendocrine neoplasms

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World Journal of Gastrointestinal endoscopy 2022年第5期14卷 267-290页

作者： Andrew Canakis Linda S Lee Division of Gastroenterology and Hepatology University of Maryland School of MedicineBaltimoreMD 21201United States Division of Gastroenterology Hepatology and endoscopy Brigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

Gastroenteropancreatic neuroendocrine neoplasms are a heterogenous group of rare neoplasms that are increasingly being discovered,often incidentally,throughout the gastrointestinal tract with varying degrees of activity and malignant *** nomenclature has added to the complexity of managing these *** term carcinoid tumor and embryonic classification have been replaced with gastroenteropancreatic neuroendocrine neoplasm,which includes gastrointestinal neuroendocrine and pancreatic neuroendocrine neoplasms.A comprehensive multidisciplinary approach is important for clinicians to diagnose,stage and manage these *** histological diagnosis is the gold standard,recent advancements in endoscopy,conventional imaging,functional imaging,and serum biomarkers complement histology for tailoring specific treatment *** light of developing technology,our review sets out to characterize diagnostic and therapeutic advancements for managing gastroenteropancreatic neuroendocrine tumors,including innovations in radiolabeled peptide imaging,circulating biomarkers,and endoscopic treatment approaches adapted to different locations throughout the gastrointestinal system.

关键词： Gastroenteropancreatic neuroendocrine neoplasms Neuroendocrine tumors Neuroendocrine carcinoma Gastrointestinal Pancreas Small intestine

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Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

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World Journal of Gastroenterology 2017年第4期23卷 703-711页

作者： Marisol Luján-Sanchis Enrique Pérez-Cuadrado-Robles Javier Garcia-Lledo José-Francisco Juanmartinena Fernandez Luca Elli Victoria-Alejandra Jiménez-García Juan Egea-Valenzuela Julio Valle-Munoz Cristina Carretero-Ribón Ignacio Fernández-Urién-Sainz Antonio López-Higueras Noelia Alonso-Lazaro Mileidis Sanjuan-Acosta Francisco Sanchez-Ceballos Bruno Rosa Santiago González-Vázquez Federica Branchi Lucía Ruano-Díaz César Prieto-de-Frías Vicente Pons-Beltrán Pilar Borque-Barrera Begona González-Suárez Sofía Xavier Federico Argüelles-Arias Juan-Manuel Herrerías-Gutiérrez Enrique Pérez-Cuadrado-Martínez Javier Sempere-García-Argüelles Digestive Diseases Unit General University Hospital of Valencia Small Bowel Unit Hospital Morales Meseguer Digestive Diseases Unit General University Gregorio Maranón Unit of Gastroenterology and endoscopy Complejo Hospitalario de Navarra Center for prevention and Diagnosis of Celiac Disease Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Unit of Gastroenterology and endoscopy University Hospital Virgen Macarena Gastroenterology department Hospital Virgen de la Arrixaca Department of Gastroenterology Complejo Hospitalario de Toledo Department of Gastroenterology University of Navarra Clinic1 endoscopy Digestive Unit Digestive Diseases AreaUniversitari i Politècnic La Fe Hospital1 Digestive Diseases Unit University Hospital Nuestra Senora de Candelaria1 Digestive Diseases Unit Clinical Hospital San Carlos1 Digestive Diseases Unit Hospital da Senhora da Oliveira-Guimaraes1 endoscopy Digestive Unit Hospital Clinic de Barcelona

AIM To analyze the diagnostic yield(DY), therapeutic impact(TI) and safety of capsule endoscopy(CE).METHODS This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease(CD)(mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy(Group-Ⅰ, n = 19), seropositive CD without atrophy(Group-Ⅱ, n = 39), contraindication to gastroscopy(Group-Ⅲ, n = 6), seronegative CD without atrophy, but with a compatible context(Group-Ⅳ, n = 99). DY, TI and the safety of CE were *** The overall DY was 54% and the final diagnosis was villous atrophy(n = 65, 39.9%), complicated CD(n = 12, 7.4%) and other enteropathies(n = 11, 6.8%; 8 Crohn's). DY for groups Ⅰ to Ⅳ was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases(36.9%), diffuse in 19(29.2%), jejunal in 11(16.9%), and patchy in 10 cases(15.4%). Factors associated with a greater DY were positive serology(68.3% vs 49.2%, P = 0.034) and older age(P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE resultschanged the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI(92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention(0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated *** CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.

关键词：囊内视镜检查法腹的疾病 Anti-transglutaminase 抗体没有面筋的饮食非腹的面筋敏感

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Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report

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World Journal of Clinical Cases 2021年第19期9卷 5270-5279页

作者： Takumi Fujimura Yohei Yamada Tomoshige Umeyama Yumi Kudo Hiroki Kanamori Teizaburo Mori Takahiro Shimizu Mototoshi Kato Miho Kawaida Naoki Hosoe Yasushi Hasegawa Kentaro Matsubara Naoki Shimojima Masahiro Shinoda Hideaki Obara Makoto Naganuma Yuko Kitagawa Ken Hoshino Tatsuo Kuroda Department of Pediatric Surgery National Saitama HospitalWako ShiSaitama 351-0102Japan Department of Pediatric Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Pathology Keio University School of MedicineTokyo 160-8582Japan Center for Diagnostic and therapeutic endoscopy Keio University School ofMedicineTokyo 160-8582Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Digestive Diseases Center International University of Health and WelfareMita HospitalTokyo 108-8329Japan Department of Gastroenterology and Hepatology Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Evidence has been published on the successful applications of the anti-tumor necrosis factor alpha antibody infliximab,such as induction therapy,salvage treatment for acute cellular rejection,and treatment for chronic ulcerative inflammation,in intestinal transplant ***,the optimal protocol for the effective use of infliximab remains largely undetermined due to scarcity of available clinical *** report a continuative application of infliximab as maintenance therapy for recurrent chronic ulcerative ileitis in a recipient of isolated intestinal transplantation(ITx).CASE SUMMARY The patient was a 11-year-old boy with intestinal motility disorder classified as a hypogenic type of intestinal *** patient underwent living-donor related intestinal *** immunosuppression regimen consisted of daclizumab,tacrolimus,and *** he did not show rejection while on tacrolimus monotherapy,routine screening endoscopy showed several ulcerative lesions in the distal end of the graft 2 years after the intestinal *** work up to evaluate the progression of anemia revealed stenosis with ulcerative inflammatory changes and multiple longitudinal ulcers in the *** the endoscopic findings suggested ulcerative lesions in Crohn’s disease,infliximab treatment was *** with infliximab and a small dose of oral prednisolone afforded successful withdrawal of total parenteral nutrition and maintenance of a well-functioning graft without infectious complications for 5 years since the administration of the first dose of *** Infliximab is effective as maintenance therapy for recurrent chronic ulcerative ileitis in an isolated ITx patient.

关键词： Intestinal transplantation Chronic ulcer Infliximab Crohn’s disease Tumor necrosis factor alpha Case report

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Cytotoxic synergism of Clostridioides difficile toxin B with proinflammatory cytokines in subjects with inflammatory bowel diseases

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World Journal of Gastroenterology 2023年第4期29卷 582-596页

作者： Gabrio Bassotti Alessandro Fruganti Fabrizio Stracci Pierfrancesco Marconi Katia Fettucciari Department of Medicine and Surgery GastroenterologyHepatology&Digestive Endoscopy Section University of Perugia Medical SchoolPiazza Lucio SeveriPerugia 06132Italyand Santa Maria della Misericordia HospitalGastroenterology&Hepatology Unit Perugia 06156Italy School of Biosciences and Veterinary Medicine University of CamerinoMatelica 62024Italy Medicine and Surgery Hygiene and Public Health SectionUniversity of PerugiaPerugia 06123Italy Medicine and Surgery Biosciences&Medical Embryology SectionUniversity of PerugiaPerugia 06132Italy

Clostridioides difficile(***)is progressively colonizing humans and animals living with *** this process,hypervirulent strains and mutated toxin A and B of ***(TcdA and TcdB)are originating and *** in healthy subjects colonization by *** becomes a risk after the use of antibiotics that alter the microbiome,other categories of people are more susceptible to infection and at risk of relapse,such as those with inflammatory bowel disease(IBD).Recent in vitro studies suggest that this increased susceptibility could be due to the strong cytotoxic synergism between TcdB and proinflammatory cytokines the tumor necrosis factor-alpha and interferon-gamma(CKs).Therefore,in subjects with IBD the presence of an inflammatory state in the colon could be the driver that increases the susceptibility to *** infection and its progression and *** is internalized in the cell via three receptors:chondroitin sulphate proteoglycan 4;poliovirus receptor-like 3;and Wnt receptor frizzled *** sulphate proteoglycan 4 and Wnt receptor frizzled family are involved in cell death by apoptosis or necrosis depending on the concentration of TcdB and cell types,while poliovirus receptor-like 3 induces only *** is possible that cytokines could also induce a greater expression of receptors for TcdB that are more involved in necrosis than in ***,in subjects with IBD there are the conditions:(1)For greater susceptibility to *** infection,such as the inflammatory state,and abnormalities of the microbiome and of the immune system;(2)for the enhancement of the cytotoxic activity of TcdB+Cks;and(3)for a greater expression of TcdB receptors stimulated by cytokines that induce cell death by necrosis rather than *** only therapeutic approach currently possible in IBD patients is monitoring of *** colonization for interventions aimed at reducing tumor necrosis factor-alpha and interfero

关键词： Inflammatory bowel diseases Clostridioides difficile infection Cytokines Tumor necrosis factor-alpha Interferon-gamma Necrosis Apoptosis Cytotoxic synergism

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Endo-anesthesia:a primer

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Gastroenterology Report 2022年第1期10卷 207-216页

作者： Fateh Bazerbachi Rodger M.White Nauzer Forbes Basavana Goudra Barham K.Abu Dayyeh Vinay Chandrasekhara BobbieJean Sweitzer CentraCare Interventional Endoscopy ProgramSt.Cloud HospitalSt CloudMNUSA Department of Anesthesia Massachusetts General HospitalBostonMAUSA Department of Medicine Division of Gastroenterology and HepatologyUniversity of CalgaryCalgaryAlbertaCanada Department of Anesthesiology and Critical Care Medicine Hospital of the University of PennsylvaniaPhiladelphiaPAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Systems Director University of VirginiaPreoperative MedicineInovaHealthFalls ChurchVAUSA

Gastrointestinal(GI)endoscopy has witnessed a Cambrian explosion of techniques,indications,and expanding target *** endoscopy encompasses traditional domains that include preventive measures,palliation,as alternative therapies in patients with prohibitive risks of more invasive procedures,and indicated primary ***,it has expanded to include therapeutic and diagnostic interventional endosonography,luminal endoscopic resection,third space endotherapy,endohepatology,and *** lines between surgery and endoscopy are blurred on many occasions within this ***,patients with high degrees of co-morbidity and complex physiology require more nuanced peri-endoscopic *** rising demand for endoscopy services has resulted in the development of endoscopy referral centers that offer these invasive procedures as directly booked referrals for regional and rural *** further necessitates specialized programs to ensure appropriate evaluation,risk stratification,and optimization for safe sedation and general anesthesia if *** landscape is conducive to the organic evolution of endo-anesthesia to meet the needs of these focused and evolving *** this primer,we delineate important aspects of endo-anesthesia care and provide relevant clinical and logistical considerations pertaining to the breadth of procedures.

关键词： endoscopic procedures endoscopy anesthesia

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Endoscopic ultrasound guided biliary and pancreatic duct interventions

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World Journal of Gastrointestinal endoscopy 2014年第11期6卷 513-524页

作者： David Prichard Michael F Byrne advanced and therapeutic endoscopy Vancou-ver General Hospital University of British Columbia Medicine Vancouver General Hospital Uni-versity of British Columbia

When endoscopic retrograde cholangio-pancreatog-raphy fails to decompress the pancreatic or biliary system, alternative interventions are required. In this situation, endosonography guided cholangio-pancrea-tography(ESCP), percutaneous radiological therapy or surgery can be considered. Small case series reporting the initial experience with ESCP have been superseded by comprehensive reports of large cohorts. Although these reports are predominantly retrospective, they demonstrate that endoscopic ultrasound(EUS) guided biliary and pancreatic interventions are associated with high levels of technical and clinical success. The proce-dural complication rates are lower than those seen with percutaneous therapy or surgery. This article describes and discusses data published in the last five years relat-ing to EUS-guided biliary and pancreatic intervention.

关键词： Endoscopic ultrasound Endoscopic retro-grade cholangio-pancreatography Percutaneous tran-shepatic cholangiography Bile duct Biliary drainage Pancreatic duct Pancreatic drainage

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Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

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World Journal of Gastrointestinal Oncology 2014年第9期6卷 360-368页

作者： Juana Gonzalo-Marin Juan Jose Vila Manuel Perez-Miranda Unit of endoscopy Department of GastroenterologyQuirón Hospital Unit of endoscopy Department of GastroenterologyComplejo Hospitalario de Navarra Department of Gastroenterology Hospital Universitario Rio Hortega

Endoscopic ultrasonography(EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography,computed tomography(CT) and transabdominal ultrasound for recognising early pancreatic *** a diagnostic modality for pancreatic cancer,EUS has proved rates higher than 90%,especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for ***,EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic *** complication rate of EUS is as low as 1.1%-3.0%.New technical developments such as elastography and the use of contrast agents have recently been applied to EUS,improving its diagnostic *** has been found to be superior to the recent multidetector CT for T stagingwith less risk of overstaying in comparison to both CT and magnetic resonance imaging,so that patients are not being ruled out of a potentially beneficial *** accuracy for N staging with EUS is 64%-82%.In unresectable cancers,EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block,biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy.

关键词： modality staging potentially diagnostic transabdominal celiac retrograde plexus chemotherapy adenocarcinoma

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