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世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1559-1563页

作者： Nadia Peparini azienda sanitaria locale roma 6 CiampinoRome 00043Italy

Tumour rupture of gastrointestinal stromal tumours(GISTs)has been considered to be a remarkable risk factor because of its unfavourable impact on the oncological *** tumour rupture has not yet been included in the current tumor-node-metastasis classification of GISTs as a prognostic factor,it may change the natural history of a low-risk GIST to a high-risk ***,tumour rupture was defined as the spillage or fracture of a tumour into a body cavity,but recently,new definitions have been *** definitions distinguished from the prognostic point of view between the major defects of tumour integrity,which are considered tumour rupture,and the minor defects of tumour integrity,which are not considered tumour ***,it has been demonstrated that the risk of disease recurrence in R1 patients is largely modulated by the presence of tumour ***,after excluding tumour rupture,R1 may not be an unfavourable prognostic factor for ***,after the standard adjuvant treatment of imatinib for GIST with rupture,a high recurrence rate *** review highlights the prognostic value of tumour rupture in GISTs and emphasizes the need to carefully take into account and minimize the risk of tumour rupture when choosing surgical strategies for GISTs.

关键词： Gastrointestinal stromal tumours Tumour rupture Residual tumour Resection margin Prognostic factors Surgical treatment

Total mesopancreas excision is the better staging tool of the mesopancreas in pancreatic head carcinoma

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World Journal of Gastrointestinal Surgery 2022年第7期14卷 720-722页

作者： Nadia Peparini azienda sanitaria locale roma 6 Distretto 3Rome 00043Italy

Preoperative imaging staging based on tumor,node,metastasis classification cannot be effective to avoid R1 resection because only further improvements in imaging technologies will allow the precise assessment of perineural and lymphatic invasion and the occurrence of microscopic tumour deposits in the ***,waiting for further improvements in imaging technologies,total mesopancreas excision remains the only tool able to precisely assess mesopancreatic resection margin status,maximize the guarantee of radicality in cases of negative(R0)mesopancreatic resection margins,and stage the mesopancreas.

关键词： Pancreatic head carcinoma Mesopancreas Total mesopancreas excision Staging Preoperative imaging Surgery

The "meso" of the rectum and the "meso" of the pancreas: similar terms but distinct concepts in surgical oncology

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Hepatobiliary & Pancreatic Diseases International 2015年第5期14卷 548-551页

作者： Nadia Peparini Roberto Caronna Piero Chirletti azienda sanitaria locale roma H-Distretto 3 Department of Surgical Sciences Sapienza University of Rome

A correspondence between the ＂meso＂ of the rectum and of the pancreas has recently been reported. Here we highlight the differences between mesorectum and mesopancreas. Based on anatomical findings from a series of 89 consecutive pancreaticoduodenectomies and 71 consecutive total mesorectal excisions, we observed that in contrast to the mesorectum, the mesopancreas did not have well-defined anatomic boundaries and was continuous and connected through its components with the para-aortic area. In rectal cancer,tumor deposits and nodal involvement could be confined to the mesorectum（i.e., within the mesorectal fascia）, whereas in pancreatic carcinoma, tumor deposits and nodal metastases occurred in the boundless mesopancreatic area. Total mesorectal excision was made en bloc with the rectum by dissecting along the mesorectal fascia; this was not the case for mesopancreatic excision since anatomical demarcation of the mesopancreas did not exist. Moreover, the growth pattern of pancreatic cancer showed greater dispersion, which was more prominent at the invasive front of the tumor and could potentially affect the status of the resection margin. These findings indicate that the mesorectum and mesopancreas are completely distinct from the pathological, surgical, and oncological standpoints.

关键词： pancreatic head carcinoma surgical procedure therapy pancreatic cancer

Digestive cancer surgery in the era of sentinel node and epithelial-mesenchymal transition

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World Journal of Gastroenterology 2013年第47期19卷 8996-9002页

作者： Nadia Peparini azienda sanitaria locale roma H via Mario Calo’ 5 - 00043 CiampinoItalyItaly

Lymph node involvement is one of the most important prognostic indicators of carcinoma of the digestive *** the therapeutic impact of lymphadenectomy has not been proven and the number of retrieved nodes cannot be considered a measure of successful cancer surgery,an adequate lymph node count should be guaranteed to accurately assess the N-stage through the number of involved nodes,lymph node ratio,number of negative nodes,ratio of negative to positive nodes,and log odds,i.e.,the log of the ratio between the number of positive lymph nodes and the number of negative lymph nodes in digestive *** lymphadenectomy is not without complications,sentinel node mapping has been used as the rational procedure to select patients with early digestive carcinoma in whom nodal dissection may be omitted or a more limited nodal dissection may be ***,due to anatomical and technical issues,sentinel node mapping and nodal basin dissection are not yet the standard of care in early digestive ***,in light of the biological,prognostic and therapeutic impact of tumor budding and tumor deposits,two epithelial-mesenchymal transition-related phenomena that are involved in tumor progression,the role of staging and surgical procedures in digestive carcinomas could be redefined.

关键词： Lymph node count Lymph node ratio Sentinel node Tumor budding Tumor deposits

Does antecolic reconstruction decrease delayed gastric emptying after pancreatoduodenectomy?

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World Journal of Gastroenterology 2012年第45期18卷 6527-6531页

作者： Nadia Peparini Piero Chirletti azienda sanitaria locale roma H 00043 RomeItaly Department of Surgical Sciences Sapienza University of Rome00161 RomeItaly

Delayed gastric emptying(DGE) is a frequent complication after pylorus-preserving pancreatoduodenectomy(PpPD).Kawai and colleagues proposed pylorus-resecting pancreatoduodenectomy(PrPD) with antecolic gastrojejunal anastomosis to obviate DGE occurring after *** we debate the reported differences in the prevalence of DGE in antecolic and retrocolic gastro/duodeno-jejunostomies after PrPD and PpPD,*** concluded that the route of the gastro/duodeno-jejunal anastomosis with respect to the transverse colon;i.e.,antecolic route or retrocolic route,is not responsible for the differences in prevalence of DGE after pancreatoduodenectomy(PD) and that the impact of the reconstructive method on DGE is related mostly to the angulation or torsion of the gastro/*** report a prevalence of 8.9% grade A DGE and 1.1% grade C DGE in a series of 89 subtotal stomach-preserving PDs with Roux-en Y retrocolic reconstruction with anastomosis of the isolated Roux limb to the stomach and single Roux limb to both the pancreatic stump and hepatic *** anastomosis of the isolated first jejunal loop to the gastric remnant allows outflow of the gastric contents by gravity through a "straight route".

关键词：十二指肠胃排空切除术延迟肠吻合术 DGE 患病率胃内容物

Decreased cross-sectional muscle area in male patients with clear cell renal cell carcinoma and peritumoral collateral vessels

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World Journal of Radiology 2022年第4期14卷 82-90页

作者： Federico Greco Bruno Beomonte Zobel Carlo Augusto Mallio UnitàOperativa Complessa Diagnostica per Immagini Territoriale aziendale Cittadella della Salute Azienda Sanitaria Locale di LecceLecce 73100Italy Unit of Diagnostic Imaging UniversitàCampus Bio-Medico di RomaRome 00128Italy

BACKGROUND Sarcopenia is the loss of skeletal muscle mass(SMM)and is a sign of cancer *** with advanced renal cell carcinoma(RCC)may show *** To evaluate the amount of SMM in male clear cell RCC(ccRCC)patients with and without collateral *** In this study,we included a total of 124 male Caucasian patients divided into two groups:ccRCCa group without collateral vessels(n=54)and ccRCCp group with collateral vessels(n=70).Total abdominal muscle area(TAMA)was measured in both groups using a computed tomography imaging-based *** measures were also corrected for age in order to rule out age-related *** There was a statistically significant difference between the two groups in terms of TAMA(P<0.05)driven by a reduction in patients with peritumoral collateral *** result was confirmed by repeating the analysis with values corrected for age(P<0.05),indicating no age effect on our *** This study showed a decreased TAMA in ccRCC patients with peritumoral collateral *** presence of peritumoral collateral vessels adjacent to ccRCC might be a fine diagnostic clue to sarcopenia.

关键词： Cancer cachexia Body composition Clear cell renal cell carcinoma Collateral vessels Kidney cancer Sarcopenia

Mesopancreas:A boundless structure,namely the rationale for dissection of the paraaortic area in pancreaticoduodenectomy for pancreatic head carcinoma

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World Journal of Gastroenterology 2015年第10期21卷 2865-2870页

作者： Nadia Peparini azienda sanitaria locale roma H- Distretto 3 00043 Ciampino (Rome)Italy

This review highlights the rationale for dissection of the 16a2 and 16b1 paraaortic area during pancreaticoduodenectomy(PD)for carcinoma of the head of the *** advances in surgical anatomy of the mesopancreas indicate that the retropancreatic area is not a single entity with well defined boundaries but an anatomical site of embryological fusion of peritoneal layers,and that continuity exists between the neuro lymphovascular adipose tissues of the retropancreaticand paraaortic *** advances in surgical pathology and oncology indicate that,in pancreatic head carcinoma,the mesopancreatic resection margin is the primary site for R1 resection,and that epithelialmesenchymal transition-related processes involved in tumor progression may impact on the prevalence of R1 resection or local recurrence rates after R0 *** concepts imply that mesopancreas resection during PD for pancreatic head carcinoma should be extended to the paraaortic area in order to maximize retropancreatic clearance and minimize the likelihood of an R1 resection or the persistence of residual tumor cells after R0 *** PD for pancreatic head carcinoma,the rationale for dissection of the paraaortic area is to control the spread of the tumor cells along the mesopancreatic resection margin,rather than to control or stage the nodal *** mesopancreatic resection cannot be considered"complete"or"en bloc",it should be"extended as far as possible"or be"maximal",including dissection of16a2 and 16b1 paraaortic areas.

关键词： Pancreatic carcinoma Mesopancreas Mesopancreas res

The undisclosed role of anoxia/hypoxia and disturbed sleep on glucose metabolism

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Journal of Diabetes Mellitus 2012年第2期2卷 186-190页

作者： Patrizio Tatti Desiderio Passali Luisa Passali Diabetes and Endocrinology Unit Azienda Sanitaria Locale Roma “H” Roma Italy ENT Department University of Siena Siena Italy

Up to recently the respiratory disturbances were considered a risk factor for hypertension, but there was no trace of a role in metabolic disorders. Only recently the existence of a connection among the respiratory disturbance caused by the obstruction of the upper airways and a wide array of metabolic disturbances has been demonstrated. The respective roles of anoxia/ hypoxia and the attendant disturbed sleep remain, however, to be clarified.

关键词： Diabetes Mellitus OSAS Sleep Disturbance

Tumor rupture during surgery for gastrointestinal stromal tumors: Pay attention!

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World Journal of Gastroenterology 2013年第12期19卷 2009-2010页

作者： Nadia Peparini Piero Chirletti azienda sanitaria locale roma H Department of Surgical Sciences Sapienza University of Rome

In a recently published letter to the editor, we debated the proposal by Coccolini et al to treat gastrointestinal stromal tumors (GISTs) of the esophagogastric junction with enucleation and, if indicated, adjuvant therapy. We highlighted that, because the prognostic impact of a T1 high-mitotic rate esophageal GIST is worse than that of a T1 high-mitotic rate gastric GIST, enucleation may not be adequate surgery for esophagogastric GISTs with a high mitotic rate. In rebuttal, Coccolini et al pointed out the possible bias in assessment of the mitotic rates due to the lack of standardized methods and underlined that the site and features of the tumor need to be carefully considered in evaluation of the risk-benefit balance. Here we confirm that, apart from the problematic issue of mitotic counting, enucleation should not be indicated for GISTs at any site to reduce the risk of tumor rupture, which has been recently considered to be an unfavorable prognostic factor, and to avoid microscopic residual tumor.

关键词： Gastrointestinal stromal tumor Esophagogastric junction Surgery Resection Enucleation

Dental-derived stem cells and biowaste biomaterials:What’s next in bone regenerative medicine applications

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BIOCELL 2022年第4期46卷 923-929页

作者： MICHELE DI COSOLA STEFANIA CANTORE MARIO GIOSUÈBALZANELLI CIRO GARGIULO ISACCO KIEU CAO DIEM NGUYEN RAJIV SAINI ANNARITA MALCANGI MARGHERITA TUMEDEI MARIATERESA AMBROSINO ANTONIO MANCINI SALVATORE SCACCO RICCARDO NOCINI LUIGI SANTACROCE ANDREA BALLINI EDOARDO BRAUNER Department of Clinical and Experimental Medicine Universitàdegli Studi di FoggiaFoggia71122Italy Department Interdisciplinary of Medicine University of Bari“Aldo Moro”Bari70124Italy SET-118 Department of Pre-Hospital and EmergencySG Giuseppe Moscati HospitalTaranto74010Italy azienda sanitaria locale BAT Trani76125Italy Department of Medical Oral and Biotechnological SciencesUniversity of ChietiChieti66100Italy Department of Basic Medical Sciences Neuroscience and Sense OrgansUniversity of Bari“Aldo Moro”Bari70124Italy Department of Surgical Sciences DentistryGynecology and PediatricUniversity of VeronaVerona37126Italy School of Medicine University of Bari“Aldo Moro”Bari70124Italy Department of Precision Medicine University of Campania“Luigi Vanvitelli”Naples80138Italy Department of Oral and Maxillo-Facial Sciences Sapienza University of RomeRoma00161Italy

The human teeth and oral cavity harbor various populations of mesenchymal stem cells(MSCs),so called dental-derived stem cells(D-dSCs)with self-renewing and multilineage differentiation capabilities.D-dSCs properties involves a strong paracrine component resulting from the high levels of bioactive molecules they secrete in response to the local ***,this viewpoint develops a general picture of current innovative strategies to employ D-dSCs combined with biomaterials and bioactive factors for regenerative medicine purposes,and offers information regarding the available scientific data and possible applications.

关键词： Dental-derived stem cells Secretome Biomaterials Bone regenerative medicine Waste medicine