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Intestinal natural killer/T-cell lymphoma presenting as a pancreatic head space-occupying lesion:A case report

World Journal of Gastrointestinal Oncology 2023年第1期15卷 195-204页

作者： Ya-Nan Wang Yi-Miao Zhu Xiao-Ju Lei Yuan Chen Wan-Mao Ni Zheng-Wei Fu Wen-Sheng Pan College of Biotechnology and Bioengineering Zhejiang University of TechnologyHangzhou 310032Zhejiang ProvinceChina Department of gastroenterology Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Department of Endoscopy Center Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Department of Pathology Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Cancer Center Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang ProvinceZhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina Molecular Diagnosis Laboratory Zhejiang Provincial People's HospitalPeople's Hospital of Hangzhou Medical CollegeHangzhou 310014Zhejiang ProvinceChina

BACKGROUND Intestinal natural killer/T-cell lymphoma(NKTCL)is a rare and aggressive non-Hodgkin’s lymphoma,and its occurrence is closely related to Epstein-Barr virus *** addition,the clinical symptoms of NKTCL are not obvious,and the specific pathogenesis is still *** NKTCL may occur in any segment of the intestinal tract,its distinct location in the periampullary region,which leads clinicians to consider mimics of a pancreatic head mass,should also be ***,there remain huge challenges in the diagnosis and treatment of intestinal *** SUMMARY In this case,we introduce a male who presented to the clinic with edema of both lower limbs,accompanied by diarrhea,and abdominal *** ultrasound(EUS)showed well-defined homogeneous hypoechoic lesions with abundant blood flow signals and compression signs in the head of the *** the guidance of EUS-fine needle biopsy(FNB)with 19 gauge or 22 gauge needles,combined with multicolor flow cytometry immunophenotyping(MFCI)helped us diagnose *** treatments,the patient was prescribed the steroid(dexamethasone),methotrexate,ifosfamide,L-asparaginase,and etoposide chemotherapy ***,he died of leukopenia and severe septic shock in a local *** clinicians should enhance their understanding of *** key factors,including EUS characteristics,the right choice of FNB needle,and combination with MFCI,are crucial for improving the diagnostic rate and reducing the misdiagnosis rate.

关键词： Intestinal natural killer/T-cell lymphoma Endoscopic ultrasound-guided fine-needle biopsy Multicolor flow cytometry immunophenotyping Diagnosis Case report

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Thrombotic microangiopathy-like disorder after living-donor liver transplantation:A single-center experience in Japan

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World Journal of gastroenterology 2011年第14期17卷 1848-1857页

作者： Tomohide Hori Toshimi Kaido Fumitaka Oike Yasuhiro Ogura Kohei Ogawa Yukihide Yonekawa Koichiro Hata Yoshiya Kawaguchi Mikiko Ueda Akira Mori Yasutsugu Takada Hiroto Egawa Atsushi Yoshizawa Shinji Uemoto Hajime Segawa Kimiko Yurugi Takuma Kato Kanako Saito Linan Wan Mie Torii Feng Chen Ann-Marie T Baine Lindsay B Gardner Departments of Hepato-pancreato-biliary Transplant and Pediatric Surgery Kyoto University Hospital Kyoto 606-8507 Japan Department of Critical Care Medicine Kyoto University Hospital Kyoto 606-8507 Japan Department of Transfusion Medicine and Cell Therapy Kyoto University Hospital Kyoto 606-8507 Japan Department of Cellular and Molecular Immunology Mie University Hospital Graduate School of Medicine Mie 514-8507 Japan Department of Neuroscience Mayo Clinic Florida FL 32224 United States

AIM:To investigate thrombotic microangiopathy (TMA)in liver transplantion,because TMA is an infrequent but life-threatening complication in the transplantation field. METHODS:A total of 206 patients who underwent living-donor liver transplantation (LDLT) were evaluated,and the TMA-like disorder (TMALD) occurred in seven recipients. RESULTS:These TMALD recipients showed poor outcomes in comparison with other 199 recipients. Although two TMALD recipients successfully recovered,the other five recipients finally died despite intensive treatments including repeated plasma exchange (PE) and re-transplantation. Histopathological analysis of liver biopsies after LDLT revealed obvious differences according to the outcomes. Qualitative analysis of antibodies against a disintegrin-like domain and metalloproteinase with thrombospondin type 1 motifs (ADAMTS-13) were negative in all patients. The fragmentation of red cells,the microhemorrhagic macules and the platelet counts were early markers for the suspicion of TMALD after LDLT. Although the absolute values of von Willebrand factor (vWF) and ADAMTS-13 did not necessarily reflect TMALD,the vWF/ADAMTS-13 ratio had a clear diagnostic value in all cases. The establishment of adequate treatments for TMALD,such as PE for ADAMTS-13 replenishment or treatments against inhibitory antibodies,must be decided according to each case. CONCLUSION:The optimal induction of adequate therapies based on early recognition of TMALD by the reliable markers may confer a large advantage for TMALD after LDLT.

关键词： Thrombotic microangiopathy Liver transplan-tation von Willebrand factor A disintegrin-like domain and metalloproteinase with thrombospondin type 1 motifs Complication

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对来自Barrett食管的细胞学标本进行荧光原位杂交:初步可行性研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 32-33页

作者： Falk G.W. Skacel M. Gramlich T.L. 赵丽娜 Ctr. Swallowing Esopha geal Disord. Depts. Gastroenterol.Hepatol. C. Cleveland Clinic Foundation Cl eveland OHUnited StatesDr.

Background Endoscopic brush cytology is a promising surveillance technique for Barrett’s esophagus. However, there is a need for ancillary biomarkers to incr ease the sensitivity of cytology and to allow identification of patients at increased risk for disease progression. The aims of this study were to eval uate the feasibility of fluorescence in situ hybridization of endoscopic brush c ytology specimens and to determine if there are specific chromosomal changes in cytologic specimens from patients with cancer that are not present in patients w ithout dysplasia. Methods Archival cytology slides from 16 patients with Barrett ’s esophagus were studied: 8 negative for dysplasia and 8 positive for adenocar cinoma. Fluorescence in situ hybridization was used to detect two alterations: H ER-2 gene(17q11.2-q12) and 20q13.2 region amplification. Observations For 7 of 8 adenocarcinoma cases, there was amplification/aneusomy of at least one of the two analyzed regions by fluorescence in situ hybridization. None of the samples negative for dysplasia were abnormal for either of the two genomic regions stud *** Fluorescence in situ hybridization is feasible by using routine Barrett’s esophagus cytologic specimens. Differences in genomic makeup can be d etected in cells from patients negative for dysplasia and in those with adenocar cinoma.

关键词： Barrett 荧光原位杂交初步可行性研究不典型增生阴性样阴性患者刷检非整倍体生物标记

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Percutaneous local therapies for hepatocellular carcinoma impair gastric function

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World Journal of gastroenterology 2006年第1期12卷 157-158页

作者： Fumihiko Kinekawa Kazuya Matsuda Tsutomu Masaki Kazutaka Kurokohchi Hirohito Yoneyama Hideyuki Inoue Hirohide Kurata Yoshihito Uchida Seishiro Watanabe Shigeki Kuriyama Third Department of Internal Medicine Kagawa University School of Medicine1750-1 lkenobeMiki-choKita-gunKagawa 761-0793Japan Department of Internal Medicine Matsuda Clinic1-3-20 Fujitsuka-choTakamatsu-cityKagawa 760-0071Japan Department of Internal Medicine Takuma Municipal National Health Insurance Eikoh Hospital1381 TakumaTakuma-choMitoyo-gunKagawa 769-1101Japan

Percutaneous local therapies, such as percutaneous ethanol injection （PEI）, microwave coagulation and radiofrequency ablation （RFA）, are frequently used worldwide for the treatment of hepatocellular carcinoma （HCC） because of their high effectiveness. Although these treatment modalities can induce effectively coagulated tumor necrosis in the liver, they may cause adverse effects on extrahepatic abdominal organs. There are, however, no published reports on the influence of percutaneous local therapies on the gastric myenteric activity. Therefore, it is unclear whether or not gastric function is affected by percutaneous local therapies. In this study, to make clear the effect of PEI and RFA on the gastric function, we continuously recorded the gastric myoelectric activity by electrogastrography （EGG） and estimated the effect of percutaneous local therapies for HCC on gastric function.

关键词： Electrogastrography Gastric myentericactivity Hepatocellular carcinoma, Percutaneous ethanolinjection Radiofrequency ablation

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Risk of hepatitis B virus reactivation in cancer patients undergoing treatment with tyrosine kinase-inhibitors

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World Journal of gastroenterology 2024年第24期30卷 3052-3058页

作者： Bansi P Savaliya Ramin Shekouhi Fatima Mubarak Harsheen K Manaise Paola Berrios Jimenez Gabrielle Kowkabany Reed A Popp Kyle Popp Emmanuel Gabriel Department of Surgery Medical Academy Named after SI Georgievsky of Vernadsky Crimean Federal UniversitySimferopol 295015CrimeaRussia Division of Plastic and Reconstructive Surgery Department of SurgeryUniversity of FloridaGainesvilleFL 32608United States Department of Surgery Aga Khan UniversityKarachi 74800SindhPakistan Department of Surgery Government Medical College and HospitalChandigarh 160030PunjabIndia Department of Surgery University of Puerto Rico School of MedicineSan Juan 00921Puerto Rico Department of Chemical and Biological Engineering University of AlabamaTuscaloosaAL 35487United States Department of Surgery University of Florida College of MedicineGainesvilleFL 32610United States Department of Surgery Florida State UniversityTallahasseeFL 32306United States Department of Surgery Mayo ClinicJacksonvilleFL 32224United States

This editorial commented on an article in the World Journal of gastroenterology titled“Risks of Reactivation of Hepatitis B Virus in Oncological Patients Using Tyrosine Kinase-Inhibitors:Case Report and Literature Analysis”by Colapietro et *** this editorial,we focused on providing a more comprehensive exploration of hepatitis B virus reactivation(HBVr)associated with the usage of tyrosine kinase inhibitors(TKIs).It includes insights into the mechanisms underlying HBV reactivation,the temporal relationship between TKIs and HBV reactivation,and preventive *** aim is to understand the need for nucleos(t)ide analogs(NAT)and serial blood tests for early recognition of reactivation and acute liver injury,along with management *** are considered to be an intermediate(1%-10%)of *** guidelines stipulate that patients receiving therapy with high or moderate risks of reactivation or recent cancer diagnosis must have at least tested hepatitis B surface antigen,anti-hepatitis B core antigen(HBc),and anti-hepatitis B surface ***-HBc screening in highly endemic areas means people with negative tests should be vaccinated against *** or nucleotide analogs(NAs)like entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide(TAF)form the basis of HBV reactivation prophylaxis and treatment during ***,lamivudine,telbivudine,and adefovir are generally discouraged due to their reduced antiviral efficacy and higher risk of fostering drug-resistant viral ***,these less effective NAs may still be utilized in cases where ETV,TDF,and TAF are not feasible treatment options.

关键词： Hepatitis B virus Reactivation Chronic hepatitis B Tyrosine-kinase inhibitor Immunomodulators Immunosuppressant Nucleoside analogue Hemato-oncology

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与肠功能失调相关的肛门失禁亚型:临床、生理及社会心理方面的特征

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世界核心医学期刊文摘（胃肠病学分册） 2005年第4期1卷 19-20页

作者： Crowell M.D. Lacy B.E. Schettler V.A. 樊菁 Gastrointest. Physiol. and Motility Div. of Gastroenterol. and Hepatol. Mayo Clinic Scottsdale 13400 E. Shea Blvd. Scottsdale AZ 85259 United StatesDr.

BACKGROUND: We hypothesized that functional anal incontinence with no structur al explanation comprises distinct pathophysiologic subgroups that could be ident ified on the basis of the predominant presenting bowel pattern. METHODS: Consecu tive patients (n = 80) were prospectively grouped by bowel symptoms as 1) incont inence only, 2) incontinence +constipation, 3) incontinence +diarrhea, and 4) incontinence +alternating bowel symptoms. The Hopkins Bowel Symptom Questionnai re, the Symptom Checklist 90-R, and anorectal manometry were completed. RESULTS : Significant group differences were found between subcategories of incontinent patients on the basis of symptoms. Abdominal pain was more frequent in patients with altered bowel patterns. Patients with alternating symptoms reported the hig hest prevalence of abdominal pain, rectal pain, and bloating. Basal anal pressur es were significantly higher in alternating patients (P = 0.03). Contractile pre ssures in the distal anal canal were diminished in the incontinent only and dia rrhea groups (P = 0.004). Constipated patients with incontinence exhibited eleva ted thresholds for the urge to defecate (P = 0.027). Dyssynergia was significant ly more frequent in patients with incontinence and constipation or alternating b owel patterns. CONCLUSIONS: Distinct patterns of pelvic floor dysfunction were i dentified in patient subgroups with anal incontinence, based on the presence or absence of altered bowel patterns. Physiologic assessments suggested different p athophysiologic mechanisms among the subgroups. The evaluation of patients with fecal incontinence should consider altered bowel function.

关键词：肛门失禁功能失调肠道症状社会心理肛门直肠测压交替性便时盆底功能直肠痛腹胀症状

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Prevalence and Factors Associated with Hepatic Steatosis in Patients with Metabolic Syndrome in Cameroon: Cases of 4 Reference Hospitals

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Open Journal of gastroenterology 2023年第3期13卷 99-110页

作者： Winnie Tatiana Bekolo Nga Martine Claude Etoa Bidjogo Gwet Marina Servais A. F. Eloumou Bagnaka Antonin Wilson Ndjitoyap Ndam Agnès Malongue Mathurin Kowo Christian Tzeuton Dominique Noah Noah Oudou Njoya Firmin Ankouane Andoulo Luma H. Namme Department of Internal Medicine General Hospital of Douala Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon National Obesity Centre Central Hospital of Yaoundé Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine Gynecologic and Pediatric Hospital of Douala Douala Cameroon Department of Internal Medicine Teaching Hospital of Yaoundé Yaoundé Cameroon clinic of Capucines Douala Cameroon

Introduction: Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide and its prevalence increases with that of metabolic syndrome and its components. NAFLD is associated with complications such as cirrhosis and hepatocellular carcinoma. Diagnosis is mainly based on liver biopsy, but there are validated non-invasive methods. The purpose of the study was to assess the impact of metabolic steatopathy in patients with metabolic syndrome in Cameroon. Methods: This was a cross-sectional and analytical study conducted over a 6-month period from January 1st, 2019, to August 31st, 2022. Included were patients with metabolic syndrome who had consulted in endocrinology or gastroenterology at Yaoundé Central Hospital, Douala General Hospital and Douala Gyneco-obstetric and Pediatric Hospital. The diagnosis of NAFLD was made on abdominal ultrasound in front of a homogeneous or heterogeneous hyperechogenic aspect of the hepatic parenchyma compared to that of the right renal cortex called “brilliant liver” and fibrosis evaluated through non-invasive scores (Fib4 and NALFD Fibrosis score). Logistic regression by a uni- and multivariate analysis made it possible to search for the associated factors. Results. We included 133 patients. The female sex represented 64.7%. The mean age was 55 ± 9 years. The prevalence of NAFLD was 48.9%. At the evaluation of fibrosis was significant according to FIB-4 and NAFLD fibrosis score respectively in 6.2% and 4.6% of cases. The independently associated factors were Triglyceridemia ≤ 1.5 g/l (OR = 0.33;95% CI [0.11 - 0.95];p = 0.04) and LDL hypercholesterolemia (OR = 2.94;95% CI [1.07 - 8.11];p = 0.036). Conclusion: NAFLD was present in almost half of patients with metabolic syndrome. We had very few patients with significant fibrosis, but it needs to be further evaluated. The associated factors are hypertriglyceridemia and LDL hypercholesterolemia.

关键词： Hepatic Steatosis Metabolic Syndrome Prevalence Cameroon

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Tumor burden score and alpha-fetoprotein level predict prognosis of patients with unresectable hepatocellular carcinoma treated with tyrosine kinase inhibitor and anti-PD-1 antibody

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iLIVER 2024年第3期3卷 22-31页

作者： Shichuan Tang Tingfeng Huang Cong Luo Jun Fu Kailing Zhang Qingjing Chen Jie Kong Jianxi Zhang Zhenghong Sun Yongkang Diao Kongying Lin Yongyi Zeng Department of Hepatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhou 350025China Department of Hepatopancreatobiliary Surgery Wanyuan Central HospitalWanyuan 636350China Department of Hepatopancreatobiliary Surgery Zizhong County People's HospitalZizhong 641200China Department of gastroenterology Wenjiang District People's HospitalChengdu 611100China Department of Hepatobiliary Heze Municipal HospitalHeze 274000China Department of Hepatobiliary Surgery Xiamen Hospital of Traditional Chinese MedicineXiamen 361000China Department of General Surgery Guizhou Maotai HospitalZunyi 564500China Department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalNavy Medical University(Second Military Medical University)Shanghai 200082China The Liver Disease Research Center of Fujian Province Fuzhou 350025China

Background:Tyrosine kinase inhibitors(TKIs)and anti-PD-1 antibodies in combination provide survival benefits for patients with unresectable hepatocellular carcinoma(uHCC).However,the tool used to determine which patients likely benefit most from this treatment strategy has not been *** sought to develop a prognostic scoring system based on tumor burden score(TBS)and alpha-fetoprotein(AFP)to predict the long-term prognosis of uHCC treated with TKIs and anti-PD-1 ***:Data on patients with uHCC treated with TKIs and anti-PD-1 antibodies from multiple centers were *** prognostic accuracy of TBS,AFP,Barcelona clinic Liver Cancer(BCLC),and CTA(Combined TBS and AFP)for 2-year progression-free survival(PFS)and overall survival(OS)was ***:Overall,278 patients with uHCC treated with TKIs and anti-PD-1 antibodies were enrolled,including 48 BCLC-B and 230 BCLC-C HCC ***(AUC?0.721 and 0.683)outperformed TBS(AUC?0.680 and 0.621),AFP(AUC?0.606 and 0.594),and BCLC staging(AUC?0.551 and 0.555)in predicting PFS and *** 2-year PFS and OS for low CTA(low TBS/low AFP)were 65.7%and 94.4%,respectively,which were significantly higher than 21.6%and 44.9%(p<0.001 and p?0.002),respectively,for intermediate CTA(low TBS/high AFP or high TBS/low AFP)and 8.7%and 12.1%(both p<0.001),respectively,for high CTA(high TBS/high AFP).Multivariable Cox regression analysis indicated that CTA grading was an independent prognostic factor for PFS and OS(referent:low CTA;intermediate CTA,HR 2.87 and 7.17;high CTA,HR 5.52 and 10.31,respectively).Conclusions:CTA grading is an accurate tool for stratifying the prognosis of uHCC treated with TKIs and anti-PD-1 antibodies and may help determine which patients may benefit more from this treatment strategy.

关键词： Hepatocellular carcinoma Tyrosine kinase inhibitor Anti-PD-1 antibody Tumor burden score Alpha-fetoprotein

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脂肪性肝病的肝移植

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胃肠病学 2011年第3期16卷 149-149页

作者： John FUNG 王园园钱本余 Cleveland clinic ClevelandOhioUSA

随着肥胖症发病率在美国乃至全球的持续上升，非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的诊断日益增多，并被认为是终末期肝病（ESLD）的病因之一。

关键词：非酒精性脂肪性肝病肝移植非酒精性脂肪性肝炎终末期肝病发病率肥胖症

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Comparison of patients with hepatitis B virus-associated hepatocellular carcinoma:Data from two hospitals from Turkey and China

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Portal Hypertension & Cirrhosis 2023年第4期2卷 165-170页

作者： Brian I.Carr Fajuan Rui Volkan Ince Sezai Yilmaz Xinya Zhao Yuemin Feng Jie Li Liver Transplantation Institute Inonu UniversityMalatyaTurkey Department of Infectious Diseases Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineNanjingJiangsuChina Department of Radiology Shandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina Department of gastroenterology Shandong Provincial Hospital Affiliated to Shandong UniversityJinanShandongChina Department of Infectious Diseases Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjingJiangsuChina

Aims:There are many studies on the incidence of hepatitis B virus(HBV)-associated hepatocellular carcinoma(HCC),but very little is known about the HCC features in different *** study aimed to compare characteristics in two cohorts of patients with HBV-associated hepatocellular carcinoma from Turkey and ***:Data on patients with HBV-associated HCC diagnosed by imaging or liver biopsy were retrospectively collected from Shandong Provincial Hospital(n=578)and Inonu University Hospital(n=359)between January 2002 and December 2020,and the liver function and HCC characteristics were *** variables were compared using Student's t-test or Mann-Whitney U test and categorical variables were compared using the χ^(2) test or Fisher's exact ***:The patients in the Turkish cohort had significantly worse Child-Pugh scores(Child-Pugh A:38.3%vs.87.9%;Child-Pugh B:40.3%vs.11.1%;Child-Pugh C:21.4%vs.1.0%;pclinic Liver Cancer(BCLC)score(BCLC 1:5.1%vs.71.8%;BCLC 2:48.7%vs.24.4%;BCLC 3:24.4%vs.3.8%;BCLC 4:21.8%vs.0;all pclinical characteristics than patients from the Chinese cohort.

关键词： China Hepatocellular Carcinoma Turkey

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