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Value of thyroglobulin combined with ultrasound-guided fine-needle aspiration cytology for diagnosis of lymph node metastasis of thyroid carcinoma

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World Journal of Clinical Cases 2022年第2期10卷 492-501页

作者： Liu-Yang Zhang Yong Chen Ya-Zhou Ao department of Thyroid surgery Affiliated Hospital of Chengde Medical UniversityChengde 067000Hebei ProvinceChina

BACKGROUND surgery for thyroid carcinoma offers a good prognosis;however,cervical lymph node metastasis may occur in the early *** effective diagnostic method can accurately guide clinical surgical planning and the scope of lymph node dissection,ultimately improving patient *** To explore the diagnostic value of fine-needle aspiration of thyroglobulin(FNATg)combined with ultrasound(US)-guided fine-needle aspiration cytology for cervical lymph node metastasis in thyroid *** We enrolled 209 pathologically confirmed thyroid carcinoma patients who visited our hospital between Jan 2017 and Dec *** were tentatively diagnosed with cervical lymph node enlargement using preoperative *** underwent US-guided fine-needle aspiration cytology and *** value of single and combined application of the two methods for the diagnosis of cervical lymph node metastasis was *** factors affecting FNA-Tg for diagnosis were analyzed using univariate and multivariate *** FNA-Tg values were significantly higher among patients with positive cervical lymph node *** sensitivity and specificity of US-guided fine-needle aspiration cytology,FNA-Tg,and US-guided fine-needle aspiration cytology+FNA-Tg were 85.48%and 90.59%,83.06%and 87.06%,and 96.77%and 91.76%,*** area under the receiver operating characteristic curve for USguided fine-needle aspiration cytology,FNA-Tg,and the two combined,was 0.880,0.851,and 0.943,respectively.A long diameter/short diameter ratio<2,an insufficient number of acquired cells,a low serum thyroglobulin level,and an absence of typical metastatic US features increased the risk of cervical lymph node metastasis in thyroid carcinoma patients misdiagnosed using *** The diagnostic value of FNA-Tg for detecting cervical lymph node metastasis is not high;however,combined with US-guided fine-needle aspiration cytology,it is significantly improved.

关键词： Thyroid carcinoma Ultrasonic guidance Fine-needle aspiration cytology Lymph node puncture Thyroglobulin Diagnosis

Does the addition of Braun anastomosis to Billroth Ⅱ reconstruction on laparoscopic-assisted distal gastrectomy benefit patients?

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World Journal of Gastrointestinal Oncology 2022年第6期14卷 1141-1147页

作者： Xiong-Guang Li Qi-Ying Song Di Wu Shuo Li Ben-Long Zhang Li-Yu Zhang Da Guan Xin-Xin Wang Lu Liu department of General surgery The First Medical Center of Chinese PLA General HospitalBeijing 100853China

BACKGROUND Operation is the primary therapeutic option for patients with distal *** anastomosis is usually performed after Billroth Ⅱ reconstruction,which is wildly applied on distal gastrectomy because it is believed to benefit ***,studies are needed to confirm *** To identify whether the addition of Braun anastomosis to Billroth Ⅱ reconstruction on laparoscopy-assisted distal gastrectomy benefits *** A total of 143 patients with gastric cancer underwent laparoscopy-assisted distal gastrectomy at Centre 1 of PLA general hospital between January 2015 and December *** data of the patients were collected,and 93 of the 143 patients were followed *** 93 patients were divided into two groups:Group 1(Billroth Ⅱ reconstruction,33 patients);and Group 2(Billroth Ⅱ reconstruction combined with Braun anastomosis,60 patients).Postoperative complication follow-up data and relevant clinical data were compared between the two *** There were no significant differences between Group 1 and Group 2 in postoperative complications(6.1%vs 6.7%,P=0.679),anal exhaust time or blood *** follow-up prevalence of reflux gastritis indicated no significant difference between Group 1 and Group 2(68.2%vs 51.7%,P=0.109).The followup European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 scores revealed no evident difference between Group 1 and Group 2 as *** 1 had a shorter operating time than Group 2 on average(234.6 min vs 262.0 min,P=0.017).CONCLUSION Combined with Billroth Ⅱ reconstruction,Braun anastomosis has been applied due to its ability to reduce the prevalence of reflux *** in this study,the prevalence of reflux gastritis showed no significant difference,leading to a conclusion that under the circumstance of Braun anastomosis costing more time and more money,simple Billroth Ⅱ reconstruction should be widely applied.

关键词： Gastric cancer BillrothⅡreconstruction Braun anastomosis Bile reflux

Lateral pelvic lymph nodes for rectal cancer:A review of diagnosis and management

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1412-1424页

作者： Shimpei Ogawa Michio Itabashi Yuji Inoue Takeshi Ohki Yoshiko Bamba Kurodo Koshino Ryosuke Nakagawa Kimitaka Tani Hisako Aihara Hiroka Kondo Shigeki Yamaguchi Masakazu Yamamoto department of surgery Institute of GastroenterologyTokyo Women's Medical UniversityTokyo 162-8666Japan

The current status and future prospects for diagnosis and treatment of lateral pelvic lymph node(LPLN)metastasis of rectal cancer are described in this *** resonance imaging(MRI)is recommended for the diagnosis of LPLN metastasis.A LPLN-positive status on MRI is a strong risk factor for metastasis,and evaluation by MRI is important for deciding treatment *** dissection(LPLD)has an advantage of reducing recurrence in the lateral pelvis but also has a disadvantage of complications;therefore,LPLD may not be appropriate for cases that are less likely to have LPLN *** therapy(RT)and chemoradiation therapy(CRT)have limited effects in cases with suspected LPLN metastasis,but a combination of preoperative CRT and LPLD may improve the treatment ***,RT and CRT plus selective LPLD may be a rational strategy to omit unnecessary LPLD and produce a favorable treatment outcome.

关键词： Diagnosis Treatment Rectal cancer Lateral pelvic lymph node metastasis Lateral pelvic lymph node dissection Radiotherapy

Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis

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World Journal of Gastrointestinal surgery 2024年第10期16卷 3171-3184页

作者： Zhao Gao Shi-Kai Wu Shi-Jie Zhang Xin Wang Ying-Chao Wu Xuan Jin department of Medical Oncology Peking University First HospitalBeijing 100034China department of Thoracic surgery Peking University First HospitalBeijing 100034China department of Gastrointestinal surgery Peking University First HospitalBeijing 100034China

BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains *** To assess the efficacy of ACT in patients after PM resection for *** This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July *** primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication ***-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,*** had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT *** analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved *** ACT does not improve survival after PM resection for *** well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.

关键词： Colorectal cancer Resection of pulmonary metastasis Adjuvant chemotherapy Inverse probability treatment weighting Prognosis

Management of recurrent rectal cancer:A population based study in greater Amsterdam

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World Journal of Gastroenterology 2008年第39期14卷 6018-6023页

作者： Roel Bakx Otto Visser Judith Josso Sybren Meijer J Frederik M Slors J Jan B van Lanschot department of surgery Academic Medical CentreAmsterdam AZ 1105Netherlands Comprehensive Cancer Centre Amsterdam Amsterdam CX 1066Netherlands department of surgery Free University Medical CentreAmsterdam HV 1081Netherlands Presently at the Erasmus Medical Center Rotterdam CE 3015Netherlands

AIM： To analyze, retrospectively in a populationbased study, the management and survival of patients with recurrent rectal cancer initially treated with a macroscopically radical resection obtained with total mesorectal excision （TME）. METHODS： All rectal carcinomas diagnosed during 1998 to 2000 and initially treated with a macroscopically radical resection （632 patients） were selected from the Amsterdam Cancer Registry. For patients with recurrent disease, information on treatment of the recurrence was collected from the medical records. RESULTS： Local recurrence with or without clinically apparent distant dissemination occurred in 62 patients （10%）. Thirty-two patients had an isolated local recurrence. Ten of these 32 patients （31%） underwent radical re-resection and experienced the highest survival （three quarters survived for at least 3 years）. Eight patients （25%） underwent non-radical surgery （median survival 24 rno）, seven patients （22%） were treated with radio- and/or chemotherapy without surgery （median survival 15 mo） and seven patients （22%） only received best supportive care （median survival 5 too）. Distant dissemination occurred in 124 patients （20%） of whom 30 patients also had a local recurrence. The majority （54%） of these patients were treated with radio- and/or chemotherapy without surgery （median survival 15 mo）. Twenty-seven percent of these patients only received best supportive care （median survival 6 mo）, while 16% underwent surgery for their recurrence. Survival was best in the latter group （median survival 32 mo）. CONCLUSION： Although treatment options and survival are limited in case of recurrent rectal cancer after radical local resection obtained with TME, patients can benefit from additional treatment, especially if a radical resection is feasible.

关键词： Rectal cancer Total mesorectal excision Local recurrence Relative survival

Liver transplantation for hepatic tumors:a systematic review

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World Journal of Gastroenterology 2014年第18期20卷 5345-5352页

作者： Matteo Ravaioli Giorgio Ercolani Flavia Neri Matteo Cescon Giacomo Stacchini Massimo Del Gaudio Alessandro Cucchetti Antonio Daniele Pinna department of General surgery and Transplantation Sant’Orsola-Malpighi HospitalUniversity of Bologna40138 BolognaItaly

Improvements in the medical and pharmacological management of liver transplantation (LT) recipients have led to a better long-term outcome and extension of the indications for this procedure. Liver tumors are relevant to LT; however, the use of LT to treat malignancies remains a debated issue because the high risk of recurrence. In this review we considered LT for hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), liver metastases (LM) and other rare tumors. We reviewed the literature, focusing on the past 10 years. The highly selected Milan criteria of LT for HCC (single nodule < 5 cm or up to 3 nodules < 3 cm) have been recently extended by a group from the University of S. Francisco (1 lesion < 6.5 cm or up to 3 lesions < 4.5 cm) with satisfying results in terms of recurrence-free survival and the “up-to-seven criteria”. Moreover, using these criteria, other transplant groups have recently developed downstaging protocols, including surgical or loco-regional treatments of HCC, which have increased the post-operative survival of recipients. CCA may be treated by LT in patients who cannot undergo liver resection because of underlying liver disease or for anatomical technical challenges. A well-defined protocol of chemoirradiation and staging laparotomy before LT has been developed by the Mayo Clinic, which has resulted in long term disease-free survival comparable to other indications. LT for LM has also been investigated by multicenter studies. It offers a real benefit for metastases from neuroendocrine tumors that are well differentiated and when a major extrahepatic resection is not required. If LT is an option in these selected cases, liver metastases from colorectal cancer is still a borderline indication because data concerning the disease-free survival are still lacking. Hepatoblastoma and hemangioendothelioma represent rare primary tumors for which LT is often the only possible and effective cure because

关键词： Liver transplantation Liver cancer Hepatocellular carcinoma Cholangiocarcinoma Neuroendocrine carcinoma Liver metastases Hepatoblastoma Hemangioendothelioma

Inferior pancreaticoduodenal artery pseudoaneurysm in a patient with calculous cholecystitis: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2851-2856页

作者： Qiao-Dong Xu Song-Gang Gu Jia-Hong Liang Shao-Dong Zheng Zhi-Hua Lin Pei-Dong Zhang Jiang Yan department of Biliary-Pancreatic Minimally Invasive surgery The First Affiliated Hospital of Shantou University Medical College

BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. CASE SUMMARY A 69-year-old man was admitted to our hospital due to right upward abdominal pain. A computed tomography (CT) scan demonstrated acute cholecystitis and cholecystolithiasis. Percutaneous gallbladder drainage was performed subsequently. He was discharged after 3 d and readmitted to hospital for cholecystectomy as arranged 1 mo later. A repeat CT scan revealed an emerging enhancing mass between the pancreatic head and the descending duodenum. Then, he suffered hematochezia and hemorrhagic shock suddenly. Emergency percutaneous angiogram was performed and selective catheterization of the superior mesenteric artery demonstrated a pseudoaneurysm in the inferior PDA. Coil embolization was performed and his clinical condition improved quickly after embolization and blood transfusion. He underwent laparoscopic cholecystectomy and was discharged from hospital after surgery under satisfactory conditions. CONCLUSION PDA pseudoaneurysms are uncommon. Acute haemorrhage is a severe complication of pseudoaneurysm with high mortality which clinicians should pay attention to.

关键词： Calculous cholecystitis Inferior pancreaticoduodenal artery pseudoaneurysm Gastrointestinal haemorrhage Coil embolization Case report

Expression of aFGF, bFGF, and FGFR_1 in ovarian epithelialneoplasm

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Chinese Medical Journal 2004年第4期117卷 601-603页

作者：张颐郭科军尚海王亚军孙黎光 department of Gynecology department of surgery department of Biochemistry

Ovarian epithelial cancer is a common malignant ovarian neoplasm with a high mortality. The factors that regulate the rapid growth of ovarian epithelial cancers are still largely unknown. There are some evidences indicating that oncogene can confer growth factor automatically onto cancer cells. The autocrine secretion hypothesis proposes that, as a result of oncogene activation, neoplastic cells can escape growth-restraining mechanism by independently producing and responding to their own growth factors. In recent years, attention has focused on fibroblast growth factor (FGF), as well as acidic fibroblast growth factor (aFGF) and basic fibroblast growth factor (bFGF), because it is a polypeptide growth factor with a widespread biological activity. In order to explore the factors responsible for the rapid growth and proliferation of human ovarian cancer, we investigated the possible role of aFGF and bFGF and their receptors (FGFR1).

关键词： fibroblast growth factor gene expression ovarian neoplasms

Recent advances in artificial intelligence for pancreatic ductal adenocarcinoma

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World Journal of Gastroenterology 2021年第43期27卷 7480-7496页

作者： Hiromitsu Hayashi Norio Uemura Kazuki Matsumura Liu Zhao Hiroki Sato Yuta Shiraishi Yo-ichi Yamashita Hideo Baba department of Gastroenterological surgery Graduate School of Life SciencesKumamoto UniversityKumamoto 860-8556Japan

Pancreatic ductal adenocarcinoma(PDAC)remains the most lethal type of *** 5-year survival rate for patients with early-stage diagnosis can be as high as 20%,suggesting that early diagnosis plays a pivotal role in the prognostic improvement of PDAC *** the medical field,the broad availability of biomedical data has led to the advent of the“big data”*** overcome this deadly disease,how to fully exploit big data is a new challenge in the era of precision *** intelligence(AI)is the ability of a machine to learn and display intelligence to solve *** can help to transform big data into clinically actionable insights more efficiently,reduce inevitable errors to improve diagnostic accuracy,and make real-time ***-based omics analyses will become the next alterative approach to overcome this poor-prognostic disease by discovering biomarkers for early detection,providing molecular/genomic subtyping,offering treatment guidance,and predicting recurrence and *** in AI may therefore improve PDAC survival outcomes in the near *** present review mainly focuses on recent advances of AI in PDAC for *** believe that breakthroughs will soon emerge to fight this deadly disease using AI-navigated precision medicine.

关键词： Pancreatic cancer Pancreatic ductal adenocarcinoma Artificial intelligence Machine learning Precision medicine