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Ectopic hepatocellular carcinoma mimicking a retroperitoneal tumor:A case report

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World Journal of Gastroenterology 2020年第18期26卷 2268-2275页

作者： Yuki Adachi Hiromitsu Hayashi Toshihiko Yusa Toru Takematsu Kazuki Matsumura Takaaki Higashi Kensuke Yamamura Takanobu Yamao Katsunori Imai Yo-ichi Yamashita Hideo Baba department of gastroenterological Surgery Graduate School of Life SciencesKumamoto UniversityKumamoto 8608556Japan

BACKGROUND An ectopic hepatocellular carcinoma(EHCC)arises from the ectopic liver which is defined as a hepatic organ or tissue not connected to surrounding *** is a rare disease and it is difficult to diagnose ***,the clinical features are not fully *** SUMMARY A retroperitoneal tumor(6 cm)was located at the dorsal side of the pancreas head on abdominal ultrasonography in an 81-year old woman positive for hepatitis C virus *** enhanced-computed tomography and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging showed viable HCC patterns with early enhancement and delayed *** tumor markers-serum alphafetoprotein and alpha-fetoprotein-L3%-were increased to 30.1 ng/m L and83.1%,*** induced by vitamin K absence or antagonist-Ⅱwas within normal levels(17 m AU/m L).Positron emission tomography-computed tomography showed strong accumulation into the tumor(Standardized Uptake Value max:13.8),and the tumor cytology following endoscopic ultrasoundguided fine needle aspiration showed poorly differentiated *** extirpation was performed,and operative findings showed that the retroperitoneal tumor was disconnected from the pancreas and the *** lymph nodes near the tumor were histologically *** histological examination,the tumor was finally diagnosed as EHCC with Arginase-1 positive *** We report our experience of a rare EHCC which was difficult to diagnose,and we present a review of the literature.

关键词： Ectopic hepatocellular carcinoma Differential diagnosis Retroperitoneal tumor Case report

Laparoscopic distal pancreatectomy: Up-to-date and literature review

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World Journal of Gastroenterology 2012年第38期18卷 5329-5337页

作者： Maurizio Iacobone Marilisa Citton Donato Nitti Minimally Invasive Endocrine Surgery Unit Department of Surgical Oncological and Gastroenterological Sciences University of Padua 35128 Padova Italy

Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffu- sion. Additional researches are necessary to determine the best technique to improve the procedure results.

关键词：英文文献胰腺癌腹腔镜切除术远端 LDP 肿瘤患者挑战性

Self-expanding metal stent placement and pathological alterations among obstructive colorectal cancer cases

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World Journal of Gastrointestinal Endoscopy 2022年第11期14卷 704-717页

作者： Keisuke Kosumi Kosuke Mima Kosuke Kanemitsu Takuya Tajiri Toru Takematsu Yuki Sakamoto Mitsuhiro Inoue Yuji Miyamoto Takao Mizumoto Tatsuo Kubota Nobutomo Miyanari Hideo Baba department of gastroenterological Surgery Kumamoto UniversityKumamoto 860-8556Japan department of Surgery National Hospital Organization Kumamoto Medical CenterKumamoto 860-0008Japan department of gastroenterological Surgery Graduate School of Medical SciencesKumamoto UniversityHonjo 860-8556KumamotoJapan

BACKGROUND Experimental studies suggest that self-expanding metal stents(SEMSs)enhance the aggressive behavior of obstructive colorectal *** influence of SEMS placement on pathological alterations remains to be *** To determine whether SEMS placement is associated with molecular or pathological features of colorectal carcinoma *** Using a nonbiased molecular pathological epidemiology database of patients with obstructive colorectal cancers,we examined the association of SEMS placement with molecular or pathological features,including tumor size,histological type,American Joint Committee on Cancer(AJCC)-pTNM stage,and mutation statuses in colorectal cancer tissues compared with the use of transanal tubes.A multivariable logistic regression model was used to adjust for potential *** SEMS placement was significantly associated with venous invasion(P<0.01),but not with the other features examined,including tumor size,disease stage,mutation status,and lymphatic *** both the univariable and multivariable models with adjustment for potential factors including tumor location,histological type,and AJCC-pT stage,SEMS placement was significantly associated with severe venous invasion(P<0.01).For the outcome category of severe venous invasion,the multivariable odds ratio for SEMS placement relative to transanal tube placement was 19.4(95%confidence interval:5.24–96.2).No significant differences of disease-free survival and overall survival were observed between SEMS and transanal tube *** SEMS placement might be associated with severe venous invasion in colorectal cancer tissue,providing an impetus for further investigations on the pathological alterations by SEMSs in colorectal cancer development.

关键词： Bridge to surgery Colorectal carcinoma Obstruction Stent Venous invasion

Could there be an interplay between periodontal changes and pancreatic malignancies?

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World Journal of Clinical Cases 2023年第3期11卷 545-555页

作者： Bogdan Silviu Ungureanu Dorin Nicolae Gheorghe Flavia Mirela Nicolae Sandu Ramboiu Petru Adrian Radu Valeriu MarinȘurlin Victor Dan Eugen Strambu Dan Ionut Gheonea Alexandra Roman PetraȘurlin department of Gastroenterology University of Medicine and Pharmacy of CraiovaCraiova 200349Romania department of Periodontology Research Center of Periodontal-Systemic ImplicationsUniversity of Medicine and Pharmacy of CraiovaCraiova 200349Romania department 1st of Surgery University of Medicine and Pharmacy of CraiovaCraiova 200349Romania department of General Surgery “Carol Davila”University of Medicine and PharmacyBucharest 020021Romania department of Periodontology "Iuliu Hațieganu"University of Medicine and PharmacyCluj-Napoca 400012Romania

The term"periodontal disease"refers to a group of chronic inflammatory illnesses caused by specific microorganisms from subgingival biofilm,that affect the toothsupporting *** research has also shown that periodontal infection plays a role in aggravating systemic disease states at distal sites,reinforcing the significance of the oral cavity for general ***,it has been suggested that gastroenterological malignancies may be promoted by hematogenous,enteral or lymphatic translocation of *** the past 25 years,the global burden of pancreatic cancer(PC)has more than doubled,making it one of the major causes of cancer-related *** has been linked to at least 50%increased risk of PC and it could be considered a risk factor for this malignancy.A recent study performed on 59000 African American women with a follow up of 21 years showed that participants who had poor dental health had higher chances of *** findings,according to researchers,might be related to the inflammation that some oral bacteria *** the mortality of PC,periodontitis considerably raises the chance of dying from *** alterations in the gut,oral cavity and pancreatic tissues of PC patients occur when compared to healthy flora,demonstrating a link between PC and *** may also contribute to PC development,although the underlying pathway is not yet *** function of the microbiome in PC risk has drawn more focus over the last *** risk of PC has been linked to the oral microbiome,specifically increased levels of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and decreased relative abundance of Leptotrichia and Fusobacteria,suggesting that it may have an impact on the inflammatory condition by expanding,altering,and regulating the commensal *** who received periodontal treatment had significantly decreased incidence rate ratios for *** analyzing patterns in

关键词： Periodontal disease Pancreatic cancer Microbiome Periodontitis Periopathogens Periodontal medicine

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

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World Journal of Gastroenterology 2008年第17期14卷 2776-2779页

作者： Yoshikazu Toyoki Kenichi Hakamada Shunji Narumi Masaki Nara Keinosuke Ishido Mutsuo Sasaki department of gastroenterological Surgery Hirosaki University School of Medicine

Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment.

关键词：胰性血液症状治疗方法疗效

Progress in researches about focal adhesion kinase in gastrointestinal tract

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World Journal of Gastroenterology 2009年第47期15卷 5916-5923页

作者： Hui Fang Hao Yoshio Naomoto Xiao-Hong Bao Nobuyuki Watanabe Kazufumi Sakurama Kazuhiro Noma Yasuko Tomono Takuya Fukazawa Yasuhiro Shirakawa Tomoki Yamatsuji Junji Matsuoka Munenori Takaoka department of gastroenterological Surgery Transplantation and Surgical Oncology Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama University Okayama 700-8558 Japan Shigei Medical Research Institute Okayama 700-8558 Japan

Focal adhesion kinase(FAK)is a 125-kDa non-receptor protein *** factors or the clustering of integrins facilitate the rapid phosphorylation of FAK at Tyr-397 and this in turn recruits Src-family protein tyrosine kinases,resulting in the phosphorylation of Tyr-576 and Tyr-577 in the FAK activation loop and full catalytic FAK *** plays a critical role in the biological processes of normal and cancer cells including the gastrointestinal *** also plays an important role in the restitution,cell survival and apoptosis and carcinogenesis of the gastrointestinal *** is over-expressed in cancer cells and its over-expression and elevated activities are associated with motility and invasion of cancer *** has been proposed as a potential target in cancer *** molecule inhibitors effectively inhibit the kinase activity of FAK and show a potent inhibitory effect for the proliferation and migration of tumor cells,indicating a high potential for application in cancer therapy.

关键词：粘着斑激酶胃肠道酪氨酸磷酸化蛋白酪氨酸激酶癌症治疗 FAK 受体蛋白生物过程

Perianal Crohn's disease: Is there something new?

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World Journal of Gastroenterology 2011年第15期17卷 1939-1946页

作者： Cesare Ruffolo Marilisa Citton Marco Scarpa Imerio Angriman Marco Massani Ezio Caratozzolo Nicolò Bassi Ⅱ department of Surgery (IV unit) Regional Hospital Ca' Foncello 31100 Treviso Italy department of Surgicaland gastroenterological Sciences University of Padova 35122 Padua Padova Italy department of Oncological Surgery VenetoOncological Institute 35100 Padova Italy department of Surgicaland gastroenterological Sciences University of Padova 35122Padua Padova Italy

Perianal lesions are common in patients with Crohn's disease, and display aggressive behavior in some cases. An accurate diagnosis is necessary for the optimal management of perianal lesions. Treatment of perianal Crohn's disease includes medical and/or surgical options. Recent discoveries in the pathogenesis of this disease have led to advances in medical and surgical therapy with good results. Perianal lesions in Crohn's disease remain a challenging aspect for both gastroenterologists and surgeons and lead to a greatly impaired quality of life for all patients affected by this disease. A multidisciplinary approach is mandatory to obtain the best results.

关键词：手术治疗攻击行为病变化管理胃肠病挑战性强制性多学科

Chemoprevention of gastric cancer development after Helicobacter pylori eradication therapy in an East Asian population:Meta-analysis

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World Journal of Gastroenterology 2020年第15期26卷 1820-1840页

作者： Mitsushige Sugimoto Masaki Murata Yoshio Yamaoka department of gastroenterological Endoscopy Tokyo Medical University HospitalSinjukuTokyo 1600023Japan department of Gastroenterology National Hospital Organization Kyoto Medical CenterKyoto 6128555Japan department of Gastroenterology Department of Environmental and Preventive MedicineOita University Faculty of MedicineYufuOita 8795593Japan

BACKGROUND Helicobacter pylori(***)infection is a risk factor for gastric cancer(GC),especially in East Asian *** East Asian populations infected with *** are at higher risk for GC than ***-positive European and United States *** eradication therapy reduces gastric cancer risk in patients after endoscopic and operative resection for GC,as well as in non-GC patients with atrophic *** To clarify the chemopreventive effects of *** eradication therapy in an East Asian population with a high incidence of *** PubMed and the Cochrane library were searched for randomized control trials(RCTs)and cohort studies published in English up to March *** analyses were conducted with regard to study designs(i.e.,RCTs or cohort studies),country where the study was conducted(i.e.,Japan,China,and South Korea),and observation periods(i.e.,≤5 years and>5 years).The heterogeneity and publication bias were also *** For non-GC patients with atrophic gastritis and patients after resection for GC,4 and 4 RCTs and 12 and 18 cohort studies were included,*** RCTs,the median incidence of GC for the untreated control groups and the treatment groups was 272.7(180.4–322.4)and 162.3(72.5–588.2)per 100000 person-years in non-GC cases with atrophic gastritis and 1790.7(406.5–2941.2)and 1126.2(678.7–1223.1)per 100000 person-years in cases of after resection for *** with non-treated ***-positive controls,the eradication groups had a significantly reduced risk of GC,with a relative risk of 0.67[95%confidence interval(CI):0.47–0.96]for non-GC patients with atrophic gastritis and 0.51(0.36–0.73)for patients after resection for GC in the RCTs,and 0.39(0.30–0.51)for patients with gastritis and 0.54(0.44–0.67)for patients after resection in cohort *** In the East Asian population with a high risk of GC,*** eradication effectively reduced the risk of GC,irrespective of past histo

关键词： Helicobacter pylori Eradication therapy Gastric cancer Metachronous cancer East Asia Prevention

Lenvatinib for large hepatocellular carcinomas with portal trunk invasion:Two case reports

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World Journal of Clinical Cases 2020年第12期8卷 2574-2584页

作者： Satoshi Komiyama Kazushi Numata Satoshi Moriya Hiroyuki Fukuda Makoto Chuma Shin Maeda gastroenterological Center Yokohama City University Medical CenterYokohamaKanagawa 2320024Japan department of Gastroenterology Yokohama City University Graduate School of MedicineYokohamaKanagawa 2360004Japan

BACKGROUND In a phase III trial of lenvatinib as first-line treatment for advanced unresectable hepatocellular carcinoma(uHCC),the drug proved non-inferior to sorafenib in terms of the overall survival,but offered better progression-free ***,the effects of lenvatinib in uHCC patients with a tumor thrombus in the main portal vein and/or a high tumor burden(tumor occupancy more than 50%of the total liver volume),remain unclear,because these were set as exclusion criteria in the aforementioned *** SUMMARY A 53-year-old man(case 1)and 66-year-old woman(case 2)with uHCC presented to us with a tumor thrombus in both the main portal vein and inferior vena cava,a high tumor burden accompanied by a tumor diameter greater than>100 mm,and distant metastasis,with the residual liver function classified as grade 2A according to the modified Albumin–Bilirubin *** started both patients on *** therapeutic effect,as evaluated by the modified Response Evaluation Criteria in Solid Tumors,was rated as partial response in both case 1 and case 2(at 8 wk and 4 wk after the start of lenvatinib administration,respectively).The therapeutic effect was sustained for 6 mo in case 1 and 20 mo in case *** occurred as an adverse event in both case 1 and 2,and hyperthyroidism and thrombocytopenia in only case 2,neither of which,however,necessitated treatment *** Even in hepatocellular carcinoma patients with poor prognostic factors,if the liver function is well-preserved,lenvatinib is effective and safe.

关键词： Hepatocellular carcinoma Lenvatinib Modified Response Evaluation Criteria in Solid Tumors Main portal vein tumor thrombus High tumor burden Case report