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Gastric cancer arising from the remnant stomach after distal gastrectomy:A review

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World Journal of Gastroenterology 2014年第38期20卷 13734-13740页

作者： Shinsuke Takeno Tatsuya Hashimoto Kenji Maki Ryosuke Shibata Hironari Shiwaku Ippei Yamana Risako Yamashita Yuichi Yamashita department of gastroenterological Surgery Fukuoka University Faculty of Medicine

Gastric stump carcinoma was initially reported by Balfore in 1922,and many reports of this disease have since been published. We herein review previous reports of gastric stump carcinoma with respect to epidemiology,carcinogenesis,Helicobacter pylori(H. pylori) infection,Epstein-Barr virus infection,clinicopathologic characteristics and endoscopic treatment. In particular,it is noteworthy that no prognostic differences are observed between gastric stump carcinoma and primary upper third gastric cancer. In addition,endoscopic submucosal dissection has recently been used to treat gastric stump carcinoma in the early stage. In contrast,many issues concerning gastric stump carcinoma remain to be clarified,including molecular biological characteristics and the carcinogenesis of *** *** herein review the previous pertinent literature and summarize the characteristics of gastric stump carcinoma reported to date.

关键词： Remnant gastric cancer Distal gastrectomy Carcinogenesis Helicobacter pylori Endoscopic submucosal dissection

Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype:Case study and literature review

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World Journal of Gastroenterology 2015年第11期21卷 3388-3393页

作者： Gustaw Lech Wojciech Korcz Emilia Kowalczyk Tomasz Guzel Marcin Radoch Ireneusz Wojciech Krasnodebski department of General Gastroenterological and Oncological SurgeryMedical University of Warsaw Students’ Scientific Group at department of General Gastroenterological and Oncological SurgeryMedical University of Warsaw

Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract *** is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation,asymptomatic progress and late *** resected tumour,giant in diameters,was confirmed to represent the most rare histopathologic subtype of GISTs- sarcomatoid epithelioid *** report this case and review the literature with a special focus on pathomorphological evaluation,biological aggressiveness and prognostic *** our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid *** is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical *** tumours diagnosed at a late stage,which is often the case,can be large on *** for patients diagnosed with GIST depend on tumour size,mitotic rate,histopathologic subtype and tumour *** is why early diagnosis and R0 resection,which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs,are the key factors for further treatment and good prognosis.

关键词： Gastrointestinal stromal tumour Sarcomatoid epithe

Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port

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World Journal of Gastroenterology 2016年第13期22卷 3558-3563页

作者： Hirohito Mori Nobuya Kobayashi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Taiga Chiyo Maki Ayaki Takashi Nagase Tsutomu Masaki department of Gastroenterology and Neurology Kagawa University department of gastroenterological Surgery Ehime Rosai Hospital

AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or ***: Two dogs(11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one ***: We are sure of great feasibility of endoscopic cholecystectomy via single port for human.

关键词： Laparoscopic and endoscopic cooperative surgery Endoscopic cholecystectomy Single port Safer and complete resection Feasibility

Benefit of laparoscopic liver resection in high body mass index patients

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World Journal of Gastroenterology 2016年第10期22卷 3015-3022页

作者： Hiroki Uchida Yukio Iwashita Kunihiro Saga Hiroomi Takayama Kiminori Watanabe Yuichi Endo Kazuhiro Yada Masayuki Ohta Masafumi Inomata department of gastroenterological and Pediatric Surgery Oita University Faculty of Medicine

AIM: To explore the impact of body mass index(BMI) on surgical outcomes in patients undergoing laparoscopic liver resection(LLR).METHODS: From January 2010 to February 2015, sixty-eight patients who underwent primary partial liver resection in our institute were retrospectively reviewed. Surgical outcomes of LLR were compared with those of open liver resection(OLR). In addition, we analyzed associations with BMI and surgical ***: Among 68 patients, thirty-nine patients underwent LLR and 29 were performed OLR. Significant difference in operation time, blood loss, and postoperative hospital stay was observed. There were no signi ficant di fferences in mortali ty and morbidity in two groups. Twenty-two patients(32.4%) were classified as obese(BMI ≥ 25). A statistically significant correlation was observed between BMI and operation time, between BMI and blood loss in OLR, but not in LLR. The operation time and blood loss of OLR were significantly higher than that of LLR in obese patients. Open liver resection and BMI were independent predictors for prolonged operation time and increased blood loss in multivariate ***: The present study demonstrated that BMI had influenced to surgical outcomes of OLR. LLR was less influenced by BMI and had great benefit in obese patients.

关键词： Laparoscopic liver resection Obesity Body mass index Prolonged operation time Increased blood loss

Long-lasting discussion: Adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer

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World Journal of Gastroenterology 2019年第22期25卷 2743-2751页

作者： Koki Nakanishi Mitsuro Kanda Yasuhiro Kodera department of gastroenterological Surgery(Surgery Ⅱ) Nagoya University Graduate School of Medicine

Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires perioperative allogeneic blood transfusion. There are lasting discussions and controversies about whether intraoperative blood loss or perioperative blood transfusion has adverse effects on the prognosis in patients with gastric cancer. We reviewed laboratory and clinical evidence of these associations in patients with gastric cancer. A large amount of clinical evidence supports the correlation between excessive intraoperative blood loss and adverse effects on the prognosis. The laboratory evidence revealed three possible causes of such adverse effects: anti-tumor immunosuppression, unfavorable postoperative conditions, and peritoneal recurrence by spillage of cancer cells into the pelvis. Several systematic reviews and meta-analyses have suggested the adverse effects of perioperative blood transfusions on prognostic parameters such as all-cause mortality, recurrence, and postoperative complications. There are two possible causes of adverse effects of blood transfusions on the prognosis: Anti-tumor immunosuppression and patient-related confounding factors (e.g., preoperative anemia). These factors are associated with a worse prognosis and higher requirement for perioperative blood transfusions. Surgeons should make efforts to minimize intraoperative blood loss and transfusions during gastric cancer surgery to improve patients’ prognosis.

关键词： Gastric cancer Blood loss Prognosis Transfusion Adverse effect Immunosuppression Mortality Recurrence Complication

MicroRNA-596 acts as a tumor suppressor in gastric cancer and is upregulated by promotor demethylation

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World Journal of Gastroenterology 2019年第10期25卷 1224-1237页

作者： Zhen Zhang Dong-Qiu Dai department of gastroenterological Surgery the Fourth Affiliated Hospital of China Medical University

BACKGROUND In the present study, we investigated a suppressive role of microRNA-596(miR-596) in gastric cancer(GC). Moreover, the downregulation of miR-596 in GC cell lines was associated with an increase of miR-596 promoter methylation. We also established that miR-596 controls the expression of peroxiredoxin 1(PRDX1),which has never been reported before, suggesting that this interaction could play an important role in GC *** To study the potential role and possible regulatory mechanism of miR-596 in *** The expression levels of miR-596 and PRDX1 in gastric cancer tissues and cell lines were detected by quantitative real-time PCR(qRT-PCR). Western blot and luciferase reporter assay were used to detect the effect of miR-596 on PRDX1 expression. Then, the proliferation, metastasis, and invasion of GC cell lines transfected with miR-596 mimics were analyzed, respectively, by Cell Counting Kit-8 proliferation assay, wound healing assay, and transwell invasion ***, the methylation status of the promoter CpG islands of miR-596 in GC cell lines was detected by methylation-specific PCR(MSP).RESULTS Expression of miR-596 was decreased and PRDX1 was upregulated in GC tissues and cell lines. Overexpression of miR-596 decreased the expression of PRDX1 and luciferase reporter assays detected the direct binding of miR-596 to the 3'-untranslated region(UTR) of PRDX1 transcripts. Furthermore, we found that overexpression of miR-596 remarkably suppressed cell proliferation, migration,and invasion in GC cells. We further analyzed miR-596 promoter methylation by MSP and qRT-PCR, and found the downregulation of miR-596 was associated with promoter methylation status in GC cell lines. Moreover, DNA demethylation and reactivation of miR-596 after treatment with 5-Aza-2'-deoxycytidine inhibited the proliferative ability of GC *** MiR-596 has a tumor suppressive role in GC and is downregulated partly due to promoter hypermethylation. Furthermore

关键词： Gastric cancer MicroRNA-596 Methylation Peroxiredoxin 1

Liver transplantation for intermediate hepatocellular carcinoma: An adaptive approach

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World Journal of Gastroenterology 2017年第18期23卷 3195-3204页

作者： Marco Biolato Giuseppe Marrone Luca Miele Antonio Gasbarrini Antonio Grieco Liver Transplant Medicine gastroenterological Area Gastroenterological and Endocrino Metabolical Sciences Department Fondazione Policlinico Universitario Gemelli Universita’ Cattolica del Sacro Cuore

Hepatocellular carcinoma is becoming an increasing indication for liver transplantation, but selection and allocation of patients are challenging because of organ shortages. Conventional Milan criteria are the reference for the selection of patients worldwide, but many expanded criteria, like University of California San Francisco criteria and up-to-7 criteria, have demonstrated that survival and recurrence results are lower than those for restricted indications. Correct staging is crucial and should include surrogate markers of biological aggressiveness(α-fetoprotein, response to loco-regional treatments). Successful down-staging can select between patients with tumor burden initially beyond transplantation criteria those with a more favorable biology, provided a 3-mo stability in meeting the transplantation criteria. Allocation rules are constantly adjusted to minimize the imbalance between the priorities of candidates with and without hepatocellular carcinoma, and take into account local donor rate and waitlist dynamics. Recently, Mazzaferro et al proposed a benefit-oriented "adaptive approach", in which the selection and allocation of patients are based on their response to non-transplantation treatments: low priority for transplantation in case of complete response, high priority in case of partial response or recurrence, and no listing in case of progression beyond transplantation criteria.

关键词： Milan criteria α-fetoprotein Down-staging Allocation Adaptive approach

Covert hepatic encephalopathy: Agreement and predictive validity of different indices

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World Journal of Gastroenterology 2014年第42期20卷 15756-15762页

作者： Sara Montagnese Esmeralda Balistreri Sami Schiff Michele De Rui Paolo Angeli Giacomo Zanus Umberto Cillo Giancarlo Bombonato Massimo Bolognesi David Sacerdoti Angelo Gatta Carlo Merkel Piero Amodio department of Medicine University of Padova department of Surgical Oncological and Gastroenterological Sciences University of Padova

AIM: To investigate the agreement and prognostic value of different measures of covert hepatic encephalopathy (CHE).

关键词： Hepatic encephalopathy Electroencephalography Psychometry Ammonia Liver cirrhosis

Genetic and epigenetic aspects of initiation and progression of hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第37期21卷 10584-10597页

作者： Mitsuro Kanda Hiroyuki Sugimoto Yasuhiro Kodera department of gastroenterological Surgery (Surgery Ⅱ) Nagoya University Graduate School of Medicine

Hepatocellular carcinoma(HCC) is a primary cancer of the liver that is predominant in developing countries and is responsible for nearly 600000 deaths each year worldwide. Similar to many other tumors, the development of HCC must be understood as a multistep process involving the accumulation of genetic and epigenetic alterations in regulatory genes, leading to the activation of oncogenes and the inactivation or loss of tumor suppressor genes. Extensive research over the past decade has identified a number of molecular biomarkers, including aberrant expression of HCCrelated genes and microRNAs. The challenge facing HCC research and clinical care at this time is to address the heterogeneity and complexity of these genetic and epigenetic alterations and to use this information to direct rational diagnosis and treatment strategies. The multikinase inhibitor sorafenib was the first molecularly targeted drug for HCC to show some extent of survival benefits in patients with advanced tumors. Although the results obtained using sorafenib support the importance of molecular therapies in the treatment of HCC, there is still room for improvement. In addition,no molecular markers for drug sensitivity, recurrence and prognosis are currently clinically available. In this review, we provide an overview of recently published articles addressing HCC-related genes and microRNAs to update what is currently known regarding genetic and epigenetic aspects of the pathogenesis of HCC and propose novel promising candidates for use as diagnostic and therapeutic targets in HCC.

关键词： Hepatocellular carcinoma Oncogene Tumor suppressor