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National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

World Journal of Gastroenterology 2024年第9期30卷 1018-1042页

作者： Faisal Saud Dar Zaigham Abbas Irfan Ahmed Muhammad Atique Usman Iqbal Aujla Muhammad Azeemuddin Zeba Aziz Abu Bakar Hafeez Bhatti Tariq Ali Bangash Amna Subhan Butt Osama Tariq Butt Abdul Wahab Dogar Javed Iqbal Farooqi Faisal Hanif Jahanzaib Haider Siraj Haider Syed Mujahid Hassan Adnan Abdul Jabbar Aman Nawaz Khan Muhammad Shoaib Khan Muhammad Yasir Khan Amer Latif Nasir Hassan Luck Ahmad Karim Malik Kamran Rashid Sohail Rashid Mohammad Salih Abdullah Saeed Amjad Salamat Ghias-un-Nabi Tayyab Aasim Yusuf Haseeb Haider Zia Ammara Naveed department of Hepatopancreatic Biliary Surgery&Liver Transplant Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of Hepatogastroenterology and Liver Transplantation Dr.Ziauddin University HospitalKarachi 75600SindhPakistan University of Aberdeen Aberdeen B243FXUnited Kingdom department of pathology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of Gastroenterology&Hepatology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of Radiology Aga Khan UniversityKarachi 74800Pakistan department of Oncology Hameed Latif HospitalLahore 54000Pakistan Division of Hepatopancreatic Biliary Surgery&Liver Transplantation Shifa International HospitalIslamabad 44000Pakistan department of Hepatopancreatic Biliary Surgery&Liver Transplant Shaikh Zayed Hospital and Post Graduate Medical InstituteLahore 54000Pakistan department of Medicine Aga Khan University HospitalKarachi 74800Pakistan department of Liver Transplant Pir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan department of Medicine&Gastroenterology Lifecare Hospital and Research CentrePeshawar 25000Khyber PakhtunkhwaPakistan department of Hepatopancreatobiliary&Liver Transplant Bahria International HospitalLahore 54000Pakistan department of Surgery Hepatopancreatobiliary&Liver TransplantDow University of Health SciencesKarachi 74800Pakistan department of Gastroenterology Hepatology&NutritionPir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan department of Oncology Dr.Ziauddin HospitalKarachi 74800Pakistan department of Radiology Rehman Medical InstitutePeshawar 25000Pakistan Army Liver Transplant Unit Pak Emirates Military HospitalRawalpindi 46000Pakistan department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan Rashid Nursing Home and Cancer Clinic Rashid Nursing Home and Cancer ClinicRawalpindi 46000Pakistan department of Gastroentero

A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the *** Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this *** effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these *** coordinated effort can minimise delays and give patients a chance for curative treatment and effective *** diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance *** cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for ***,histopathologic confirmation is not always required before *** ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for *** only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette *** patients with unresectable hCCA can be considered for liver *** chemotherapy should be offered to patients with a high risk of *** use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary *** with acute cholangitis can be drained with endoscopic or percutaneous biliary *** chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.

关键词： Hilar cholangiocarcinoma Bismuth-Corlette classification memorial Sloan Kettering Cancer Centre Staging Preoperative biliary drainage Portal vein embolisation Surgical resection Hepatectomy

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Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study

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Journal of Intensive Medicine 2024年第1期4卷 94-100页

作者： Hakan Erdem Jaffar AAl-Tawfiq Maha Abid Wissal Ben Yahia George Akafity Manar Ezzelarab Ramadan Fatma Amer Amani El-Kholy Atousa Hakamifard Bilal Ahmad Rahimi Farouq Dayyab Hulya Caskurlu Reham Khedr Muhammad Tahir Lysien Zambrano Mumtaz Ali Khan Aun Raza Nagwa Mostafa El-Sayed Magdalena Baymakova Aysun Yalci Yasemin Cag Umran Elbahr Aamer Ikram department of Infectious Diseases&Clinical Microbiology Gulhane School of MedicineTurkish Health Sciences UniversityAnkaraTurkey Specialty Internal Medicine and Quality and Patient Safety department Johns Hopkins Aramco HealthcareDhahranSaudi Arabia Division of Infectious Diseases Indiana University School of MedicineIndianapolisINUSA department of Infectious Diseases Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Internal Medicine department Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Cape Coast Teaching hospital Cape CoastGhana Medical Parasitology Faculty of MedicineSuez UniversitySuezEgypt department of Medical Microbiology and Immunology Faculty of MedicineZagazig UniversityZagazigEgypt department of Clinical pathology Faculty of MedicineCairo UniversityGizaEgypt department of Infectious Diseases School of MedicineIsfahan University of Medical SciencesIsfahanIran department of Infectious Diseases Kandahar University Medical FacultyTeaching HospitalKandaharAfghanistan department of Infectious Diseases Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac CenterAwaliBahrain department of Infectious Diseases and Clinical Microbiology Faculty of MedicineIstanbul Medeniyet UniversityIstanbulTurkey department of Pediatric Oncology National Cancer Institute–Cairo UniversityChildren Cancer Hospital EgyptCairoEgypt department of Medicine Federal General HospitalIslamabadPakistan Institute for Research in Medical Sciences and Right to Health(ICIMEDES) Scientific Research Unit(UIC)Faculty of Medical Sciences(FCM)National Autonomous University of Honduras(UNAH)TegucigalpaHonduras National Institute of Health IslamabadPakistan shaukat Khanum memorial Cancer hospital and Research Center LahorePakistan Medical Parasitology department Research Institute of OphthalmologyGizaEgypt department of Infectious Diseases Military Medical AcademySofiaBulgaria department of Infecti

Background:Fever of unknown origin(FUO)in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of ***:A multi-center study for infectious causes of FUO in lower middle-income countries(LMIC)and lowincome countries(LIC)was conducted between January 1,2018 and January 1,*** total,15 participating centers from seven different countries provided the data,which were collected through the Infectious DiseasesInternational Research Initiative *** adult patients with confirmed infection as the cause of FUO were included in the *** severity parameters were quick Sequential Organ Failure Assessment(qSOFA)≥2,intensive care unit(ICU)admission,vasopressor use,and invasive mechanical ventilation(IMV).Results:A total of 160 patients with infectious FUO were included in the ***,148(92.5%)patients had community-acquired infections and 12(7.5%)had hospital-acquired *** most common infectious syndromes were tuberculosis(TB)(n=27,16.9%),infective endocarditis(n=25,15.6%),malaria(n=21,13.1%),brucellosis(n=15,9.4%),and typhoid fever(n=9,5.6%).Plasmodium falciparum,Mycobacterium tuberculosis,Brucellae,Staphylococcus aureus,Salmonella typhi,and Rickettsiae were the leading infectious agents in this study.A total of 56(35.0%)cases had invasive procedures for *** mean qSOFA score was 0.76±0.94{median(interquartile range[IQR]):0(0–1)}.ICU admission(n=26,16.2%),vasopressor use(n=14,8.8%),and IMV(n=10,6.3%)were not ***,38(23.8%)patients had at least one of the severity *** mortality rate was 15(9.4%),and the mortality was attributable to the infection causing FUO in 12(7.5%)***:In LMIC and LIC,tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.

关键词： Developing countries Fever of unknown origin Infection

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Primary hepatic leiomyosarcoma:A case report and literature review

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World Journal of Hepatology 2022年第9期14卷 1830-1839页

作者： Hassan Ahmed Hassaan Bari Umer Nisar Sheikh Muhammad Irfan Basheer department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore 54782Pakistan department of pathology Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore 54782Pakistan

BACKGROUND Primary hepatic leiomyosarcoma(PHL)is a rare tumor with a very low incidence of about 0.2%.CASE SUMMARY A 48-year-old diabetic,hypertensive,and morbidly obese female patient presented with a history of abdominal pain and weight loss for 2 *** had no history of fever,jaundice,or other liver disease(s).Clinical examination revealed a palpable mass in the *** evaluation with a contrast-enhanced computed tomography(CT)scan of the abdomen and pelvis revealed an illdefined enhancing hyper vascular hepatic mass of 9.9 cm×7.8 cm occupying the left hepatic lobe with evidence of central necrosis,compression effect on the left hepatic vein,and partial wash-out on delayed *** further workup,the maximum standardized uptake value on positron emission computed tomography scan was 6.4,which was suggestive of *** remaining part of the liver was normal without any evidence of ***-guided biopsy of the mass showed smooth muscle neoplasm suggestive of *** optimization for co-morbidities,an extended left hepatectomy was planned in a multidisciplinary team *** intraoperative ultrasound,the left hepatic lobe was entirely replaced by a large tumor extending to the caudate lobe with a compression effect on the middle and left hepatic *** histopathology showed nodular and whorled white tumor comprised of spind-led/fascicular cells with moderate to severe pleomorphism and focal *** mitotic index was greater than 20 mitoses per 10 high-power *** resection margins were free of ***(IHC)depicted a desmin-positive/caldesmon-negative/discovered on gastrointestinal stromal tumor 1-negative/cluster of differentiation 117-negative profile,confirming the definitive diagnosis as *** This case report highlights the rare malignant mesenchymal hepatic *** confirm PHL diagnosis,one requires peculiar histopathological findings with ancillary IHC confirmation.M

关键词： Leiomyosarcoma Immunohistochemistry Hepatectomy Surgical resection Case Report

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Hypofractionated chemoradiation in locally advanced squamous cell carcinoma of the buccal mucosa

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中国口腔颌面外科杂志 2008年第B5期6卷 113-114页

作者： Arif Jamshed Raza Hussain Muhammad A Ilyas Shoaib Ahmed Hassan Iqbal department of Radiation Oncology Shaukat Khartum Memorial Hospital and Research Center Lahore Pakistan. department of Surgery Shaukat Khanum Memorial Hospital and Research Center Lahore Pakistan

Purpose: Advanced stage squamous cell carcinomas of buccal mucosa are aggressive tumours with a poor outcome to conventional treatment。We evaluated tumor control rates in locally advanced squamous cell carcinoma (SCC) buccal mucosa treated with hypofractionated chemoradiation (HypoCRT) in our institution。Methods: Between February 2005 and September 2007, 39 patients with biopsy proven SCC buccal mucosa completed HypoCRT at shaukat Khanum memorial Cancer hospital and Research Centre。Data was collected prospectively on the head and neck unit database。M:F ratio was 72%:28% with a median age of 50 years (range 26 - 74)。According to AJCC staging 5% (2) had stage III and 95% (37) had stage IVaJIVb disease。Radiation therapy was administered as 2.75 Gy/day, 5 days/week, up to a dose of 55 Gy。Cisplatin 75 mg/m2 was given on day 1 and 22 with radiation therapy。Sixty seven percent (26) also received induction chemotherapy with Cisplatin 75mg/m2 day 1 and Gemcitabine 1000m2 day 1 and 8, repeat day 22×2 cycles。Percutaneous endoscopic gastrostomy was placed in 69% (27)。Results: Response was assessed at 6 weeks following completion of HypoCRT。Complete response was seen in 69% (27) and persistent/progressive disease in 31% (12)。Kaplan- Meier estimate for overall and disease fi-ee survival at 28 months was 60% and 44% respectively。Median disease flee survival is 17 months (95% CI:9.52 - 24.21)。Conclusions: Overall and disease flee survival results with HypoCRT in advanced SCC buccal mucosa are encouraging and merit further evaluation in controlled clinical trials。

关键词：口腔粘膜鳞状细胞癌治疗方法临床分析

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Forkhead box P3 and indoleamine 2,3-dioxygenase co-expression in Pakistani triple negative breast cancer patients

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World Journal of Clinical Oncology 2020年第12期11卷 1018-1028页

作者： Kashif Asghar Asif Loya Iftikhar Ali Rana Muhammad Abu Bakar Asim Farooq Muhammad Tahseen Muhammad Ishaq Iqra Masood Muhammad Usman Rashid department of Basic Science Research Shaukat Khanum Memorial Cancer Hospital and Research CentreLahorePunjab 54000Pakistan department of pathology Shaukat Khanum Memorial Cancer Hospital and Research CentreLahorePunjab 54000Pakistan department of Cancer Registry and Clinical Data Management Shaukat Khanum Memorial Cancer Hospital and Research CentreLahorePunjab 54000Pakistan department of Clinical Research Shaukat Khanum Memorial Cancer Hospital and Research CentreLahorePunjab 54000Pakistan

BACKGROUND Forkhead box P3(FOXP3)is a specific marker for immunosuppressive regulatory T(T-reg)cells.T-regs and an immunosuppressive enzyme,indoleamine 2,3-dioxygenase(IDO),are associated with advanced disease in *** To evaluate the co-expression of FOXP3 and IDO in triple negative breast cancer(TNBC)with respect to hormone-positive breast cancer patients from *** Immunohistochemistry was performed to analyze the expression of FOXP3,IDO,estrogen receptor,progesterone receptor,and human epidermal growth factor receptor on tissues of breast cancer patients(n=100):Hormone-positive breast cancer(n=51)and TNBC(n=49).A total of 100 patients were characterized as FOXP3 negative vs positive and further categorized based on low,medium,and high IDO expression *** and multivariate logistic regression models were *** Out of 100 breast tumors,25%expressed FOXP3 positive T-regs.A significant coexpression of FOXP3 and IDO was observed among patients with TNBC(P=0.01)compared to those with hormone-positive breast *** variables were identified as significant independent risk factors for FOXP3 positive:IDO expression high(adjusted odds ratio(AOR)5.90;95%confidence interval(CI):1.22-28.64;P=0.03)and TNBC(AOR 2.80;95%CI:0.96-7.95;P=0.05).CONCLUSION Our data showed that FOXP3 positive cells might be associated with high expression of IDO in TNBC ***3 and IDO co-expression may also suggest its involvement in disease,and evaluation of FOXP3 and IDO expression in TNBC patients may offer a new therapeutic option.

关键词： Forkhead box P3 Indoleamine 2,3-dioxygenase Triple negative breast cancer T-regs Immunotherapy Cancer

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Review of 10 years of research on breast cancer patients:Focus on indoleamine 2,3-dioxygenase

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World Journal of Clinical Oncology 2021年第6期12卷 429-436页

作者： Kashif Asghar Asim Farooq Bilal Zulfiqar Asif Loya department of Basic Sciences Research Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore 54000Pakistan department of Clinical Research Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore 54000Pakistan Griffith Institute for Drug Discovery Griffith UniversityBrisbaneQueensland 4111Australia department of pathology Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore 54000Pakistan

Therapeutic manipulation of the immune system in cancer has been an extensive area of research in the field of *** regulates antitumour immune *** immunosuppressive enzyme,indoleamine 2,3-dioxygenase(IDO)mediates tumour immune escape in various malignancies including breast *** upregulation in breast cancer cells may lead to the recruitment of regulatory T(T-regs)cells into the tumour microenvironment,thus inhibiting local immune responses and promoting *** induced by myeloid derived suppressor cells activated in an IDOdependent manner may enhance the possibility of immune evasion in breast *** overexpression has independent prognostic significance in a subtype of breast cancer of emerging interest,basal-like breast *** inhibitors as adjuvant therapeutic agents may have clinical implications in breast *** review proposes future prospects of IDO not only as a therapeutic target but also as a valuable prognostic marker for breast cancer.

关键词： Indoleamine 2,3-dioxygenase Breast cancer Therapeutic target Prognostic marker Immune responses Immune escape

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Significance of the number of positive cervical lymph nodes in resected early T stage squamous cell carcinoma of the oral tongue

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中国口腔颌面外科杂志 2008年第B5期6卷 87-87页

作者： Hassan Iqbal Arif Jamshed Raza Hussain Rafay Azhar Uzma Majeed department of Surgey Shaukat Khartum Memorial Hospital Lahore Pakistan department of Radiation Oncology Shaukat Khartum Memorial Hospital Lahore Pakistan department of pathology shaukat khartum memorial hospital Lahore Pakistan

Purpose: Neck node metastasis in squamous cell carcinoma of the oral tongue (SCCOT) is a recognized prognostic factor。However, the significance between number of positive nodes and survival is still not defined。This study was conducted to determine the impact of number of pathologically positive nodes on survival in patients with T1-2 SCCOT。Methods: Between August 2004 and September 2007, 50 patients with Tl-2 SCCOT treated with curative surgery at shaukat Khanum memorial Cancer hospital and Research Centre were analyzed retrospectively。M 50%:F 50% (range 15—68 years)。All patients underwent partial glossectomy with neck dissection。Neck dissection was ipsilateral in 46 patients (92%) and bilateral in 4 patients (8%)。Forty four (88%) percent had post operative radiotherapy。Patients were divided in to 3 subgroups to determine the significance of number of positive nodes on survival: node negative (GroupⅠ), 1 - 3 positive nodes (GroupⅡ) and 4 or more nodes (Group III)。Results: AJCC stage was pTlpN0 31%, pT1pN+ 18%, pT2pN0 27% and pT2pN+ 24%。A total of 2230 cervical lymph nodes were analysed。Number of nodes in levelⅠ,Ⅱ,Ⅲ,ⅣandⅤwas 387, 721,465, 562 and 25 respectively。The mean and median number of nodes removed was 44 and 41 respectively。Twenty nine (58%) patients had NO (GroupⅠ), 15 (30%) patients had 1 to 3 positive lymph nodes (GroupⅡ) and 6 (12%) had 4 or more positive cervical lymph nodes(GroupⅢ)。Kaplan Meier estimate for 3 year disease free survival (DFS) for GroupⅠ,ⅡandⅢwas 71%, 48% and 0% respectively (P=-0.004)。DFS for the whole group was 57%。Conclusion: Increasing number of pathologically positive cervical lymph node metastasis has an inverse influence on survival。In patients with 4 or more positive nodes aggressive adjuvant post operative treatment with radiation and chemotherapy should be considered as the prognosis is poor。

关键词：口腔癌鳞状细胞癌颈部淋巴结点治疗方法

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Breast Cancer Risk Genes-Association Analysis in More than 113,000 Women

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四川生理科学杂志 2021年第1期43卷 7-7页

作者： Leila Dorling The authors' affiliations are as follows: the Centre for Cancer Genetic Epidemiology Departments of Public Health and Primary Care (L.D. S. Carvalho J.A. K.A.P. Q.W. M.K.B. J.D. B.D. N. Mavaddat K. Michailidou A.C.A. P.D.P.P. D.F.E.) and Oncology (C.L. P.A.H. C. Baynes D.M.C. L.F. V.R. M. Shah P.D.P.P. A.M.D. D.F.E.) University of Cambridge Cambridge the Centre for Genomic and Experimental Medicine MRC Institute of Genetics and Molecular Medicine (A. Campbell D.J.P.) and the Centre for Cognitive Ageing and Cognitive Epidemiology Department of Psychology (D.J.P.) University of Edinburgh the Cancer Research UK Edinburgh Centre (D.A.C. J.F.) and the Usher Institute of Population Health Sciences and Informatics University of Edinburgh Medical School (A. Campbell J.F.) Edinburgh the Divisions of Informatics Imaging and Data Sciences (E.F.H.) Cancer Sciences (A. Howell) Population Health Health Services Research and Primary Care (A. Lophatananon K. Muir) and Evolution and Genomic Sciences School of Biological Sciences (W.G.N. E.M.V. D.G.E.) University of Manchester the NIHR Manchester Biomedical Research Unit (E.F.H.) and the Nightingale Breast Screening Centre Wythenshawe Hospital (E.F.H. H.I.) Academic Health Science Centre and North West Genomics Laboratory Hub and the Manchester Centre for Genomic Medicine St. Mary's Hospital Manchester University NHS Foundation Trust (W.G.N. E.M.V. D.G.E.) Manchester the School of Cancer and Pharmaceutical Sciences Comprehensive Cancer Centre Guy's Campus King's College London London (E.J.S.) the Institute of Cancer and Genomic Sciences University of Birmingham Birmingham (I.T.) and the Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre University of Oxford Oxford (I.T.) - all in the United Kingdom the Human Genotyping-CEGEN Unit Human Cancer Genetic Program (A.G.-N. M.R.A. N.Á. B.H. R.N.-T.) and the Human Genetics Group (V.F. A.O. J.B.) Spanish National Cancer Research

Background:Genetic testing for breast cancer susceptibility is widely used,but for many genes,evidence of an association with breast cancer is weak,underlying risk estimates are imprecise,and reliable subtype-specific risk estimates are ***:We used a panel of 34 putative susceptibility genes to perform sequencing on samples from 60,466 women with breast cancer and 53,461 *** separate analyses for protein-truncating variants and rare missense variants in these genes,we estimated odds ratios for breast cancer overall and tumor *** evaluated missense-variant associations according to domain and classification of pathogenicity.

关键词： cancer Breast Cancer

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