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Development and validation of a machine learning-based early prediction model for massive intraoperative bleeding in patients with primary hepatic malignancies

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 90-101页

作者： Jin Li Yu-Ming Jia Zhi-Lei Zhang Cheng-Yu Liu Zhan-Wu Jiang Zhi-Wei Hao Li Peng Department of Hepatological surgery The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of general surgery II Baoding First Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of ***,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective *** To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and *** The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary surgery Department of the Fourth Hospital of Hebei Medical university between 2010 and *** regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve *** Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative *** regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction *** 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction *** The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin ***

关键词： Primary liver cancer Intraoperative bleeding Machine learning Model

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UPLC-Q-TOF/MS-Based Serum Metabolomics Reveals Potential Anti-tumor Mechanism of Banxia Xiexin Decoction in Colorectal Cancer Mice

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Chinese Journal of Integrative Medicine 2024年第7期30卷 623-632页

作者： YUE Yin-zi LI Ming-xuan WANG Xiao-hui QIN Yuan-yuan WANG Ya-hui TAN Jin-hua SU Lian-lin YAN Shuai Department of general surgery Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China School of Pharmacy Nanjing University of Chinese MedicineNanjing210023China Department of general surgery Bayinguoleng Mongolian Autonomous Prefecture People’s HospitalXinjiang Uygur Autonomous RegionKorla841000China Department of Pharmacy Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China Department of Anorectal surgery Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China

Objective To clarify the potential mechanism of Banxia Xiexin Decoction(BXD)on colorectal cancer(CRC)from the perspective of *** Forty male C57BL/6 mice were randomly divided into normal control(NC),azoxymethane/dextran sulfate sodium(AOM/DSS)model,low-dose BXD(L-BXD),high-dose BXD(H-BXD)and mesalamine(MS)groups according to a random number table,8 mice in each *** cancer model was induced by AOM/*** was administered daily at doses of 3.915(L-BXD)and 15.66 g/kg(H-BXD)by gavage for consecutive 21 days,and 100 mg/kg MS was used as positive *** the entire modeling cycle,colon length of mice was measured and quantity of colorectal tumors were *** spleen and thymus index were determined by calculating the spleen/thymus weight to body *** cytokine and changes of serum metabolites were analyzed by enzyme-linked immunosorbent assay kits and ultra performance liquid chromatography-quadrupole/time-of-flight mass spectrometry(UPLC-Q/TOF-MS),*** Notably,BXD supplementation protected against weight loss,mitigated tumor formation,and diminished histologic damage in mice treated with AOM/DSS(P<0.05 or P<0.01).Moreover,BXD suppressed expression of serum inflammatory enzymes,and improved the spleen and thymus index(P<0.05).Compared with the normal group,102 kinds of differential metabolites were screened in the AOM/DSS group,including 48 potential biomarkers,involving 18 main metabolic *** 18 potential biomarkers related to CRC were identified,and the anti-CRC mechanism of BXD was closely related to D-glutamine and D-glutamate metabolism,phenylalanine,tyrosine and tryptophan biosynthesis,arginine biosynthesis,nitrogen metabolism and so *** BXD exerts partial protective effects on AOM/DSS-induced CRC by reducing inflammation,protecting organism immunity ability,and regulating amino acid metabolism.

关键词： colorectal cancer metabolomics ultra performance liquid chromatography-quadrupole/time-of-flight mass spectrometry azoxymethane dextran sulfate sodium Banxia Xiexin Decoction Chinese medicine

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Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:State of art and future perspectives

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： Paschalis Gavriilidis Timothy M Pawlik Daniel Azoulay Department of surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of Hepato-Biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage *** vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if *** sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic ***:Centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic *** elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical *** review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of ***:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

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Early-onset and later-onset cancer:trends,risk factors,and prevention in Northern China

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Science China(Life Sciences) 2024年第9期67卷 1928-1940页

作者： Tong Liu Chen-An Liu Qing-Song Zhang Qi Zhang Yi-Ming Wang Meng-Meng Song Shi-Qi Lin Li Deng Shou-Ling Wu Han-Ping Shi Department of Gastrointestinal surgery Department of Clinical NutritionBeijing Shijitan HospitalCapital Medical UniversityBeijing 100038China National Clinical Research Center for Geriatric Diseases Xuanwu HospitalCapital Medical UniversityBeijing 100053China Key Laboratory of Cancer FSMP for State Market Regulation Beijing 100038China Laboratory for Clinical Medicine Capital Medical UniversityBeijing 100038China Department of general surgery Kailuan General HospitalTangshan 063000China Department of Genetics Yale School of MedicineNew Haven 06510USA Department of Hepatobiliary surgery Kailuan General HospitalTangshan 063000China Cardiovascular Research Institute University of CaliforniaSan Francisco 94158USA Department of Cardiology Kailuan General HospitalTangshan 063000China

The characteristics of early-onset(onset age<50 years)and later-onset(onset age≥50 years)cancers differ *** novel risk factors for both types of cancer is crucial for increasing awareness of cancer prevention and for reducing its *** study aimed to analyze the trends in incidence and risk factors for early-onset and late-onset *** conducted a prospective study by drawing data from the Kailuan *** study included 6,741 participants with cancer(624 with early-onset cancer and 6,117 with later-onset cancer)and 6,780 matched controls among the 186,249 participants who underwent Kailuan health examinations from 2006 to *** primary outcomes were cancer incidence rates,and associated risk factors for early-and later-onset *** Cox regression was used to calculate hazard ratios and 95% confidence intervals of each exposure factor for early-and later-onset cancer by cancer *** risk proportions were used to estimate the number of cases that could be prevented by eliminating a risk factor from the *** for liver cancer,incidence rates for nearly all types of cancer increased during the study ***,alcohol consumption,lipid metabolism disorders,hypertension,diabetes mellitus,fatty liver,and inflammation were associated with a significantly increased risk of cancer at multiple sites,but risk factors for cancer incidence differed by ***,alcohol consumption,inflammation,and hypertension were the major contributors to preventable *** incidence of several different types of cancer,including earlyonset cancer,is increasing in northeastern *** in risk factors between early-onset and later-onset malignancies may contribute to the divergence in the observed changes in incidence trends between these two specific types of cancer.

关键词： cancer early-onset later-onset trend risk factor prevention

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Unraveling the efficacy network: A network meta-analysis of adjuvant external beam radiation therapy methods after hepatectomy

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World Journal of Gastrointestinal surgery 2024年第1期16卷 205-214页

作者： Gao-Yuan Yang Zhi-Wei He Yong-Chang Tang Feng Yuan Ming-Bo Cao Yu-Peng Ren Yu-Xuan Li Xiao-Rui Su Zhi-Cheng Yao Mei-Hai Deng Department of Hepatobiliary surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina Department of general surgery Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of general surgery The First Affiliated HospitalGuangzhou Medical UniversityGuangzhou 511436Guangdong ProvinceChina Department of Hepatobiliary and Pancreatic surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina

BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient *** adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer ***,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further *** To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal *** This study involved network meta-analyses and followed the PRISMA *** data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane *** included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary *** magnitudes of the effects were determined using risk ratios with 95%confidential *** results were analyzed using R software and STATA *** A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this *** was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and *** analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest *** who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent ***

关键词： Primary liver cancer Hepatocellular carcinoma Network meta-analysis External beam radiation therapy Stereotactic body radiotherapy Intensity modulated radiotherapy

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Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intraabdominal fluid accumulation

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World Journal of Gastrointestinal surgery 2024年第1期16卷 134-142页

作者： Rui Chen Hua-Qiang Chen Rui-Die Li Hui-Min Lu Department of general surgery Chengdu Sixth People’s HospitalChengdu 610058Sichuan ProvinceChina West China Center of Exellence for Pancreatitis Institute of Integrated Traditional Chinese and Western MedicineWest ChinaDivision of Pancreatic SurgeryDepartment of General SurgeryWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina HospitalSichuan University

BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and *** To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid *** Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three *** The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group *** length of hospit

关键词： Abdominal paracentesis catheter drainage Timing Severe acute pancreatitis Intra-abdominal fluid Application value

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Clinical efficacy of Gamma Knife® combined with transarterial chemoembolization and immunotherapy in the treatment of primary liver cancer

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World Journal of Gastrointestinal surgery 2024年第6期16卷 1601-1608页

作者： Guo-Feng Wang Chang-Xin Shu Xiao-Dong Cai Hong-Bo Wang Jian-Hong Xu Yu-Qing Jia Department of general surgery Yangzhou Friendship Hospital Affiliated to Medical College of Yangzhou UniversityYangzhou 225000Jiangsu ProvinceChina

BACKGROUND This study was designed to investigate the clinical efficacy and safety of Gamma Knife®combined with transarterial chemoembolization(TACE)and immunotherapy in the treatment of primary liver *** To investigate the clinical efficacy and safety of Gamma Knife®combined with TACE and immune-targeted therapy in the treatment of primary liver *** Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively *** patients underwent Gamma Knife®treatment combined with TACE and *** clinical efficacy,changes in liver function,overall survival(OS),and progression-free survival(PFS)of patients with different treatment responses were evaluated,and adverse reactions were *** The last follow-up for this study was conducted on October 31,*** evaluation of the 51 patients with primary liver cancer revealed a partial response(PR)in 27 patients,accounting for 52.94%(27/51);stable disease(SD)in 16 patients,accounting for 31.37%(16/51);and progressive disease(PD)in 8 patients,accounting for 15.69%(8/51).The objective response rate was 52.94%,and the disease control rate was 84.31%.Alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment(all P=0.000).The median OS was 26 months[95%confidence interval(95%CI):19.946-32.054]in the PR group and 19 months(95%CI:14.156-23.125)in the SD+PD group,with a statistically significant difference(P=0.015).The median PFS was 20 months(95%CI:18.441-34.559)in the PR group and 12 months(95%CI:8.745-13.425)in the SD+PD group,with a statistically significant difference(P=0.002).Common adverse reactions during treatment included nausea and vomiting(39.22%),thrombocytopenia(27.45%),and leukopenia(25.49%),with no treatment-related deaths *** Gamma Knife®combined with TACE and immune-targeted th

关键词： Gamma Knife® Transarterial chemoembolization Immunotherapy Primary liver cancer Liver function

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Current Epidemiology of Intracranial Metastases in Two university Teaching Reference Hospitals of the Town of Yaounde, Cameroon: Analysis of 35 Cases Recorded in the Neurosurgery Departments

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Open Journal of Modern Neurosurgery 2024年第2期14卷 124-136页

作者： Nassourou Oumarou Haman Ronaldo Fonju Anu Orlane Ndome Toto Bello Figuim Indira Baboke Marguerite Gwladys Nzedzou Vincent de Paul Djientcheu Department of surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Neurosurgery Yaounde General Hospital Yaounde Cameroon Department of surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon

Background: The incidence of intracranial metastases (ICMET) has been steadily rising, and its frequency with respect to primary brain tumours is relatively high. Objective: The objectives of this study were to elucidate the current epidemiology and describe the clinical, diagnostic and therapeutic features of ICMET in Yaounde. Method and findings: A descriptive cross-sectional study was done in the neurosurgery departments of the general and Central Hospitals of Yaounde during the period from January 2016 to December 2022. We included all medical booklets of patients admitted for a tumoral intracranial expansive process with our target population being patients with histological evidence of ICMET, and did a retrospective inclusion of data using a pre-established technical form aimed at collecting sociodemographic data, clinical data, paraclinical data, and the treatment procedures. Analysis was done using the SPSS statistical software. A total of 614 cases of intracranial tumors were included among whom 35 presented histological evidence of ICMET. This gives a frequency of 5.7%. The sex ratio was 0.94, the mean age was 55.68 +/- 14.4 years, extremes 28 and 86 years and the age range 50 - 59 was affected in 28.57% of cases. The clinical presentation included signs of raised intracranial pressure (headache, blurred vision, vomiting) in 26 cases (74.3%), motor deficit 48.6%, seizures 17.1%. The mode of onset was metachronous in 71.4% and synchronous in 28.6%. The imaging techniques were cerebral CT scan in 82.9%, cerebral MRI in 40%, TAP scan in 22.9%. The metastatic lesions were supratentorial in 94.3% and single in 62.9%. The primary cancers found were breast cancer (31.4%), lung cancer (25.7%), prostate cancer (17.1%), thyroid cancer (5.7%), colon cancer (2.9%), and melanoma (2.9%). The therapeutic modalities were total resection (68.6%), radiotherapy (37.1%). Conclusion: Intracranial metastases are relatively frequent. There is a female sex predominance and the ag

关键词： Intracranial Metastases Epidemiology Yaounde

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Oncological features and prognosis of colorectal cancer in human immunodeficiency virus-positive patients: A retrospective study

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World Journal of Gastrointestinal surgery 2024年第1期16卷 29-39页

作者： Fu-Yu Yang Fan He De-Fei Chen Cheng-Lin Tang Saed Woraikat Yao Li Kun Qian Department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of general surgery Chongqing Public Health Medical CenterChongqing 400036China

BACKGROUND Due to the prolonged life expectancy and increased risk of colorectal cancer(CRC)among patients with human immunodeficiency virus(HIV)infection,the prognosis and pathological features of CRC in HIV-positive patients require *** To compare the differences in oncological features,surgical safety,and prognosis between patients with and without HIV infection who have CRC at the same tumor stage and *** In this retrospective study,we collected data from HIV-positive and-negative patients who underwent radical resection for *** random stratified sampling,24 HIV-positive and 363 HIV-negative patients with colorectal adenocarcinoma after radical resection were *** propensity score matching,we selected 72 patients,matched 1:2(HIV-positive:negative=24:48).Differences in basic characteristics,HIV acquisition,perioperative serological indicators,surgical safety,oncological features,and long-term prognosis were compared between the two *** Fewer patients with HIV infection underwent chemotherapy compared to patients ***-positive patients had fewer preoperative and postoperative leukocytes,fewer preoperative lymphocytes,lower carcinoembryonic antigen levels,more intraoperative blood loss,more metastatic lymph nodes,higher node stage,higher tumor node metastasis stage,shorter overall survival,and shorter progression-free survival compared to patients who were *** Compared with CRC patients who are HIV-negative,patients with HIV infection have more metastatic lymph nodes and worse long-term survival after *** treatment options for HIV-positive patients with CRC should be explored.

关键词： Colorectal cancer Human immunodeficiency virus Propensity score matching Oncological features Surgical safety Prognosis

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Absent in melanoma 2 attenuates proliferation and migration and promotes apoptosis of human colorectal cancer cells by activating P38MAPK signaling pathway

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Oncology Research 2024年第2期32卷 353-360页

作者： ZHI ZHANG XIAOSONG LI YING ZHANG HAO ZHU ZHENGUO QIAO YANG LU XIUWEI MI HUIHUA CAO GENHAI SHEN SONGBING HE Department of general surgery Suzhou Ninth People’s HospitalSuzhou Ninth Hospital Affiliated to Soochow UniversitySuzhouChina Medical College of Nantong university NantongChina Department of Gastroenterology Suzhou Ninth People’s HospitalSuzhou Ninth Hospital Affiliated to Soochow UniversitySuzhouChina Department of general surgery The First Affiliated Hospital of Soochow UniversitySuzhouChina Department of Oncological surgery Kunshan Traditional Hospital Affiliated to Nanjing University of Chinese MedicineKunshanChina

Colorectal cancer(CRC)stands among the top prevalent cancers worldwide and holds a prominent position as a major contributor to cancer-related mortality *** in melanoma 2(AIM2),a constituent of the interferoninducible hematopoietic interferon-inducible nuclear antigens with 200 amino acid repeats protein family,contributes to both cancer progression and inflammasome *** this understanding,the precise biological functions and molecular mechanisms governed by AIM2 in CRC remain ***,this study endeavors to assess AIM2’s expression levels,explore its potential antitumor effects,elucidate associated cancer-related processes,and decipher the underlying signaling pathways in *** findings showed a reduced AIM2 expression in most CRC cell *** of AIM2 levels suppressed CRC cell proliferation and migration,altered cell cycle by inhibiting G1/S transition,and induced cell *** research uncovered the participation of P38 mitogen-activated protein kinase(P38MAPK)in AIM2-mediated modulation of CRC cell apoptosis and ***,our achievements distinctly underscored AIM2’s antitumor role in ***2 overexpression inhibited proliferation and migration and induced apoptosis of CRC cells via activating P38MAPK signaling pathway,indicating AIM2 as a prospective and novel therapeutic target for CRC.

关键词： Absent in melanoma 2 Proliferation Migration Apoptosis P38MAPK Colorectal cancer

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