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Nomograms for predicting pathological response to neoadjuvant treatments in patients with rectal cancer

World Journal of Gastroenterology 2019年第1期25卷 118-137页

作者： Dong-Lin Ren Juan Li Hui-Chuan Yu Shao-Yong Peng Wei-Da Lin Xiao-Lin Wang Roshan Ara Ghoorun Yan-Xin Luo Department of colorectal and Anal Surgery Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital Sun Yat-sen University guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital Sun Yat-sen University Department of colorectal Surgery Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital Sun Yat-sen University

BACKGROUND In recent decades, neoadjuvant therapy(NT) has been the standardized treatment for locally advanced rectal cancer(LARC). Approximately 8%-35% of patients with LARC who received NT were reported to have achieved a complete pathological response(pCR). If the pathological response(PR) can be accurately predicted, these patients may not need surgery. In addition, no response after NT implies that the tumor is destructive, resistant to both chemotherapy and radiotherapy, and prone to having a high metastatic potential. Therefore,developing accurate models to predict PR has great clinical significance and can help achieve individualized treatment in LARC *** To establish nomograms for predicting PR to different NT regimens based on pretreatment parameters for patients with *** Rectal cancer patients were identified from the database of The Sixth Affiliated Hospital, Sun Yat-sen University from January 2012 to December 2016. Logistic regression and nomograms were developed to predict the probability of pCR and good downstaging to ypT0-2N0M0(ypTNM 0-I), respectively, based on pretreatment parameters for all LARC patients. Nomograms were also developed for three NT regimens(capecitabine/deGramont-RT, mFOLFOX6, and m FOLFOX6-RT) to predict pCR *** Four hundred and three patients were included in this study; 72(17.9%) had pCR at the final pathology report, and 177(43.9%) achieved good downstaging to ypT0-2N0M0(ypTNM 0-I). The nomogram for predicting pCR probability showed that NT regimens, tumor differentiation, mesorectal fascia(MRF) status,and tumor length significantly influenced pCR probability. When predicting the probability of good downstaging, tumor differentiation, MRF status, and clinical T stage were the significant factors. Nomograms were developed based on NT regimens. For the capecitabine/de Gramont-RT group, the multivariate analysis showed that the neutrophil-lymphocyte ratio(NLR) was the only significant factor, thu

关键词： Neoadjuvant therapy Locally advanced rectal cancer Nomogram Prediction of pathological response Complete pathological response Good downstaging

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Male gender is associated with an increased risk of anastomotic leak in rectal cancer patients after total mesorectal excision

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Gastroenterology Report 2018年第2期6卷 137-143,I0003页

作者： Jian-ping Wang and Ping Lan Chi Zhou Xian-rui Wu Xuan-hui Liu Yu-feng Chen Jia Ke Xiao-wen He Xiao-sheng He Tuo Hu Yi-feng Zou Xiao-bin Zheng Hua-shan Liu Jian-cong Hu Xiao-jian Wu Jian-ping Wang Ping Lan Department of colorectal Surgery the Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhouGuangdong 510065China

Background:The impact of a patient’s gender on the development of anastomotic leak(AL)in rectal cancer patients following total mesorectal excision(TME)remains *** aim of this study was to evaluate the association between patients’gender and the risk of ***:All rectal cancer patients following TME with a primary anastomosis during the study period from 2010 to 2014 were *** of the post-operative AL incidence rate between male and female patients were ***:Of all patients examined(n¼956),587(61.4%)were males and 369(38.6%)were *** patients were more likely to have a history of smoking and drinking alcohol,but less likely to have a history of abdominal surgery compared to female patients.A higher incidence rate of pre-operative bowel obstruction and larger tumor volume in male patients was observed in our *** all the patients,81(8.5%)developed post-operative *** male patients(n¼62,10.6%)suffered from AL than females(n¼19,5.1%)(P¼0.003).Multivariate logistic regression analyses confirmed the association between male gender and AL[odds ratio(OR):2.41,95%confidence interval(CI):1.37–4.23,P¼0.002].Similar results were also obtained in patients who underwent laparoscopic TME(OR:2.11,95%CI:1.15–3.89,P¼0.016).Conclusions:Male patents were found to have an increased risk for AL following TME with a primary anastomosis.A temporary protecting stoma may help to protect the anastomosis and lessen the risk for AL especially in male patients.

关键词： rectal cancer anastomotic leak gender risk factor total mesorectal excision primary anastomosis

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The microbiome in inflammatory bowel diseases:from pathogenesis to therapy

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Protein & Cell 2021年第5期12卷 331-345页

作者： Sheng Liu Wenjing Zhao Ping Lan Xiangyu Mou guangdong provincial key laboratory of colorectal and pelvic floor diseases The Sixth Affiliated HospitalSchool of MedicineSun Yat-sen UniversityGuangzhou 510275China

Inflammatory bowel disease(IBD)has become a global disease with accelerating incidence worldwide in the 21st century while its accurate etiology remains *** the past decade,gut microbiota dysbiosis has consistently been associated with *** many IBDassociated dysbiosis have not been proven to be a cause or an effect of IBD,it is often hypothesized that at least some of alteration in microbiome is protective or *** this article,we selectively reviewed the hypothesis supported by both association studies in human and pathogenesis studies in biological ***,we reviewed the potential protective bacterial pathways and species against IBD,as well as the potential causative bacterial pathways and species of *** also reviewed the potential roles of some members of mycobiome and virome in ***,we covered the current status of therapeutic approaches targeting microbiome,which is a promising strategy to alleviate and cure this inflammatory disease.

关键词： inflammatory bowel disease pathogenesis etiology microbiome dysbiosis therapy

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Efficacy and complications of argon plasma coagulation for hemorrhagic chronic radiation proctitis

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World Journal of Gastroenterology 2019年第13期25卷 1618-1627页

作者： Qing-Hua Zhong Zhan-Zhen Liu Zi-Xu Yuan Teng-Hui Ma Xiao-Yan Huang Huai-Ming Wang Dai-Ci Chen Jian-Ping Wang Lei Wang guangdong provincial key laboratory of colorectal and pelvic floor diseases Sun Yat-sen University Department of colorectal Surgery the Sixth Affiliated Hospital Sun Yat-sen University guangdong Institute of Gastroenterology

BACKGROUND Chronic radiation proctitis(CRP) is a complication which occurs in 1%-5% of patients who undergo radiotherapy for pelvic malignancies. Although a wide range of therapeutic modalities are available, there is no literature to date showing any particularly appropriate therapeutic modality for each disease stage. Argon plasma coagulation(APC) is currently recommended as the firstchoice treatment for hemorrhagic CRP, however, its indication based on longterm follow-up is still unclear. On the hypothesis that the long-term efficacy and safety of APC are not fully understood, we reviewed APC treatment for patients with hemorrhagic CRP from a single *** To assess the long-term efficacy and safety of APC for hemorrhagic *** This is a retrospective study of consecutive patients treated with APC for hemorrhagic CRP from January 2013 to October 2017. Demographics, clinical variables, and typical endoscopic features were recorded independently. Success was defined as either cessation of bleeding or only occasional traces of bloody stools with no further treatments for at least 12 mo after the last APC *** performed univariate and multivariate analyses to identify factors associated with success and risk factors for *** Forty-five patients with a median follow-up period of 24 mo(range: 12-67 mo)were enrolled. Fifteen(33.3%) patients required blood transfusion before *** treatment with APC was achieved in 31(68.9%) patients. The mean number of APC sessions was 1.3(1-3). Multivariate analysis showed that APC failure was independently associated with telangiectasias present on more than50% of the surface area [odds ratio(OR) = 6.53, 95% confidence interval(CI): 1.09-39.19, P = 0.04] and ulcerated area greater than 1 cm^2(OR = 8.15, 95%CI: 1.63-40.88, P = 0.01). Six(13.3%) patients had severe complications involving rectal fistulation. The only factor significantly associated with severe complications was ulcerated area great

关键词： Argon plasma coagulation Chronic radiation proctitis Radiation proctopathy Efficacy Safety

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Dysbiosis of gut microbiota in promoting the development of colorectal cancer

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Gastroenterology Report 2018年第1期6卷 1-12,I0001页

作者： Shaomin Zou Lekun Fang Mong-Hong Lee Research Institute of Gastroenterology Sun Yat-sen UniversityGuangzhou 510020China guangdong provincial key laboratory of colorectal and pelvic floor disease The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510020China

Gastrointestinal microbiome,containing at least 100 trillion bacteria,resides in the mucosal surface of human *** studies show that perturbations in the microbiota may influence physiology and link to a number of diseases,including colon *** cancer(CRC),the third most common cancer,is the disease resulting from multi-genes and multi-factors,but the mechanistic details between gut microenvironment and CRC remain poorly *** to new technologies such as metagenome sequencing,progress in large-scale analysis of the genetic and metabolic profile of gut microbial has been possible,which has facilitated studies about microbiota composition,taxonomic alterations and host *** bacterial species and their metabolites play critical roles in the development of ***,microbiota is important in the inflammatory response and immune processes deregulation during the development and progression of *** review summarizes current studies regarding the association between gastrointestinalmicrobiota and the development of CRC,which provides insights into the therapeutic strategy of CRC.

关键词： gut microbiota microbiome dysbiosis colorectal cancer tumorigenesis

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Identification of immune cell infiltration landscape for predicting prognosis of colorectal cancer

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Gastroenterology Report 2023年第1期11卷 260-270页

作者： Xueqian Wu Jianxia Li Yuanzhe Zhang Yi Cheng Zehua Wu Weixiang Zhan Yanhong Deng Department of Medical Oncology The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China guangdong provincial key laboratory of colorectal and pelvic floor disease Guangdong Research Institute of GastroenterologyThe Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background:The tumor microenvironment plays an essential role in the therapeutic response to *** is necessary to identify immune cell infiltration(ICI)subtypes for evaluating prognosis and therapeutic *** study aimed to evaluate the ICI score as an effective prognostic biomarker for immune ***:The cell-type identification by estimating relative subsets of RNA transcripts and the estimation of stromal and immune cells in malignant tumors using expression methods were used to analyse ICI landscapes in 161 colorectal cancer(CRC)samples with patients’clinical and prognostic data,RNA sequencing data,and whole-exome sequencing data from the Sixth Affiliated Hospital,Sun Yat-sen University(Guangzhou,China).Statistical analysis and data processing were conducted to calculate ICI scores,and to analyse the prognosis of CRC patients with different ICI scores and other features.A similar analysis with RNA sequencing and clinical data of colon adenocarcinoma(COAD)samples from The Cancer Genome Atlas(TCGA)database was conducted to confirm the correctness of the ***:The high-ICI score group with a better prognosis(hazard ratio[HR],2.19;95%confidence interval[CI],1.03–4.64;logrank test,P=0.036)was characterized by the increased tumor mutational burden and interleukin-17(IL-17)signaling *** differences in the prognosis and the expression levels of immune checkpoints and chemokine marker genes were found between the two ICI score *** COAD samples from TCGA,the results also showed a significant difference in patients’prognosis between the two ICI score groups(HR,1.72;95%CI,1.00–2.96;log-rank test,P=0.047).Conclusions:Tumor heterogeneity induced differences in identifying ICI subtypes of CRC *** ICI score may serve as an effective biomarker for predicting prognosis,help identify new therapeutic markers for CRC,and develop novel effective immune checkpoint blockade therapies.

关键词： colorectal cancer prognosis immune cell infiltration ICI scores immunology tumor microenvironment

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Fabrication of Silver Yolk@Porous Janus Polymer Shell Nanospheres for Synergistic Catalysis

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Chinese Journal of Polymer Science 2020年第8期38卷 847-852,I0007页

作者： Shao-hong Liu Yan-huan Lin Wen-tai Guo Shi-mei Li Wei-cong Mai Hui Wang Ruo-wen Fu Ding-cai Wu Materials Science Institute PCFM Lab and GDHPPC LabSchool of ChemistrySun Yat-sen UniversityGuangzhou 510275China Department of colorectal Surgery Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655China

Yolk-shell nanostructures have recently attracted tremendous research interests in various areas because of their unique structural ***,there is an urgent need for developing porous shells with multifunctional features to enhance their performance in various ***,advanced yolk-shell nanospheres have been facilely prepared by encapsulating silver nanoparticles with porous Janus polymer shells that consist of a hypercrosslinked polystyrene(xPS)outer layer and a tethered poly(acrylic acid)(PAA)brush *** xPS outer layer possesses well-developed porosity as mass diffusion *** importantly,the tethered PAA brushes with customized carboxyl groups exhibit great affinity toward specific species(e.g.,cationic dyes),leading to their enrichment from the bulk solution into the interior *** unusual combination of highly porous outer layers with customizable inbuilt polymer linings in the porous Janus shells endows them with great promise for synergistically catalytic degradation of cationic dyes.

关键词： Yolk-shell nanostructure Janus shell Selective diffusion Synergistic catalysis

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Harness the functions of gut microbiome in tumorigenesis for cancer treatment

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Cancer Communications 2021年第10期41卷 937-967页

作者： Mong-Hong Lee Research Institute of Gastroenterology Sun Yat-sen University GuangzhouGuangdong 510020P.R.China guangdong provincial key laboratory of colorectal and pelvic floor disease the Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510020P.R.China

It has been shown that gut microbiota dysbiosis leads to physiological changes and links to a number of diseases,including ***,many cancer categories and treatment regimens should be investigated in the context of the *** to the availability of metagenome sequencing and multiomics studies,analyses of species characterization,host genetic changes,and metabolic profile of gut microbiota have become feasible,which has facilitated an exponential knowledge gain about microbiota composition,taxonomic alterations,and host interactions during ***,the complexity of the gut microbiota,with a plethora of uncharacterized host-microbe,microbemicrobe,and environmental interactions,still contributes to the challenge of advancing our knowledge of the microbiota-cancer *** interactions manifest in signaling relay,metabolism,immunity,tumor development,genetic instability,sensitivity to cancer chemotherapy and *** review summarizes current studies/molecular mechanisms regarding the association between the gut microbiota and the development of cancers,which provides insights into the therapeutic strategies that could be harnessed for cancer diagnosis,treatment,or prevention.

关键词： cancer biomarkers chemotherapy fecal microbiota transplantation gut microbiome immunotherapy microbiota probiotics

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Development of a prognostic model for one-year surgery risk in Crohn’s disease patients: A retrospective study

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World Journal of Gastroenterology 2020年第5期26卷 524-534页

作者： Jia-Yin Yao Yi Jiang Jia Ke Yi Lu Jun Hu Min Zhi Department of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510655Guangdong ProvinceChina Department of colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510655Guangdong ProvinceChina Department of Anesthesiology Guangzhou Hospital of Traditional Chinese MedicineGuangzhou 510130Guangdong ProvinceChina guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510655Guangdong ProvinceChina

BACKGROUND Accelerated therapeutic treatment should be considered in patients with progressive Crohn’s disease(CD)to prevent complications as well as ***,screening for risk factors and predicting the need for early surgery are of great importance in clinical *** To establish a model to predict CD-related early *** This was a retrospective study collecting data from CD patients diagnosed at our inflammatory bowel disease center from January 1,2012 to December 31,*** data were randomly stratified into a training set and a testing set at a ratio of 8:*** logistic regression analysis was conducted with receiver operating characteristic curves constructed and areas under the curve *** model was further validated with calibration and discrimination estimated.A nomogram was finally *** A total of 1002 eligible patients were enrolled with a mean follow-up period of 53.54±13.10 *** total,24.25%of patients received intestinal surgery within 1 year after diagnosis due to complications or disease *** behavior(B2:OR[odds ratio]=6.693,P<0.001;B3:OR=14.405,P<0.001),smoking(OR=4.135,P<0.001),body mass index(OR=0.873,P<0.001)and C-reactive protein(OR=1.022,P=0.001)at diagnosis,previous perianal(OR=9.483,P<0.001)or intestinal surgery(OR=8.887,P<0.001),maximum bowel wall thickness(OR=1.965,P<0.001),use of biologics(OR=0.264,P<0.001),and exclusive enteral nutrition(OR=0.089,P<0.001)were identified as independent significant factors associated with early intestinal surgery.A prognostic model was established and further *** receiver operating characteristic curves and calculated areas under the curves(94.7%)confirmed an ideal predictive ability of this model with a sensitivity of 75.92%and specificity of 95.81%.A nomogram was developed to simplify the use of the predictive model in clinical *** This prognostic model can effectively predict 1-year risk of CD-related intest

关键词： Crohn’s disease Prognostic model Nomogram Early surgery Inflammatory bowel disease Retrospective study

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Role of gut microbiota in functional constipation

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Gastroenterology Report 2021年第5期9卷 392-401,I0001页

作者： Shengsheng Zhang Ruixin Wang Danyan Li Luqing Zhao Lixin Zhu Digestive disease Center Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijingP.R.China Department of colorectal Surgery Guangdong Institute of GastroenterologyGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China

Functional constipation(FC)is common,yet the etiology is not *** evidence suggests an association between FC and abnormal gut *** relationship between the gut microbiota and the gut transit is likely *** review summarizes the current evidence regarding the impact of gut microbiota on the pathogenesis of *** modulating the colonic motility,secretion,and absorption,gut microbiota may contribute to the development of FC through microbial metabolic activities involving bile acids,short-chain fatty acids,5-hydroxytryptamine,and *** support of the key roles of the gut microbiota in FC,treatment with probiotics,prebiotics,synbiotics,and traditional Chinese medicine often result in compositional and functional changes in the gut *** studies on the pathogenesis of FC and the therapeutic mechanism of microecological agents will provide a knowledge base for better management of FC.

关键词： gut microbiota functional constipation bile acids SCFA serotonin traditional Chinese medicine

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