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IN VIVO NEAR-INFRAREDFLUOREsCENCEIMAGING OF HUMANCOLONADENOCARCINOMABY sPECIFIC IMMUNOTARGETINGOFA TUMOR-AssOCIATEDMUCIN

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Journal of Innovative Optical Health sciences 2009年第4期2卷 407-422页

作者： RALPH s.DACOstA YING TANG TUULA KALLIOMAKI RAYMOND M.REILLY ROBERT WEERsINK ALIsHA R.ELFORD NORMAN E.MARCON BRIAN C.WILsON Division of Biophysics and Bioimaging Ontario Cancer Institute 610 University of TorontoTorontoOntarioM5G 2M9Canada Department of Medical Biophysics University of Toronto Princess Margaret Hospital/Ontario Cancer Institute University Health NetworkTorontoOntarioCanada NIH/NCI Radiation Oncology Branch BethesdaMDUSA Division of Clinical Investigation and Human Physiology toronto General hospital Research Institute and University of Toronto Leslie Dan Faculty of Pharmacy TorontoOntarioCanada Laboratory for Applied Biophotonics University Health Network TorontoOntarioCanada Campbell Family Institute for Breast Cancer Research University Health Network/Ontario Cancer Institute Department of Medical Biophysics and Immunology toronto OntarioCanada st.michael’s hospital center for therapeutic endoscopy and endoscopic oncology toronto OntarioCanada

Background and Aims: Accurate endoscopic detection of premalignant lesions and earlycancers in the colon is essential for cure, since prognosis is closely related to lesion size andstage. Although it has great clinical potential, autofluorescence endoscopy has limited tumorto-normal tissue image contrast for detecting small preneoplastic lesions. We have developed amolecularly specific, near-infrared fluorescent monoclonal antibody (CC49) bioconjugate whichtargets tumor-associated glycoprotein 72 (TAG72), as a contrast agent to improve fluorescencebased endoscopy of colon cancer. Methods: The fluorescent anti-TAG72 conjugate was evaluated in vitro and in vivo in athymic nude mice bearing human colon adenocarcinoma (Ls174T)subcutaneous tumors. Autofluorescence, a fluorescent but irrelevant antibody and the free fluorescent dye served as controls. Fluorescent agents were injected intravenously, and in vivowhole body fluorescence imaging was performed at various time points to determine pharmacokinetics, followed by ex vivo tissue analysis by confocal fluorescence microscopy and histology Results: Fluorescence microscopy and histology confirmed specific Ls174T cell membrane targeting of labeled CC49 in vitro and ex vivo. In vivo fluorescence imaging demonstrated significant tumor-to-normal tissue contrast enhancement with labeled-CC49 at three hours postinjection, with maximum contrast after 48 h. Accumulation of tumor fluorescence demonstratedthat modification of CC49 antibodies did not alter their specific tumor-localizing properties, andwas antibody-dependent since controls did not produce detectable tumor fluorescence. Conclusions: These results show proof-of-principle that our near-infrared fluorescent-antibody probetargeting a tumor-associated mucin detects colonic tumors at the molecular level in real time,and offer a basis for future improvement of image contrast during clinical fluorescence endoscopy.

关键词： Autofluorescence imaging endoscopy colon adenocarcinoma TAG72 CC49 mucin monoclonal antibody conjugate confocal fluorescence microscopy.

superiority of urgent vs early endoscopic hemostasis in patients with upper gastrointestinal bleeding with high-risk stigmata

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Gastroenterology Report 2021年第6期9卷 543-551页

作者： Masayasu Horibe Eisuke Iwasaki Juntaro Matsuzaki Fateh Bazerbachi Tetsuji Kaneko Kazuhiro Minami seiichiro Fukuhara Tatsuhiro Masaoka Naoki Hosoe Yuki Ogura shin Namiki Yasuo Hosoda Haruhiko Ogata Takanori Kanai Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineTokyoJapan Division of Gastroenterology and Hepatology Mayo ClinicMNUSA Interventional endoscopy Program CentraCareSt Cloud HospitalMNUSA Department of Clinical Trial Tokyo Metropolitan Children’s Medical CenterTokyoJapan Teikyo Academic Research center Teikyo UniversityTokyoJapan center for Diagnostic and therapeutic endoscopy Keio University HospitalTokyoJapan Department of Gastroenterology and Hepatology Tokyo Metropolitan Tama Medical CenterTokyoJapan Division of Gastroenterology Department of Internal MedicineNational Hospital Organization Saitama National HospitalSaitamaJapan

Background Guidelines recommend that all patients with upper gastrointestinal bleeding(UGIB)undergo endoscopy within 24 *** is unclear whether a subgroup may benefit from an urgent *** aimed to evaluate the influence of endoscopic hemostasis and urgent endoscopy on mortality in UGIB patients with high-risk stigmata(HRs).Methods Consecutive patients with suspected UGIB were enrolled in three Japanese hospitals with a policy to perform endoscopy within 24 *** primary outcome was 30-day *** hemostasis and endoscopy timing(urgent,6h;early,>6h)were evaluated in a regression model adjusting for age,systolic pressure,heart rate,hemoglobin,creatinine,and variceal bleeding in multivariate analysis.A propensity score of 1:1 matched sensitivity analysis was also *** HRs were present in 886 of 1966 patients,and 35 of 886(3.95%)patients *** urgent-endoscopy time(n=769)was 3.0h(interquartile range[IQR],2.0–4.0 h)and early endoscopy(n紏117)was 12.0h(IQR,8.5–19.0 h).successful endoscopic hemostasis and urgent endoscopy were significantly associated with reduced mortality in multivariable analysis(odds ratio[OR],0.22;95%confidence interval[CI],0.09–0.52;P=0.0006,and OR,0.37;95%CI,0.16–0.87;P=0.023,respectively).In a propensity-score-matched analysis of 115 pairs,adjusted comparisons showed significantly lower mortality of urgent vs early endoscopy(2.61%vs 7.83%,Psions A subgroup of UGIB patients,namely those harboring HRs,may benefit from endoscopic hemostasis and urgent endoscopy rather than early endoscopy in reducing *** triage scores that predict the presence of such lesions is important.

关键词： UGIB urgent endoscopy non-variceal bleeding variceal bleeding HARBINGER GBs upper gastrointestinal bleeding

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结肠镜诊断阑尾黏液囊肿

世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 35-36页

作者： Zanati s.A. Martin J.A. Baker J.P. N.E. Marcon 尹勇 Centre for therapeutic endoscopy and endoscopic oncology 16-062 Cardinal Carter Wing St. Michael’s Hospital 30 Bond St Toronto Ont. M5B 1W8 Canada Dr.

Background: Appendiceal mucoceles are uncommon cystic neoplasms characterized by distension of the appendiceal lumen with mucus. There have been no reported series of colonoscopically diagnosed mucoceles with clinicopathologic correlation. Methods: A retrospective review of colonoscopies performed at our institution over the past 14 years was undertaken with patient demographics, clinical data, surgical outcomes, and histopathology obtained from hospital records. Observations: seven patients (6 women) with mucocele of the appendix were identified at colonoscopy. Three had complained of right lower quadrant pain. All 7 patients underwent surgical resection. Histopathology demonstrated mucinous cystadenoma in all. No cases revealed carcinoma, and there have been no deaths related to the mucocele. Conclusions: Appendiceal mucoceles may be recognized at colonoscopy as a smooth bulbous submucosal lesion of the cecum with an impression formed by the appendiceal orifice. Recognition at colonoscopy is important because it enables accurate diagnosis and directs management. surgery is recommended in all cases given the risk of malignancy or perforation with resultant pseudomyxoma peritonei.

关键词：阑尾黏液囊肿结肠镜检查阑尾腔黏液囊腺瘤囊性肿瘤腹膜假性黏液瘤手术预后人口统计学文献报

endoscopic ultrasound fine-needle biopsy vs fine-needle aspiration for lymph nodes tissue acquisition:a systematic review and meta-analysis

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Gastroenterology Report 2022年第1期10卷 544-551页

作者： Antonio Facciorusso stefano Francesco Crino Paraskevas Gkolfakis Daryl Ramai Andrea Lisotti Ioannis s Papanikolaou Benedetto Mangiavillano Ilaria Tarantino Andrea Anderloni Carlo Fabbri Konstantinos Triantafyllou Pietro Fusaroli Gastroenterology Unit Department of Surgical and Medical SciencesUniversity of FoggiaFoggiaItaly Department of Medicine Gastroenterology and Digestive Endoscopy UnitThe Pancreas InstituteUniversity Hospital of VeronaVeronaItaly Department of Gastroenterology Hepatopancreatologyand Digestive OncologyCUB Erasme HospitalUniversite Libre de Bruxelles(ULB)BrusselsBelgium Gastroenterology and Hepatology University of Utah HealthSalt Lake CityUTUSA Gastroenterology Unit Hospital of ImolaUniversity of BolognaImolaItaly Hepatogastroenterology Unit Second Department of Internal Medicine-PropaedeuticMedical SchoolNational and Kapodistrian University of Athens‘Attikon’University General HospitalAthensGreece Gastrointestinal endoscopy Unit Humanitas Mater DominiCastellanzaVareseItaly endoscopy service Department of Diagnostic and Therapeutic ServicesIRCCS-ISMETTPalermoItaly Digestive endoscopy Unit Humanitas Clinical and Research Center—IRCCSRozzanoMilanoItaly Gastroenterology and Digestive endoscopy Unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly

Background:endoscopic ultrasound(EUs)-guided tissue acquisition represents the choice of methods for suspected lymph nodes(LNs)located next to the gastrointestinal *** study aimed to compare the pooled diagnostic performance of EUs-guided fine-needle biopsy(EUs-FNB)and fine-needle aspiration(EUs-FNA)for LNs ***:We searched PubMed/MedLine and Embase databases through August *** outcome was diagnostic accuracy;secondary outcomes were sensitivity,specificity,sample adequacy,optimal histological core procurement,number of passes,and adverse *** performed a pairwise meta-analysis using a random-effects *** results are presented as odds ratio(OR)or mean difference along with 95%confidence interval(CI).Results:We identified nine studies(1,276 patients)in this *** these patients,66.4%were male;the median age was 67 *** accuracy was not significantly different between the two approaches(OR,1.31;95%CI,0.81–2.10;P=0.270).The accuracy of EUs-FNB was significantly higher when being performed with newer end-cutting needles(OR,1.87;95%CI,1.17–3.00;P=0.009)and in abdominal LNs(OR,2.48;95%CI,1.52–4.05;Ps of sample adequacy was observed between the two approaches(OR,1.40;95%CI,0.46–4.26;P=0.550);however,histological core procurement and diagnostic sensitivity with EUs-FNB were significantly higher than those with EUs-FNA(OR,6.15;95%CI,1.51–25.07;P=0.010 and OR,1.87;95%CI,1.27–2.74,P=0.001).The number of needle passes needed was significantly lower in the EUs-FNB group than in the EUs-FNA group(mean difference,-0.54;95%CI,-0.97 to -0.12;P=0.010).Conclusions EUs-FNA and EUs-FNB perform similarly in LN sampling;however,FNB performed with end-cutting needles outperformed FNA in terms of diagnostic accuracy.

关键词： EUs FNA FNB cancer metastases lymphoma

Prediction of colorectal tumor grade and invasion depth through narrow-band imaging scoring

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World Journal of Gastroenterology 2018年第42期24卷 4809-4820页

作者： Yasuhiko Maeyama Keiichi Mitsuyama Tetsuhiro Noda shiuchiro Nagata Tsutomu Nagata shinichiro Yoshioka Hikaru Yoshida Michita Mukasa Hiroaki sumie Hiroshi Kawano Jun Akiba Yuko Araki Tatsuyuki Kakuma Osamu Tsuruta Takuji Torimura Division of Gastroenterology Department of MedicineKurume University School of Medicine Department of Gastroenterology St.Mary’s HospitalKurume Department of Diagnostic Pathology Kurume University Hospital Biostatistics center Kurume University School of Medicine

AIM To determine the usefulness of assigning narrow-band imaging(NBI) scores for predicting tumor grade and invasion depth in colorectal *** A total of 161 colorectal lesions were analyzed from138 patients who underwent endoscopic or surgical resection after conventional colonoscopy and magnifying endoscopy with NBI. The relationships between the surface and vascular patterns of the lesions, as visualized with NBI, and the tumor grade and depth of submucosa(sM) invasion were determined *** were assigned to distinct features of the surface microstructures of tubular and papillary-type *** a multivariate analysis, a model was developed for predicting the tumor grade and depth of invasion based on NBI-finding *** NBI findings that correlated with a high tumor grade were associated with the "regular/irregular"(P surface patterns and the "avascular area" pattern(P =0.0600). The vascular patterns of "disrupted vessels"(P = 0.0714) and "thick vessels"(P = 0.0133) but none of the surface patterns were associated with a depth of invasion of ≥ 1000 μm. In our model, a total NBIfinding score ≥ 1 was indicative of a high tumor grade(sensitivity: 0.97; specificity: 0.24), and a total NBIfinding score ≥ 9(sensitivity: 0.56; specificity: 1.0) was predictive of a sM invasion depth ≥ 1000 μm. scores less than these cutoff values signified adenomas and a sM invasion depth spectively. Associations were also noted between selected NBI findings and tumor tissue architecture and *** Our multivariate statistical model for predicting tumor grades and invasion depths from NBI-finding scores may help standardize the diagnosis of colorectal lesions and inform therapeutic strategies.

关键词： Colorectal cancer Magnifying narrow-band imaging score surface pattern Vascular pattern

Web-based system for training and dissemination of a magnification chromoendoscopy classification

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World Journal of Gastroenterology 2008年第46期14卷 7086-7092页

作者： Mário Jorge Dinis-Ribeiro Ricardo Cruz Correia Cristina santos sónia Fernandes Ernesto Palhares Rui Almeida silva Pedro Amaro Miguel Areia Altamiro Costa-Pereira Luis Moreira-Dias Gastroenterology Department Portuguese Oncology Institute center for Research in Information systems and Health Technologies (CINTEsIs)/Department of Biostatistics and Medical Informatics Porto Faculty of Medicine Gastroenterology Department Coimbra University Hospital

AIM： To evaluate the use of web-based technologies to assess the learning curve and reassess reproducibility of a simplified version of a classification for gastric magnification chromoendoscopy （MC）. METHODs： As part of a multicenter trial, a hybrid approach was taken using a CD-ROM, with 20 films of MC lasting 5 s each and an ＂autorun＂ file triggering a local HTML frameset referenced to a remote questionnaire through an Internet connection. Three endoscopists were asked to prospectively and independently classify 10 of these films randomly selected with at least 3 d apart. The answers were centrally stored and returned to participants together with adequate feedback with the right answer. REsULTs： For classification in 3 groups, both intra- [Cohen＇s kappa （K） = 0.79-1.00 to 0.89-1.00] and inter-observer agreement increased from 1st （moderate） to 6th observation （k = 0.94）. Also, agreement with reference increased in the last observations （0.90, 1.00 and 1.00, for observers A, B and C, respectively）. Validity of 100% was obtained by all observers at their 4th observation. When a 4th （sub）group was considered, inter-observer agreement was almost perfect （K = 0.92） at 6th observation. The relation with reference clearly improved into K （0.93-1.00） and sensitivity （75%-100%） at their 6th observations. CONCLUsION： This MC classification seems to be easily explainable and learnable as shown by excellent intra- and inter-observer agreement, and improved agreement with reference. A web system such as the one used in this study may be useful for endoscopic or other image based diagnostic procedures with respect to definition, education and dissemination.

关键词： Magnification Chromoendoscopy Reproducibility Learning curve

single balloon enteroscopy for endoscopic retrograde cholangiography in patients with Roux-en-Y hepaticojejuno anastomosis

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World Journal of Gastroenterology 2013年第44期19卷 8047-8055页

作者： Bohuslav Kianika Jan Lata Ivo Novotny Petr Dítě Jirí Vaníek 2nd Clinic of Internal Medicine Department of Gastroenterology St. Anne’s University Hospital Brno 656 91 Brno Czech Republic University of Ostrava Faculty of Medicine 703 00 Ostrava Czech Republic Department of Gastroenterology Masaryk Memorial Cancer Institute 602 00 Brno Czech Republic Academic Centre of Digestive oncology Faculty of Medicine University of Ostrava 703 00 Ostrava Czech Republic Department of Diagnostic Imaging and International Clinical Research center (ICRC) St. Anne’s University Hospital Brno 656 91 Brno Czech Republic

AIM:To evaluate single balloon enteroscopy in diagnostic and therapeutic endoscopic retrograde cholangiography(ERC)in patients with Roux-en-Y hepaticojejunoanastomosis(HJA).METHODs:The study took place from January 2009to December 2011 and we retrospectively assessed 15patients with Roux-en-Y HJA who had signs of biliary *** total,23 ERC procedures were performed in these patients and a single balloon videoen-teroscope(Olympus sIF Q 180)was used in all of the cases.A transparent overtube was drawn over the videoenteroscope and it freely moved on the working part of the *** distal end was equipped with a silicone balloon that was inflated by air from an external pump at a pressure of≤5.4 *** technical limitations or rather the parameters of the single balloon enteroscope(working length-200 cm,diameter of the working channel-2.8 mm,absence of Albarran bridge)showed the need for special endoscopic ***:Cannulation success was reached in diagnostic ERC in 12 of 15 *** findings were normal in 1 of 12 *** in the remaining 11 patients showed some pathological *** of these(cystic bile duct dilation)was subsequently resolved *** treatment was initialized in the remaining 10 patients(5 with HJA stenosis,2 with choledocholithiasis,and 3 with both).This treatment was successful in 9 of 10 *** endoscopic therapeutic procedures included:balloon dilatation of HJA stenosis-11 times(7 patients);choledocholitiasis extraction-five times(5 patients);biliary plastic stent placement-six times(4 patients);and removal of biliary stents placed by us-six times(4 patients).The mean time of performing a single ERC was 72 *** longest procedure took 110 min and the shortest took34 *** shows that it is necessary to allow for more time in individual ***,these procedures require the presence of an *** did not observe any complications in these 15 ***

关键词： single balloon enteroscopy endoscopic retrograde cholangiography Roux-Y hepaticojejunoanastomosis endoscopic diagnosis endoscopic treatment

Multimodal treatments of “gallstone cholangiopancreatitis”

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World Journal of Gastrointestinal endoscopy 2022年第7期14卷 467-470页

作者： serafino Vanella Mario Baiamonte Francesco Crafa Division of General and surgical oncology St.Giuseppe Moscati HospitalCenter of National Excellence and High SpecialtyAvellino 83100Italy General and Emergency surgery Unit Civico Benfratelli Di Cristina HospitalPalermo 90121Italy Oncological and General surgery Unit St.Giuseppe Moscati HospitalCenter of National Excellence and High SpecialtyAvellino 83100Italy

Gallstone cholangiopancreatitis is a potentially life-threatening pathology which requires quick intervention involving endoscopists,interventional radiologists,anesthesiologists and surgeons in relation to clinical *** possibilities are varied,especially with current progress in advanced endoscopy,interventional radiology,and minimally invasive *** following treatments are available:endoscopic sphincterotomy(Es)with stone extraction followed by laparoscopic cholecystectomy;simultaneous endoscopic stone extraction with laparoscopic cholecystectomy(rendezvous technique);combined laparoscopic cholecystectomy and common bile duct(CBD)exploration;open CBD exploration;Es post-cholecystectomy;percutaneous placement of biliary drains for unstable patients,followed by percutaneous cholangioscopy;and lithotripsy with different approaches,including a laser and balloon dilation of the sphincter of *** technique has its strengths and weaknesses,and there is great discussion in the literature on choosing the ideal approach based on the patient’s clinical conditions.

关键词： Cholangiopancreatitis Common bile duct stones endoscopic retrograde cholangiopancreatography endoscopic sphincterotomy Laparoscopic common bile duct exploration Percutaneous

Role of endoscopy in inflammatory bowel disease

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Gastroenterology Report 2018年第2期6卷 75-82,I0001页

作者： shishira Bharadwaj Neeraj Narula Parul Tandon Mohammad Yaghoobi Department of Gastroenterology/Hepatology Beth Israel Deaconess Medical Center330 Brookline AveBostonMA 02215USA Division of Gastroenterology McMaster University1280 Main St WHamiltonON L8S 4L8Canada Department of Medicine The Ottawa Hospital501 Smyth RdOttawaON K1H 8L6Canada

Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of *** diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be ***,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or ***,there has been increased recognition of the role of the therapeutic endoscopist in the field of *** imaging techniques have been developed to aid in the differentiation of UC vs ***,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD *** ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith ***,chromoendoscopymay help to detect dysplasia earlier compared with white-light ***,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD *** role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia *** this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.

关键词： Inflammatory bowel disease small-bowel imaging therapeutic endoscopy chromoendoscopy endoscopic balloon dilation