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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 526-529页

作者： Alessandro Fancellu Mario Maiore Lavinia Grasso Miriam Ferrara Alberto Porcu Department of Medicine Surgery and PharmacyUnit of General Surgery 2-Clinica ChirurgicaUniversity of SassariSassari 07100Italy Department of Medicine Surgery and PharmacyUnit of RadiologyUniversity of SassariSassari 07100Italy

Total pancreatectomy(TP) is a surgical procedure which includes the complete removal of the pancreatic gland, the spleen, the duodenum, the gallbladder, and the distal part of the stomach. TP represents the curative treatment of pancreatic cancer which simultaneously involves the head and the body/tail of the pancreas. Other possible indications for TP comprise multifocal parenchymal diseases, such as intraductal papillary mucinous neoplasms, pancreatic neuroendocrine tumors, multiple endocrine neoplasms, and chronic pancreatitis. Sometimes, TP is carried out in patients scheduled for pancreaticoduodenectomy(where only the head of the pancreas is removed) when a cancer located in the pancreatic head is intraoperatively found to also extend to the pancreatic body [1].

关键词： neoplasms stomach spleen

Lymphatic vessel:origin,heterogeneity,biological functions,and therapeutic targets

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Signal Transduction and Targeted Therapy 2024年第2期9卷 442-478页

作者： Zhaoliang Hu Xushi Zhao Zhonghua Wu Bicheng Qu Minxian Yuan Yanan Xing Yongxi Song Zhenning Wang Department of Surgical Oncology and General surgery The First Hospital of China Medical UniversityKey Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors(China Medical University)Ministry of Education155 North Nanjing StreetHeping DistrictShenyang 110001China

Lymphatic vessels,comprising the secondary circulatory system in human body,play a multifaceted role in maintaining homeostasis among various tissues and *** are tasked with a serious of responsibilities,including the regulation of lymph absorption and transport,the orchestration of immune surveillance and *** vessel development undergoes a series of sophisticated regulatory signaling pathways governing heterogeneous-origin cell populations stepwise to assemble into the highly specialized lymphatic vessel ***,as defined by new lymphatic vessels sprouting from preexisting lymphatic vessels/embryonic veins,is the main developmental mechanism underlying the formation and expansion of lymphatic vessel networks in an ***,abnormal lymphangiogenesis could be observed in many pathological conditions and has a close relationship with the development and progression of various *** studies have revealed a set of lymphangiogenic factors and cascades that may serve as the potential targets for regulating abnormal lymphangiogenesis,to further modulate the progression of ***,an increasing number of clinical trials have demonstrated the promising interventions and showed the feasibility of currently available treatments for future clinical *** lymphangiogenic promoters or inhibitors not only directly regulates abnormal lymphangiogenesis,but improves the efficacy of diverse *** conclusion,we present a comprehensive overview of lymphatic vessel development and physiological functions,and describe the critical involvement of abnormal lymphangiogenesis in multiple ***,we summarize the targeting therapeutic values of abnormal lymphangiogenesis,providing novel perspectives for treatment strategy of multiple human diseases.

关键词： therapeutic origin specialized

Application of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging in recurrent anastomotic tumors after surgery in digestive tract tumors

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2474-2483页

作者： Deng-Feng Ge Hao Ren Zi-Chen Yang Shou-Xiang Zhao Zhen-Ting Cheng Da-Da Wu Bin Zhang Department of Cardiothoracic surgery Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina Department of Gastrointestinal surgery Shanghai Sixth People’s HospitalShanghai 250063China

BACKGROUND This study was to investigate the application value of whole-body dynamic ^(18)F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomogra-phy(PET/CT)imaging in recurrent anastomotic tumors of digestive tract after gastric and esophageal cancer *** patients with gastric and esophageal cancer have a high risk of tumor recurrence,and traditional imaging methods have certain limitations in early detection of recurrent ***-body dynamic ^(18)F-FDG PET/CT imaging,due to its high sensitivity and specifi-city,can provide comprehensive information on tumor metabolic activity,which is expected to improve the early diagnosis rate of postoperative recurrent tumors,and provide an important reference for clinical treatment *** A retrospective analysis was performed on 53 patients with upper digestive tract tumors after operation and systemic dynamic ^(18)F-FDG PET/CT imaging indi-cating abnormal FDG uptake by anastomosis,including 29 cases of gastric cancer and 24 cases of esophageal *** to the follow-up results of gas-troscopy and other imaging examinations before and after PET/CT examination,the patients were divided into an anastomotic recurrence group and anastomotic inflammation *** multi-parameter analysis software was used to obtain the metabolic rate(MRFDG),volume of distribution maximum(DVmax)of anastomotic lesions,and MRmean and DVmean of normal liver *** lesion/background ratio(LBR)was calculated by dividing the MRFDG and DVmax of the anastomotic lesion by the MRmean and DVmean of the normal liver tissue,respectively,to obtain LBR-MRFDG and *** independent sample t test was used for statistical analysis,and a receiver operating characteristic curve was used to analyze the differential diagnostic efficacy of each parameter for anastomotic recurrence and *** The dynamic ^(18)F-FDG PET/CT imaging parameters MRFDG,DVmax,LBR-MRFDG,and LBR-DVmax of post

关键词： Gastric cancer Esophageal cancer Anastomosis Dynamic positron emission tomography Differential diagnosis Metabolic rate

Close relationship between mediators of inflammation and pancreatic cancer:Our experience

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World Journal of Gastroenterology 2024年第23期30卷 2927-2930页

作者： Francesca Vescio Michele Ammendola Giuseppe Currò Silvia Curcio Department General Surgery UnitUniversity“Magna Graecia”Medical SchoolUniversity Hospital“R.Dulbecco”Catanzaro 88100Italy Science of Health Department Digestive Surgery UnitUniversity“Magna Graecia”Medical SchoolUniversity Hospital“R.Dulbecco”Catanzaro 88100Italy

In this editorial,we focus specifically on the mechanisms by which pancreatic inflammation affects pancreatic *** of the pancreas remains one of the deadliest cancer *** highest incidence and mortality rates of pancreatic cancer are found in developed *** of pancreatic cancer incidence and mortality vary considerably worldwide.A better understanding of the etiology and identification of the risk factors is essential for the primary prevention of this *** tumors are characterized by a complex microenvironment that orchestrates metabolic alterations and supports a milieu of interactions among various cell types within this *** this editorial,we highlight the foundational studies that have driven our understanding of these *** our experimental center,we have carefully studied the mechanisms of that link pancreatic inflammation and pancreatic *** focused on the role of mast cells(MCs).MCs contain pro-angiogenic factors,including tryptase,that are associated with increased angiogenesis in various *** this editorial,we address the role of MCs in angiogenesis in both pancreatic ductal adenocarcinoma tissue and adjacent normal *** assessment includes the density of c-Kit receptor-positive MCs,the density of tryptase-positive MCs,the area of tryptasepositive MCs,and angiogenesis in terms of microvascularization density.

关键词： Mast cells C-Kit receptor Tryptase Angiogenesis Microvascular density Endothelial area Pancreatic tumor tissue Adjacent normal tissue

Immunotherapy of gastric cancer:Present status and future perspectives

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World Journal of Gastroenterology 2024年第8期30卷 779-793页

作者： John K Triantafillidis Manousos M Konstadoulakis Apostolos E Papalois Inflammatory Bowel Disease unit “Metropolitan General”HospitalHolargos 15562AtticaGreece.Hellenic Society for Gastrointestinal Oncology354 Iera OdosChaidari 12461AtticaGreece Second Department of surgery University of Athens School of MedicineAretaieion HospitalAthens 11528AtticaGreece unit of Surgical Research and Training Second Department of SurgeryUniversity of AthensSchool of MedicineAretaieion HospitalAthens 11528AtticaGreece

In this editorial,we comment on the article entitled“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review(1999-2023),”which was published in the recent issue of the World Journal of *** focused on the results of the authors’bibliometric analysis concerning gastric cancer immunotherapy,which they analyzed in depth by compiling the relevant publications of the last 20 *** that,we briefly describe the most recent data concerning the epidemiological parameters of gastric cancer(GC)in different countries,attempting to give an interpretation based on the etiological factors involved in the etiopathogenesis of the *** then briefly discuss the conservative treatment(chemotherapy)of the various forms of this malignant *** describe the treatment of resectable tumors,locally advanced neoplasms,and unresectable(advanced)*** attention is given to modern therapeutic approaches with emphasis on immunotherapy,which seems to be the future of GC treatment,especially in combination with *** is also a thorough analysis of the results of the study under review in terms of the number of scientific publications,the countries in which the studies were conducted,the authors,and the scientific centers of origin,as well as the clinical studies in ***,an attempt is made to draw some conclusions and to point out possible future directions.

关键词： Gastric cancer Chemotherapy Immunotherapy Immune checkpoint inhibitors Bibliometrics Scientometrics

Metformin and pancreatic neuroendocrine tumors:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 759-769页

作者： Maja Cigrovski Berkovic Alessandro Coppola Vibor Sesa Anna Mrzljak Quirino Lai Department for Sport and Exercise Medicine Faculty of Kinesiology University of ZagrebZagreb 10000Croatia Department of surgery Sapienza University of RomeRome 00185Italy Department of Gastroenterology and Hepatology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia General surgery and Organ Transplantation unit Department of SurgerySapienza University of RomeRome 00018Italy

BACKGROUND Most patients with advanced pancreatic neuroendocrine tumors(pNETs)die due to tumor ***,identifying new therapies with low toxicity and good tolerability to use concomitantly with the established pNET treatment is *** this perspective,metformin is emerging as a molecule of *** studies have described metformin,a widely used agent for the treatment of patients with type 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR *** systematic review evaluates the role of T2DM and metformin in the insurgence and post-treatment outcomes in patients with *** To systematically analyze and summarize evidence related to the diagnostic and prognostic value of T2DM and metformin for predicting the insurgence and posttreatment outcomes of *** A systematic review of the published literature was undertaken,focusing on the role of T2DM and metformin in insurgence and prognosis of pNET,measured through outcomes of tumor-free survival(TFS),overall survival and progression free *** A total of 13 studies(5674 patients)were included in this *** of 809 pNET cases from five retrospective studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of pNET(OR=2.13,95%CI=1.56-4.55;P<0.001).The pooled data from 1174 pNET patients showed the correlation between T2DM and post-treatment TFS in pNET patients(hazard ratio=1.84,95%CI=0.78-2.90;P<0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the possibility of performing pooled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and prognosis of *** T2DM represents a risk factor for the insurgence of pNET and is a significant predictor of poor post-treatment TFS

关键词： Pancreatic neuroendocrine tumors Type 2 diabetes mellitus Prognosis Treatment Metformin

Pancreatic neuroendocrine tumors:Are tumors smaller than 2 cm truly indolent?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1756-1762页

作者： Sergio Hoyos Pablo Posada-Moreno Natalia Guzman-Arango Romario Chanci-Drago Jaime Chavez Alvaro Andrés-Duarte Santiago Salazar-Ochoa Hepatobilary and Liver Transplant unit Hospital Pablo Tobon Uribe and Gastrohepathology Group Universidad de AntioquiaMedellin 050034AntioquiaColombia Department of General surgery Universidad Pontificia BolivarianaMedellín 050034AntioquiaColombia

BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are relatively rare but rank as the second most common pancreatic *** can be functional,causing early metabolic disturbances due to hormone secretion,or non-functional and diagnosed later based on tumor size-related *** diagnoses of PNETs under 2 cm in size have sparked debates about their management;some practitioners advocate for surgical removal and others suggest observation due to the tumors’lower potential for ***,it is unclear whether managing these small tumors expectantly is truly *** To evaluate poor prognostic factors in PNETs based on tumor size(>2 cm orsurgery,followed by semi-annual con-sultations at the hospital's hepatobiliary surgery *** variables were described using absolute and relative frequencies,and quantitative variables were expressed using measures of central tendency and their corresponding measures of *** The presence of lymph node involvement,neural involvement,and lymphovascular invasion were all associated with an increased risk of mortality,with hazard ratios of 5.68(95%CI:1.26–25.61,P=0.024),6.44(95%CI:1.43–28.93,P=0.015),and 24.87(95%CI:2.98–207.19,P=0.003),*** involvement and lymphovascular invasion were present in tumors smaller than 2 cm in diameter and those larger than 2 cm in *** recurrence rates between the two tumor groups were furthermore similar:18.2%for tumors smaller than 2 cm and 21.4%for tumors larger than 2 *** survival was additionally comparable between the two tumor *** Tumor size does not dictate prognosis;lymph node and lymphovascular involvement a

关键词： Neuroendocrine tumor Pancreatic neoplasm Pancreas Pancreatic neuroendocrine neoplasm Pancreatic neuroendocrine tumors

Ex vivo liver resection and auto-transplantation as an alternative for the treatment of liver malignancies: Progress and challenges

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 117-122页

作者： Xin Yang Lu Lu Wen-Wei Zhu Yi-Feng Tao Cong-Huan Shen Jin-Hong Chen Zheng-Xin Wang Lun-Xiu Qin Hepatobiliary surgery and Liver Transplantation Centers Department of General SurgeryHuashan Hospital&Cancer Metastasis InstituteFudan UniversityShanghai 200040China

Hepatectomy is still the major curative treatment for patients with liver ***,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the retrohepatic inferior vena cava and hepatic *** vivo liver resection and auto-transplantation(ELRA),a hybrid technique of the traditional liver resection and transplantation,has brought new hope to these patients and therefore becomes a valid alternative to liver *** to its technical difficulty,ELRA is still concentrated in a few hepatobiliary centers that have experienced surgeons in both liver resection and liver *** efficacy and safety of this technique has already been demonstrated in the treatment of benign liver diseases,especially in the advanced alveolar ***,the application of ELRA for liver malignances has gained more ***,standardization of clinical practice norms and international consensus are still *** prognostic impact in these oncologic patients also needs further *** this review,we summarized the principles and recent progresses on ELRA.

关键词： Ex vivo liver resection Liver auto-transplantation Oncology Liver malignancies

Consideration on immunotherapy of liver metastases of malignant tumors

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2374-2381页

作者： Chuang Jiang Zhi-Hong Zhang Jia-Xin Li Division of Liver surgery Department of General Surgery and Laboratory of Liver Surgeryand State Key Laboratory of Biotherapy and Collaborative Innovation Center of BiotherapyWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of General surgery Dafang County People's HospitalBijie 551600Guizhou ProvinceChina

In this editorial,we comment on the article“Analysis of the impact of immuno-therapy efficacy and safety in patients with gastric cancer and liver metastasis”by Liu et al that was published in the recent issue of the World Journal of Gastroin-testinal *** has prompted us to think and summarize some thoughts on immunotherapy for malignant tumor liver *** plays a crucial role in the treatment of malignant tumors;however,the presence of liver metastases in advanced tumors may impact its *** patients with liver metastases can still benefit from immunotherapy,multiple clinical studies have indicated that,compared to other sites of metastasis,liver metastases may diminish the effectiveness of *** efficacy of immune checkpoint inhibitors in patients with liver metastases often fails to reach the ideal level,primarily due to the liver metastases exploiting the host's peripheral immune to-lerance mechanisms to promote systemic CD8(+)T cell exhaustion,resulting in a systemic immune-tolerant *** article aims to summarize the reasons for the decreased efficacy of immunotherapy following liver metastasis in various malignant tumors and propose potential clinical strategies for manage-ment.

关键词： Liver metastasis Immunotherapy Immune tolerance Cancer Treatment

Efficacy and safety of low-dose cyclophosphamide combined with lenvatinib, pembrolizumab and TACE for unresectable hepatocellular carcinoma:A single-center, prospective,single-arm clinical trial

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Chinese Journal of Cancer Research 2024年第2期36卷 114-123页

作者： Yupeng Ren Yuxuan Li Mingbo Cao Yongchang Tang Feng Yuan Gaoyuan Yang Zhiwei He Zheng Shi Xiaorui Su Zhicheng Yao Meihai Deng Department of Hepatobiliary surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China Department of General surgery Qilu HospitalShandong UniversityJinan 250012China Department of Hepatobiliary surgery the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120China Department of Hepatobiliary and Pancreatic surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China

Objective: Unresectable hepatocellular carcinoma(uHCC) continues to pose effective treatment options. The objective of this study was to assess the efficacy and safety of combining low-dose cyclophosphamide with lenvatinib, pembrolizumab and transarterial chemoembolization(TACE) for the treatment of ***: From February 2022 to November 2023, a total of 40 patients diagnosed with uHCC were enrolled in this small-dose, single-center, single-arm, prospective study. They received a combined treatment of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE. Study endpoints included progression-free survival(PFS), objective response rate(ORR), and safety assessment. Tumor response was assessed using the modified Response Evaluation Criteria in Solid tumors(mRECIST), while survival analysis was conducted through KaplanMeier curve analysis for overall survival(OS) and PFS. Adverse events(AEs) were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events(version 5.0).Results: A total of 34 patients were included in the study. The median follow-up duration was 11.2 [95% confidence interval(95% CI), 5.3-14.6] months, and the median PFS(mPFS) was 15.5(95% CI, 5.4-NA) *** OS(mOS) was not attained during the study period. The ORR was 55.9%, and the disease control rate(DCR) was 70.6%. AEs were reported in 27(79.4%) patients. The most frequently reported AEs(with an incidence rate >10%) included abnormal liver function(52.9%), abdominal pain(44.1%), abdominal distension and constipation(29.4%), hypertension(20.6%), leukopenia(17.6%), constipation(17.6%), ascites(14.7%), and insomnia(14.7%). Abnormal liver function(14.7%) had the most common grade 3 or higher ***: A combination of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE is safe and effective for u HCC, showcasing a promising therapeutic strategy for managing uHCC.

关键词： Hepatocellular carcinoma lenvatinib low-dose cyclophosphamide pembrolizumab transarterial chemoembolization