中华消化杂志最新文献

{"title":"Analysis of atypical computed tomography features of primary small intestinal lymphoma","authors":"Fang-Hong Chen, Xue-song Zhao, Jiayi Yan","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.09.006","url":null,"abstract":"Objective \u0000To investigate the atypical computed tomography (CT) features of primary small intestinal lymphoma (PSIL), and its correlation with pathology. \u0000 \u0000 \u0000Methods \u0000From July 2007 to June 2018, at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, the clinical features and CT imaging data of 29 histopathologically diagnosed PSIL with atypical CT features were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000A total of 29 cases were all confirmed as Non-Hodgkin′s lymphoma including 23 cases of B cell lymphoma and six cases of peripheral T cell lymphoma. In 24 PSIL patients, the intestinal wall was unevenly thickened. While five cases had intra- and extra-intestinal masses. Images of four PSIL patients showed heterogeneous density at unenhanced CT scan, five cases presented with heterogeneous mild to moderate enhancement and five cases demonstrated with obvious enhancement at portal venous phase. Multiple ulcers in mucosa were found in 20 cases, and obviously abnormal mucosal enhancement was found in five cases, and 13 cases showed rough serosa layer of intestinal wall and the fat gap around the intestinal wall disappeared. Adjacent organs were involved in four cases and intestinal obstruction occurred in eight cases. \u0000 \u0000 \u0000Conclusion \u0000The atypical imaging of PSIL can be heterogeneous density of the lesion, heterogeneous or obvious enhancement at enhanced scan, multiple ulcers on the mucosal surface, thickening of the mucosal surface, blurred peripheral fat space, involvement of adjacent organs and intestinal obstruction. \u0000 \u0000 \u0000Key words: \u0000Primary lymphoma; Small intestinal; Computed tomography","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"52 1","pages":"626-629"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77208116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of microtubule actin cross-linking factor 1 in gastric carcinoma and its effect on cell invasion and metastasis","authors":"Yong-xu Jia, Z. Chang, Hong Tang, H. Fan, Yaohe Wang, Y. Qin","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.09.005","url":null,"abstract":"Objective \u0000To explore the role of microtubule actin cross-linking factor 1(MACF1) in the metastasis of gastric cancer. \u0000 \u0000 \u0000Methods \u0000From 2009 to 2012, at The First Affiliated Hospital of Zhengzhou University, the paraffin blocks of gastric cancer and normal tissue adjacent to cancer of 107 patients who received radical gastrectomy were collected. The expression of MACF1 in tissues at protein level was detected by immunohistochemical staining. In 2017, at The First Affiliated Hospital of Zhengzhou University, fresh specimens samples of gastric cancer and normal tissue adjacent to cancer of 42 patients who received radical gastrectomy were also collected. The expression of MACF1 at mRNA level was determined by quantitative real-time polymerase chain reaction (PCR). MACF1 knockout gastric cell line was established. The effects of MACF1 on cell migration and invasion were verified by wound-healing test and Transwell assay. The effects of MACF1 on cell microtubule and actin were analyzed by filamentous actin (F-actin) staining. T-test, chi-square test and multivariate analysis were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000The positive expression rate of MACF1 in gastric carcinoma tissues was 71.0%(76/107), which was significantly higher than that of the corresponding normal tissues adjacent to cancer (22.4%, 24/107), and the difference was significant (t=4.145, P=0.016). The expression of MACF1 at mRNA level in cancer tissues of 42 patients with gastric cancer was 6.463±0.672, which was significantly higher than that of corresponding normal tissue adjacent to cancer (1.727±0.331), and the difference was statistically significant (t=6.326, P<0.01). The differences in positive expression rate of MACF1 in different tumor infiltration depth, different TNM stage and lymph nodes metastasis were statistically significant (χ2=1.170, 7.959 and 5.288; all P<0.01). The five-year survival rate of patients with high expression of MACF1 was 32.9% (25/76), which was significantly lower than that of patients with normal MACF1 expression (64.5%, 20/31), and the difference was statistically significant (χ2=25.093, P=0.034). The high expression of MACF1 was an independent prognostic factor affecting overall survival rate in patients with gastric cancer after surgery(hazard ratio (HR)=0.513, 95%confidence interval (CI): 0.411 to 0.922, P=0.038). The results of wound-healing assay showed that at 24 hour after wound the migration ability of MACF1 knockout AGS- MACF1-/- cells was (18.77±3.82)%, which was lower than that of wild type AGS cells ((76.24±5.36)%), and the difference was statistically significant (t=6.249, P=0.014). The migration ability of MACF1 knockout HGC27-MACF1-/-cells was (42.48±7.37)%, which was lower than that of wild type HGC27 cells ((82.35±4.28)%), and the difference was statistically significant (t=5.938, P=0.017). The results of Transwell assay indicated that the number of migration cells of MACF1 knockout AGS-MACF1-/- cells was 87.0±11.0, whic","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"71 1","pages":"619-625"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76482035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and pathological characteristics of 107 esophageal neuroendocrine carcinoma","authors":"Y. Meng, Ya-jun Lian, Shanshan Li, H. Gou, Yameng Wang, Jie Chen, Min A Song","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.008","url":null,"abstract":"Objective \u0000To investigate the clinical and pathological features of patients with esophageal neuroendocrine carcinoma (ENEC). \u0000 \u0000 \u0000Methods \u0000From January 2011 to November 2018, 107 patients with pathologically confirmed ENEC were enrolled at the First Affiliated Hospital of Zhengzhou University. The clinical manifestation, tumor location, tumor size, clinical pathological classification and immunohistochemical markers were analyzed. Statistical description was used for measurement data analysis, and chi-square test was performed for classification data analysis. \u0000 \u0000 \u0000Results \u0000Among 107 patients with ENEC, feeling obstruction during eating was the most common initial symptom, accounting for 63.6%(68/107); followed by chest and back pain, accounting for 13.1%(14/107). About 60.7%(65/107) patients were diagnosed by biopsy under endoscopy and 39.3% (42/107) patients were confirmed by pathological diagnosis after surgery. The proportion of tumor located in the upper thoracic esophagus and middle and lower thoracic segments was 13.1%(14/107), 45.8%(49/107) and 41.1%(44/107), respectively. The length of tumor was 0.7 cm to 9.0 cm, and the median was 2.5 cm. Among them, 57.0%(61/107) were less than 2.5 cm and 43.0%(46/107) were over 2.5 cm. Among 107 patients, 50 (46.7%) patients were ulcerative type, 32 (29.9%) patients were medullary type, 16 (15.0%) patients were mushroom type and nine (8.4%) patients were protrude type. Among 107 patients, 96 (89.7%) patients were pure neuroendocrine carcinoma (P-NEC; including 95 small cell types, one large cell type); 11 (10.3%) patients were mixed neuroendocrine carcinoma (M-NEC; including nine small cell carcinoma mixed with squamous cell carcinoma, two small cell carcinoma mixed with adenocarcinoma). The positive rates of synaptophysin, CD56 and chromogranin A were 99.0%(104/105), 98.0%(100/102) and 31.5%(17/54), respectively. Ki-67 proliferation index of 47.7% tumors (51/107) was between 90% and 100%. P-NEC with the maximum diameter over 2.5 cm accounting for 42.1%(45/107), and M-NEC accounting for 0.9%(1/107). The maximum diameter of P-NEC group was larger than that of M-NEC group, and the difference was statistically significant (χ2=4.311, P=0.038). \u0000 \u0000 \u0000Conclusions \u0000ENEC is a kind of highly aggressive malignant tumor with nonspecific manifestations. The diagnosis mainly depends on histopathology and immunohistochemistry. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, neuroendocrine; Esophagus; Immunohistochemistry; Pathology; Clinic","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"40 1","pages":"533-538"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85363469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical classification and pathology of gastric neuroendocrine neoplasm","authors":"Jiesheng Luo, Yanfeng Shi","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.004","url":null,"abstract":"胃神经内分泌肿瘤(g-NEN)有4个临床亚型。1型和2型g-NEN都是低级别胃泌素依赖性肠嗜铬样细胞肿瘤。1型g-NEN发生于自身免疫性萎缩性胃炎基础上，2型发生于佐林格-埃利森综合征和(或)多发性内分泌肿瘤1型相关性胃泌素瘤患者，3型为非胃泌素依赖性散发性神经内分泌瘤，4型为神经内分泌癌或混合性腺-神经内分泌癌。4个亚型因病因病理不同而各具临床特征。","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"10 1","pages":"516-520"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91123784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the clinical characteristics and related background diseases of 134 type 1 gastric neuroendocrine tumor","authors":"Yixuan Zhang, Yingying Chen, Z. Qi, Luohai Chen, Jie Luo, Yuan Lin, Ji-xi Liu, H. Tan, Jie Chen","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.009","url":null,"abstract":"Objective \u0000To explore the clinical characteristics and related background diseases of type 1 gastric neuroendocrine tumor (g-NET) and to provide reference information for clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000From January 2011 to February 2019, at the First Affiliated Hospital of Sun Yat-sen University and China-Japan Friendship Hospital, the clinical features and related background diseases of type 1 g-NET patients (41 cases and 93 cases respectively)were retrospectively analyzed. The clinical symptoms, serological indicators, gastroscopic and pathological features, tumor location, metastasis and treatment, and concomitant diseases were statistically described. \u0000 \u0000 \u0000Results \u0000Among 134 patients with type 1 g-NET, there were 53 males (39.6%) and 81 females(60.4%); and the mean diagnosed age was (51±11) years (21 to 76 years). Main clinical manifestations were non-specific gastrointestinal symptoms. The mean level of serum chromogranin A was (237.7±176.8) μg/L. The endoscopic findings of 97.8% (131/134) of the patients were polypoid or protuberant lesions at gastric fundus or gastric body. And 75.0%(96/128) of the patients had multiple tumors.65.7%(88/134) of the patients had the tumors with the maximum diameter less than 1 cm (77.2%, 88/114) and the lesions mainly located in mucosa (59.8%, 52/87) and submucosa (40.2%, 35/87). The pathological classification of 79.3%(96/121) of the tumors was G1 grade and 20.7%(25/121) were G2 grade.The rate of local lymph node metastasis was 1.4%(1/73) and no distant metastasis was found. About 70.9% (95/134) of the patients received endoscopic treatment. Among the patients, 93.6%(103/110) of the patients had chronic atrophic gastritis confirmed by endoscopy or pathology, 45.6%(47/103) were confirmed by both endoscopy and pathology. Among the patients with chronic atrophy gastritis, serum gastrin levels of 93.2%(96/103)patients were twice higher than the upper limit of the normal value. The positive rates of anti-parietal cells antibody (PCA) and intrinsic factor (IFA) were 78.5%(73/93) and 51.9%(14/27), respectively.The incidence of Helicobacter pylori (H.pylori) infection was 28.1%(16/57). The incidence of autoimmune atrophy gastritis was 80.6%(75/93). The percentage of patients with deficiency of serum vitamin B12 and ferritin was 70.8%(63/89) and 30.7%(27/88), respectively. Patients with anemia accounted for 27.8%(25/90). The patients with microcytic anemia, normocyticanemia and macrocytic anemia were 28.0%(7/25), 56.0%(14/25) and 16.0%(4/25), respectively. 46.9%(45/96) of the patients had increased thyroid autoantibodies and 17.9%(17/95) patients had changes of thyroid hormone level. \u0000 \u0000 \u0000Conclusions \u0000Type 1 g-NET is more common in women and mainly caused by autoimmune atrophic gastritis. The level of serum PCA and IFA increase in more than half of the patients. And it is often accompanied by vitamin B12 deficiency and autoimmune thyroid disease. \u0000 \u0000 \u0000Key words: \u0000Type 1 gastric neuroendocrine tumor;","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"67 5 1","pages":"539-544"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89892022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the changes of plasma levels of leptin and obesity in patients with insulinoma","authors":"Shuang Yu, Hai‐yan Wu, Ming Li, Qiang Wang, Li-ming Zhu, Yuan-jia Chen","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.010","url":null,"abstract":"Objective \u0000To analyze the relationship between the changes of fasting plasma level of leptin and obesity in patients with insulinoma before operation. \u0000 \u0000 \u0000Methods \u0000From January 2003 to May 2008, 40 patients with insulinoma diagnosed at Peking Union Medical College Hospital were selected. Preoperative fasting plasma samples of them were collected. From January 2003 to May 2008, the plasma samples of 28 volunteers matched with age, gender and body weight matched with the patients were collected as the controls. All the subjects were divided into overweight-obesity group and normal weight group according to their body mass index (BMI). Plasma levels of leptin of all the subjects were measured by enzyme linked immunosorbent assay(ELISA). The Mann-Whitney U test and the correlation coefficient test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000The plasma leptin level of patients with insulinoma was 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL), which was higher than that of the control group (0.29 ng/mL, 0.25 ng/mL to 1.15 ng/mL), and the difference was statistically significant (U=324.50, P=0.003). In the normal-weight group, the plasma leptin level of the patients with insulinoma was 0.35 ng/mL (0.27 ng/mL to 0.62 ng/mL), which was higher than that of the control group (0.28 ng/mL, 0.25 ng/mL to 0.37 ng/mL), and the difference was statistically significant (U=28.000, P=0.001). While in the overweight-obesity group, the plasma leptin levels of the patients with insulinoma and the controls were 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL) and 0.34 ng/mL (0.26 ng/mL to 1.15 ng/mL), respectively, and the difference was not statistically significant (U=153.500, P=0.525). Plasma leptin levels in both the patients with insulinoma and the controls, were correlated with BMI (r=0.355, P=0.025; r=0.571, P=0.001, respectively). \u0000 \u0000 \u0000Conclusion \u0000Preoperative fasting plasma level of leptin increase in patients with insulinoma which is correlated with BMI. \u0000 \u0000 \u0000Key words: \u0000Insulinoma; Obesity; Leptin; Insulin; Body mass index; Pancreatic neuroendocrine tumor","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"118 1","pages":"545-548"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87956728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of adverse effects of infliximab treatment in 486 patients with Crohn′s disease","authors":"Kan Wang, L. Ye, Yipeng Pan, Wei-li Liu, Q. Cao","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.012","url":null,"abstract":"Objective \u0000To assess the safety of infliximab(IFX) treatment in patients with Crohn′s disease(CD). \u0000 \u0000 \u0000Methods \u0000From January 2009 to May 2018, at inflammatory bowel disease (IBD) center of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 486 CD patients received the treatment of IFX were enrolled and their clinical data were collected. Univariate and multivariate regression of binary logistic were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The median follow-up duration was 31.1 months (12.0 months to 40.0 months). The median duration of IFX therapy was 13.0 months (7.0 months to 21.0 months). Among 486 patients, 98 (20.16%) patients reported adverse effects, and 12 (2.47%) patients discontinued the therapy because of adverse effects. Acute infusion reaction was the most common adverse effect in CD patients who received IFX treatment accounting for 41.84%(41/98)of all the adverse effects, and the incidence was 8.44%. Thirty-nine patients had mild and moderate infusion reaction, and all improved after symptomatic treatment (eight patients discontinued IFX therapy because of recurrent infusion reaction). Two patients developed severe infusion reaction as allergic shock, and both relieved after emergency rescue. Four patients developed late-phase allergic reactions. Among 486 patients, 39 (8.02%) patients had infections, including infections of Clostridium difficile, cytomegalovirus, herpeszoster virus, Mycobacterium tuberculosis, and other opportunistic pathogens. There was no cases of infection related death. Thirty-six patients continued with IFX treatment after infection controlled. Among 486 patients, 14(2.88%) patients had severe infection, and all the cases improved after anti-infection treatment. Twenty-seven CD patients with hepatitis B virus (HBV) infection received anti-viral treatments, no active HBV infection was observed. Colon adenocarcinoma was found in one patient under colonoscopy at 22 months after discontinuation of IFX therapy. There were six patients with the history of benign tumors, and no evidence of recurrence, progress or malignancy during treatment. In terms of other rare adverse effects in 486 patients, there were eight (1.64%) patients with liver function injury, two (0.41%) patients with anemia, one (0.21%) patient with peripheral neuropathy, and four (0.82%) patients with skin lesion. Prolonged duration of IFX therapy, without combination of immune-suppressors and with increased baseline body mass index (BMI) were the risk factors of acute infusion reactions. Prolonged duration of IFX therapy and with low baseline albumin level were the risk factors of infections. \u0000 \u0000 \u0000Conclusions \u0000IFX is generally safe as the treatment for CD patients, and its adverse effects can be clinically controlled. Screening before therapy and monitoring during therapy may reduce the risks of adverse effects. \u0000 \u0000 \u0000Key words: \u0000Crohn disease; Infection; Neoplasms; Infliximab; Adverse effects; Infusion reaction","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"5 1","pages":"555-561"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80538235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of pancreatic neuroendocrine neoplasm: consensus and controversy","authors":"Jin Xu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.003","url":null,"abstract":"胰腺神经内分泌肿瘤包括胰腺神经内分泌瘤和胰腺神经内分泌癌，由于缺乏大样本、前瞻性、随机对照临床试验，许多共识来源于小样本的回顾性研究，证据级别不高，在外科治疗方面尚存在很多争议。现结合最新的美国国立综合癌症网络和欧洲神经内分泌肿瘤协会指南，就近年来外科治疗在胰腺神经内分泌肿瘤中的共识与争议进行梳理。","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"1 1","pages":"513-516"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89962924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis analysis of 338 rectal neuroendocrine neoplasms with maximum diameter of 1 cm to 2 cm","authors":"Min Liu, Xiaolin Li, Ye Tian, J. Bai, Ping-an Hu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.08.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.08.011","url":null,"abstract":"Objective \u0000To analyze the clinical characteristics and prognostic factors of rectal neuroendocrine neoplasm (r-NEN) with the maximum diameter of 1 cm to 2 cm, and to provide a theoretical evidence for selection of resection method. \u0000 \u0000 \u0000Methods \u0000From 1988 to 2015, the data of patients pathologically diagnosed as r-NEN with the maximum diameter less than 2 cm were selected from American surveillance, epidemiology, and end results (SEER) database with SEER* Stat 8.3.5 software. According to the resection method, the patients were divided into local resection group and radical resection group. T test and chi-square test were performed to compare the clinicopathological features. Kaplan-Meier survival analysis and Cox multivariate analysis were used to analyze the prognostic factors analysis. \u0000 \u0000 \u0000Results \u0000The maximum diameter of tumors of 1 831 patients with r-NEN was less than 1 cm, and that of 338 patients with r-NEN was between 1 cm and 2 cm. There were significant differences between two groups in tumor grade, tumor stage, T stage, lymph node metastasis, distant metastasis and resection method (χ2=7.120, 144.728, 86.296, 133.096, 42. 842 and 52.048, all P<0.05). The prognosis of the former was better than that of the latter (χ2=11.590, P=0.001). Among the patients with r-NEN with the maximum diameter of 1 cm to 2 cm, 279 (82.5%) patients received local resection and 59(17.5%) patients underwent radical surgery. Propensity score matching was used to pair the r-NEN patients with the maximum diameter of 1 cm to 2 cm who received different resection methods, and 41 pairs of cases were enrolled. The results of univariate analysis showed that age and tumor grade affected the survival prognosis of patients with r-NEN of the maximum diameter of 1 cm to 2 cm (χ2=6.837 and 10.852, P=0.009 and 0.004). The results of Cox multivariate analysis indicated that age was an independent prognostic factor of patients with r-NEN of the maximum diameter of 1 cm to 2 cm (hazard ratio (HR)=1.110, 95% confidence interval (CI) 1.040 to 1.184, P=0.002). Analysis of subgroups without lymph nodes or distant metastases demonstrated that age (HR=1.101, 95%CI 1.042 to 1.162, P=0.001) and resection method (HR=3.128, 95%CI 1.003 to 9.754, P=0.049) were the independent factors. \u0000 \u0000 \u0000Conclusions \u0000Age is an independent factor of patients with r-NEN of the maximum diameter of 1 cm to 2 cm. Among the patients without lymph nodes or distant metastasis the younger cases and those with local resection have better prognosis. \u0000 \u0000 \u0000Key words: \u0000Prognosis; Rectal neuroendocrine neoplasm; Tumor diameter; Local excision; Radical surgery","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"21 1","pages":"549-554"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86153311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and mechanism of tumor necrosis factor ligand-related molecule 1A in chronic experimental colitis associated intestinal fibrosis","authors":"Rong Zhan, Dong Wang, W. Jia, Jia Song, Mengyao Wu, Hui Li, F. Yin, Na Wang, Chenxing Peng, Hong Zhang, Mei-Juan Song, Shuang Chen, D. Shih, Xiaolan Zhang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.07.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.07.004","url":null,"abstract":"Objective \u0000To explore the role and mechanism of tumor necrosis factor ligand-related molecule 1A (TL1A) in chronic experimental colitis associated intestinal fibrosis. \u0000 \u0000 \u0000Methods \u0000The model of chronic experimental colitis-associated intestinal fibrosis was induced by dextran sodium sulfate (DSS). The mice with high TL1A (L-Tg) expression in lymphoid cells and wild-type mice with the same genetic background were divided into wild type control group, wild type DSS group, transgenic control group and transgenic DSS group. The changes of body mass, length of colon, disease activity index (DAI) and colonic pathological score were compared among different groups. The degree of colonic inflammation was evaluated by Hematoxylin-Eosin (H-E) staining. The degree of intestinal fibrosis was assessed by Masson staining and Sirius red staining. The expression of vimentin, α smooth muscle actin (α-SMA), type Ⅰ collagen, Ⅲ collagen and transforming growth factor-β1 (TGF-β1)/Smad3 in colon tissue was examined by immunohistochemistry. T test was performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The body mass of the transgenic DSS group decreased by (9.6±1.8)%, which was more than wild-type DSS group (6.2±1.3)%, the difference was statistically significant (t=3.751, P<0.01). The DAI score and colonic pathological score of transgenic DSS group were both higher than those of wild-type DSS group (7.33±0.58 vs. 6.00±1.00, and 14.00±1.05 vs. 11.75±0.50, respectively), and the differences were statistically significant (t=2.818 and 4.739, both P<0.05). The results of Masson staining and Sirius red staining showed aggravation of intestinal fibrosis. The results of immunohistochemical staining showed that the cumulative positive absorbance values of vimentin, α-SMA, TGF-β1 and Smad3 of wild-type DSS group were lower than those of transgenic DSS group (0.650±0.050 vs. 0.800±0.020, 0.390±0.040 vs. 0.600±0.040, 0.550±0.040 vs. 0.730±0.040, 0.590±0.020 vs. 0.830±0.040), and the differences were statistically significant (t=6.823, 9.093, 7.794 and 10.390, all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000TL1A may promote the proliferation and activation of fibroblasts through TGF-β1/Smad3 pathway, leading to the genesis and development of experimental colitis associated intestinal fibrosis. \u0000 \u0000 \u0000Key words: \u0000Inflammatory bowel diseases; Intestinal fibrosis; Tumor necrosis factor ligand-related molecule 1A","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"208 1","pages":"452-457"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80531584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}