Journal of Surgical Research最新文献

{"title":"Racial Variability in Platelet Response Among Patients With Peripheral Artery Disease","authors":"Sasha P. Suarez Ferreira MD ,&nbsp;Adriana A. Rodriguez Alvarez MD ,&nbsp;Isabella Ferlini Cieri MD ,&nbsp;Shiv Patel BA ,&nbsp;Mounika Boya MD ,&nbsp;Kellie Machlus PhD ,&nbsp;Trisha Roy MD ,&nbsp;Anahita Dua MD, MBA, MSC","doi":"10.1016/j.jss.2025.01.022","DOIUrl":"10.1016/j.jss.2025.01.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral artery disease (PAD) is prevalent among the elderly population, with Black Americans facing a higher incidence and complications than White Americans. Antiplatelet therapy is crucial for PAD. This observational study aims to discern racial variability in platelet function using viscoelastic assays in patients’ postrevascularization for PAD.</div></div><div><h3>Methods</h3><div>Patients with PAD who underwent revascularization between December 2020 and October 2023 were prospectively enrolled. The cohort was divided by race and antiplatelet therapy regimen. Serial perioperative Thromboelastography with Platelet Mapping assays were performed, and the platelet function was evaluated.</div></div><div><h3>Results</h3><div>A total of 42 patients met the study criteria, and 99 samples were analyzed. In the Thromboelastography with Platelet Mapping assay, the White-Americans cohort showed a significantly lower maximum amplitude (clot strength), lower percentage of platelet aggregation (platelet reactivity), and a significantly higher percentage of platelet inhibition than Black, Asian, and Hispanic Americans on the same antiplatelet regimen.</div></div><div><h3>Conclusions</h3><div>These findings suggest potential racial disparities in platelet response to standard medications, highlighting the critical need for personalized pharmacological approaches that account for genetic and physiological variations across different ethnic populations. Further research is essential to elucidate the underlying mechanisms of these differential platelet responses, which could have significant implications for precision medicine and targeted therapeutic strategies.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 107-115"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Treatment Modalities on Lung Injury in Experimental Pulmonary Contusion Model","authors":"Mustafa Kuzucuoğlu MD ,&nbsp;Cenk Balta MD ,&nbsp;Eren Altun MD ,&nbsp;Ali Cem Yekdeş ,&nbsp;Arkın Acar MD","doi":"10.1016/j.jss.2025.01.017","DOIUrl":"10.1016/j.jss.2025.01.017","url":null,"abstract":"<div><h3>Introduction</h3><div>The study experimentally evaluated the efficacies of different agents in treating pulmonary contusion.</div></div><div><h3>Methods</h3><div>In our study, 42 Wistar albino rats were divided into six groups of seven animals each. A model of lung contusion with blunt chest trauma was performed in five groups, except for the control group. One group with pulmonary contusion was considered an untreated group, and saline was administered. For other groups, prednisolone, tranexamic acid, N-acetylcysteine, and vitamin E were applied to determine their efficacy in treatment. The rats were sacrificed 24 h after trauma, and their injured lungs were collected for histopathological examination and blood samples for blood gas analysis. Histopathologically, bronchial damage, alveolar hemorrhage, emphysema, and leukocyte infiltration were assessed using the scoring system.</div></div><div><h3>Results</h3><div>In our study, statistically significant differences were detected between the rat groups in terms of intraalveolar hemorrhage, leukocyte infiltration, and bronchial damage. In post hoc analysis, intraalveolar hemorrhage was significantly higher in the untreated group compared to the control group (<em>P</em> = 0.012). A near-significant difference was observed between the untreated group and the N-acetylcysteine group (<em>P</em> = 0.061). Regarding leukocyte infiltration, the tranexamic acid group showed significantly higher values compared to both the prednisolone and control groups (<em>P</em> = 0.007; <em>P</em> = 0.016, respectively). For bronchial damage, the levels observed in the vitamin E and tranexamic acid groups were significantly higher than those in the control group (<em>P</em> = 0.08 and <em>P</em> = 0.037, respectively).</div></div><div><h3>Conclusions</h3><div>Many agents are used to treat pulmonary contusion, but no gold standard treatment exists. Prednisolone and N-acetylcysteine play significant roles in treatment. These two drugs contributed to the regression of the findings in pulmonary contusion treatment.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 100-106"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Disproportionate Increase in Pediatric Laparoscopic Cholecystectomies During the COVID-19 Pandemic","authors":"Philip M. Lee BS ,&nbsp;Cameron Harvey DO ,&nbsp;Eli Snyder BS ,&nbsp;Sneha Singh MD ,&nbsp;Kaushal Desai MD, MPH ,&nbsp;Benjamin Tabak MD ,&nbsp;Sidney Johnson MD ,&nbsp;Devin Puapong MD ,&nbsp;Russell Woo MD","doi":"10.1016/j.jss.2025.01.008","DOIUrl":"10.1016/j.jss.2025.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic limited many patients to an unhealthy, sedentary lifestyle, with literature specifically demonstrating an increasing trend of obesity in pediatric patients. The goal of this study is to assess the relationship between the COVID-19 pandemic and total number of laparoscopic cholecystectomies performed pre-COVID compared to during COVID.</div></div><div><h3>Methods</h3><div>Data between 2017 and 2021 were collected from the National Surgical Quality Improvement Program on patients ≤18 ys who underwent elective or urgent cholecystectomies. Data was categorized as pre-COVID (2017-2018) or during COVID (2020-2021). Analysis subcategories included case acuity (elective <em>versus</em> urgent <em>versus</em> emergent), wound classification, race, weight, and complications.</div></div><div><h3>Results</h3><div>There were 13,579 pediatric laparoscopic cholecystectomies from 2017 to 2021. The COVID group had 7605 (56.0%) cases, and pre-COVID group 5974 (44.0%). The COVID group had significantly greater average weight and body mass index (BMI) than pre-COVID group (<em>P</em> &lt; 0.001). Increased BMI was associated with increased case acuity and complication rates. Minorities including African Americans and Native American/Pacific Islanders had an increase in number of cholecystectomies performed during COVID. Undergoing a cholecystectomy during COVID was more likely to be classified as urgent or emergent than pre-COVID (<em>P</em> &lt; 0.0001). The COVID group overall had less favorable surgical wound classification as more were classified as class III or class IV cases.</div></div><div><h3>Conclusions</h3><div>There were increases in weight/BMI, case severity, and total laparoscopic cholecystectomies performed during COVID-19. A statistically significant difference in average weight may suggest a relationship between isolation during the COVID-19 pandemic and rates of cholecystectomy. Future research is encouraged to identify contributing factors in these trends.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 93-99"},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Equity and Emergency Colorectal Surgery in the United States: A Scoping Review","authors":"Tamara Byrd MD ,&nbsp;Sebastian Boland MD ,&nbsp;Mary Lou Klem PhD, MLIS ,&nbsp;David Silver MD, MPH ,&nbsp;Liling Lu MS ,&nbsp;Matthew D. Neal MD ,&nbsp;Joshua B. Brown MD, MSc","doi":"10.1016/j.jss.2025.01.019","DOIUrl":"10.1016/j.jss.2025.01.019","url":null,"abstract":"<div><h3>Introduction</h3><div>The emergency colorectal surgery population represents one of the most vulnerable subsets of the larger emergency general surgery population, characterized by increased complication rates, mortality rates, health resource utilization, and hospitalization costs. Disparities and inequities are documented for the emergency general surgery population and its emergency colorectal subset. Addressing health inequities can lead to decreased costs and improvement in patient outcomes; however, it is important to have a full scope of drivers of health inequities in different populations. We summarize the scope of literature that evaluates inequities in patients who undergo emergency colorectal surgery using two equity-based frameworks.</div></div><div><h3>Methods</h3><div>We conducted a systematic search using Medline, Embase, and Web of Science Core Collection databases. Articles were evaluated for inclusion based on evaluation of disparities, inequities, and social determinants in patients who underwent emergency abdominal colorectal surgery in the United States between 2014 and 2024. We extracted data based on components of the PROGRESS (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital) framework and classified studies based on the Phases of Health Disparity Research framework.</div></div><div><h3>Results</h3><div>Twenty-two articles met inclusion criteria. Race/ethnicity was most commonly evaluated in studies (86%) followed by socioeconomic status/insurance status/income. Sex/gender, social support, language, social support, and religion were less commonly evaluated. The majority of the studies focused on malignant disease were in the detecting phase of disparities research.</div></div><div><h3>Conclusions</h3><div>Future studies evaluating inequities in the emergency colorectal surgery population should consider a comprehensive analysis of social factors and measures of structural racism.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 86-92"},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Control Trial Investigating the Effect of Different Treatment Strategies on Mitochondrial Function in Peripheral Arterial Disease-A Study Protocol","authors":"Laura Schoenherr MD ,&nbsp;Juliana Heidler PhD ,&nbsp;Michaela Kluckner MD ,&nbsp;Daniela Lobenwein MD ,&nbsp;Dominik Pesta PhD ,&nbsp;Jan Paul Frese MD ,&nbsp;Sabine Helena Wipper MD ,&nbsp;Alexandra Gratl MD","doi":"10.1016/j.jss.2025.01.014","DOIUrl":"10.1016/j.jss.2025.01.014","url":null,"abstract":"<div><div>Peripheral arterial disease encompasses different clinical symptoms, depending on the severity of the disease. In early stages, a walking-induced pain, known as intermittent claudication, is the leading clinical symptom. Repeating cycles of ischemia and reperfusion induce a typical myopathy, with mitochondria playing the key role within this pathophysiological condition. The aim of this study is to further evaluate the effects of different treatment strategies on mitochondrial function and overall cardiovascular outcomes within a randomized controlled trial. After inclusion, patients will be randomized into different study groups. Study group 1 will receive conservative treatment, while study group 2 will receive revascularization of underlying atherosclerotic lesions. Additionally, a healthy control group will be included. Muscle biopsies will be obtained from ischemic and nonischemic muscle regions, being defined by the anatomic localization of the atherosclerotic lesion, before initiation of treatment as well as after a time interval of 12 wk. Mitochondrial function and content will be evaluated using high-resolution respirometry and citrate synthase activity measurements. Cardiovascular outcomes will be determined by established protocols. This study is registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>–NCT05644158. This study aims to gain further insights into the exact pathophysiological mechanism underlying mitochondrial dysfunction in peripheral arterial disease. The potential effects of mitochondrial regeneration within ischemic muscle regions following a conservative treatment approach will be compared to those reported after revascularization procedures. Additionally, correlation with cardiovascular outcome parameters and <em>in vivo</em> methods will provide a comprehensive approach to this research question.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 78-85"},"PeriodicalIF":1.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Robotic Surgical Approach in Peritoneal Carcinomatosis","authors":"Muhammad Talha Waheed MD ,&nbsp;Matthew C. Hernandez MD ,&nbsp;Ibrahim Malik BS ,&nbsp;Thinzar Lwin MD ,&nbsp;Yanghee Woo MD ,&nbsp;Isaac B. Paz MD ,&nbsp;Laleh Melstrom MD ,&nbsp;Yuman Fong MD ,&nbsp;Stephen J. Lee MD ,&nbsp;Mihae Song MD ,&nbsp;Thanh Dellinger MD ,&nbsp;Mehdi Moslemi-Kebria MD ,&nbsp;Ernest Han MD ,&nbsp;Mustafa Raoof MD","doi":"10.1016/j.jss.2025.01.016","DOIUrl":"10.1016/j.jss.2025.01.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in robotic instrumentation have facilitated minimally invasive completion of complex cancer operations. The objective of this study is to determine the feasibility of robotic approach for cytoreduction (R-CRS) for peritoneal carcinomatosis in a series of 16 consecutive cases.</div></div><div><h3>Methods</h3><div>Single institution retrospective study of consecutive patients with peritoneal carcinomatosis deemed appropriate for R-CRS after multidisciplinary review between 2017 and 2022. Feasibility was defined as the proportion of patients in whom complete cytoreduction was achieved without conversion to open.</div></div><div><h3>Results</h3><div>A total of 16 patients (median interquartile range [IQR]: age 60 ys [45.8-70.5], body mass index 29 [24.5-33.6], peritoneal carcinomatosis index 5 [2.8-6.3]) underwent R-CRS of which six also received hyperthermic intraperitoneal chemtotherapy. Seven patients had gastrointestinal primary cancers (3 colorectal, 3 appendiceal, 1 small bowel neuroendocrine); and nine had gynecologic cancers (7 ovarian, 2 endometrial). Median operative time was 6.0 h (IQR: 5.0-9.0), and median estimated blood loss was 87.5 mL (IQR: 30.0-262.5). Robotic procedures included: pelvic tumor debulking 12 (75%), omentectomy 8 (50%), peritonectomy 6 (38%), large bowel resection 6 (37%), retroperitoneal mass resection 4 (25%), and hepatectomy 3 (19%). Median length of stay was 3.5 ds (IQR: 1.8-5.3) for the whole cohort and only 2 ds (IQR: 1.0-5.5) for patients who did not undergo hyperthermic intraperitoneal chemotherapy. Feasibility rate was 87.5%, whereas conversion, 30-d complication, and 30-d mortality rates were 12.5%, 18.8%, and 0%, respectively.</div></div><div><h3>Conclusions</h3><div>Our experience with R-CRS demonstrates feasibility of the approach with a potential for benefit in short-term outcomes in a carefully selected cohort of patients when performed at a high-volume robotic surgery center.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 70-77"},"PeriodicalIF":1.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Surgery for Patients With Coexisting Heart and Lung Disease: A Retrospective Study","authors":"Yibo Yin MD ,&nbsp;Chaoyang Tong PhD ,&nbsp;Hongwei Zhu MD ,&nbsp;Jingxiang Wu PhD","doi":"10.1016/j.jss.2025.01.012","DOIUrl":"10.1016/j.jss.2025.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal surgical approach and the associated adverse outcomes in patients with lung cancer and heart disease remain unknown. This study was designed to explore the potential influence of simultaneous or staged surgery on the perioperative and oncological outcomes of these patients.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study analyzed 158 patients who underwent cardiac and thoracic surgery between January 2016 and December 2021. The patients were divided into two groups according to the timing of surgery: simultaneous and staged. Perioperative and oncologic outcomes between the two groups were compared using 1:1 propensity score matching analysis and Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>In the 50 patients (72% male, mean age 60.9 ± 11.7 y) of the simultaneous surgery group, 10 (20%) developed tumor metastasis or recurrence and 6 (12%) died from tumor metastasis. In the staged surgery group, with 108 patients (75% male, mean age 66.1 ± 8.4 y), 18 (16.7%) developed tumor metastasis or recurrence, and 8 (7.4%) died. There was no significant difference in overall survival or progression-free survival between the groups. Compared with the staged surgery group, the simultaneous surgery group had a higher incidence of pulmonary infection (3.7% <em>versus</em> 18.0%; <em>P</em> = 0.002), longer operative time (173.9 ± 104.4 <em>versus</em> 295.6 ± 77.1 min; <em>P</em> &lt; 0.001), increased intraoperative blood loss (89.2 ± 53.1 <em>versus</em> 386.0 ± 207.0 mL; <em>P</em> &lt; 0.001), and a prolonged hospital stay (7.0 ± 3.1 <em>versus</em> 16.5 ± 6.1 d; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>For patients with concurrent lung cancer and heart disease, staged surgery holds certain advantages when it comes to postoperative complications. Further researches are still needed to verify these findings.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 53-61"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative and Qualitative Analysis of Clinical Trial Acronyms From Surgical Journals","authors":"Hong-min Ahn MD ,&nbsp;Hyeon Woo Shin ,&nbsp;Heung-Kwon Oh MD, PhD ,&nbsp;Yoon Ju Jung MD ,&nbsp;Anuj Naresh Singhi MD ,&nbsp;Min Hyeong Jo MD ,&nbsp;Mi Jeong Choi MD ,&nbsp;Tae-Gyun Lee MD ,&nbsp;Hye Rim Shin MD ,&nbsp;Duck-Woo Kim MD, PhD ,&nbsp;Sung-Bum Kang MD, PhD","doi":"10.1016/j.jss.2025.01.009","DOIUrl":"10.1016/j.jss.2025.01.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Acronyms, the short form of a word or phrase, are commonly used in medical research to identify studies. However, their usage and quality assessment in surgical journals are unclear. This study aimed to determine the impact of identifying acronyms for clinical studies on the number of citations by comparing studies published in surgical and medical journals.</div></div><div><h3>Methods</h3><div>Articles were screened from five highly cited journals (<em>Annals of Surgery, British Journal of Surgery, JAMA Surgery, Journal of the American College of Surgeons,</em> and <em>New England Journal of Medicine,</em> alphabetically). The correlation between acronym use and number of citations was analyzed. In addition, the characteristics and quality of acronyms, in terms of lettering and wording scores, used to identify studies were evaluated for acronymous trials using a developed and self-validated scoring tool.</div></div><div><h3>Results</h3><div>Of 291 eligible articles, 167 (57.4%) were acronymous studies. Although 70.5% (122/173) of articles in general medical journals used identifying acronyms, only 38.1% (45/118) used them in surgical journals (<em>P</em> &lt; 0.001). The median number of citations was higher for acronymous studies (212 <em>versus</em> 53; <em>P</em> &lt; 0.001). Multivariable analysis revealed that acronymous studies had a 2.5-fold higher possibility of being a highly cited (odds ratio 2.514, <em>P</em> = 0.004). The average quality scores of the acronyms were similar for surgical and general medical journals (5.1 ± 1.7 <em>versus</em> 5.1 ± 1.6, <em>P</em> = 0.949). Surgical journals had lower lettering (2.20 ± 1.14 <em>versus</em> 3.02 ± 1.04, <em>P</em> &lt; 0.001) but higher wording scores (2.89 ± 1.01 <em>versus</em> 2.09 ± 1.14, <em>P</em> &lt; 0.001) than general medical journals.</div></div><div><h3>Conclusions</h3><div>Given the publicity effect of acronyms, a memorable acronym devised using the first or continuous letters for surgical studies may help recognize their clinical impact.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 62-69"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and Subtype Discordance Between Core Needle Biopsy and Surgical Specimen in Breast Cancer","authors":"Min Xu MS ,&nbsp;Yiwei Yan MA ,&nbsp;Yueqin Chen MS ,&nbsp;Xiaobin Chen MD ,&nbsp;Kai Gong MD ,&nbsp;Fangmeng Fu MD, PhD","doi":"10.1016/j.jss.2025.01.010","DOIUrl":"10.1016/j.jss.2025.01.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptors 2 (HER2s) are crucial for the molecular subtype classification and therapy decision-making in breast cancer. Core needle biopsy (CNB) serves as an essential preoperative diagnostic tool for biomarker evaluation, offering minimal invasiveness and convenience. However, CNB has limitations including insufficient sampling volume, sampling errors, underestimation and false results. This study evaluated the discordance of ER, PR, HER2, and molecular subtype between CNB and surgical specimen (SS) in breast cancer, explored the factors associated with discordance and discussed which specific breast cancer cases were recommended for retesting.</div></div><div><h3>Materials and methods</h3><div>Medical records of invasive breast cancer patients admitted to Fujian Medical University Union Hospital from January 2014 to January 2020 were retrospectively collected. Immunohistochemistry and fluorescence <em>in situ</em> hybridization were used to assess the status of ER, PR, and HER2 in both CNB and SS. The agreement analyses were performed using the Kappa test. Univariable and multivariable logistic regressions were employed to identify factors associated with discordance of biomarkers and molecular subtypes.</div></div><div><h3>Results</h3><div>A total of 2099 patients were included in the study. Discordance rates were 3.9% (<em>n</em> = 82) for the ER, 4.8% (<em>n</em> = 101) for PR and 1.2% (<em>n</em> = 25) for HER2. High agreement was observed between CNB and SS for ER (<em>κ</em>=0.899), PR (<em>κ</em>=0.896) and HER2 (<em>κ</em>=0.972). There were 344 cases of molecular typing discordance, with the majority (<em>n</em> = 226, 65.7%) occurring between Luminal A and Luminal B (HER2-). Factors of ER discordance were large tumor size (OR = 8.715, <em>P</em> &lt; 0.001), ER-low biopsy status (OR = 49.959, <em>P</em> &lt; 0.001) and PR-high biopsy status (OR = 0.046, <em>P</em> &lt; 0.001. Factors of molecular subtype discordance were carcinoma <em>in situ</em> (OR = 1.930, <em>P</em> = 0.007), ER-low biopsy status (OR = 40.527, <em>P</em> &lt; 0.001) and Ki67-high biopsy status (OR = 0.332, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>CNB showed good accuracy in evaluating ER, PR, HER2, and molecular subtypes in breast cancer. However, concerning the factors associated with discordance, we recommend retesting for three CNB cases (1) ER-negative and PR-positive, (2) ER low-expression and PR-negative, and (3) Luminal A subtype with tumors ≤2 cm, which might offer a valuable reference for clinical decision-making.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 42-52"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Immune Microenvironment Differences Associated With Racial Disparities in Pancreatic Cancer","authors":"Zachary Gao MD ,&nbsp;Joseph Azar MD ,&nbsp;Derek Erstad MD ,&nbsp;Zequn Sun PhD ,&nbsp;Harinarayanan Janakiraman PhD ,&nbsp;Dongjun Chung PhD ,&nbsp;David Lewin MD ,&nbsp;Hyun-Sung Lee MD PhD ,&nbsp;George Van Buren MD ,&nbsp;William Fisher MD ,&nbsp;Mark P. Rubinstein PhD ,&nbsp;E. Ramsay Camp MD","doi":"10.1016/j.jss.2025.01.005","DOIUrl":"10.1016/j.jss.2025.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Racial differences in antitumoral immunity have been identified in a variety of cancers and may contribute to survival disparities, but limited data exist exploring the molecular differences in pancreatic adenocarcinoma (PDAC). Using racially diverse PDAC datasets, we explored biologic differences that may drive disparities between African American (AA) and European American (EA) PDAC patients.</div></div><div><h3>Methods</h3><div>Genomic PDAC mutational data was analyzed for mutational differences based on race. In a separate cohort, surgical PDAC specimens were processed for both tissue microarray and multiplex gene expression analysis using NanoString.</div></div><div><h3>Results</h3><div>Of the 4679 patient samples in the mutational dataset, AA PDAC patients had significantly more TP53 mutations compared to the EA cohort. The tissue microarray included 12 AA and 41 EA surgically resected treatment-naive PDAC samples. NanoString analysis revealed significant differences between AA and EA groups in immunologic gene annotations (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>In the present study, we demonstrated that across racially diverse datasets, there exist molecular and microenvironmental differences between AA and EA patients that may contribute to cancer survival disparities. Defining molecular differences underlying PDAC racial disparities is an essential step in advancing care and improving outcomes for AA patients that suffer worse survival across cancer types.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"307 ","pages":"Pages 21-32"},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}