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1.
Angew Chem Int Ed Engl ; 60(37): 20483-20488, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34235851

RESUMEN

The role of solution aggregates on the charge transport process of conjugated polymers in electronic devices has gained increasing attention; however, the correlation of the charge carrier mobilities between the solution aggregates and the solid-state films remains elusive. Herein, three polymers, FBDOPV-2T, FBDOPV-2F2T, and FBDOPV-4F2T, are designed and synthesized with distinct aggregation behavior in solution. By combining contact-free ultrafast terahertz (THz) spectroscopy and field-effect transistor measurements, we track the charge carrier mobility of the aggregates of these polymers from the solution to the thin-film state. Remarkably, the mobility of these three polymers is found to follow nearly the same trend (FBDOPV-2T>FBDOPV-2F2T≫FBDOPV-4F2T) in both solutions and thin-film states. The quantitative mobility correlation indicates that the charge transport properties of solution aggregates play a critical role in determining the thin-film charge transport properties and final device performance. Our results highlight the importance of investigating and controlling solution aggregation structures towards efficient organic electronic devices.

2.
Oncologist ; 25(6): e920-e927, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31922308

RESUMEN

BACKGROUND: Superficial colorectal cancer (SCRC) is defined as colorectal cancer (CRC) confined to the mucosa or submucosa. Endoscopic resection (ER) is widely used to resect differentiated SCRC from patients without lymph node metastasis (LNM). However, it is unclear whether ER is suitable for use with patients with differentiated early-onset SCRC because early-onset CRC is more aggressive. Therefore, we aimed to investigate the association between age of CRC onset and LNM. MATERIALS AND METHODS: We retrieved data for patients with surgically resected differentiated-type SCRCs from the Surveillance, Epidemiology, and End Results (SEER) database. Rate of LNM was compared among patients aged 18-39, 40-49, 50-59, 60-69, and ≥70 years. The association between age and LNM was further examined using multivariate logistic regression. RESULTS: We retrieved 34,506 records of differentiated SCRCs from the SEER database, including 667 patients aged 18-39 years, 2,385 aged 40-49, 8,075 aged 50-59 years, 9,577 aged 60-69 years, and 13,802 aged ≥70 years. Rates of LNM were 15.74%, 14.13%, 10.67%, 8.07%, and 6.76% for patients aged 18-39, 40-49, 50-59, 60-69, and ≥70 years, respectively. We found an inverse correlation between age at diagnosis and risk of LNM from the univariate analysis (p < .001). Compared with patients aged 18-39, the odds ratios with 95% confidence interval (CI) for patients aged 40-49, 50-59, 60-69, and ≥70 years were 0.90 (0.71-1.15, p = .376), 0.69 (0.56-0.87, p = .001), 0.54 (0.43-0.68, p < .001), and 0.47 (0.38-0.60, p < .001), respectively. CONCLUSION: In differentiated SCRCs, younger age at diagnosis was associated with higher risk of LNM. IMPLICATIONS FOR PRACTICE: Endoscopic resection (ER) is widely used to resect differentiated superficial colorectal cancer (SCRC) without lymph node metastasis (LNM). However, no study has ever investigated risk of LNM of early-onset SCRC compared with average onset SCRC to explore whether ER is suitable for early-onset SCRC. To the authors' knowledge, this population-based study is the first study to find inverse correlation between age at diagnosis and risk of LNM in differentiated SCRCs. This finding indicates that ER may not be suitable for young patients with differentiated SCRC. Because the 30-day operative mortality after surgery is higher but the risk of LNM is lower in older patients compared with younger patients, ER for differentiated SCRCs may be advantageous over surgery for older patients.


Asunto(s)
Neoplasias Colorrectales , Neoplasias Gástricas , Anciano , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/cirugía , Humanos , Modelos Logísticos , Ganglios Linfáticos , Metástasis Linfática , Invasividad Neoplásica , Factores de Riesgo
3.
Mol Med ; 25(1): 47, 2019 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-31706267

RESUMEN

BACKGROUND: The hunt for the molecular markers with specificity and sensitivity has been a hot area for the tumor treatment. Due to the poor diagnosis and prognosis of pancreatic cancer (PC), the excision rate is often low, which makes it more urgent to find the ideal tumor markers. METHODS: Robust Rank Aggreg (RRA) methods was firstly applied to identify the differentially expressed genes (DEGs) between PC tissues and normal tissues from GSE28735, GSE15471, GSE16515, and GSE101448. Among these DEGs, the highly correlated genes were clustered using WGCNA analysis. The co-expression networks and molecular complex detection (MCODE) Cytoscape app were then performed to find the sub-clusters and confirm 35 candidate genes. For these genes, least absolute shrinkage and selection operator (lasso) regression model was applied and validated to build a diagnostic risk score model. Cox proportional hazard regression analysis was used and validated to build a prognostic model. RESULTS: Based on integrated transcriptomic analysis, we identified a 19 gene module (SYCN, PNLIPRP1, CAP2, GNMT, MAT1A, ABAT, GPT2, ADHFE1, PHGDH, PSAT1, ERP27, PDIA2, MT1H, COMP, COL5A2, FN1, COL1A2, FAP and POSTN) as a specific predictive signature for the diagnosis of PC. Based on the two consideration, accuracy and feasibility, we simplified the diagnostic risk model as a four-gene model: 0.3034*log2(MAT1A)-0.1526*log2(MT1H) + 0.4645*log2(FN1) -0.2244*log2(FAP), log2(gene count). Besides, a four-hub gene module was also identified as prognostic model = - 1.400*log2(CEL) + 1.321*log2(CPA1) + 0.454*log2(POSTN) + 1.011*log2(PM20D1), log2(gene count). CONCLUSION: Integrated transcriptomic analysis identifies two four-hub gene modules as specific predictive signatures for the diagnosis and prognosis of PC, which may bring new sight for the clinical practice of PC.


Asunto(s)
Perfilación de la Expresión Génica/métodos , Neoplasias Pancreáticas , Transcriptoma/genética , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/metabolismo , Pronóstico
4.
J Cell Biochem ; 119(4): 3608-3617, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29231991

RESUMEN

Due to the complexity and heterogeneity of gastric cancer (GC) in individual patient, current staging system is inadequate for predicting outcome of GC. Comprehensive computational and bioinformatics approach may triumph for the prediction. In this study, GC patients were devided according to stage and treatment: curative surgery plus chemoradiotherapy in stage II, curative surgery plus chemoradiotherapy in stages III, and IV, unresectable metastatic gastric cancer. The training sets were downloaded from GEO datasets (GSE26253 and GSE14208). Gene set enrichment analysis (GSEA) was performed to explore enriched difference between recurrence and nonrecurrence. The core enrichment genes of enriched pathways significantly associated with recurrence or progression were identified using Cox proportional hazards analysis. Thereafter, the risk score models were externally validated in independent datasets-GSE15081 and The Cancer Genome Atlas (TCGA). We generated respective risk score models of patients in different stages and treatment. A five-gene signature comprising FARP1, SGCE, SGCA, LAMA4, and COL9A2 was strongly associated with recurrence of patients with curative surgery plus chemoradiotherapy in stage II. A six-gene signature consisting of SHH, NF1, AP4B1, COMP, MATN3, and CCL8 was correlated with recurrence of patients with curative surgery plus chemoradiotherapy in stages III and IV. And a four-gene signature composing of ABCC2, AHNAK2, RNF43, and GSPT2 was highly related to progression of patients with unresectable metastatic GC. Taking into consideration TNM stage and gene signature reflecting recurrence or progression, the risk score models significantly improved the accuracy in predicting outcome of GC.


Asunto(s)
Neoplasias Gástricas/patología , Anciano , Biomarcadores de Tumor/metabolismo , Progresión de la Enfermedad , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Proteína 2 Asociada a Resistencia a Múltiples Medicamentos , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias/métodos , Pronóstico
5.
J Cell Biochem ; 119(10): 8249-8259, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-29968931

RESUMEN

Currently, the combination of ultrasonography and fine-needle aspiration biopsy (FNAB) can not discriminate between benign and malignant tumor of thyroid in some cases. The main issue in assessing the patients with thyroid nodules is to distinguish thyroid cancer from benign nodules, and reduce diagnostic surgery. To identify potential molecular biomarkers for patients with indeterminate FNAB, we explored the differentially expressed genes (DEGs) and differentially expressed long non-coding RNAs (DElncRNAs) in TCGA database between 318 papillary thyroid carcinoma (PTC) tissues and 35 normal thyroid gland tissues by DESeq R. Furthermore, DEGs were verified by gene expression profile GSE33630. Ten top DEGs and DElncRNAs were identified as candidate biomarkers for diagnosis and Lasso (Least Absolute Shrinkage and Selection Operator) logistic regression analysis were performed to improve the diagnostic accuracy of them. Besides, partial molecular biomarkers of top DEGs and DElncRNAs were closely related to the tumor stage (T), lymph node metastasis (N), metastasis (M) and pathological stage of PTC, which could reflect behavior of tumor progression. According to multivariate Cox analysis, the combination of two DEGs (METTL7B and KCTD16) and two DElncRNAs (LINC02454 and LINC02471) could predict the outcome in a more exact way. In conclusion, top DEGs and DElncRNAs could raise diagnosis of PTC in indeterminate FNAB specimens, and some could function as molecule biomarkers for tumor progression and prognosis.


Asunto(s)
Biomarcadores de Tumor/genética , Proteínas Portadoras/genética , Regulación Neoplásica de la Expresión Génica , Péptidos y Proteínas de Señalización Intracelular/genética , Proteínas del Tejido Nervioso/genética , ARN Largo no Codificante/genética , Cáncer Papilar Tiroideo/genética , Neoplasias de la Tiroides/genética , Nódulo Tiroideo/genética , Atlas como Asunto , Biomarcadores de Tumor/metabolismo , Proteínas Portadoras/metabolismo , Diagnóstico Diferencial , Progresión de la Enfermedad , Perfilación de la Expresión Génica , Humanos , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Metástasis Linfática , Clasificación del Tumor , Estadificación de Neoplasias , Proteínas del Tejido Nervioso/metabolismo , Pronóstico , ARN Largo no Codificante/metabolismo , Sensibilidad y Especificidad , Análisis de Supervivencia , Cáncer Papilar Tiroideo/diagnóstico , Cáncer Papilar Tiroideo/mortalidad , Cáncer Papilar Tiroideo/patología , Glándula Tiroides/metabolismo , Glándula Tiroides/patología , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/mortalidad , Neoplasias de la Tiroides/patología , Nódulo Tiroideo/diagnóstico , Nódulo Tiroideo/mortalidad , Nódulo Tiroideo/patología
6.
Inorg Chem ; 57(3): 1342-1349, 2018 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-29345923

RESUMEN

Two robust metal-organic frameworks (MOFs), {H4[Ni(π-H2O)2]2[Ni(rt-H2O)2]8Ni4(Tri)24}[VIVW12O40]2·24H2O (1) and {H[Ni(π-O)2]2[Ni(rt-H2O)2]8Ni4(Tri)24}[VIVW10VV2O40V2][VIVW9VV3O40VIV2]·24H2O (2) (Tri = 1,2,4-triazole), composed of polyoxometalates (POMs) and metal-organic units, were designed and synthesized by a hydrothermal method. Structure analysis indicates that there is a metal-organic crown [{Ni3(Tri)6(H2O)4}4] ({Ni12}) in these two compounds. In 1, the {Ni12} crown embraces four pendant Tri ligands that could capture a cationic [Ni(H2O)2]2+ group, resulting in the Ni13-Tri building unit [Ni(H2O)2{Ni3(Tri)6(H2O)4}4] ({Ni13}). The {Ni13} building unit was fused together by Tri bridges into the 2D metal-organic layers, which are pillared by a typical Keggin-type POM [VW12O40]4- to construct a 3D supramolecular framework via the hydrogen bonds. Interestingly, the 2D metal-organic layer in 1 was successfully transferred into a 3D covalent MOF via extension of the length of the pillars by capping a Keggin-type POM with V-O units. Moreover, electrochemical behaviors and electrocatalytic properties of these two compounds were both studied, which can act as bifunctional electrocatalysts toward the reduction of H2O2 and oxidation of nitrite in neutral aqueous solution.

10.
Nutr Cancer ; 66(4): 539-49, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24707954

RESUMEN

There is evidence pointing to a possible role of diet on cancer etiology. Prior studies evaluating the relationship between fish consumption and lung cancer risk reported inconclusive results. The aim of this study was to achieve a comprehensive assessment of the relationship between fish consumption and lung cancer risk through systematic review and meta-analysis. Case control and cohort studies up to September 1, 2012 about fish consumption and lung cancer risk were confirmed by an online search. Separate relative risk (RR) or odds ratio (OR) estimates with 95% confidence interval (CI) of the relationship between lung cancer risk and fish consumption level from the included articles were combined by Stata11.0 software. Publication bias was evaluated by Egger's linear regression test and funnel plot. Twenty articles (17 case-control and 3 cohort studies) comprising 8799 cases of lung cancer and 17,072 noncases were included in the final analysis. The pooled results from all studies indicated that high fish consumption was significantly associated with a decreased risk of lung cancer (pooled RR: 0.79; 95% CI: 0.69-0.92). There was heterogeneity among the studies (I(2) = 73%, P < 0.05). Pooled RR in case control and cohort studies were 0.76 (95% CI: 0.63-0.91) and 0.95 (95% CI: 0.73-1.24), respectively. Omission of any single study had little effect on the combined risk estimates. This article had no publication bias. This study identifies a significant association between fish consumption and lung cancer, confirming a protective role of fish in lung cancer. More well-designed prospective studies are required to further verify the effect of fish consumption on lung cancer.


Asunto(s)
Conducta Alimentaria , Neoplasias Pulmonares/epidemiología , Alimentos Marinos , Animales , Dieta , Peces , Humanos , Factores de Riesgo
11.
Dig Dis Sci ; 59(2): 436-45, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24178897

RESUMEN

BACKGROUND: Cyclooxygenase-2 (COX-2) is believed to be involved in gastric carcinogenesis. However, it is still controversial whether COX-2 expression can be regarded as a prognostic factor for gastric cancer patients. AIM: To obtain a more accurate relationship between COX-2 overexpression and prognosis in gastric cancer by meta-analysis. METHOD: Relevant articles published up to May 2013 were searched by use of several keywords in electronic databases. Separate hazard ratio (HR) estimates and 95 % confidence intervals (95 % CI) for COX-2 overexpression and overall survival (OS) and disease-free survival (DFS) with gastric cancer were extracted. Combined HR with 95 % CI was calculated by use of Stata11.0 software to estimate the size of the effect. Publication bias testing and sensitivity analysis were also performed. RESULTS: A total of 27 studies which included 3,891 gastric cancer patients were combined in the final analysis. Combined results suggested that COX-2 overexpression was associated with an unfavorable OS (HR 1.58, 95 % CI 1.36-1.84) but not DFS (HR 1.15, 95 % CI 0.93-1.43) among patients with gastric cancer. Publication bias was absent. Sensitivity analysis suggested that the results of this meta-analysis were robust. CONCLUSIONS: The results of this meta-analysis suggest that high COX-2 expression may be an independent risk factor for poor OS of patients with gastric cancer. More large prospective studies are now needed to further clarify the prognostic value of COX-2 expression for DFS in gastric cancer.


Asunto(s)
Biomarcadores de Tumor/análisis , Ciclooxigenasa 2/análisis , Neoplasias Gástricas/enzimología , Neoplasias Gástricas/mortalidad , Distribución de Chi-Cuadrado , Supervivencia sin Enfermedad , Humanos , Estimación de Kaplan-Meier , Modelos Lineales , Análisis Multivariante , Factores de Riesgo , Factores de Tiempo , Regulación hacia Arriba
12.
BMC Complement Med Ther ; 24(1): 240, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38902771

RESUMEN

BACKGROUND: Acupuncture is a method for treating tic disorder. However, there is a lack of sufficient clinical objective basis in regards of its treatment efficacy. Indeed, there are structural abnormalities present in energy metabolism and infrared thermography in children with tic disorder. Therefore, this study proposes a clinical trial scheme to explore the possible mechanism of acupuncture in treating tic disorder. METHODS: This randomized controlled trial will recruit a total of 90 children, in which they will be divided into non-intervention group and intervention group. The non-intervention group consists of 30 healthy children while the intervention group consists of 60 children with tic disorder. The intervention group will be randomly allocated into either the treatment group or the control group, with 30 children randomly assigned in each group. Children either received acupuncture treatment and behavioral therapy (treatment group) or sham acupuncture treatment and behavioral therapy (control group), 3 treatment sessions per week for a period of 12 weeks, with a total of 36 treatment sessions. Outcome measures include YGTSS, urinary and fecal metabolomics, infrared thermography of body surface including governor vessel. For the intervention group, these outcome measures will be collected at the baseline and 90th day prior to intervention. Whereas for the non-intervention group, outcome measures (excluding YGTSS) will be collected at the baseline. DISCUSSION: The main outcome will be to observe the changes of the severity of tic condition, the secondary outcome will be to observe the changes of structural characteristic of infrared thermography of body surface/acupoints along the governor vessel and to evaluate the changes of urinary and fecal metabolomics at the end of the treatment, so as to analyze the relationship between them and to provide further knowledge in understanding the possible mechanism of acupuncture in improving the clinical symptoms via regulating and restoring the body metabolomics network, which in future it can develop as a set of clinical guideline (diagnosis, treatment, assessment, prognosis) in treating tic disorder. ChiCTR2300075188(Chinese Clinical Trial Registry, http://www.chictr.org.cn , registered on 29 August 2023).


Asunto(s)
Terapia por Acupuntura , Metabolómica , Termografía , Trastornos de Tic , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Terapia por Acupuntura/métodos , Rayos Infrarrojos , Ensayos Clínicos Controlados Aleatorios como Asunto , Termografía/métodos , Trastornos de Tic/terapia
13.
Tumour Biol ; 34(4): 2053-62, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23690235

RESUMEN

The prognostic role of survivin expression in breast cancer patients has been widely reported. However, controversy still remains. Thus, a meta-analysis was conducted to obtain a more precise estimation of the relationship between survivin expression and overall survival (OS) in breast cancer patients. Relevant articles were selected for further assessment by online search in PubMed, EMBASE, and China National Knowledge Infrastructure. Pooled hazard ratios (HR) with 95 % confidence interval (95 % CI) were used to estimate the strength of the association between survivin expression and OS in breast cancer patients. Funnel plots of Begger's and Egger's linear regression test were used to evaluate the publication bias. Heterogeneity and sensitivity analysis were also assessed. Fifteen studies were included in the final analysis with the total number of 2,202 patients. There was a significant association between positive survivin expression and a poor OS consequence in patients with breast cancer (pooled HR 1.80, 95 % CI 1.55-2.09). No significant heterogeneity was observed among all the eligible studies (x (2) = 21.87, p = 0.081, I (2) = 36.0 %). Publication bias was absent. Sensitivity analysis revealed that the results of this meta-analysis were robust. Our results suggested that high survivin expression had an unfavorable prognostic role for patients with breast cancer.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/mortalidad , Proteínas Inhibidoras de la Apoptosis/metabolismo , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Proteínas Asociadas a Microtúbulos/metabolismo , Pronóstico , Análisis de Supervivencia , Survivin
14.
Adv Mater ; 35(21): e2300634, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36905682

RESUMEN

Charge transport of conjugated polymers in functional devices closely relates to their density of states (DOS) distributions. However, systemic DOS engineering for conjugated polymers is challenging due to the lack of modulated methods and the unclear relationship between DOS and electrical properties. Here, the DOS distribution of conjugated polymers is engineered to enhance their electrical performances. The DOS distributions of polymer films are tailored using three processing solvents with different Hansen solubility parameters. The highest n-type electrical conductivity (39 ± 3 S cm-1 ), the highest power factor (63 ± 11 µW m-1 K-2 ), and the highest Hall mobility (0.14 ± 0.02 cm2 V-1 s-1 ) of the polymer (FBDPPV-OEG) are obtained in three films with three various DOS distributions, respectively. Through theoretical and experimental exploration, it is revealed that the carrier concentration and transport property of conjugated polymers can be efficiently controlled by DOS engineering, paving the way for rationally fabricating organic semiconductors.

15.
Int J Biol Sci ; 19(11): 3526-3543, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37496994

RESUMEN

Cuproptosis, a new type of programmed cell death (PCD), is closely related to cellular tricarboxylic acid cycle and cellular respiration, while hypoxia can modulate PCD. However, their combined contribution to tumor subtyping remains unexplored. Here, we applied a multi-omics approach to classify TCGA_COADREAD based on cuproptosis and hypoxia. The classification was validated in three colorectal cancer (CRC) cohorts and extended to a pan-cancer analysis. The results demonstrated that pan-cancers, including CRC, could be divided into three distinct subgroups (cuproptosis-hypoxia subtypes, CHSs): CHS1 had active metabolism and poor immune infiltration but low fibrosis; CHS3 had contrasting characteristics with CHS1; CHS2 was intermediate. CHS1 may respond well to cuproptosis inducers, and CHS3 may benefit from a combination of immunotherapy and anti-fibrosis/anti-hypoxia therapies. In CRC, the CHSs also showed a significant difference in prognosis and sensitivity to classic drugs. Organoid-based drug sensitivity assays validated the results of transcriptomics. Cell-based assays indicated that masitinib and simvastatin had specific effects on CHS1 and CHS3, respectively. A user-friendly website based on the classifier was developed (https://fan-app.shinyapps.io/chs_classifier/) for accessibility. Overall, the classifier based on cuproptosis and hypoxia was applicable to most pan-cancers and could aid in personalized cancer therapy.


Asunto(s)
Neoplasias Colorrectales , Multiómica , Humanos , Inmunoterapia , Apoptosis , Perfilación de la Expresión Génica , Hipoxia , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/genética
16.
Nat Commun ; 14(1): 3340, 2023 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-37286537

RESUMEN

It remains challenging to understand the structural evolution of conjugated polymers from single chains to solvated aggregates and film microstructures, although it underpins the performance of optoelectrical devices fabricated via the mainstream solution processing method. With several ensemble visual measurements, here we unravel the morphological evolution process of a model system of isoindigo-based conjugated molecules, including the hidden molecular assembly pathways, the mesoscale network formation, and their unorthodox chain dependence. Short chains show rigid chain conformations forming discrete aggregates in solution, which further grow to form a highly ordered film that exhibits poor electrical performance. In contrast, long chains exhibit flexible chain conformations, creating interlinked aggregates networks in solution, which are directly imprinted into films, forming interconnective solid-state microstructure with excellent electrical performance. Visualizing multi-level assembly structures of conjugated molecules provides a deep understanding of the inheritance of assemblies from solution to solid-state, accelerating the optimization of device fabrication.

17.
Front Oncol ; 12: 1015916, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36313715

RESUMEN

Background and Aim: Endoscopic resection (ER) and laparoscopic resection (LAP) have been recommended for the treatment of gastric gastrointestinal stromal tumors (GISTs) less than 2 cm. However, the therapeutic approach for gastric GISTs between 2 and 5 cm in diameter is still under debate. In this retrospective study, we aimed to evaluate the feasibility, efficacy, and safety of ER for gastric GISTs (2-5 cm) compared with LAP. Methods: From January, 2011 to January, 2018, 197 patients with GISTs at our institution with tumor diameter between 2 and 5 cm were included in our study. Clinical baseline characteristics, histopathological results, and perioperative outcomes were collected and compared in all the patients. Propensity score matching (PSM) methods were used to balance baseline characteristics. Results: There was no significant difference in age (p = 0.246), gender (p = 0.572), tumor location (p = 0.333), pathological risk classification (p = 0.543), Ki-67 index (p = 0.212), and follow-up time (p = 0.831) in the ER and LAP groups. However, significance difference was found in times to liquid diet intake (4.45 ± 1.2 vs. 5.40 ± 1.5 days, p = 0.013) and hospital stays (7.72 ± 1.1 vs. 10.01 ± 1.3 days, p < 0.001). During the follow-up period, there was one recurrence in the ER group vs. two recurrences in the LAP group. After PSM, the tumor size was balanced between the two groups with 49 patients in each group. The times to liquid diet intake (4.18 ± 1.3 vs. 5.16 ± 1.6 days, p = 0.042) and hospital stay days (7.12 ± 1.1 vs. 9.94 ± 1.3, p < 0.0001) were still short in the ER group. Conclusions: ER is more associated with a quick postoperative recovery than LAP. ER could be an alternative approach for gastric GISTs (2-5 cm). However, the long-term follow-up outcomes are still unclear and random control trials are needed.

18.
Exp Ther Med ; 21(3): 196, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33488805

RESUMEN

Peroral endoscopic myotomy (POEM) is the first-line treatment of achalasia cardia (AC). However, the efficacy of POEM in treating patients with advanced AC remains to be determined. The aim of the present study was to evaluate the feasibility and clinical outcome of POEM in treating patients with advanced AC involving different esophageal morphologies. The study was a single-center, retrospective analysis of patients suffering from advanced AC. The primary endpoint was the Eckardt score at the follow-up examination. Secondary endpoints were procedural-related details, including the operation time and length of myotomy, adverse events (AEs) and hospital stay, as well as post-procedural gastroesophageal reflux disease. The technical success rate was 100%. All 50 patients enrolled underwent successful endoscopic myotomy (conventional POEM, n=20; modified POEM, n=30). AEs were observed in 10 patients. During a 6- to 50-month follow-up period, 41 patients achieved clinical success as evidenced by a decrease in the Eckardt score. Only 3 of 6 patients with a sigmoid-shaped megaesophagus obtained symptomatic relief. Symptomatic reflux occurred in 13 of 46 patients who completed their follow-up. In conclusion, POEM is safe, feasible and effective in treating advanced AC. Patients with a sigmoid-shaped megaesophagus are less likely to report palliation of symptoms.

19.
EBioMedicine ; 60: 102979, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32980692

RESUMEN

BACKGROUND: Log odds of positive lymph nodes (LODDS) classification showed superiority over 8th edition N staging in predicting survival of small bowel adenocarcinoma (SBA) patients. The aim of this study was to develop and validate the Tumor, LODDS, and Metastasis (TLM) staging of SBA. METHODS: Totally 1789 SBA patients from the Surveillance, Epidemiology, and End Results (SEER) database between 1988-2010, 437 patients from SEER database between 2011-2013 and 166 patients from multicenters were categorized into development, validation and test cohort, respectively. The TLM staging was developed in the development cohort using Ensemble Algorithm for Clustering Cancer Data (EACCD) method. C-index was used to assess the performance of the TLM staging in predicting cancer-specific survival (CSS) and was compared with the traditional 8th edition TNM staging. FINDINGS: Four-category TLM staging designed for the development cohort showed higher discriminatory power than TNM staging in predicting CSS in the development cohort (0.682 vs. 0.650, P < 0.001), validation cohort (0.682 vs. 0.654, P = 0.022), and test cohort (0.659 vs. 0.611, P = 0.023), respectively. TLM staging continued to show its higher predictive efficacy than the 8th TNM in TNM stage II/III patients or in patients with lymph node yield less than 8. INTERPRETATION: TLM staging showed a better prognostic performance than the 8th TNM staging especially TNM stage II/III or patients with lymph node yield less than 8 and therefore, could serve to complement the TNM staging in patients with SBA. FUNDING: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.


Asunto(s)
Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidad , Neoplasias Intestinales/diagnóstico , Neoplasias Intestinales/mortalidad , Intestino Delgado/patología , Estadificación de Neoplasias/métodos , Adenocarcinoma/epidemiología , Adenocarcinoma/terapia , Adulto , Anciano , Femenino , Humanos , Neoplasias Intestinales/epidemiología , Neoplasias Intestinales/terapia , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Metástasis de la Neoplasia , Evaluación del Resultado de la Atención al Paciente , Vigilancia de la Población , Guías de Práctica Clínica como Asunto , Pronóstico , Reproducibilidad de los Resultados , Programa de VERF
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