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1.
Nano Lett ; 24(4): 1081-1089, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38227962

RESUMO

Oral administration of probiotics orchestrates the balance between intestinal microbes and the immune response. However, effective delivery and in situ colonization are limited by the harsh environment of the gastrointestinal tract. Herein, we provide a microfluidics-derived encapsulation strategy to address this problem. A novel synergistic delivery system composed of EcN Nissle 1917 and prebiotics, including alginate sodium and inulin gel, for treating inflammatory bowel disease and colitis-associated colorectal cancer is proposed. We demonstrated that EcN@AN microparticles yielded promising gastrointestinal resistance for on-demand probiotic delivery and colon-retentive capability. EcN@AN microparticles efficiently ameliorated intestinal inflammation and modulated the gut microbiome in experimental colitis. Moreover, the prebiotic composition of EcN@AN enhanced the fermentation of relative short-chain fatty acid metabolites, a kind of postbiotics, to exert anti-inflammatory and tumor-suppressive effects in murine models. This microfluidcis-based approach for the coordinated delivery of probiotics and prebiotics may have broad implications for gastrointestinal bacteriotherapy applications.


Assuntos
Colite , Probióticos , Animais , Camundongos , Prebióticos , Microfluídica , Colite/terapia , Probióticos/uso terapêutico , Imunidade
2.
Cancer Sci ; 115(2): 369-384, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38050654

RESUMO

In gastric cancer (GC), the liver is a common organ for distant metastasis, and patients with gastric cancer with liver metastasis (GCLM) generally have poor prognosis. The mechanism of GCLM is unclear. Invadopodia are special membrane protrusions formed by tumor cells that can degrade the basement membrane and ECM. Herein, we investigated the role of invadopodia in GCLM. We found that the levels of invadopodia-associated proteins were significantly higher in liver metastasis than in the primary tumors of patients with GCLM. Furthermore, GC cells could activate hepatic stellate cells (HSCs) within the tumor microenvironment of liver metastases through the secretion of platelet-derived growth factor subunit B (PDGFB). Activated HSCs secreted hepatocyte growth factor (HGF), which activated the MET proto-oncogene, MET receptor of GC cells, thereby promoting invadopodia formation through the PI3K/AKT pathway and subsequently enhancing the invasion and metastasis of GC cells. Therefore, cross-talk between GC cells and HSCs by PDGFB/platelet derived growth factor receptor beta (PDGFRß) and the HGF/MET axis might represent potential therapeutic targets to treat GCLM.


Assuntos
Neoplasias Hepáticas , Podossomos , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Proteínas Proto-Oncogênicas c-sis/metabolismo , Células Estreladas do Fígado/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Neoplasias Hepáticas/patologia , Transdução de Sinais , Microambiente Tumoral
3.
Biochem Biophys Res Commun ; 719: 150084, 2024 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-38733742

RESUMO

INTRODUCTION: Colorectal cancer (CRC) is a prevalent digestive malignancy with significant global mortality and morbidity rates. Improving diagnostic capabilities for CRC and investigating novel therapeutic approaches are pressing clinical imperatives. Additionally, carcinoembryonic antigen (CEA) has emerged as a highly promising candidate for both colorectal tumor imaging and treatment. METHODS: A novel active CEA-targeting nanoparticle, CEA(Ab)-MSNs-ICG-Pt, was designed and synthesized, which served as a tumor-specific fluorescence agent to help in CRC near-infrared (NIR) fluorescence imaging. In cell studies, CEA(Ab)-MSNs-ICG-Pt exhibited specific targeting to RKO cells through specific antibody-antigen binding of CEA, resulting in distribution both within and around these cells. The tumor-targeting-specific imaging capabilities of the nanoparticle were determined through in vivo fluorescence imaging experiments. Furthermore, the efficacy of the nanoparticle in delivering chemotherapeutics and its killing effect were evaluated both in vitro and in vivo. RESULTS: The CEA(Ab)-MSNs-ICG-Pt nanoparticle, designed as a novel targeting agent for carcinoembryonic antigen (CEA), exhibited dual functionality as a targeting fluorescent agent. This CEA-targeting nanoparticle showed exceptional efficacy in eradicating CRC cells in comparison to individual treatment modalities. Furthermore, it exhibits exceptional biosafety and biocompatibility properties. CEA(Ab)-MSNs-ICG-Pt exhibits significant promise due to its ability to selectively target tumors through NIR fluorescence imaging and effectively eradicate CRC cells with minimal adverse effects in both laboratory and in vivo environments. CONCLUSION: The favorable characteristics of CEA(Ab)-MSNs-ICG-Pt offer opportunities for its application in chemotherapeutic interventions, tumor-specific NIR fluorescence imaging, and fluorescence-guided surgical procedures.


Assuntos
Antígeno Carcinoembrionário , Neoplasias Colorretais , Nanopartículas , Antígeno Carcinoembrionário/metabolismo , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Neoplasias Colorretais/metabolismo , Nanopartículas/química , Humanos , Animais , Linhagem Celular Tumoral , Imagem Óptica/métodos , Camundongos , Camundongos Nus , Antineoplásicos/farmacologia , Antineoplásicos/química , Antineoplásicos/uso terapêutico , Camundongos Endogâmicos BALB C , Corantes Fluorescentes/química
4.
Small ; 20(10): e2305174, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37875654

RESUMO

Photodynamic therapy (PDT) has promising applications. However, the lethal function of reactive oxygen species (ROS) produced during PDT is typically limited. This restriction is induced by oxygen shortage in the tumor microenvironment due to tumor cell hypermetabolism and reductive chemicals overexpression in tumor tissues. Glutamine (Gln) metabolism is crucial for malignancy development and is closely associated with redox. Herein, a novel nanoparticle (NP) named IRCB@M is constructed to boost PDT through dual effects. This NP simultaneously blocks aerobic respiration and inhibits cellular reduced substances by blocking the Gln metabolic pathway. Within the nanocomplex, a photosensitizer (IR-780) and a glutaminase inhibitor (CB-839) are self-assembled and then encapsulated by cancer cell membranes for homologous targeting. The Gln metabolism intervention relieves hypoxia and decreases the levels of nicotinamide adenine dinucleotide phosphate (NADPH) as well as reduced glutathione (GSH) in vitro and in vivo, which are the dual amplification effects on the IR-780-mediated lethal PDT. The antitumor effects against gastric cancer are ultimately evoked in vivo, thus offering a novel concept for enhancing PDT and other ROS-dependent therapeutic approaches.


Assuntos
Benzenoacetamidas , Indóis , Nanopartículas , Fotoquimioterapia , Tiadiazóis , Espécies Reativas de Oxigênio/metabolismo , Glutaminase/farmacologia , Linhagem Celular Tumoral , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/química , Nanopartículas/química , Microambiente Tumoral
5.
Nutr Cancer ; : 1-8, 2024 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-39313935

RESUMO

OBJECTIVE: Identifying early predictive indicators of symptomatic hypocalcemia in patients after thyroidectomy with neck lymph node dissection can help to identify high-risk patients, provide timely intervention, and improve prognosis. METHODS: A retrospective analysis of all relevant information was conducted for patients who underwent total thyroidectomy with neck lymph node dissection at our hospital between April 2021 and September 2022. The primary outcome measure was symptomatic hypocalcemia. RESULTS: Of the 210 patients who underwent total thyroidectomy with l neck lymph node dissection, 76 patients (36%) experienced symptoms of hypocalcemia. The analysis confirmed that the rate of parathyroid hormone (PTH) decline (OR = 238.414, 95%CI: 51.904-1095.114, P = 0.000) was an independent risk factor for symptomatic hypocalcemia after total thyroidectomy with neck lymph node dissection. The ROC curve indicated that a PTH decline cutoff value of 0.7425 was significantly correlated with symptoms of hypocalcemia, with a sensitivity of 89% and specificity of 69%, which could effectively predict symptomatic hypocalcemia. CONCLUSION: A PTH decline rate greater than the cutoff value of 0.7425 is a predictive factor for symptomatic hypocalcemia in adults and may be considered as a high-risk patient and actively managed to supplement calcium as soon as possible to ensure patient safety.

6.
Int J Colorectal Dis ; 39(1): 84, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38829434

RESUMO

OBJECTIVES: Lymph node metastasis (LNM) in colorectal cancer (CRC) patients is not only associated with the tumor's local pathological characteristics but also with systemic factors. This study aims to assess the feasibility of using body composition and pathological features to predict LNM in early stage colorectal cancer (eCRC) patients. METHODS: A total of 192 patients with T1 CRC who underwent CT scans and surgical resection were retrospectively included in the study. The cross-sectional areas of skeletal muscle, subcutaneous fat, and visceral fat at the L3 vertebral body level in CT scans were measured using Image J software. Logistic regression analysis were conducted to identify the risk factors for LNM. The predictive accuracy and discriminative ability of the indicators were evaluated using receiver operating characteristic (ROC) curves. Delong test was applied to compare area under different ROC curves. RESULTS: LNM was observed in 32 out of 192 (16.7%) patients with eCRC. Multivariate analysis revealed that the ratio of skeletal muscle area to visceral fat area (SMA/VFA) (OR = 0.021, p = 0.007) and pathological indicators of vascular invasion (OR = 4.074, p = 0.020) were independent risk factors for LNM in eCRC patients. The AUROC for SMA/VFA was determined to be 0.740 (p < 0.001), while for vascular invasion, it was 0.641 (p = 0.012). Integrating both factors into a proposed predictive model resulted in an AUROC of 0.789 (p < 0.001), indicating a substantial improvement in predictive performance compared to relying on a single pathological indicator. CONCLUSION: The combination of the SMA/VFA ratio and vascular invasion provides better prediction of LNM in eCRC.


Assuntos
Composição Corporal , Neoplasias Colorretais , Metástase Linfática , Invasividade Neoplásica , Curva ROC , Humanos , Masculino , Feminino , Neoplasias Colorretais/patologia , Neoplasias Colorretais/diagnóstico por imagem , Pessoa de Meia-Idade , Idoso , Estadiamento de Neoplasias , Tomografia Computadorizada por Raios X , Fatores de Risco , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/patologia , Adulto , Estudos Retrospectivos , Análise Multivariada , Músculo Esquelético/patologia , Músculo Esquelético/diagnóstico por imagem , Vasos Sanguíneos/patologia , Vasos Sanguíneos/diagnóstico por imagem
7.
World J Surg Oncol ; 22(1): 65, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38395931

RESUMO

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. This study aimed to investigate the clinical characteristics and prognosis of postoperative recurrence or metastasis in patients with low-risk stromal tumors, in order to take individualized postoperative management and treatment for patients with low-risk GISTs with relatively high recurrence. METHODS: We retrospectively analyzed the clinicopathological and follow-up data of patients with GISTs who underwent surgical resection in Nanjing Drum Tower Hospital from March 2010 to December 2021. A total of 282 patients with low-risk GISTs were included, none of whom were treated with imatinib. Univariate and multivariate Cox analysis and survival curves were used to explore the relationship between clinical features and recurrence or metastasis in patients with low-risk GISTs. RESULTS: Of the 282 patients with low-risk GISTs who met inclusion criteria, 14 (4.96%) had recurrence or metastasis. There was a correlation between tumor size, primary site, resection type, Ki67 index, neutrophil lymphocyte ratio (NLR) and CD34 expression and postoperative recurrence or metastasis of GISTs (P < 0.05). Subsequently, multifactorial analysis showed that tumor primary site, tumor size, and Ki67 index were independent risk factors affecting postoperative recurrent or metastasis in patients with low-risk GISTs (P < 0.05). Ultimately, According to Kaplan-Meier analysis, non-gastric primary tumors, larger tumors, and high Ki67 index were significantly associated with poor progression-free survival ( PFS ). CONCLUSIONS: Tumor location, tumor size and Ki-67 were independent risk factors for postoperative recurrence and metastasis in patients with low-risk GISTs. Based on the 2008 modified NIH recurrence risk grading system, combined with the above three factors, it can be used to evaluate the prognosis of patients with low-risk GISTs and provide personalized postoperative review and follow-up management recommendations.


Assuntos
Tumores do Estroma Gastrointestinal , Humanos , Prognóstico , Tumores do Estroma Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/patologia , Estudos Retrospectivos , Antígeno Ki-67/metabolismo , Estimativa de Kaplan-Meier
8.
Immunology ; 170(2): 167-179, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37132045

RESUMO

Mucosa-associated invariant T cells (MAIT) are a class of innate-like T lymphocytes mainly presenting CD8+ phenotype with a semi-invariant αß T-cell receptor, which specifically recognises MR1-presented biosynthetic derivatives of riboflavin synthesis produced by various types of microbiomes. As innate-like T lymphocytes, MAIT can be activated by a variety of cytokines, leading to immediate immune responses to infection and tumour cues. As an organ that communicates with the external environment, the digestive tract, especially the gastrointestinal tract, contains abundant microbial populations. Communication between MAIT and local microbiomes is important for the homeostasis of mucosal immunity. In addition, accumulating evidence suggests changes in the abundance and structure of the microbial community during inflammation and tumorigenesis plays a critical role in disease progress partly through their impact on MAIT development and function. Therefore, it is essential for the understanding of MAIT response and their interaction with microbiomes in the digestive tract. Here, we summarised MAIT characteristics in the digestive tract and its alteration facing inflammation and tumour, raising that targeting MAIT can be a candidate for treatment of gastrointestinal diseases.


Assuntos
Células T Invariantes Associadas à Mucosa , Neoplasias , Humanos , Citocinas , Trato Gastrointestinal , Inflamação
9.
J Surg Res ; 282: 160-167, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36306586

RESUMO

INTRODUCTION: The treatment regimen for early gastric cancer (EGC) with mixed histologic type remains controversial. We aimed to clarify the relationship between mixed histologic type and lymph node metastasis (LNM) in EGC, with emphasis on submucosal invasive EGC. METHODS: We collected data on 730 consecutive EGC patients at Nanjing Drum Tower hospital between June 2010 and May 2019. Risk factors of LNM and overall survival were analyzed to compare the prognostic differences between different histologic types. RESULTS: Mixed-type EGC patients had higher LNM rates than differentiated-type patients (29.2 % versus 10.6 %, P < 0.001), while no significant difference was found between mixed-type and undifferentiated-type EGC patients (29.2% versus 24.0%, P = 0.225). Multivariate analyses identified tumor location (cardiac and bottom versus antrum), larger tumor size, submucosal invasion, histologic differentiation (undifferentiated-type, mixed-type versus differentiated-type), and lymphovascular invasion as independent risk factors for LNM in EGC patients. Subgroup analysis further elucidated that mixed histologic type was associated with LNM in submucosa invasive EGC, but not in mucosa-confined EGC. There was no statistical significance in overall survival and disease-specific survival of submucosal invasive EGC patients who underwent radical gastrectomy with lymphadenectomy between different histologic types (P = 0.151). CONCLUSIONS: Mixed histologic type may be an independent risk factor for LNM in submucosal invasive EGC. Curative resection with lymphadenectomy should be considered the appropriate treatment for submucosal invasive EGC with mixed histologic type.


Assuntos
Carcinoma , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Metástase Linfática/patologia , Mucosa Gástrica/cirurgia , Mucosa Gástrica/patologia , Estudos Retrospectivos , Gastrectomia , Excisão de Linfonodo , Fatores de Risco , Carcinoma/patologia , Invasividade Neoplásica/patologia
10.
BMC Gastroenterol ; 23(1): 25, 2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36703123

RESUMO

BACKGROUND: Carbohydrate antigen 125 (CA125) is elevated as a tumor marker in many carcinomas, but its association with gastrointestinal stromal tumor (GIST) has received less attention. This study intends to evaluate whether CA125 level can predict tumor progression and overall survival (OS) of GIST patients. METHODS: We retrospectively analyzed the clinical data and follow-up records of GIST patients who underwent surgical resection in Nanjing Drum Tower Hospital from August 2010 to December 2020. All patients were classified according to serum CA125 level. The relationship between CA125 and clinical outcomes was then examined. RESULTS: A total of 406 GIST patients were enrolled in this study, among which 46 patients had preoperative elevated serum CA125 level and 13 patients with high CA125 level both preoperative and postoperative were observed. Preoperative CA125 concentration was significantly related to rupture status, resection style, tumor site, tumor size, mitotic index, NIH risk grade and c-kit exons. According to Kaplan-Meier curve analysis, high expression of postoperative CA125 was significantly correlated with worse progression-free survival (PFS) and OS among patients with preoperative elevated CA125 level. Ultimately, Cox proportional regression model analysis revealed that increase of preoperative and concurrent postoperative CA125 concentration was an independent predictive factor for PFS. CONCLUSIONS: The concurrent abnormality of serum CA125 before and after operation was an independent risk factor for GIST progression, suggesting its significance as a serum biomarker in the overall management of GIST patients.


Assuntos
Antígeno Ca-125 , Tumores do Estroma Gastrointestinal , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Antígeno Ca-125/sangue
11.
BMC Gastroenterol ; 23(1): 383, 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-37950183

RESUMO

BACKGROUND: The criteria for surgical intervention after non-curative endoscopic submucosal dissection (ESD) of early gastric cancer are unclear. We aimed to clarify the risk factors for residual cancer and lymph node metastasis after non-curative ESD and to identify recommendations for additional surgery. METHODS: We collected data on 133 consecutive patients who underwent additional surgery after non-curative ESD of early gastric cancer at Nanjing Drum Tower Hospital from January 2013 to July 2022. Univariate and multivariate analyses were performed to seek risk factors of residual cancer and lymph node metastasis. RESULTS: The incidence rates of residual cancer and lymph node metastasis were 13.5% (18/133) and 10.5% (14/133), respectively. There was neither residual tumor nor lymph node metastasis in 104 (78.2%) cases. Multivariate analyses elucidated that horizontal margin was an independent risk factor for local residual cancer, whereas lymphatic infiltration was an independent risk factor for lymph node metastasis. Patients with mixed histological types were more likely to suffer lymph node metastasis and further undergo additional surgery after non-curative ESD than pure histological type. CONCLUSIONS: Additional gastrectomy with lymph node dissection was strongly recommended in patients with lymphatic infiltration after non-curative ESD of early gastric cancer. Patients with mixed histological type have a high propensity for lymph node metastasis and should be treated as a separate subtype.


Assuntos
Ressecção Endoscópica de Mucosa , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Ressecção Endoscópica de Mucosa/efeitos adversos , Metástase Linfática/patologia , Neoplasia Residual/patologia , Estudos Retrospectivos , Excisão de Linfonodo , Fatores de Risco , Gastrectomia/efeitos adversos , Mucosa Gástrica/cirurgia , Mucosa Gástrica/patologia
12.
World J Surg Oncol ; 21(1): 139, 2023 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-37120543

RESUMO

BACKGROUND: There has been limited research on the prognosis differences in patients with gastric stromal tumor invasion of the plasma membrane surface. This study intended to investigate whether there is a difference in prognosis in patients with endogenous or exogenous 2-5 cm diameter GISTs. METHODS: We retrospectively analyzed the clinicopathological and follow-up data of gastric stromal tumor patients, all of whom underwent surgical resection for primary GIST at Nanjing Drum Tower Hospital from December 2010 to February 2022. We classified patients based on tumor growth patterns and then investigated the association between tumor growth patterns and clinical outcomes. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan‒Meier method. RESULTS: A total of 496 gastric stromal tumor patients were enrolled in this study, among which 276 patients had tumors of 2-5 cm in diameter. Of these 276 patients, 193 had exogenous tumors, and 83 had endogenous tumors. Tumor growth patterns were significantly related to age, rupture status, resection style, tumor site, tumor size, and intraoperative bleeding. According to Kaplan‒Meier curve analysis, the tumor growth pattern among patients with 2-5 cm diameter tumors was significantly correlated with worse progression-free survival (PFS). Ultimately, multivariate analyses identified the Ki-67 index (P = 0.008), surgical history (P = 0.031), and resection style (P = 0.045) as independent prognostic markers for PFS. CONCLUSIONS: Although gastric stromal tumors with a diameter of 2-5 cm are classified as low risk, the prognosis is lower for exogenous tumors than for endogenous tumors, and exogenous gastric stromal tumors have a risk of recurrence. Consequently, clinicians should be vigilant regarding the prognosis of patients with this type of tumor.


Assuntos
Tumores do Estroma Gastrointestinal , Neoplasias de Tecidos Moles , Neoplasias Gástricas , Humanos , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Tumores do Estroma Gastrointestinal/patologia
13.
J Transl Med ; 20(1): 327, 2022 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-35864528

RESUMO

BACKGROUND: Recent studies have shown that the fox family plays a vital role in tumorigenesis and progression. Forkhead Box S1 (FOXS1), as a newly identified subfamily of the FOX family, is overexpressed in certain types of malignant tumors and closely associated with patient's prognosis. However, the role and mechanism of the FOXS1 in colorectal cancer (CRC) remain unclear. METHOD: FOXS1 level in CRC tissues and cell lines was analyzed by western blot and quantitative real-time polymerase chain reaction (qRT-PCR). Immunohistochemistry (IHC) was used to detect the relationship between FOXS1 expression and clinicopathological features in 136 patients in our unit. The expression of FOXS1 was knocked down in CRC cells using small interfering RNA (siRNA) technology. Cell proliferation was assessed by CCK8 assay, colony formation, and 5-Ethynyl-20-deoxyuridine (EdU) incorporation assay. Flow cytometry detected apoptosis and wound healing, and Transwell assays determined cell migration and invasion. Western blotting was used to detect the levels of proteins associated with the Wnt/ß-catenin signaling pathway. Then, we used short hairpin RNA (shRNA) to knock down FOXS1 to see the effect of FOXS1 on the proliferation, migration, invasion, and metastasis of CRC cells in vivo. Finally, we investigated the impact of Wnt activator LiCl on the proliferation, migration, invasion, and metastasis of CRC cells after FOXS1 knockdown. RESULT: Compared to those in normal groups, FOXS1 overexpressed in CRC tissues and CRC cells (P < 0.05). Upregulation of FOXS1 association with poor prognosis of CRC patients. si-FOXS1 induced apoptosis and inhibited proliferation, migration, invasion, the epithelial-mesenchymal transition (EMT), and the Wnt/ß-catenin signaling pathway in vitro; sh-FOXS1 inhibited the volume and weight of subcutaneous xenografts and the number of lung metastases in vivo. LiCl, an activator of Wnt signaling, partially reversed the effect of FOXS1 overexpression on CRC cells. CONCLUSION: FOXS1 could function as an oncogene and promote CRC cell proliferation, migration, invasion and metastasis through the Wnt/ßcatenin signaling pathway, FOXS1 may be a potential target for CRC treatment.


Assuntos
Neoplasias Colorretais , Via de Sinalização Wnt , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Neoplasias Colorretais/patologia , Transição Epitelial-Mesenquimal/genética , Fatores de Transcrição Forkhead/metabolismo , Regulação Neoplásica da Expressão Gênica , Humanos , RNA Interferente Pequeno , Via de Sinalização Wnt/genética , beta Catenina/metabolismo
14.
Support Care Cancer ; 30(4): 3269-3277, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34981197

RESUMO

PURPOSE: Sarcopenia is an independent risk factor for poor prognosis of cancers. The nutritional risk screening 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) tools are widely used tools for nutrition risk screening and assessing. The purpose of this study was to investigate whether NRS2002 and PG-SGA scores are associated with sarcopenia in gastrointestinal cancers. METHODS: A consecutive cohort comprised of 432 gastrointestinal cancer patients was conducted. We used NRS2002 and PG-SGA to assess their nutrition status. Sarcopenia was diagnosed with CT scan at the third lumber vertebra level. The correlations of nutritional scores with SMI, nutritional categories with sarcopenia were assessed by Spearman's correlation test and point biserial correlation. The cut-off value of nutritional scores for identifying sarcopenia was obtained by maximum Youden index. Logistic regression was used to confirm the associations. RESULTS: Sarcopenia patients had higher NRS2002 (2.63 ± 1.16 vs. 2.15 ± 1.20, p < 0.001) and PG-SGA (8.69 ± 1.16 vs. 5.56 ± 3.28, p < 0.001) scores. The NRS2002 (r = -0.198, p < 0.001) and PG-SGA (r = -0.409, p < 0.001) scores were significantly and negatively correlated with skeletal muscle mass index. The cut-off value of PG-SGA score for predicting sarcopenia was 7. In multivariate logistic regression, the PG-SGA exceeded 7 score (OR = 7.489, 95% CI: 4.122-13.608, p < 0.001) was significantly associated with increased risk of sarcopenia, while NRS2002 score showed no significant association with sarcopenia. CONCLUSIONS: PG-SGA ≥ 7 was associated with increased risk of sarcopenia and could serve as a useful criterion for capturing sarcopenia in gastrointestinal cancers. Routine PG-SGA evaluation for patient with gastrointestinal cancers is important.


Assuntos
Neoplasias Gastrointestinais , Desnutrição , Sarcopenia , Estudos Transversais , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/epidemiologia , Humanos , Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Sarcopenia/etiologia
15.
World J Surg Oncol ; 20(1): 282, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36058930

RESUMO

BACKGROUND: The clinical application of robotic-assisted gastrectomy remains controversial, especially as clinical studies of this operation navigated by carbon nanoparticle suspension injection (CNSI) have not been conducted. This study aims to assess the perioperative safety and efficacy of CNSI-guided robotic-assisted gastrectomy in patients with gastric cancer by focusing on short-term outcomes. METHODS: A retrospective analysis of patients who underwent CNSI-guided laparoscopic or robotic-assisted gastrectomy with a pathological diagnosis of gastric cancer was conducted. Data on demographics, surgical management, clinical-pathological results and short-term outcomes were compared among the groups. RESULTS: A total of 126 eligible patients were separated into the robotic-assisted gastrectomy (RAG) group (n = 16) and the laparoscopic gastrectomy (LG) group (n = 110) in total. The operation time of the RAG group is longer than the LG group (p = 0.0000). When it comes to perioperative and short-term complications, there exists no statistical difference between the two groups. CONCLUSION: The time required for CNSI-guided robotic-assisted gastrectomy is longer than that for CNSI-guided laparoscopic gastrectomy. CNSI-guided robotic-assisted gastrectomy is safe and effective.


Assuntos
Laparoscopia , Nanopartículas , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas , Carbono , Gastrectomia/métodos , Humanos , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
16.
Cancer Cell Int ; 21(1): 418, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372874

RESUMO

BACKGROUND: WD40 repeat (WDR)43 is an RNA-binding protein that belongs to the WDR domain protein family. Its biological function is largely unclear, particularly in colorectal cancer (CRC). METHODS: In the present study, we searched the TCGA database and found the correlation between WDR43 and CRC. Subsequently, the high expression of WDR43 in human clinical samples of CRC was validated and we further examined the biological functions of it in CRC cells. Finally, we explored potential downstream proteins or pathways and established subcutaneous xenograft model to verify our findings. RESULTS: Immunohistochemistry of 16 patient specimens confirmed that the expression of WDR43 was elevated in CRC. WDR43 knockdown was shown to increase apoptosis and inhibit the proliferation, migration and invasion of CRC cells in vitro and reduce tumorigenesis in animal models. In addition, it was found that WDR43 knockdown inhibited vimentin (VIM) expression in CRC cells and overexpression of VIM can partially reverse the effects of WDR43 both in vitro and in vivo. CONCLUSION: In conclusion, the role of WDR43 in the occurrence and development of CRC was investigated in the present study. WDR43 may serve as a valuable biomarker and provide new options for the diagnosis and treatment of colorectal cancer.

17.
BMC Gastroenterol ; 21(1): 107, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33663423

RESUMO

BACKGROUND: It is well established that the controlling nutritional status (CONUT) score was correlated with long-term outcomes in gastric cancer (GC), but the significance of CONUT for postoperative short-term outcomes remains unclear. The study aimed to characterize the relationship between CONUT and short-term complications following gastrectomy of GC. METHODS: We collected data on 1479 consecutive GC patients at Nanjing Drum Tower Hospital between January 2016 and December 2018. Univariate and multivariate analyses of predictive factors for postoperative complications were performed. The cutoff value of the CONUT score was determined by Youden index. RESULTS: Among all of the patients, 431 (29.3%) patients encountered postoperative complications. Multivariate analyses identified CONUT was an independent predictor for postoperative short-term complications (OR 1.156; 95% CI 1.077-1.240; P < 0.001). Subgroup analysis elucidated that CONUT was related to postoperative complications both in early gastric cancer and advanced gastric cancer. We further explored that patients with high CONUT score had prolonged hospital stay (12.3 ± 6.0 vs 11.1 ± 4.6, P < 0.001) and more total hospital charges (7.6 ± 2.4 vs 7.1 ± 1.6, P < 0.001). CONCLUSIONS: The present study demonstrated that the preoperative CONUT was an independent predictor for short-term complications following gastrectomy of GC.


Assuntos
Neoplasias Gástricas , Gastrectomia/efeitos adversos , Humanos , Estado Nutricional , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia
18.
World J Surg Oncol ; 19(1): 227, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344373

RESUMO

BACKGROUND: Immunoinflammatory and nutritional markers, such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Onodera's prognostic nutritional index (OPNI), have gained considerable attention and have been preliminarily revealed as prognostic markers of gastrointestinal stromal tumors (GISTs). METHODS: In this study, we first investigated the prognostic value of OPNI in GISTs treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, and data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: The patients were divided into groups treated and not treated with TKIs, and we used the propensity score matching method to homogenize their baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen, and 280 of them were included for analysis under the inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI as an independent prognostic marker that was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.409; P < 0.001) was associated with worse RFS. CONCLUSIONS: Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated and not treated with TKIs. Higher NLR and PLR have negative effects on RFS.


Assuntos
Tumores do Estroma Gastrointestinal , Avaliação Nutricional , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Humanos , Prognóstico , Inibidores de Proteínas Quinases , Estudos Retrospectivos
19.
World J Surg Oncol ; 19(1): 271, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503530

RESUMO

BACKGROUND: The safety and efficacy of indocyanine green (ICG) imaging navigational laparoscopic gastrectomy remain controversial. This study is to evaluate the short-term and long-term outcomes of ICG-guided laparoscopic radial gastrectomy in patients with gastric cancer. METHODS: Consecutive patients with definitive diagnosis of gastric cancer that underwent laparoscopic radical gastrectomy were collected retrospectively. Propensity score matching (PSM) at 1:1 ratio was performed to compare the outcomes of two groups. RESULTS: A total of 122 qualified patients were divided into ICG group (n = 34) and non-ICG group (n = 88). PSM yielded 28 patients with comparable baseline characteristics into each group. The number of retrieved lymph node in ICG group was significantly higher than that in non-ICG group (P = 0.0196). There was no statistical difference of perioperative, short-term, and long-term complications between the two groups. CONCLUSION: ICG-guided laparoscopic radical gastrectomy is safe and effective, and ICG-navigated lymphadenectomy improves the number of retrieved lymph nodes for patients with gastric cancer.


Assuntos
Laparoscopia , Neoplasias Gástricas , Gastrectomia , Humanos , Verde de Indocianina , Excisão de Linfonodo , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
20.
BMC Surg ; 21(1): 174, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789664

RESUMO

BACKGROUND: Lymph node metastasis (LNM) plays a vital role in the determination of clinical outcomes in patients with gastric neuroendocrine tumor (G-NET). Preoperative identification of LNM is helpful for intraoperative lymphadenectomy. This study aims to investigate risk factors for LNM in patients with G-NET. METHODS: We performed a retrospective study involving 37 patients in non-LNM group and 82 patients in LNM group. Data of demographics, preoperative lab results, clinical-pathological results, surgical management, and postoperative situation were compared between groups. Significant parameters were subsequently entered into logistic regression for further analysis. RESULTS: Patients in LNM group exhibited older age (p = 0.011), lower preoperative albumin (ALB) (p = 0.003), higher carcinoembryonic antigen (CEA) (p = 0.020), higher International normalized ratio (p = 0.034), longer thrombin time (p = 0.018), different tumor location (p = 0.005), higher chromogranin A positive rate (p = 0.045), and higher Ki-67 expression level (p = 0.002). Logistic regression revealed ALB (p = 0.043), CEA (p = 0.032), tumor location (p = 0.013) and Ki-67 (p = 0.041) were independent risk factors for LNM in G-NET patients. CONCLUSIONS: ALB, CEA, tumor location, and Ki-67 expression level correlate with the risk of LNM in patients with G-NET.


Assuntos
Metástase Linfática , Tumores Neuroendócrinos , Neoplasias Gástricas , Idoso , Humanos , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
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