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Recently,Th9 cells have been confirmed to be a subtype of CD4+ helper T lymphocytes co-induced by interleukin(IL)-4 and transforming growth factor(TGF)-β,which is mainly characterized by the secretion of IL-9.Previous studies have shown that Th9 cells play an important role in autoimmune diseases,parasitic infections,and allergic diseases.Further,Th9 cells/IL-9 have been found to be involved in tumor immune responses,especially in solid tumors.Th9 cells/IL-9 exhibit powerful anti-tumor properties.However,the role of Th9 cells/IL-9 in the development of gastrointestinal cancers remains unclear.This article reviewed the mechanism of Th9 cell/IL-9 differentiation,biological characteristics and research progress in gastrointestinal cancer.
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Objective:To evaluate the predictive value of the ratio of bedside index of severity in acute pancreatitis (BISAP) to serum calcium (BISAP/Ca) within 24 hours of admission in the severity of acute pancreatitis (AP).Methods:From January 1, 2020, to December 31, 2022, 711 AP patients visited the First Affiliated Hospital of Soochow University were enrolled. According to the severity of AP, the 711 patients were divided into mild AP group (586 cases) and severe AP group (including moderately severe and severe AP patients, 125 cases). According to the occurrence of respiratory dysfunction, the 711 patients were divided into a group without respiratory dysfunction (594 cases) and a group with respiratory dysfunction (117 cases). Acute physiology and chronic health evaluation-Ⅱ (APACHE-Ⅱ) score was calculated based on the worst indicators (highest or lowest values) within 24 hours of admission. BISAP score was calculated based on the indicator values of the patients within 24 hours of admission. And modified computed tomography (CT) severity index (MCTSI) score was calculated based on the results of enhanced CT within 72 hours of admission. Mann-Whitney U test and chi-square test were used for statistical comparison. The predictive value of BISAP/Ca for the severity of AP was assessed by receiver operating characteristic curve (ROC), and the optimal cut-off value was calculated based on sensitivity and specificity. Univariate and multivariate logistic regression analyses were used to analyze the risk factors of developing respiratory dysfunction in AP patients. Results:The hospital stay, proportion of patients with systemic inflammatory response syndrome, proportion of patients with pleural effusion, and scores of APACHE-II, BISAP, MCTSI, and BISAP/Ca of the severe AP group were higher than those of the mild AP group (18.00 d (12.00 d, 29.00 d) vs. 9.00 d (6.00 d, 12.00 d), 74.4% (93/125) vs. 22.5% (132/586), 90.4% (113/125) vs. 42.3% (248/586), 9.00(6.00, 13.50) vs. 4.00(2.00, 7.00), 2.00(2.00, 3.00) vs. 1.00(0.00, 1.00), 4.00(4.00, 6.00) vs. 4.00(2.00, 4.00), 1.05(0.92, 1.54) vs. 0.47(0.00, 0.55)), all the differences were statistically significant ( Z=-12.39, χ2=128.16 and 95.28, Z=-10.83, -12.50, -11.54, and -13.27; all P<0.001). The results of ROC analysis showed that the area under the curve (95% confidence interval) of BISAP/Ca, BISAP, serum calcium, MCTSI, and APACHE-Ⅱ score for predicting the severity of AP were 0.873 (0.842 to 0.904), 0.839 (0.804 to 0.875), 0.797 (0.752 to 0.843), 0.802 (0.762 to 0.842), and 0.807 (0.762 to 0.852), respectively, all the differences were statistically significant (all P<0.001). According to the Youden index, the optimal cut-off value of BISAP/Ca distinguishing mild AP from severe AP was 0.515, with a sensitivity of 0.880 and a specificity of 0.722. The result of multivariate logistic regression analyses showed that BISAP/Ca >0.515 was an independent risk factor of developing respiratory dysfunction in AP ( OR (95% confidence interval) 27.588(14.083 to 54.045), 12.057 (5.762 to 25.229), both P<0.001). Conclusion:BISAP/Ca may be a valuable predictive indicator for the severity and developing respiratory dysfunction in AP patients.
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Background: Glycolytic function is obviously related to the proliferation, metastasis and drug resistance of colorectal cancer, and there is still a lacking of corresponding indicators for quantitatively evaluating the level of glycolysis. Aims: To investigate the correlation between
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To evaluate the psychological symptoms of patients with Crohn disease (CD), and to explore the risk factors affecting quality of life (QOL) in CD patients, 50 adult patients with CD, and 50 healthy controls were enrolled. Psychological questionnaires including self-rating anxiety scale (SAS), self-rating depression scale (SDS), the inflammatory bowel disease questionnaire (IBDQ) and the short form-36 health survey (SF-36) were completed. The results showed both the SAS (40.3±8.5 VS 37.6±7.0) and the SDS (47.1±11.1 VS 41.8±9.6) in CD patients were significantly higher than those in the healthy controls ( t=5.4, P<0.05; t=10.6, P<0.05). The IBDQ scores revealed the physical symptoms scores were 49.50±7.62, systemic symptoms scores 23.92±5.07, emotional functions scores 57.13±15.62, and social function scores 22.15±9.08 in CD active phase. However, the above scores were 60.12±4.01, 26.24±3.97, 67.34±15.17, and 25.44±2.03 respectively in the remission phase. Four subscale items of IBDQ in CD active phase were significant lower than those in the remission phase (all P<0.05). The subscale items of SF-36 scores (PF, RP, BP, GH, VT, SF, RE, MH) in CD patients were significant lower than those in healthy controls (all P<0.05). The SF-36 items scores of PF,RP and MH in the remission phase were significant higher than those in the active phase (all P<0.05). The SF-36 items scores of GH and VT in patients with malnutrition were significant lower than those with nutrition (both P<0.05). Multivariate regression analysis showed that disease status and nutritional risk ( P<0.05) significantly affected the patients' IBDQ scores. Factors including sex, age, marital status, education background, medical insurance, use of biologicals, surgery treatment had little influence on the total score of IBDQ ( P>0.05). Psychological conseling and treatment in the active phase may improve QOL of CD patients.
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Gastrointestinal cancers are the common malignant tumors of the digestive system, and their morbidity and mortality are in the forefront of malignant tumors. Currently, cancer immunotherapy is the hottest topic in cancer research field. Although cancer immunotherapy has achieved some results in the fundamental research and clinical application of gastrointestinal tumors, there are still a series of problems that need to be resolved. In this article, we review the fundamental and clinical research progress of several common methods of cancer immunotherapy in the field of gastrointestinal tumors.
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Objective:To explore the detection rate of non-caseating granuloma under endoscopy in patients with Crohn′s disease and its influencing factors, in order to improve the pathological diagnosis rate of Crohn′s disease.Methods:From July 2016 to April 2021, at the First Affiliated Hospital of Soochow University, 199 patients who met the clinical diagnostic criteria for Crohn′s disease and underwent endoscopic biopsy were collected. The detection rates of non-caseating granulomas in all patients with Crohn′s disease, in different types (primary and recurrent) and whether the biopsy site included the colon were analyzed. According to whether non-caseating granulomas were detected by endoscopic biopsy, the patients were divided into the detected group and the undetected group. The clinical data of the two groups of patients were compared, which included gender, age, course of disease, body mass index, smoking status, clinical manifestations (abdominal pain, diarrhea, gastrointestinal bleeding, perianal lesions, weight loss, fever, intestinal obstruction), therapeutic medication (5-aminosalicylic acid, immunosuppressants, glucocorticoid, biological agents, exclusive enteral nutrition), history of bowel surgery, laboratory examination results (hemoglobin, platelet count, neutrophil count, C-reactive protein, erythrocyte sedimentation rate, albumin), endoscopic manifestation (ulcer, fistula, stricture), simplified Crohn′s disease activity index (CDAI), total number of biopsy samples, and site of biopsy. Chi-square test, continuity correction chi-square test, Mann-Whitney U test and Fisher exact test were used for statistical analysis, and logistic regression analysis was used to analyzed the influencing factors of detection of non-caseating granulomas under endoscopy. Results:Among the 199 patients with Crohn′s disease, 67 cases were detected with non-caseating granuloma (detected group), and the overall detection rate was 33.7% (67/199); 132 cases were not detected with non-caseating granuloma (undetected group). The detection rate of non-caseating granulomas in patients with primary Crohn′s disease was higher than that of recurrent patients (39.9%, 59/148 vs. 15.7%, 8/51), and the detection rate of non-caseating granulomas in patients with Crohn′s disease whose biopsy site included the colon was higher than that of patients whose biopsy site did not include colon (64.1%, 25/39 vs. 26.3%, 42/160), and the differences were statistically significant ( χ2=9.93 and 20.12 , P=0.002 and <0.001). The age of patients in the detected group was younger than that of the undetected group; the course of disease of the detected group was shorter than that of the undetected group; the proportions of patients with abdominal pain and history of biological treatment in the detected group were lower than those of the undetected group; the simplified CDAI score of the detected group was higher than that of the undetected group; and the total number of biopsy samples of the detected group was more than that of the undetected group (30.0 years old (25.0 years old, 37.00 years old) vs. 32.0 years old (28.0 years old, 41.0 years old); 1.0 year (0.0 year, 3.0 years) vs. 2.0 years (0.0 year, 5.0 years), 61.2%, 41/67 vs. 75.8%, 100/132; 0, 0/67 vs. 10.6%, 14/132; 5.00 (2.00, 7.00) vs. 4.00 (2.00, 6.00); 10 (8, 12) vs. 6 (3, 9)), and the differences were statistically significant ( Z=-2.29, -1.99, χ2=4.56, corrected χ2=6.11, Z=-2.05, -5.64, all P<0.05). The case number of biopsy location in terminal ileum, colon, ileocolon, upper gastrointestinal tract, terminal ileum+ upper gastrointestinal tract, ileocolon+ upper gastrointestinal tract in the detected group was 36, 4, 18, 1, 5 and 3, respectively, compared with those of undetected group (94, 4, 8, 11, 13 and 2), the difference was statistically significant (Fisher′s exact test, P<0.001). The results of multivariate logistic regression analysis suggested that the total number of biopsy samples, whether the biopsy site included the colon and disease type were independent influencing factors for the detection of non-caseating granulomas under endoscopy in patients with Crohn′s disease (regression coefficients=0.157, 0.979 and -0.960, OR=1.171, 2.662 and 0.383; 95% confidence interval 1.067 to 1.284, 1.140 to 6.214, 0.158 to 0.929; P=0.001, 0.024 and 0.034). Conclusions:For endoscopic examination in patients with suspected Crohn′s disease, the total number of biopsy samles should be increased as much as possible, and biopsy should be performed at the colonic lesions, in order to improve the detection rate of non-caseating granulomas under endoscopy thereby providing more pathological evidence for the diagnosis of Crohn′s disease.
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Colorectal cancer is one of the most common malignant tumors in China. Early diagnosis and accurate staging and grading help to clarify treatment options and improve the prognosis and quality of life of patients. With the rapid development of PET/CT, it plays an important role in preoperative diagnosis, staging and prognosis assessment of colorectal cancer. This article reviewed the current status and progress of PET/CT in preoperative application of colorectal cancer.
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Colonoscopy with polypectomy significantly reduces the incidence of colorectal cancer and cancer - related mortality. However, a pooled miss rate of 22% for polyps was documented. Aims: To explore the clinical application value of an artificial intelligence (AI)-based colorectal polyp diagnostic system for polyp detection. Methods: A total of 400 patients who underwent colonoscopy in the First Affiliated Hospital of Soochow University from September to November 2021 were selected according to the inclusion and exclusion criteria and were randomly divided into two groups: one group received routine colonoscopy, and the other group received AI system assisted colonoscopy. There were 200 cases in each group. The Boston Bowel Preparation Scale (BBPS) was used to evaluate bowel preparation quality. The primary outcome was polyp detection rate (PDR), and the secondary outcome was polyps per colonoscopy (PPC). Results: AI system significantly increased PDR and PPC (37.0% vs. 23.0%, 0.775 vs. 0.495, all P0.05). The bowel preparation quality was classified as“poor”(BBPS 0-5 points),“qualified”(BBPS 6-7 points) and“excellent”(BBPS 8-9 points). There were no significant differences in polyp detection between the two groups when the bowel preparation quality was“poor”or “excellent”(all P>0.05). PDR and PPC were significantly increased in AI group when the bowel preparation quality was “qualified”(33.0% vs. 20.0%, 0.670 vs. 0.450, all P<0.05). Conclusions: AI-based colorectal polyp diagnostic system can significantly improve PDR and PPC because of the significant increase in the number of diminutive and small polyps detected. In addition, when the bowel preparation is qualified, the AI system can play better for polyp detection.
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Immune-mediated enteropathy (IME) is a rare gastrointestinal disease characterized by malabsorption syndrome caused by immune overreaction. The lack of specificity of clinical manifestations brings difficulties to clinical diagnosis and treatment. This article reviewed several commonly seen IMEs from the aspects of disease introduction, pathogenesis, clinical manifestations, diagnosis, and treatment, so as to improve the clinicians’understanding of the disease.
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Gastric cancer is a common malignant tumor in China. The treatment of gastric cancer has entered the era of immunotherapy. Multiplex immunofluorescence technology is a new detection technology in recent years, including multiplex immunofluorescence staining, multispectral imaging and tissue quantitative analysis, which can co-locate specific immune cell populations in tumor immune microenvironment. A large number of studies used multiplex immunofluorescence technology to detect different cell subsets and their molecular expression in the immune microenvironment of gastric cancer, which had shown important clinical value in the treatment and prognosis evaluation of gastric cancer. This technique has certain limitation, but it has much advantages, such as high repeatability, high efficiency and high cost-effectiveness compared with traditional methods. This article reviewed the clinical application of multiplex immunofluorescence technique in immunotherapy of gastric cancer.
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Background: Helicobacter pylori (Hp) is closely associated with peptic ulcer, gastric cancer and other gastrointestinal diseases. Eradication therapy is the main approach to prevent and treat Hp-associated diseases, and patient management is crucial for improving the efficacy of eradication therapy. Aims: To explore the effect of whole-course management on medication adherence and reexamination rate of Hp eradication therapy. Methods: Patients who received Hp eradication therapy in the Hp Specialist Clinic of the First Affiliated Hospital of Soochow University from June 2020 to November 2020 were recruited consecutively. One hundred and twelve patients who received eradication therapy between June 2020 and August 2020 were served as the control group, and 112 patients who received eradication therapy between September 2020 and November 2020 were served as the observation group. Patients in control group were informed only the medication method and reexamination time, while patients in observation group were given the whole-course management composed of informing medication method and reexamination time plus following up online by WeChat and reminding the reexamination by WeChat and by phone. Patients in both groups received a 14-day bismuth quadruple therapy, and were told to undergo
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Objective:To evaluate the efficacy of hemostatic powder on preventing delayed bleeding after endoscopic submucosal dissection (ESD).Methods:Patients who received ESD in the First Affiliated Hospital of Soochow University and Yulin No.2 Hospital from June 2017 to August 2018 were enrolled with informed consents, and randomly divided into the study group and the control group. Hemostatic powder was applied on post-ESD ulcer after routine hemostasis method in the study group, and the control group was given routine hemostasis method only. The time and dosage of hemostatic powder spraying and its adverse events were observed in the study group. The operation time, rate of delayed bleeding (within 30 days after operation) and early delayed bleeding (within 48 hours after operation), and postoperative hospital stay were compared between the two groups.Results:A total of 196 patients were enrolled including 97 in the study group and 99 in the control group. The baseline data were comparable between the two groups (all P>0.05). In the study group, the time to spray powder was 68.78±19.75 s, dosage was 2.51±0.93 g. Powder delivery catheter was blocked in one case (1.03%, 1/97). No adverse event was reported during 30 days of follow-up. The operation time was not statistically different in the study group and the control group (61.92±11.71 min VS 59.76±11.01 min, t=1.330, P=0.185). The delayed bleeding rate of the study group was significantly lower than that of the control group [1.03% (1/97) VS 8.08% (8/99), P=0.035]. There was no case of early delayed bleeding occurred in the study group, while 6 cases (6.06%, 6/99) in the control group ( P=0.029). The postoperative hospital stay was not statistically different between the study group and the control group (4.57±0.85 d VS 4.86±1.37 d, t=1.778, P=0.077). Conclusion:Although capacity of hemostatic system remains to be improved, hemostatic powder is an effective, safe and simple method to reduce delayed bleeding rate after ESD, especially on early delayed bleeding.
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Objective:To compare the efficiency and safety of T knife and Dual knife in endoscopic submucosal dissection (ESD) in the treatment of esophageal lesios.Methods:A total of 59 hospitalized patients with esophageal lesions who underwent ESD in the First Affiliated Hospital of Soochow University from June 2018 to January 2019 were enrolled in the study, and the patients were randomly divided into T knife group ( n=29) and Dual knife group ( n=30). The operation time, resection speed, complete resection rate, and complications of the two groups were compared. Results:There were no significant differences in gender, age and comorbidity between the T knife group and the Dual knife group (all P > 0.05). The operation time of T knife group and Dual knife group was 57.86±24.62 min and 66.28±29.48 min, respectively, and the difference was statistically significant ( t=1.189, P=0.024). The resection speed of the two groups was 22.80±7.31 mm 2/min and 16.20±7.24 mm 2/min, respectively, with significant difference ( t=3.484, P=0.001). The complete resection rate of the two group was 86.2% (25/29) and 86.7% (26/30), respectively, with no significant difference ( χ2 =0.108, P=0.742). There were 2 (6.9%) cases of complications in the T knife group, while 5 (16.7%) cases in the Dual knife group, the incidence of complications was no significant difference ( χ2=0.574, P=0.449). There was no perforation or bleeding in the both groups. Conclusion:In the treatment of esophageal lesions, T knife in ESD has the advantages of short operation time and high resection speed compared with Dual knife, and is worthy of clinical application.
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Mast cell activation syndrome (MCAS) is a chronic multisystem disorder caused by inappropriate activation of mast cells. The gastrointestinal tract harbors a large population of mast cells and is easily to be involved by MCAS. Being an under-recognized disease, and because gastrointestinal symptoms are frequently reported, MCAS is often misdiagnosed as functional gastrointestinal disorders(FGIDs). Definite diagnosis should be based on the clinical manifestations, detection of mast cell mediators and pathological examination; and above all, other organic diseases should be excluded. Routine symptomatic treatment is often ineffective in relieving gastrointestinal symptoms. In addition to avoiding triggers, the best treatment modalities are mast cell mediator antagonists and regulation of the activation process of mast cells. In this article, the function of mast cells, and the clinical manifestations, diagnosis, differential diagnosis and treatment of MCAS were briefly introduced.
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Background: Gastric cancer is one of the common gastrointestinal malignancies. Early diagnosis can reduce the mortality rate significantly. In the Chinese consensus published in 2017, the New Gastric Cancer Screening Scoring System was recommended to be used for risk stratification of gastric cancer. Aims: To preliminarily explore the value of the New Gastric Cancer Screening Scoring System in early gastric cancer screening in asymptomatic community population. Methods: At several communities in Suzhou City Xiangcheng District, a questionnaire survey was conducted in asymptomatic community residents willing to accept voluntary serum tests to collect information on high risk factors of gastric cancer. Serum pepsinogen (PG), PGⅡ, gastrin 17 (G-17) and Helicobacter pylori (Hp) IgG were tested simultaneously. Risk stratification of gastric cancer was carried out in accordance with the New Gastric Cancer Screening Scoring System. Gastroscopy was recommended for moderate to high risk individuals. Results: A total of 540 asymptomatic individuals completed the study, of which 11 were categorized as high risk (2.0%), 168 as moderate risk (31.1%), and 361 as low risk (66.9%). Sixty-four moderate to high risk individuals completed the gastroscopy with a response rate of 35.8%. Four precancerous lesions were detected (6.2%), including 3 gastric low-grade intraepithelial neoplasia and 1 duodenal adenoma. No gastric cancer was detected. Conclusions: The New Gastric Cancer Screening Scoring System is useful for risk stratification of gastric cancer in asymptomatic population and may provide a basis for further endoscopic examination. However, the value of this scoring system in low risk areas of gastric cancer needs to be further verified.
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Objective To detect whether patients with gastric cancer had unique serum metabolomic characteristics by liquid chromatography-mass spectrometry (LC-MS) metabolomic analysis,and to screen potential markers for early gastric cancer and to preliminarily explore the related metabolic pathways.Methods At the First Affiliated Hospital of Soochow University,66 patients with gastric cancer and 44 patients with benign gastric disease from July,2017 to January,2018 were enrolled,and 50 healthy subjects served as controls.Twenty-five patients with gastric cancer at stage Ⅰ and Ⅱ and 25 patients with gastric cancer at stage Ⅲ and Ⅳ were selected from the 66 patients with gastric cancer,and 25 subjects were also selected from 50 healthy controls.The plasma small molecule metabolites of patients with gastric cancer and benign gastric disease and healthy controls were detected by LC-MS method.Multivariate logistic regression analysis was used to establish and validate the principal component analysis (PCA) model and partial least squares-discriminant analysis (PLS-DA) model and screen the differential metabolites.The receiver operating characteristic curve analysis was used to evaluated the clinical efficacy of differential metabolites.Results PCA and PLS-DA models showed that gastric cancer had a obviously specific metabolites profile,the profile of benign gastric disease overlapped with that of gastric cancer and healthy controls.The results of multivariate logistic regression analysis confirmed that four metabolites including isoleucine,benzophenone,sphingosine-1-phosphate and galactopyranose set could be used to establish an optimal diagnostic model.The area under the curve (AUC)(95% confidence interval (CI)) was 0.963 (0.930 to 0.997),and the best cut off value,sensitivity and specificity were 0.871,93.1% and 94.0%,respectively.Meanwhile,patients with gastric cancer at stage Ⅰ + Ⅱ and stage Ⅲ + Ⅳ had a distinct clustering trend compared with the control group.In the serum of patients with gastric cancer at stage Ⅰ + Ⅱ and stage Ⅲ + Ⅳ,a total of 24 differential metabolites were identified,theconcentration of five of which including lysine,carnitine,benzenesulfonamide,arginine and docosahexaenoic acid ethyl ester,increased along with the progression of gastric cancer.Pipecolic acid and kynurenine might served as biomarkers for early and mid gastric cancer (stage [+ Ⅱ) screening.Conclusions LC-MS metabolomic effectively confirm the unique changes of serum metabolites in patients with gastric cancer.The screened differential metabolites have potential clinical application value for predicting the risk of gastric cancer.
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Objective To evaluate the therapeutic value of endoscopic jejunal tube placement, endoscopic clipping, and over the scope clip ( OTSC) for digestive fistula. Methods Data of 38 patients with digestive fistulas at the First Affiliated Hospital of Soochow University admitted from July 2015 to July 2017 were retrospectively analyzed. Treatments were chosen according to the size and the site of the fistulas. Thirteen patients underwent jejunal tube placement ( the jejunal tube group ) , 20 underwent endoscopic clipping( the endoscopic clipping group) , and 5 underwent OTSC( the OTSC group) . The technical success rate, clinical cure rate and postoperative hospital stay were analyzed. Results All patients received the endoscopic operation successfully with no significant complications. In the jejunal tube group, 4 patients′fistulas fully healed, lesion was smaller after treatment in 3 patients, lesion didn′t change in 5 patients, and 1 patient died. The complete cure rate was 30. 8% (4/13), and the postoperative hospital stay was 47. 4± 14. 1 days. For the endoscopic clipping group, 16 patients′ fistulas fully healed, lesion was no smaller compared with that before treatment in 3 cases, and 1 patient died. The complete cure rate was 80. 0% ( 16/20) , and the postoperative hospital stay was 17. 9 ± 8. 9 days. Total patients in the OTSC group were completely cured, with 100. 0%( 5/5) of complete cure rate. One patient with refractory esophageal fistula underwent OTSC repeatedly with endoscopic clipping, and the healing time of fistula was 102 days. The postoperative hospital stay of 4 others was 5. 3±1. 7 days. The cure rate of fistula was higher (P=0. 03, P<0. 001) and the postoperative hospital stay was shorter ( P=0. 04, P<0. 001) in the OTSC group compared with the clipping group and the jejunal tube group. Conclusion Endoscopic management is safe and effective for digestive fistulas with less trauma, easy performance and short time of healing.
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Objective To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with Helicobacter pylori (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Methods Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. Results The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Conclusions Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.
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Objective To analyze the clinical characteristics and prognosis of patients with rectal gastrointestinal stromal tumor ( GIST) . Methods We collected the data of 31 rectal GIST patients definitely demonstrated by pathology and immunohistochemistry in the First Affiliated Hospital of Soochow University, the Second Affiliated Hospital of Soochow University, and Suzhou Wuzhong People′s Hospital from January 2008 to December 2016. The clinical characteristics, therapeutic modalities, and prognoses were retrospectively analyzed. Results Among the 31 rectal GIST patients, 16 underwent local resection and 15 underwent radical surgery. There was no significant difference on the three-year survival rate between the two groups [ 93. 8% ( 15/16 ) VS 73. 3% ( 11/15 ) , P=0. 135 ] . There was no significant difference on the survival rate between the oral imatinib patients and non-oral imatinib patients in the local resection group [ 75. 0% ( 3/4) VS 100. 0% ( 12/12) , P=0. 083] and the radical surgery group[ 77. 8% ( 7/9) VS 66. 7%(4/6), P=0. 579]. The postoperative recurrence and metastasis rate of the two groups was no significantly different[31. 3% (5/16) VS 53. 3% (8/15), P=0. 213]. Conclusion The choice of surgical procedure has no significant effects on the survival rate and postoperative recurrence for rectal GIST patients, and whether oral imatinib or not has no significant effects on the survival of patients.
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Objective To evaluate the clinical value of endoscopic submucosal tunnel dissection ( ESTD) for treatment of large gastric angle superficial neoplasms. Methods A retrospective analysis was performed on data of 87 patients with superfical neoplasms in gastric angle, including 32 cases undergoing ESTD and 55 cases undergoing endoscopic submucosal dissection ( ESD) in 6 institutions between July 2014 and July 2016. The dissection time, dissection speed, en bloc resection rate, curative resection rate, adverse events, and prognosis were compared between the two groups. Results The ESTD group showed a shorter dissection time ( 87. 3 ± 32. 6 min VS 136. 7 ± 64. 5 min, P<0. 01 ) , a higher dissection speed ( 0. 18 ± 0. 07 cm2/min VS 0. 08±0. 05 cm2/min, P<0. 01), a higher en bloc resection rate[100% (32/32) VS 87. 3% (48/55), P=0. 035], and a higher curative resection rate[100% (32/32) VS 85. 5% (47/55), P=0. 024] compared with the ESD group. The intraoperative bleeding rate[59. 4% (19/32) VS 100. 0%( 55/55) , P<0. 01] and muscular injury rate[ 0 ( 0/32) VS 14. 5% ( 8/55) , P=0. 024] were lower in the ESTD group than those of the ESD group. There was no statistical difference on recurrence rate between the two groups[0 (0/32) VS 1. 9% (1/54), P=0. 443]. Conclusion ESTD has a higher dissection speed and greater security on treatment of large gastric angle superficial neoplasms, and is worthy to be generalized.