Prevalence, clinical characteristics and treatment outcomes of oxyntic gland neoplasm: a single-center retrospective study.

BACKGROUND: Oxyntic gland neoplasm (OGN) is a rare subtype of gastric cancer. The aim of this study is to evaluate the prevalence, clinicopathological features, effectiveness and safety of endoscopic treatment, as well as the prognosis of OGN. METHODS: We retrospectively analyzed the data of patients pathologically diagnosed with OGN at our hospital from November 1, 2019 to May 1, 2023. RESULTS: A total of 36 patients with 45 lesions were identified, resulting in a disease frequency of 0.047% (36/76,832). The mean age was 55.0 ± 7.5 years, with a male-to-female ratio of about 1:1.12. Most lesions were ≤10 mm in size (84.4%), located in the upper third of the stomach (73.3%), exhibited slight elevation (75.5%), appeared whitish (55%), had dilated blood vessels on the surface (75.5%). 16 and 21 lesions were treated by precutting endoscopic mucosal resection (EMR-P) and endoscopic submucosal dissection (ESD), respectively. No significant differences were found between EMR-P and ESD in terms of en bloc resection rate (100% vs 100%, p = 1.000), complete resection rate (100% vs 90.5%, p = 0.495), and curative resection rate (93.8% vs 90.5%, p = 1.000). No complications such as bleeding and perforation were observed. No recurrence or metastasis was observed during the follow-up period. CONCLUSIONS: OGN is a rare tumor with unique clinical, endoscopic, and pathological characteristics. EMR-P and ESD are deemed safe and effective for treating OGNs. The relatively faster and easier EMR-P seems at least non-inferior to ESD, especially for removal of smaller OGNs. The overall prognosis is favorable.

Underwater Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors ≤20 mm: A Systematic Review With Meta-analysis.

BACKGROUND: Underwater endoscopic mucosal resection (UEMR) is increasingly applied in the treatment of superficial non-ampullary duodenal epithelial tumors (SNADETs). This meta-analysis aimed to assess the efficacy and safety of UEMR for SNADETs ≤20 mm in comparison with conventional endoscopic mucosal resection (CEMR). METHODS: The following electronic databases were searched from 2012 until November 20, 2021: PubMed, Embase, Scopus, Web of Science databases, and Cochrane Library. The primary outcomes were the rates of en bloc resection and complete (R0) resection, and the secondary outcomes were procedure time, adverse events (delayed bleeding and delayed perforation), and recurrence rate. RESULTS: A total of 6 studies with 679 lesions (331 underwent UEMR and 348 CEMR) were included in this study. The pooled analysis showed that UMER achieves a similar en bloc resection rate (87.6 vs. 89.9%; odds ratio [OR], 1.29; 95% confidence interval [CI], 0.45 to 3.73; P =0.64; I2 =74%), a similar R0 resection rate (67.3 vs. 73.6%; OR, 1.11; 95% CI, 0.55 to 2.23; P =0.78; I2 =59%), a shorter procedure time (min) (mean difference [MD], -4.05, 95% CI: -6.40 to -1.71; P =0.0007; I2 =70%) compared with CEMR. There were no significant differences in the rates of delayed bleeding, delayed perforation, and recurrence (2.4 vs. 1.7%, 0 vs. 0.6%, 2.2 vs. 4.4%, respectively). CONCLUSION: This meta-analysis demonstrated that UEMR appears to be an effective and safe alternative to CEMR for SNADETs ≤20 mm.

High-Dose Dual Therapy Versus Bismuth-Containing Quadruple Therapy for the Treatment of Helicobacter pylori Infection: A Systematic Review with Meta-Analysis.

BACKGROUND: This study aimed to evaluate the efficacy and safety of high-dose dual therapy for Helicobacter pylori (H. pylori) eradication compared to bismuth-containing quadruple therapy. METHODS: The electronic database of PubMed, Embase, and Cochrane Library were searched from inception to March 18, 2021. Randomized, controlled trials that evaluated high-dose dual therapy versus bismuth-containing quadruple therapy for H. pylori infection were included. RESULTS: We included 6 studies containing 1677 patients with H. pylori infection. This meta-analysis demonstrated that high-dose dual therapy achieved similar eradication rate compared with bismuth-containing quadruple therapy (intention-to-treat: 84.6% vs 83.7%, relative risk (RR) = 1.01, 95% CI: 0.97-1.06, P = .49; per-protocol = 88.4% vs 89.0%, RR = 1.00, 95% CI: 0.97-1.04, P = .99). However, highdose dual therapy showed fewer side effects (13.1% vs 32.0%, RR = 0.51, 95% CI: 0.34-0.78, P = .002) and better compliance (96.1% vs 93.3%, RR = 1.03, 95% CI: 1.00-1.05, P = .03) compared to bismuth-containing quadruple therapy. CONCLUSION: This meta-analysis demonstrated that high-dose dual therapy is equally effective with bismuth-containing quadruple therapy in eradicating H. pylori, with fewer side effects and better compliance.

Comparative effectiveness and tolerability of targeted agents combined with chemotherapy in patients with HER2-positive gastroesophageal cancer: A network meta-analysis.

Background: Gastric cancer (GC) or gastroesophageal junction (GEJ) cancer with HER2 overexpression is highly invasive, with a poor prognosis. With the development of new targeted agents, which agents have ideal therapeutic effects must be determined. This network meta-analysis analyzed the effectiveness and tolerability of targeted agents combined with chemotherapy in HER2-positive GC/GEJ cancer. Methods: Public databases were searched from the date of inception to October 22, 2020. Randomized controlled trials (RCTs) on targeted agent-related regimens for HER2-positive advanced GC or GEJ cancer were included. Subgroup analyses based on publication language, first-line treatment, second/third-line treatment, and HER2 staining intensity were performed. Results: In total, 13 articles were included. The trastuzumabderuxtecan (TraD) and pertuzumab plus trastuzumab and chemotherapy (PerTraChemo) regimens were considered to have high effectiveness but low tolerability. In the subgroup analysis, PerTraChemo still had high effectiveness with low tolerability as the first-line therapy. As the second- or third-line therapy, TraD and lapatinib plus chemotherapy (LapChemo) had high effectiveness and moderate tolerability. In terms of overall survival (OS) time, PerTraChemo had a relative advantage in the immunohistochemistry (IHC) 2+/in situ hybridization (ISH)+ population, whereas TraD, PerTraChemo, and trastuzumab plus chemotherapy (TraChemo) had a relative advantage in the IHC3+ population. Conclusion: TraD had relative advantages as the second- or third-line therapy and in the IHC3 + population. PerTraChemo is a potential first-line therapy, but it requires further confirmation because the JACOB phase III clinical trial failed to confirm the superiority of PerTraChemo over TraChemo with regard to OS.

Study of p-SiC/n-GaN Hetero-Structural Double-Drift Region IMPATT Diode.

Nowadays, the immature p-GaN processes cannot meet the manufacturing requirements of GaN impact ionization avalanche transit time (IMPATT) diodes. Against this backdrop, the performance of wide-bandgap p-SiC/n-GaN heterojunction double-drift region (DDR) IMPATT diode is investigated in this paper for the first time. The direct-current (DC) steady-state, small-signal and large-signal characteristics are numerically simulated. The results show that compared with the conventional GaN single-drift region (SDR) IMPATT diode, the performance of the p-SiC/n-GaN DDR IMPATT proposed in this design, such as breakdown voltage, negative conductance, voltage modulation factor, radio frequency (RF) power and DC-RF conversion efficiency have been significantly improved. At the same time, the structure proposed in this design has a larger frequency bandwidth. Due to its greater potential in the RF power density, which is 1.97 MW/cm2 in this study, indicates that the p-SiC/n-GaN heterojunction provides new possibilities for the design and manufacture of IMPATT diode.

Comparison of endoscopic therapies for rectal carcinoid tumors: Endoscopic mucosal resection with circumferential incision versus endoscopic submucosal dissection.

BACKGROUND AND OBJECTIVE: Although various endoscopic resection techniques have been established for rectal carcinoid tumors, there remains controversy regarding the best endoscopic treatment modality for these tumors. This study aimed to evaluate and compare the therapeutic efficacy and safety of EMR with circumferential incision (EMR-CI) and endoscopic submucosal dissection (ESD) for endoscopic resection of rectal carcinoid tumors. METHODS: From March 2012 to June 2016, 66 rectal carcinoid tumors in 66 patients were resected by using EMR-CI (n=30) or ESD (n=36). The rates of both en bloc resection and complete resection, procedure time, procedure-related complications, and local or metastatic recurrence were analyzed retrospectively. RESULTS: The en bloc resection rate was 96.7% (29/30) and 100% (36/36) for EMR-CI and ESD groups, respectively, and the difference was not statistically significant (P=0.455). The complete resection rate of the ESD group was 97.2% (35/36) and significantly higher than 76.7% (23/30) of the EMR-CI group (P=0.030). The mean procedure time of the ESD group was 20.44±6.64minutes, which was significantly longer than that of the EMR-CI group at 8.47±3.40minutes (P<0.001). The complication rates for ESD and EMR-CI did not differ significantly (0% for EMR-CI vs. 2.8% for ESD, P=1.000). No local or metastatic recurrence was found in either group during the follow-up period. CONCLUSION: This study suggested that ESD may be a safe, effective, and feasible endoscopic technique for removing rectal carcinoid tumors. ESD showed a similar safety profile and superior efficacy to EMR-CI.

Outcomes of hepatectomy for noncirrhotic hepatocellular carcinoma: a systematic review.

BACKGROUND: Noncirrhotic hepatocellular carcinoma (HCC) is rare. The aim of this study was to evaluate the published evidence for hepatectomy in patients with noncirrhotic HCC. METHODS: A literature search was conducted in PubMed database for eligible studies from the time of inception to March 2014. Comparisons of surgical outcomes for noncirrhotic and cirrhotic HCC were pooled and analyzed by meta-analytical techniques. RESULTS: Thirty-one observational studies comprising a total of 3771 patients who underwent hepatectomy for noncirrhotic HCC were reviewed. The median postoperative morbidity was 29.5% (range, 8.3-55.5%) and mean mortality was 2.7% (range, 0-6.5%). Median 5-year overall and disease free survival was 47.9% (range, 26-81%) and 38.0% (range, 24.0-58.4%) respectively. In comparative studies, both the 5-year disease free (odds ratio (OR): 0.61, 95% confidence interval (95% CI): 0.51-0.72; P<0.001) and overall survival (OR: 0.61, 95% CI: 0.42-0.90; P=0.01) in the noncirrhotic group were significantly better than those in the cirrhotic group. CONCLUSIONS: Hepatectomy for noncirrhotic HCC carries low perioperative morbidity and mortality and offers favorable long-term outcomes.