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1.
Acta Histochem ; 124(1): 151821, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34861601

RESUMO

The identification of the best reference gene is a critical step to evaluate the relative change in mRNA expression of a target gene by RT-qPCR. In this work, we evaluated nineteen genes of different functional classes using Real Time Human Reference Gene Panel (Roche Applied Sciences), to identify the internal housekeeping genes (HKGs) most suitable for gene expression normalization data in human cell lines. Normal cell lines CCD-19LU (lung fibroblast), HEK-293 (epithelial cell of embryonic kidney), WI-26 VA4 (lung fibroblast), and human cancer cells, BT-549 (breast cancer), Hs 578T (breast cancer), MACL-1 (breast cancer), HeLa (cervical carcinoma), U-87 MG (glioblastoma/astrocytoma), RKO-AS45-1 (colorectal carcinoma), and TOV-21G (ovarian adenocarcinoma) were cultivated according to manufacturer's protocol. Twelve candidate reference genes were commonly expressed in five cell lines (CCD-19Lu, HEK-293, RKO-AS45-1, TOV-21G, and U-87 MG). To verify the expression stability, we used the RefFinder web tool, which integrates data from the computational programs Normfinder, BestKeeper, geNorm, and the comparative Delta-Ct method. The ACTB was the most stable reference gene to the CCD-19Lu and HEK-293 cells. The best combination of HKGs for the RKO-AS45-1 and TOV-21G cell lines were B2M/GAPDH and PBGD/B2M, respectively. For the U-87 MG cells, GAPDH and IPO8 were the most suitable HKGs. Thus, our findings showed that it is crucial to use the right HKGs to precise normalize gene expression levels in cancer studies, once a suitable HKG for one cell type cannot be to the other.


Assuntos
Adenocarcinoma , Genes Essenciais , Genes Essenciais/genética , Células HEK293 , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Padrões de Referência
2.
Gan To Kagaku Ryoho ; 49(8): 829-834, 2022 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-36046965

RESUMO

Radioactive iodine has long been used clinically for patients with differentiated thyroid cancer. Radioiodine(131I) is used for the ablation of thyroid remnants or treatment of metastatic thyroid cancer. However, some patients with multiple metastases are refractory to repetitive 131I treatment, despite the targeted regions showing sufficient iodine uptake. In such patients, ß- particle therapy using 131I is inadequate and another strategy is needed using more effective radionuclide targeting the sodium/iodide symporter(NIS). Astatine(211At)is receiving increasing attention as an α-emitter for targeted radionuclide therapy. 211At is a halogen element with similar chemical properties to iodine. α particles emitted from 211At has higher linear energy transfer as compared to ß particles from 131I and exert a better therapeutic effect by inducing DNA double strand breaks and free radical formation. We showed that increase of the radiochemical purity of astatide of 211At solution by addition of ascorbic acid was associated with significantly enhanced uptake of 211At by both normal thyroid tissue and differentiated thyroid cancer cells. The treatment effect of 211At solution in the K1-NIS xenograft model was dose-dependent and was associated with prolonged survival, suggesting the potential applicability of targeted α therapy for the treatment of advanced differentiated thyroid cancer. Thus, targeted α therapy using 211At is highly promising for the treatment of advanced differentiated thyroid cancer. We have already started the clinical trial of 211At-NaAt in Osaka University Hospital since November 2021 after getting the approval by IRB and PMDA investigation. We would like to get the proof of concept that astatine can be used safely and effectively in patients, aiming at the drug approval as a targeted α therapeutic from Japan.


Assuntos
Adenocarcinoma , Astato , Neoplasias da Glândula Tireoide , Adenocarcinoma/tratamento farmacológico , Astato/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/tratamento farmacológico
3.
Chirurgia (Bucur) ; 117(4): 423-430, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049099

RESUMO

Introduction: Periampullary carcinomas represent a group of tumors that develop in a complex area, implying different anatomical structures. The most common histological type of periampullary carcinomas is the adenocarcinoma. The pancreatic type of periampullary adenocarcinomas has the worst prognosis. Immunohistochemical markers, such as ki-67 and p53, can be used in predicting survival. Material and method: we selected the patients with periampullary adenocarcinomas, intestinal or biliopancreatic type, with resectable tumors, and we performed immunohistochemical stains for ki-67 and p53 markers. The overall survival was analyzed according to the expression of immunohistochemical markers, TNM staging, tumor grade and perineural invasion. Results: Sixty-seven patients were included in the study. The median overall survival for the whole cohort was 12 months, with a 2-year survival rate of 25%. High rate of tumor proliferation (ki67 more than 80%) was significantly associated with shorter overall survival (median survival 3 months compared with 17 months for the group with ki67 index less than 80%). A high expression of p53 protein has been associated with low overall survival. The low survival was associated with poorly differentiated tumor grade and lymph node status. Conclusion: Both immunohistochemical expression of ki67 and p53 can be used as prognostic and predictive factors for overall survival of patients with resectable periampullary adenocarcinomas.


Assuntos
Adenocarcinoma , Carcinoma , Neoplasias Duodenais , Adenocarcinoma/cirurgia , Humanos , Antígeno Ki-67/metabolismo , Prognóstico , Resultado do Tratamento , Proteína Supressora de Tumor p53/metabolismo
4.
BMC Cancer ; 22(1): 953, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064338

RESUMO

PURPOSE: Adenocarcinomas of the esophagus (AEG) and stomach (AS) are among the most common cancers worldwide. Novel markers for risk stratification and guiding treatment are strongly needed. Activin is a multi-functional cytokine with context specific pro- and anti-tumorigenic effects. We aimed to investigate the prognostic role of activin tumor protein expression in AEG/ASs. METHODS: Tissue from a retrospective cohort of 277 patients with AEG/AS treated primarily by surgery at the Charité - Universitätsmedizin Berlin was collected and analyzed by immunohistochemistry using a specific antibody to the activin homodimer inhibin beta A. Additionally, we evaluated T-cell infiltration and PD1 expression as well as expression of PD-L1 by immunohistochemistry as possible confounding factors. Clinico-pathologic data were collected and correlated with activin protein expression. RESULTS: Out of 277 tumor samples, 72 (26.0%) exhibited high activin subunit inhibin beta A protein expression. Higher expression was correlated with lower Union for International Cancer Control (UICC) stage and longer overall survival. Interestingly, activin subunit expression correlated with CD4+ T-cell infiltration, and the correlation with higher overall survival was exclusively seen in tumors with high CD4+ T-cell infiltration, pointing towards a role of activin in the tumor immune response in AEG/ASs. CONCLUSION: In our cohort of AEG/AS, higher activin subunit levels were correlated with longer overall survival, an effect exclusively seen in tumors with high CD4+ cell infiltration. Further mechanistic research is warranted discerning the exact effect of this context specific cytokine.


Assuntos
Ativinas , Adenocarcinoma , Adenocarcinoma/cirurgia , Animais , Citocinas , Equidae/metabolismo , Neoplasias Esofágicas , Humanos , Subunidades beta de Inibinas , Inibinas , Prognóstico , Estudos Retrospectivos , Estômago
5.
Cancer Imaging ; 22(1): 46, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064495

RESUMO

PURPOSE: To establish a nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodules (SSNs) according to the 2021 WHO classification. METHODS: A total of 656 patients who underwent SSNs resection were retrospectively enrolled. Among them, 407 patients were assigned to the derivation cohort and 249 patients were assigned to the validation cohort. Univariate and multi-variate logistic regression algorithms were utilized to identity independent risk factors of adenocarcinomas. A nomogram based on the risk factors was generated to predict the risk of adenocarcinomas. The discrimination ability of the nomogram was evaluated using the concordance index (C-index), its performance was calibrated using a calibration curve, and its clinical significance was evaluated using decision curves and clinical impact curves. RESULTS: Lesion size, mean CT value, vascular change and lobulation were identified as independent risk factors for adenocarcinomas. The C-index of the nomogram was 0.867 (95% CI, 0.833-0.901) in derivation cohort and 0.877 (95% CI, 0.836-0.917) in validation cohort. The calibration curve showed good agreement between the predicted and actual risks. Analysis of the decision curves and clinical impact curves revealed that the nomogram had a high standardized net benefit. CONCLUSIONS: A nomogram for predicting the risk of adenocarcinomas in patients with SSNs was established in light of the 2021 WHO classification. The developed model can be adopted as a pre-operation tool to improve the surgical management of patients.


Assuntos
Adenocarcinoma , Nomogramas , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Humanos , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos , Organização Mundial da Saúde
6.
BMC Cancer ; 22(1): 958, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068487

RESUMO

BACKGROUND: Pleural deformation is associated with the invasiveness of lung adenocarcinoma(LAC). Our study focused on the pathological components of the area adjacent pleura in pulmonary pure ground-glass nodules(pGGNs) with pleural deformations(P-pGGNs) confirmed to be invasive LAC without visceral pleural invasion (VPI) pathologically. METHODS: Computed tomography(CT) imaging features of nodules and pathological components of the area adjacent pleura were analyzed and recorded. Statistical analysis was performed for subgroups of P-pGGNs. RESULTS: The 81 enrolled patients with 81 P-pGGNs were finally involved in the analysis. None of solid/micropapillary group and none of VPI was observed, 54 alveoli/lepidics and 27 acinar/papillarys were observed. In P-pGGN with acinar/papillary components of the area adjacent pleura, invasive adenocarcinoma (IAC) was more common compared to minimally invasive adenocarcinoma (MIA, 74.07% vs. 25.93%; p < 0.001). The distance in alveoli/lepidic group was significantly larger (1.50 mm vs. 0.00 mm; p < 0.001) and the depth was significantly smaller (2.00 mm vs. 6.00 mm; p < 0.001) than that in acinar/papillary group. The CT attenuation value, maximum diameter and maximum vertical diameter was valuable to distinguish acinar/papillary group form alveoli/lepidic group(p < 0.05). The type d pleural deformation was the common pleural deformation in IAC(p = 0.028). CONCLUSIONS: The pathological components of the area adjacent pleura in P-pGGN without VPI confirmed to be invasive LAC could included alveoli/lepidics and acinar/papillarys. Some CT indicators that can identify the pathological invasive components of the area adjacent pleura in P-pGGNs.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Invasividade Neoplásica , Pleura/diagnóstico por imagem , Pleura/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
7.
Sultan Qaboos Univ Med J ; 22(3): 421-425, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36072072

RESUMO

Spontaneous rupture of a metastatic liver tumour is rarely documented in the literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. We report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female patient presented to a tertiary care institute in 2020 with complaints of abdominal pain, breathlessness and fever. On examination, the patient was tachypnoeic with a right hypochondriac mass. A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo-enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung. Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy. The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and gefitinib. However, despite best efforts, the patient succumbed to the disease.


Assuntos
Adenocarcinoma , Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias Pulmonares , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Tomografia Computadorizada por Raios X
8.
Ceska Gynekol ; 87(4): 255-260, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36055785

RESUMO

OBJECTIVE: The aim of this work is to draw attention to the difficulty of differential dia-gnosis of rare adenocarcinoma of the appendix and the histological diversity of ovarian tumors. CASE REPORT: We present a case of a 62-year-old patient sent by an attending gynecologist for the finding of an asymptomatic adnextumor dia-gnosed during a routine preventive examination. Based on preoperative examinations, a malignant ovarian tumor was suspected. Standard surgery was performed including hysterectomy with bilateral adnexectomy, total omentectomy, appendectomy, pelvic and paraaortic lymphadenectomy. Definitive histopathological analysis revealed a secondary ovarian tumor, with the adenocarcinoma of the appendix appearing to be the primary site. CONCLUSION: Up to 25% of all ovarian tumors are secondary metastatic tumors. Appendix neoplasia should be considered in the differential dia-gnosis of right-sided adnextumors. Due to their localization, they can only mimic an ovarian tumor during imaging examinations, or they can be the primary origin of an already metastatic ovary, as in our case.


Assuntos
Adenocarcinoma , Neoplasias do Apêndice , Apêndice , Neoplasias Ovarianas , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Neoplasias do Apêndice/patologia , Apêndice/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia
9.
Sci Rep ; 12(1): 15028, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056076

RESUMO

Since neurotensin (NT) receptors of subtype-1 (NTS1) are expressed by different types of malignant tumors, such as pancreatic adenocarcinoma, colorectal and prostate carcinoma, they represent an interesting target for tumor imaging by positron emission tomography (PET) and endoradiotherapy. Previously reported neurotensin-derived NTS1 ligands for PET were radiolabeled by modification and prelongation of the N-terminus of NT(8-13) peptide analogs. In this study, we demonstrate that modifying Arg8 or Arg9 by Nω-carbamoylation and subsequent fluoroglycosylation provides a suitable approach for the development of NT(8-13) analogs as PET imaging agents. The Nω-carbamoylated and fluoroglycosylated NT(8-13) analogs retained high NTS1 affinity in the one-digit nanomolar range as well as high metabolic stability in vitro. In vivo, the radioligand [18F]21 demonstrated favorable biokinetics in HT-29 tumor-bearing mice with high tumor uptake and high retention, predominantly renal clearance, and fast wash-out from blood and other non-target tissues. Therefore, [18F]21 has the potential to be used as molecular probe for the imaging of NTS1-expressing tumors by PET.


Assuntos
Adenocarcinoma , Neoplasias Pancreáticas , Adenocarcinoma/metabolismo , Animais , Arginina , Humanos , Masculino , Camundongos , Neurotensina/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Receptores de Neurotensina/metabolismo , Tomografia Computadorizada por Raios X
10.
Zhonghua Wai Ke Za Zhi ; 60(9): 807-812, 2022 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-36058705

RESUMO

There are several controversies and issues in the surgical treatment of esophagogastric junction (AEG) currently. The Siewert classification and TNM staging system are commonly used to assist clinical decision and prognosis prediction. Generally, transthoracic procedure is more suitable for Siewert Ⅰ type and longer esophageal invasion patients, while transhiatal is more suitable for Siewert Ⅲ type patients. The optimal extent of lymph node dissection for AEG should be based on tumor location and esophageal invasion range. The extent of surgical resection and the method of digestive tract reconstruction should be based on the principle of radical resection and surgical safety, and the postoperative life quality of patients should be fully considered. Roux-en-Y anastomosis is the most common and efficient anastomosis after total gastrectomy, while double tract anastomosis is recommended by many experts after proximal gastrectomy. With the continuous advancement of minimally invasive techniques, experienced centers and teams can perform digestive tract reconstruction under total laparoscopy. In the future, more high-quality studies are expected to provide evidence-based medical evidence for AEG's surgical treatment decisions.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Gastrectomia/métodos , Humanos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
11.
Zhonghua Wai Ke Za Zhi ; 60(9): 813-818, 2022 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-36058706

RESUMO

In recent years, adenocarcinoma of esophagogastric junction (AEG) has received increased attention from the academic community. However, the esophagogastric junction (EGJ) straddles two anatomical regions: the thoracic cavity and the abdominal cavity. The histological features of the EGJ are different from those of the esophagus and stomach. There are general disagreements among the related disciplines regarding the definition and classification of AEG. By summarizing the views of different disciplines, including endoscopy, radiography, and pathology, a more comprehensive definition of the EGJ was formulated in the Japanese Classification of Gastric Carcinoma (the 15th edition), and the principle of endoscopic diagnostic priority was established. In recent years, with the development of physiological and anatomical studies, the EGJ has gradually expanded conceptually into a complex functional anatomical region covering the distal esophagus to the proximal stomach. The venous and lymphatic vessels in the EGJ are characterized by bidirectional flow, which is an important anatomical basis for the invasion and metastasis patterns of tumors in this region. The clinical practice of EGJ cancer has been promoted by the creation of Nishi and Siewert classification systems. With the support of a series of clinical studies for its scientificity and effectiveness, the Siewert classification is widely accepted by the international community, and successively introduced into major international practice guidelines. In general, the staging and management of Siewert Ⅰ and Ⅱ AEG are recommended as esophageal cancer, while Siewert Ⅲ AEG is recommended for gastric cancer. However, in the Japanese guidelines for the treatment of esophageal and gastric cancers, the Nishi classification is still used to define and classify EGJ cancer. Recent year, a Chinese consensus on the surgical treatment of AEG was formulated by multidisciplinary experts. The main controversies were summarized in the consensus, and proposals that incorporate the domestic situation were also presented. At present, only by returning to the basic anatomical and physiological perspectives, strengthening multidisciplinary communication and cooperation, and with the help of emerging bioinformatics, digital, and material technology, can it be possible to get out of the dilemma faced by traditional AEG classification and staging system.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Humanos , Neoplasias Gástricas/cirurgia
12.
Zhonghua Wai Ke Za Zhi ; 60(9): 846-852, 2022 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-36058711

RESUMO

Objective: To compare the prognostic influence and postoperative pathology of different comprehensive treatment models for adenocarcinoma of esophagogastric junction. Methods: Between January 2012 and December 2017, a total of 219 patients with adenocarcinoma of esophagogastric junction underwent surgery in Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute and were enrolled in this study. The clinicopathological data of these patients were collected. The patients were categorized into 3 groups according to different treatment models: surgery-first group, neoadjuvant chemotherapy (NAC) group and neoadjuvant chemoradiotherapy (nCRT) group. A trimatch propensity score analysis was applied to control potential confounders among the three groups by using R language software. A total of 7 covariates including gender, age, comorbidity, body mass index, clinical T stage, clinical N stage and Siewert type were included, and the caliper value was taken as 0.2. After matching, a total of 87 patients were included for analysis with 27 patients for each group. There were 82 males and 5 females, with a median age of 63 years (range: 38 to 76 years). The effect of preoperative treatment on postoperative tumor pathology among the three different comprehensive treatment models was explored by χ2 test, ANOVA or Wilcoxon rank sum test. Mann-Whitney U test or χ2 test were used to undergo pairwise comparisons. Kaplan-Meier method and Log-rank test were used to analyze the overall survival and progression-free survival. Results: The proportion of vascular embolism in the surgery-first group was 72.4% (21/29), which was significantly higher than NAC group (37.9% (11/29), χ2=6.971, P=0.008) and nCRT group (6.9% (2/29), χ2=26.696, P<0.01). The proportions of pathological T3-4 stage in nCRT group and NAC group were 55.2% (16/29) and 62.1% (18/29), respectively, which were significantly lower than the surgery-first group (93.1% (27/29), χ2=10.881, P=0.001; χ2=8.031, P=0.005). Compared with the NAC group (55.2% (16/29), χ2=6.740, P=0.009) and nCRT group (31.0% (9/29), χ2=18.196, P<0.01), the proportion of lymph node positivity 86.2% (25/29) were significantly higher in the surgery-first group. The 5-year overall survival rates were 62.1%, 68.6% and 41.4% for the surgery-first group, NAC group and nCRT group, respectively (χ2=4.976, P=0.083). The 5-year progression-free survival rates were 61.7%, 65.1% and 41.1% for the surgery-first group, NAC group and nCRT group, respectively. The differences in overall survival (χ2=4.976, P=0.083) and progression-free survival (χ2=4.332, P=0.115) among the three groups were nonsignificant. Conclusions: Postoperative pathology is significantly different among the three groups. Neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy could decrease the proportions of vascular embolism, pathological T3-4 stage and lymph node positivity to achieve local tumor control. The prognosis of overall survival and progression-free survival are not significantly different among the three groups.


Assuntos
Adenocarcinoma , Junção Esofagogástrica , Adenocarcinoma/patologia , Adulto , Idoso , Estudos de Coortes , Junção Esofagogástrica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Pontuação de Propensão
13.
Zhonghua Wai Ke Za Zhi ; 60(9): 853-859, 2022 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-36058712

RESUMO

Objective: To examine the long term outcome of splenic hilar lymphadenectomy (SHL) for locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG) with a tumor diameter ≥4 cm. Methods: A total of 489 locally advanced Siewert type Ⅱ and Ⅲ AEG patients with a tumor diameter ≥4 cm who underwent radical resection from January 2010 to April 2016 were included. There were 383 males and 106 females. There were 225 patients aged≥65 years and 264 patients aged <65 years. SHL was conducted in 270 patients(SHL group). Wilcoxon rank-sum test or χ2 test were conducted for inter-group comparison. Cox proportional hazard regression was used to analyze the long term outcome of SHL and the prognosis factors of overall survival. Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test. Results: Followed-up to April 2021,the median follow-up time was 78.0 months (range: 74.0 to 85.0 months), the follow-up rate was 95.5%(467/489). The splenic hilar lymphnode metastasis rate of the SHL group was 12.6% (34/270). Younger patients (<65 years old), less complications, higher proportion of patients received adjuvant chemotherapy were demonstrated in the SHL group (χ2: 5.644 to 6.744, all P<0.05). Multivariate analysis showed that SHL was the independent prognosis factor of overall survival for patients with Siewert type Ⅱ and Ⅲ AEG and a tumor diameter≥4 cm (HR=0.68, 95%CI: 0.52 to 0.88, P=0.004) along with preoperative CA19-9, pathological T stage, pathological N stage, adjuvant chemotherapy and postoperative complication. Further subgroup analysis demonstrated that the SHL group had better 5-year overall survival than non-SHL group (62.4% vs. 39.2%, χ2=17.983, P=0.006) in Siewert type Ⅲ AEG rather than in Siewert type Ⅱ AEG(57.3% vs. 53.7%, χ2=3.031, P=0.805). Conclusion: In experienced center, splenic hilar lymphadenectomy can improve the prognosis of Siewert type Ⅲ AEG with a tumor diameter ≥4 cm.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Neoplasias Esofágicas , Junção Esofagogástrica/cirurgia , Feminino , Humanos , Excisão de Linfonodo/métodos , Metástase Linfática/patologia , Masculino , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Análise de Sobrevida
14.
Acta Crystallogr D Struct Biol ; 78(Pt 9): 1143-1155, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36048154

RESUMO

Phthalonitrile derivatives are generally reported to crystallize in space groups P21/c and P1 in the literature. In this study, 7-hydroxy-4,8-dimethyl-3-pentylcoumarin (2) and its phthalonitrile derivative (2d) were crystallized; 2d crystallized in the rare trigonal space group R3. In the phthalonitrile derivative (2d), weak C-H...O hydrogen-bonding interactions promoted the formation of supramolecular double helices, and these supramolecular P and M double helices came together to form a honeycomb-like architectural motif involving one-dimensional tubular channels. In silico molecular-docking studies were performed to support the experimental processes and the results agree with each other. In vitro studies of compounds 2 and 2d were performed in LoVo colorectal adenocarcinoma and CCD18Co healthy human cell lines using flow cytometry. For compounds 2 and 2d, there was a statistically significant increase (p < 0.001) in both early and late apoptosis with respect to the control in a dose-dependent manner.


Assuntos
Adenocarcinoma , Neoplasias Colorretais , Adenocarcinoma/tratamento farmacológico , Neoplasias Colorretais/tratamento farmacológico , Cumarínicos/farmacologia , Cristalografia por Raios X , Humanos , Hidrogênio
15.
Chirurgia (Bucur) ; 117(4): 377-384, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049094

RESUMO

Pancreatico-duodenectomy (PD) is the single hope for long-term survival in a patient with pancreatic head ductal adenocarcinoma (PDAC). Unfortunately, even after curative intent PD, the long-term survival of patients with PDAC remains under expectations, with high recurrence rates, including the loco-regional ones. Positive resection margins after resection of PDAC are frequent, and they have a detrimental effect on both recurrence and long-term survival rates, particularly the R1 (direct) ones, toward the mesopancreas. In the last years, there were made increased efforts by surgeons to introduce in clinical practice several technical refinements to the standard technique of PD better to resect the tumor, including an accurate lymph node dissection, hoping to increase the rate of negative resection margins, to decrease local recurrence rates and to improve prognosis. Furthermore, to extend the number of patients with resectable disease, a few surgical techniques were also intended to convert to resectability the patients with the regional disease (i.e., anatomical borderline resectable and locally advanced PDAC) in the context of multimodal therapies, particularly neoadjuvant therapies. With this, we briefly discuss a few technical refinements addressing the resection time of PD, like the artery-first approaches and the Triangle operation. Both surgical techniques aim for better clearance of the retroperitoneal space for nerves, lymphatic nodes, and vessels, including total mesopancreas excision.


Assuntos
Adenocarcinoma , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Artérias/cirurgia , Carcinoma Ductal Pancreático/cirurgia , Humanos , Margens de Excisão , Pancreaticoduodenectomia/métodos , Resultado do Tratamento
16.
Chirurgia (Bucur) ; 117(4): 399-406, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049096

RESUMO

Pancreatic adenocarcinoma is a very aggressive tumor with a low overall survival rate. The prognostic and the treatment of this disease are strongly interconnected and highly dependent on the resectability criteria of the tumor, surgical excision being the golden standard. For local advance disease or for unresectable tumors, with or without metastasis we can take into consideration as adjuvant therapy, together with chemotherapy, the radiofrequency ablation or stereotactic ablation radiotherapy of the solid tumor mass. This article is a narrative review that aims to describe these two interventional techniques: radiofrequency ablation and stereotactic ablation radiotherapy. We will discuss the techniques themselves, benefits that they bring and also, about the possible complications that can appear when using them in the management of pancreatic cancer.


Assuntos
Adenocarcinoma , Ablação por Cateter , Neoplasias Pancreáticas , Adenocarcinoma/cirurgia , Ablação por Cateter/métodos , Terapia Combinada , Humanos , Neoplasias Pancreáticas/cirurgia , Resultado do Tratamento
17.
Chirurgia (Bucur) ; 117(4): 407-414, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049097

RESUMO

Pancreatic ductal adenocarcinoma (PDAC) is characterized by high heterogeneity; thus, even after a curative intent surgery, there is significant variability in the survival of patients, reflecting different biological behaviors. The selection of proper, personalized therapy for each patient with resectable PDAC, in multimodal therapy, by an experienced multidisciplinary team is of utmost importance to get maximal clinical benefit avoiding potentially harmful treatments. Identifications of patients with resectable PDAC that would benefit from surgical resections in the context of multimodal therapy remain a topic of interest for clinical practice. To improve PDAC patient outcomes, a significant step forward would be the integration of the molecular sub-types in the clinical decision-making between upfront surgery versus neoadjuvant treatment. Successful integration of the preoperative knowledge of the subtype of PDAC can properly guide this treatment selection to further improve patient outcomes. In this review, we present an overview of the current knowledge on the role of molecular subtyping in surgical decisions for PDAC patients.


Assuntos
Adenocarcinoma , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Adenocarcinoma/cirurgia , Carcinoma Ductal Pancreático/genética , Carcinoma Ductal Pancreático/cirurgia , Terapia Combinada , Humanos , Terapia Neoadjuvante , Pancreatectomia , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/cirurgia , Resultado do Tratamento
18.
Chirurgia (Bucur) ; 117(4): 431-436, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049100

RESUMO

Background: Pancreatic adenocarcinoma is still considered as one of the most aggressive cancers with low percentages of respectability, despite recent advances in diagnosis. Assessment of preoperative inflammatory markers can increase the rates of resectability. Methods: Patients with potentially resectable pancreatic adenoinvesticarcinoma in a single pancreatic unit were included. Ninety-six patient during a one year period were eligible for analysis. Results: CRP, d-dimers, and fibrinogen levels were similar between the two groups. On the contrary, there were statistically significant differences regarding the prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR). Conclusions: inflammatory markers can act as an additional tool in predicting resectability in patients with pancreatic adenocarcinoma.


Assuntos
Adenocarcinoma , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Adenocarcinoma/cirurgia , Biomarcadores , Carcinoma Ductal Pancreático/cirurgia , Humanos , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
19.
Chirurgia (Bucur) ; 117(4): 454-462, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049103

RESUMO

Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic tumor, known for an aggressive evolution. Intraductal papillary mucinous neoplasm (IPMN) is a rare pancreatic tumor, considered a premalignant lesion with the possibility of carcinogenesis towards PDAC. The clinical, surgical and histopathological particularities of the association between PDAC and IPMN are yet unknown, further research being needed. Methods: We have conducted a retrospective descriptive study, on a nine-year period (2012-2020), with the aim of comparing the characteristics of patients that underwent curative surgical interventions for solitary PDAC and PDAC associated to IPMN. Results: Fifteen patients with PDAC associated with IPMN (Group 1) and 386 patients with solitary PDAC (Group 2) were included in our study. Group 1 had a younger average age (61.8 years) compared to Group 2 (63.89 years). Total pancreatectomy was more frequently performed for Group 1 than Group 2 (33.33% vs 12.43%). Group 1 had a higher percentage of cases with positive perineural, perilymphatic and perivascular invasion. Group 1 registered a worse overall survival, as well as a worse short-time survival compared to Group 2. Conclusions: PDAC associated to IPMN registers distinct epidemiological, clinical and histopathological characteristics compared to solitary PDAC.


Assuntos
Adenocarcinoma Mucinoso , Adenocarcinoma , Carcinoma Ductal Pancreático , Neoplasias Intraductais Pancreáticas , Neoplasias Pancreáticas , Adenocarcinoma/patologia , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Carcinoma Ductal Pancreático/complicações , Carcinoma Ductal Pancreático/cirurgia , Humanos , Pessoa de Meia-Idade , Neoplasias Intraductais Pancreáticas/complicações , Neoplasias Intraductais Pancreáticas/cirurgia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
20.
Chirurgia (Bucur) ; 117(4): 486-492, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36049107

RESUMO

Pancreatic cancer remains one of the biggest challenges in oncology, as most patients are diagnosed in a stage of regional lymphatic or systemic spread of the disease. 10% of the patients present with peritoneal carcinomatosis upon diagnosis. In the past decades, cytoreductive surgery (CRS) combined with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) has been developed and presents a new, individualized treatment option for patients with peritoneal disseminated cancer. This case report presents the case of a 39-year-old male with the initial diagnosis of a carcinoma of the pancreatic tail with localized peritoneal carcinomatosis. As an individualized approach, neoadjuvant chemotherapy was recommended with an option for a second exploration. Re-Staging revealed a reduction in tumor size. Cytoreductive surgery (CRS) including a distal splenopancreatectomy was performed and followed by HIPEC. Postoperatively, the patient developed a clinically relevant pancreatic fistula, however recovered and was able to receive adjuvant chemotherapy. Taken together, in pancreatic cancer with localized peritoneal carcinomatosis CRS and HIPEC are a valid option in highly selective cases with potential extended overall survival and an acceptable quality of life.


Assuntos
Adenocarcinoma , Hipertermia Induzida , Neoplasias Pancreáticas , Neoplasias Peritoneais , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia do Câncer por Perfusão Regional , Terapia Combinada , Humanos , Quimioterapia Intraperitoneal Hipertérmica , Masculino , Pâncreas , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Peritoneais/tratamento farmacológico , Qualidade de Vida , Taxa de Sobrevida , Resultado do Tratamento
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