BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic ...BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Survival analysis revealed a significant difference in OS between different immune-nutritional groups(PNI:75 mo vs 42 mo,P=0.001;CONUT:69 mo vs 48 mo,P=0.033;NPS:77 mo vs 40 mo,P<0.001).CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC,in which the NPS system has relatively effective predictive performance.展开更多
AIM:To evaluate whether granulocyte colony-stimulating factor receptor(G-CSFR)expression before preoperative irradiation can predict the radiosensitivity of rectal cancer.METHODS:The expression of G-CSFR was examined,...AIM:To evaluate whether granulocyte colony-stimulating factor receptor(G-CSFR)expression before preoperative irradiation can predict the radiosensitivity of rectal cancer.METHODS:The expression of G-CSFR was examined,using immunohistochemistry,in biopsy specimens from126 patients with locally advanced rectal adenocarcinoma before preoperative irradiation.Radiosensitivity was then evaluated according to the Rectal Cancer Regression Grading.Endoscopic inspection was used to detect the tumor area in each patient.General patient information,such as age,gender,lymph node status,tumor size and degree of differentiation was recorded.A statistical analysis was then performed to evaluate the correlation between clinical or pathological parameters and G-CSFR expression in tumors.RESULTS:According to endoscopic inspection,the tumor area ranged from 4 to 48 cm2(median,15 cm2).Positive G-CSFR immunoreactions(G-CSFR+)were observed in 85 specimens,and negative(G-CSFR-)in 41.No significant differences were found in age,gender,tumor invasion,lymph node status and tumor size between G-CSFR+and G-CSFR-patients.G-CSFR expression was positively correlated with poor radiotherapy response(58.8%vs 75.6%,P=0.014,r=0.219).The proportion of well-differentiated tumors in G-CSFR+and G-CSFR-patients was 24.7%and 36.6%,respectively.Sphincter preservation was observed in 57.6%of G-CSFR+patients and 78.5%of G-CSFR-patients.Significant correlations were found between G-CSFR expression and tumor differentiation(24.7%vs 36.6%,P=0.019,r=0.210),as well as sphincter preservation(57.6%vs78.5%,P=0.044,r=0.180).CONCLUSION:The expression of G-CSFR before preoperative irradiation may predict the radiosensitivity of rectal cancer.展开更多
Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A re...Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A renoportal end-to-end anastomosis be- tween the left renal vein and the distal end of the portal vein was performed. Two vascular end-to-side anastomoses between the donor portal vein and recip- ient inferior vena cava, and between the donor aortic segment including the celiac and superior mesenteric, and left renal arteries and recipient abdominal aorta were carried out. Pancreas exocrine secretion drain- age was established with duodenocystostomy. Ureter- ostomosis of the graft was performed. Urine amylase level, fasting blood glucose and urine volumes of kid- ney allograft were monitored, and pathological chan- ges of graft were observed. Results: Of 15 recipients, 2 died of disturbance of in- ternal environment and anastomotic bleeding, re- spectively. Satisfactory results were obtained in the remaining 13 recipients. The changes of urine amyl- ase concentration were prior to those of fasting blood glucose and urine volumes of kidney allograft. The degree of rejection of the kidney allograft was more severe than that of the pancreas and duodenum al- lograft. Conclusions: Urine amylase is the early marker of a- cute rejection in SPKT with bladder drainage of pan- creatic exocrine secretion. The pathological change of kidney allograft is most significant in SPKT.展开更多
基金Supported by National Natural Science Foundation of China,No.81871946 and No.82072708Suzhou Medical Key Discipline,No.SZXK202109+1 种基金Suzhou Clinical Key Diseases Project,No.LCZX202111Project of Gusu School of Nanjing Medical University,No.GSKY20210233.
文摘BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Survival analysis revealed a significant difference in OS between different immune-nutritional groups(PNI:75 mo vs 42 mo,P=0.001;CONUT:69 mo vs 48 mo,P=0.033;NPS:77 mo vs 40 mo,P<0.001).CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC,in which the NPS system has relatively effective predictive performance.
文摘AIM:To evaluate whether granulocyte colony-stimulating factor receptor(G-CSFR)expression before preoperative irradiation can predict the radiosensitivity of rectal cancer.METHODS:The expression of G-CSFR was examined,using immunohistochemistry,in biopsy specimens from126 patients with locally advanced rectal adenocarcinoma before preoperative irradiation.Radiosensitivity was then evaluated according to the Rectal Cancer Regression Grading.Endoscopic inspection was used to detect the tumor area in each patient.General patient information,such as age,gender,lymph node status,tumor size and degree of differentiation was recorded.A statistical analysis was then performed to evaluate the correlation between clinical or pathological parameters and G-CSFR expression in tumors.RESULTS:According to endoscopic inspection,the tumor area ranged from 4 to 48 cm2(median,15 cm2).Positive G-CSFR immunoreactions(G-CSFR+)were observed in 85 specimens,and negative(G-CSFR-)in 41.No significant differences were found in age,gender,tumor invasion,lymph node status and tumor size between G-CSFR+and G-CSFR-patients.G-CSFR expression was positively correlated with poor radiotherapy response(58.8%vs 75.6%,P=0.014,r=0.219).The proportion of well-differentiated tumors in G-CSFR+and G-CSFR-patients was 24.7%and 36.6%,respectively.Sphincter preservation was observed in 57.6%of G-CSFR+patients and 78.5%of G-CSFR-patients.Significant correlations were found between G-CSFR expression and tumor differentiation(24.7%vs 36.6%,P=0.019,r=0.210),as well as sphincter preservation(57.6%vs78.5%,P=0.044,r=0.180).CONCLUSION:The expression of G-CSFR before preoperative irradiation may predict the radiosensitivity of rectal cancer.
基金This project was supported by a grant from the Science Commission of Jiangsu Prorince (No.BS99061).
文摘Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A renoportal end-to-end anastomosis be- tween the left renal vein and the distal end of the portal vein was performed. Two vascular end-to-side anastomoses between the donor portal vein and recip- ient inferior vena cava, and between the donor aortic segment including the celiac and superior mesenteric, and left renal arteries and recipient abdominal aorta were carried out. Pancreas exocrine secretion drain- age was established with duodenocystostomy. Ureter- ostomosis of the graft was performed. Urine amylase level, fasting blood glucose and urine volumes of kid- ney allograft were monitored, and pathological chan- ges of graft were observed. Results: Of 15 recipients, 2 died of disturbance of in- ternal environment and anastomotic bleeding, re- spectively. Satisfactory results were obtained in the remaining 13 recipients. The changes of urine amyl- ase concentration were prior to those of fasting blood glucose and urine volumes of kidney allograft. The degree of rejection of the kidney allograft was more severe than that of the pancreas and duodenum al- lograft. Conclusions: Urine amylase is the early marker of a- cute rejection in SPKT with bladder drainage of pan- creatic exocrine secretion. The pathological change of kidney allograft is most significant in SPKT.
