Objective: Positive peritoneal lavege cytology(CY1) gastric cancer is featured by dismal prognosis, with high risks of peritoneal metastasis. However, there is a lack of evidence on pathogenic mechanism and signature ...Objective: Positive peritoneal lavege cytology(CY1) gastric cancer is featured by dismal prognosis, with high risks of peritoneal metastasis. However, there is a lack of evidence on pathogenic mechanism and signature of CY1and there is a continuous debate on CY1 therapy. Therefore, exploring the mechanism of CY1 is crucial for treatment strategies and targets for CY1 gastric cancer.Methods: In order to figure out specific driver genes and marker genes of CY1 gastric cancer, and ultimately offer clues for potential marker and risk assessment of CY1, 17 cytology-positive gastric cancer patients and 31matched cytology-negative gastric cancer patients were enrolled in this study. The enrollment criteria were based on the results of diagnostic laparoscopy staging and cytology inspection of exfoliated cells. Whole exome sequencing was then performed on tumor samples to evaluate genomic characterization of cytology-positive gastric cancer.Results: Least absolute shrinkage and selection operator(LASSO) algorithm identified 43 cytology-positive marker genes, while Mut Sig CV identified 42 cytology-positive specific driver genes. CD3G and CDKL2 were both driver and marker genes of CY1. Regarding mutational signatures, driver gene mutation and tumor subclone architecture, no significant differences were observed between CY1 and negative peritoneal lavege cytology(CY0).Conclusions: There might not be distinct differences between CY1 and CY0, and CY1 might represent the progression of CY0 gastric cancer rather than constituting an independent subtype. This genomic analysis will thus provide key molecular insights into CY1, which may have a direct effect on treatment recommendations for CY1and CY0 patients, and provides opportunities for genome-guided clinical trials and drug development.展开更多
Although many studies have focused on the preoperative risk factors of anastomotic leakage after colorectal surgery(CAL), postoperative delay in diagnosis is common and harmful. This review provides a systematic overv...Although many studies have focused on the preoperative risk factors of anastomotic leakage after colorectal surgery(CAL), postoperative delay in diagnosis is common and harmful. This review provides a systematic overview of all available literature on diagnostic tools used for CAL. A systematic search of literature was undertaken using Medline, Embase, Cochrane and Webof-Science libraries. Articles were selected when a diagnostic or prediction tool for CAL was described and tested. Two reviewers separately assessed the eligibility and level of evidence of the papers. Sixty-nine articles were selected(clinical methods: 11, laboratory tests: 12, drain fluid analysis: 12, intraoperative techniques:22, radiology: 16). Clinical scoring leads to early awareness of probability of CAL and reduces delay of diagnosis. C-reactive protein measurement at postoperative day 3-4 is helpful. CAL patients are characterized by elevated cytokine levels in drain fluid in the very early postoperative phase in CAL patients. Intraoperative testing using the air leak test allows intraoperative repair of the anastomosis. Routine contrast enema is not recommended. If CAL is clinically suspected, rectal contrast-computer tomography is recommended by a few studies. In many studies a "no-test" control group was lacking, furthermore no golden standard for CAL is available. These two factors contributed to a relatively low level of evidence in the majority of the papers. This paper provides a systematic overview of literature on the available tools for diagnosing CAL. The study shows that colorectal surgery patients could benefit from some diagnostic interventions that can easily be performed in daily postoperative care.展开更多
Since the first outbreak of the coronavirus disease(COVID-19)in the winter of 2019,this pandemic has resulted in significant global social and economic disruption,as well as global public health and medical crises[1]....Since the first outbreak of the coronavirus disease(COVID-19)in the winter of 2019,this pandemic has resulted in significant global social and economic disruption,as well as global public health and medical crises[1].Climate,weather conditions,and even latitude have now been acknowledged to be directly associated with COVID-19 outbreaks[2-4].It was reported that 60%of the confirmed cases of COVID-19 occurred in areas where the air temperature ranged from 5℃to 15℃[4].These earlier research results strongly implied that the COVID-19 pandemic might spread cyclically and outbreaks might recur in large cities in the mid-latitudes(for example,the northern part of China)in autumn 2020[4],which has now been confirmed by the third wave of the pandemic.With quarantines and other restrictive legislations and control measures being put in action to contain the spread of the disease[5],the pandemic has also manifested additional obstacles in the treatment of other diseases.For example,a median dose delay of 14(6-20)days was found in patients who received one cycle of gastric chemotherapy in our department from the first outbreak till the spring festival of 2020(n=79).展开更多
基金supported by the National Natural Science Foundation of China (No. U20A20371)the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (No. D171100006517004)+2 种基金Beijing Municipal Administration of Hospitals’ Youth Program (QML20191103)Clinical Medicine Plus X-Young Scholars Project, Peking Universitythe Fundamental Research Funds for the Central Universities and the Science Foundation of Peking University Cancer Hospital。
文摘Objective: Positive peritoneal lavege cytology(CY1) gastric cancer is featured by dismal prognosis, with high risks of peritoneal metastasis. However, there is a lack of evidence on pathogenic mechanism and signature of CY1and there is a continuous debate on CY1 therapy. Therefore, exploring the mechanism of CY1 is crucial for treatment strategies and targets for CY1 gastric cancer.Methods: In order to figure out specific driver genes and marker genes of CY1 gastric cancer, and ultimately offer clues for potential marker and risk assessment of CY1, 17 cytology-positive gastric cancer patients and 31matched cytology-negative gastric cancer patients were enrolled in this study. The enrollment criteria were based on the results of diagnostic laparoscopy staging and cytology inspection of exfoliated cells. Whole exome sequencing was then performed on tumor samples to evaluate genomic characterization of cytology-positive gastric cancer.Results: Least absolute shrinkage and selection operator(LASSO) algorithm identified 43 cytology-positive marker genes, while Mut Sig CV identified 42 cytology-positive specific driver genes. CD3G and CDKL2 were both driver and marker genes of CY1. Regarding mutational signatures, driver gene mutation and tumor subclone architecture, no significant differences were observed between CY1 and negative peritoneal lavege cytology(CY0).Conclusions: There might not be distinct differences between CY1 and CY0, and CY1 might represent the progression of CY0 gastric cancer rather than constituting an independent subtype. This genomic analysis will thus provide key molecular insights into CY1, which may have a direct effect on treatment recommendations for CY1and CY0 patients, and provides opportunities for genome-guided clinical trials and drug development.
文摘Although many studies have focused on the preoperative risk factors of anastomotic leakage after colorectal surgery(CAL), postoperative delay in diagnosis is common and harmful. This review provides a systematic overview of all available literature on diagnostic tools used for CAL. A systematic search of literature was undertaken using Medline, Embase, Cochrane and Webof-Science libraries. Articles were selected when a diagnostic or prediction tool for CAL was described and tested. Two reviewers separately assessed the eligibility and level of evidence of the papers. Sixty-nine articles were selected(clinical methods: 11, laboratory tests: 12, drain fluid analysis: 12, intraoperative techniques:22, radiology: 16). Clinical scoring leads to early awareness of probability of CAL and reduces delay of diagnosis. C-reactive protein measurement at postoperative day 3-4 is helpful. CAL patients are characterized by elevated cytokine levels in drain fluid in the very early postoperative phase in CAL patients. Intraoperative testing using the air leak test allows intraoperative repair of the anastomosis. Routine contrast enema is not recommended. If CAL is clinically suspected, rectal contrast-computer tomography is recommended by a few studies. In many studies a "no-test" control group was lacking, furthermore no golden standard for CAL is available. These two factors contributed to a relatively low level of evidence in the majority of the papers. This paper provides a systematic overview of literature on the available tools for diagnosing CAL. The study shows that colorectal surgery patients could benefit from some diagnostic interventions that can easily be performed in daily postoperative care.
基金supported by the Summit Talent Plan(to JJ,No.DFL20181103)Young Scholar Program of Beijing Hospitals Authority(to ZW,No.QMS20191103).
文摘Since the first outbreak of the coronavirus disease(COVID-19)in the winter of 2019,this pandemic has resulted in significant global social and economic disruption,as well as global public health and medical crises[1].Climate,weather conditions,and even latitude have now been acknowledged to be directly associated with COVID-19 outbreaks[2-4].It was reported that 60%of the confirmed cases of COVID-19 occurred in areas where the air temperature ranged from 5℃to 15℃[4].These earlier research results strongly implied that the COVID-19 pandemic might spread cyclically and outbreaks might recur in large cities in the mid-latitudes(for example,the northern part of China)in autumn 2020[4],which has now been confirmed by the third wave of the pandemic.With quarantines and other restrictive legislations and control measures being put in action to contain the spread of the disease[5],the pandemic has also manifested additional obstacles in the treatment of other diseases.For example,a median dose delay of 14(6-20)days was found in patients who received one cycle of gastric chemotherapy in our department from the first outbreak till the spring festival of 2020(n=79).
基金supported by the National Natural Science Foundation of China(U20A20371)the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(D171100006517004)+3 种基金Beijing Municipal Administration of Hospitals’Youth Program(QML20191103)Clinical Medicine Plus X-Young Scholars Project,Peking Universitythe Fundamental Research Funds for the Central Universitiesthe Science Foundation of Peking University Cancer Hospital。
