Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR wer...Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.展开更多
Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. T...Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.展开更多
BACKGROUND Anastomotic leakage(AL)is a fatal complication in patients with rectal cancer after undergoing anterior resection.However,the role of abdominal composition in the development of AL has not been studied.AIM ...BACKGROUND Anastomotic leakage(AL)is a fatal complication in patients with rectal cancer after undergoing anterior resection.However,the role of abdominal composition in the development of AL has not been studied.AIM To investigate the relationship between abdominal composition and AL in rectal cancer patients after undergoing anterior resection.METHODS A retrospective case-matched cohort study was conducted.Complete data for 78 patients with AL were acquired and this cohort was defined as the AL group.The controls were matched for the same sex and body mass index(±1 kg/m^(2)).Parameters related to abdominal composition including visceral fat area(VFA),subcutaneous fat area(SFA),subcutaneous fat thickness(SFT),skeletal muscle area(SMA),skeletal muscle index(SMI),abdominal circumference(AC),anterior to posterior diameter of abdominal cavity(APD),and transverse diameter of abdominal cavity(TD)were evaluated based on computed tomography(CT)images using the following Hounsfield Unit(HU)thresholds:SFA:-190 to-30,SMA:-29 to 150,and VFA:-150 to-20.The significance of abdominal compositionrelated parameters was quantified using feature importance analysis;an artificial intelligence method was used to evaluate the contribution of each included variable.RESULTS Two thousand two hundred and thirty-eight rectal cancer patients who underwent anterior resection from 2010 to 2020 in a large academic hospital were investigated.Finally,156 cases were enrolled in the study.Patients in the AL group showed longer operative time(225.03±55.29 vs 207.17±40.80,P=0.023),lower levels of preoperative hemoglobin(123.32±21.17 vs 132.60±16.31,P=0.003)and albumin(38.34±4.01 vs 40.52±3.97,P=0.001),larger tumor size(4.07±1.36 vs 2.76±1.28,P<0.001),and later cancer stage(P<0.001)compared to the controls.Patients who developed AL exhibited a larger VFA(125.68±73.59 vs 97.03±57.66,P=0.008)and a smaller APD(77.30±23.23 vs 92.09±26.40,P<0.001)and TD(22.90±2.23 vs 24.21±2.90,P=0.002)compared to their matched controls.Feature importance analysis revealed that TD,APD,and VFA were the three most important abdominal composition-related features.CONCLUSION AL patients have a higher visceral fat content and a narrower abdominal structure compared to matched controls.展开更多
Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies wit...Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies with location and size of tumour but GIST presenting with palpable abdominal mass is rare. We report a case of 38 years old male who presented with large abdominal lump. Computed tomography(CT) scan showed a large solid-cystic lesion encasing second part of duodenum and distal common bile duct. On CT differential diagnosis of Leiomyoma, Leiomyosarcoma and GIST were made. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient underwent pancreaticodudenectomy. Post-operative course was uneventful. Patient was started on Imatinib therapy post-operatively. No recurrence noted at six months follow up.展开更多
文摘Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.
文摘Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.
基金by the Local Ethical Committee of Tongji Hospital of Huazhong University of Science and Technology(Approval No.TJ-IRB20210719).
文摘BACKGROUND Anastomotic leakage(AL)is a fatal complication in patients with rectal cancer after undergoing anterior resection.However,the role of abdominal composition in the development of AL has not been studied.AIM To investigate the relationship between abdominal composition and AL in rectal cancer patients after undergoing anterior resection.METHODS A retrospective case-matched cohort study was conducted.Complete data for 78 patients with AL were acquired and this cohort was defined as the AL group.The controls were matched for the same sex and body mass index(±1 kg/m^(2)).Parameters related to abdominal composition including visceral fat area(VFA),subcutaneous fat area(SFA),subcutaneous fat thickness(SFT),skeletal muscle area(SMA),skeletal muscle index(SMI),abdominal circumference(AC),anterior to posterior diameter of abdominal cavity(APD),and transverse diameter of abdominal cavity(TD)were evaluated based on computed tomography(CT)images using the following Hounsfield Unit(HU)thresholds:SFA:-190 to-30,SMA:-29 to 150,and VFA:-150 to-20.The significance of abdominal compositionrelated parameters was quantified using feature importance analysis;an artificial intelligence method was used to evaluate the contribution of each included variable.RESULTS Two thousand two hundred and thirty-eight rectal cancer patients who underwent anterior resection from 2010 to 2020 in a large academic hospital were investigated.Finally,156 cases were enrolled in the study.Patients in the AL group showed longer operative time(225.03±55.29 vs 207.17±40.80,P=0.023),lower levels of preoperative hemoglobin(123.32±21.17 vs 132.60±16.31,P=0.003)and albumin(38.34±4.01 vs 40.52±3.97,P=0.001),larger tumor size(4.07±1.36 vs 2.76±1.28,P<0.001),and later cancer stage(P<0.001)compared to the controls.Patients who developed AL exhibited a larger VFA(125.68±73.59 vs 97.03±57.66,P=0.008)and a smaller APD(77.30±23.23 vs 92.09±26.40,P<0.001)and TD(22.90±2.23 vs 24.21±2.90,P=0.002)compared to their matched controls.Feature importance analysis revealed that TD,APD,and VFA were the three most important abdominal composition-related features.CONCLUSION AL patients have a higher visceral fat content and a narrower abdominal structure compared to matched controls.
文摘Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies with location and size of tumour but GIST presenting with palpable abdominal mass is rare. We report a case of 38 years old male who presented with large abdominal lump. Computed tomography(CT) scan showed a large solid-cystic lesion encasing second part of duodenum and distal common bile duct. On CT differential diagnosis of Leiomyoma, Leiomyosarcoma and GIST were made. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient underwent pancreaticodudenectomy. Post-operative course was uneventful. Patient was started on Imatinib therapy post-operatively. No recurrence noted at six months follow up.
