Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per...Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.展开更多
AIM: To investigated the interaction between toll-like receptor 4 (TLR4)-activated hepatoma cells and macrophages in the induction of tumor-immune suppression mediated by CD4+CD25high family of transcription factor P3...AIM: To investigated the interaction between toll-like receptor 4 (TLR4)-activated hepatoma cells and macrophages in the induction of tumor-immune suppression mediated by CD4+CD25high family of transcription factor P3 (FOXP3) regulatory T cells (Tregs). METHODS: The proportion of FOXP3+ Tregs was identified in peripheral blood and tumor tissues of 60 hepatocellular carcinoma (HCC) patients. TLR4 expression was examined in tumor tissues and cell lines. The correlation was examined between FOXP3+ Tregs in peripheral blood and TLR4 expression of HCC tissues. Following activation of TLR4 in H22 murine hepatoma cells pre-incubated with lipopolysaccharide (LPS) and co-cultured with macrophage cell line RAW246.7, the synthesis of cytokines tumor necrosis factor-α, CCL22, and interleukin (IL)-10 by the two cell lines was detected and analyzed. RESULTS: FOXP3+ Tregs were enriched in tumor sites, and circulating FOXP3+ Tregs were increased in HCC patients in correlation with multiple tumor foci and up-regulated TLR4 expression in HCC tissues. Semi-quantitative analysis indicated that TLR4 was over-expressed in HCC compared with the matched normal tissues. Cell cultivation experiments indicated that the mRNAs of IL-10 and CCL22 were significantly up-regulated in the RAW246.7 cell line when co-cultured with LPS preincubated H22 cells. CONCLUSION: In hepatoma cell lines, TLR4 may indirectly facilitate the recruitment of Tregs to the tumor site and promote intrahepatic metastasis through its interaction with macrophages.展开更多
AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats un...AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett's esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC.展开更多
Background:Although a number of technical problems and donor safety issues associated with living donor liver transplantation(LDLT)have been resolved,some initial clinical studies showed an increased risk of hepatocel...Background:Although a number of technical problems and donor safety issues associated with living donor liver transplantation(LDLT)have been resolved,some initial clinical studies showed an increased risk of hepatocellular car cinoma(HCC)recurrence in LDLT.This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation(DDLT).Methods:After systematic retrievals of studies about LDLT and DDLT for HCC,articles were selected with a rationale of emphasizing inter-group comparability.Results from multivariate analyses were combined and discussed together with univariate analyses.In subgroup analysis,the impact of organ allocation policy was taken into consideration.Results:Seven articles were included in the meta-analysis.Overall,a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group(P=0.01).The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients.Conclusions:An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found.The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out,which may provide a possible explanation for the high rates of HCC recurrence.展开更多
To grade Small Hepatocellular Car Cinoma(SHCC)using texture analysis of CT images,we retrospectively analysed 68 cases of Grade II(medium-differentiation)and 37 cases of Grades III and IV(high-differentiation).The gra...To grade Small Hepatocellular Car Cinoma(SHCC)using texture analysis of CT images,we retrospectively analysed 68 cases of Grade II(medium-differentiation)and 37 cases of Grades III and IV(high-differentiation).The grading scheme follows 4 stages:(1)training a Super Resolution Generative Adversarial Network(SRGAN)migration learning model on the Lung Nodule Analysis 2016 Dataset,and employing this model to reconstruct Super Resolution Images of the SHCC Dataset(SR-SHCC)images;(2)designing a texture clustering method based on Gray-Level Co-occurrence Matrix(GLCM)to segment tumour regions,which are Regions Of Interest(ROIs),from the original and SR-SHCC images,respectively;(3)extracting texture features on the ROIs;(4)performing statistical analysis and classifications.The segmentation achieved accuracies of 0.9049 and 0.8590 in the original SHCC images and the SR-SHCC images,respectively.The classification achived an accuracy of 0.838 and an Area Under the ROC Curve(AUC)of 0.84.The grading scheme can effectively reduce poor impacts on the texture analysis of SHCC ROIs.It may play a guiding role for physicians in early diagnoses of medium-differentiation and high-differentiation in SHCC.展开更多
To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cas...To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS展开更多
文摘Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.
文摘AIM: To investigated the interaction between toll-like receptor 4 (TLR4)-activated hepatoma cells and macrophages in the induction of tumor-immune suppression mediated by CD4+CD25high family of transcription factor P3 (FOXP3) regulatory T cells (Tregs). METHODS: The proportion of FOXP3+ Tregs was identified in peripheral blood and tumor tissues of 60 hepatocellular carcinoma (HCC) patients. TLR4 expression was examined in tumor tissues and cell lines. The correlation was examined between FOXP3+ Tregs in peripheral blood and TLR4 expression of HCC tissues. Following activation of TLR4 in H22 murine hepatoma cells pre-incubated with lipopolysaccharide (LPS) and co-cultured with macrophage cell line RAW246.7, the synthesis of cytokines tumor necrosis factor-α, CCL22, and interleukin (IL)-10 by the two cell lines was detected and analyzed. RESULTS: FOXP3+ Tregs were enriched in tumor sites, and circulating FOXP3+ Tregs were increased in HCC patients in correlation with multiple tumor foci and up-regulated TLR4 expression in HCC tissues. Semi-quantitative analysis indicated that TLR4 was over-expressed in HCC compared with the matched normal tissues. Cell cultivation experiments indicated that the mRNAs of IL-10 and CCL22 were significantly up-regulated in the RAW246.7 cell line when co-cultured with LPS preincubated H22 cells. CONCLUSION: In hepatoma cell lines, TLR4 may indirectly facilitate the recruitment of Tregs to the tumor site and promote intrahepatic metastasis through its interaction with macrophages.
基金Supported by the Key Project of Clinical Medicine,Ministry of Health,No. 20012130
文摘AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett's esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC.
基金grants from the National Natural Science Foundation of China(No.71603272)National Science and Technology Major Project(No.2017ZX10203205-001-005).
文摘Background:Although a number of technical problems and donor safety issues associated with living donor liver transplantation(LDLT)have been resolved,some initial clinical studies showed an increased risk of hepatocellular car cinoma(HCC)recurrence in LDLT.This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation(DDLT).Methods:After systematic retrievals of studies about LDLT and DDLT for HCC,articles were selected with a rationale of emphasizing inter-group comparability.Results from multivariate analyses were combined and discussed together with univariate analyses.In subgroup analysis,the impact of organ allocation policy was taken into consideration.Results:Seven articles were included in the meta-analysis.Overall,a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group(P=0.01).The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients.Conclusions:An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found.The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out,which may provide a possible explanation for the high rates of HCC recurrence.
基金supported by the National Key R&D Program of China(No.2018YFC0807500)。
文摘To grade Small Hepatocellular Car Cinoma(SHCC)using texture analysis of CT images,we retrospectively analysed 68 cases of Grade II(medium-differentiation)and 37 cases of Grades III and IV(high-differentiation).The grading scheme follows 4 stages:(1)training a Super Resolution Generative Adversarial Network(SRGAN)migration learning model on the Lung Nodule Analysis 2016 Dataset,and employing this model to reconstruct Super Resolution Images of the SHCC Dataset(SR-SHCC)images;(2)designing a texture clustering method based on Gray-Level Co-occurrence Matrix(GLCM)to segment tumour regions,which are Regions Of Interest(ROIs),from the original and SR-SHCC images,respectively;(3)extracting texture features on the ROIs;(4)performing statistical analysis and classifications.The segmentation achieved accuracies of 0.9049 and 0.8590 in the original SHCC images and the SR-SHCC images,respectively.The classification achived an accuracy of 0.838 and an Area Under the ROC Curve(AUC)of 0.84.The grading scheme can effectively reduce poor impacts on the texture analysis of SHCC ROIs.It may play a guiding role for physicians in early diagnoses of medium-differentiation and high-differentiation in SHCC.
文摘To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS
