BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladd...BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.展开更多
BACKGROUND Phospholipase A2(PLA2)enzymes are pivotal in various biological processes,such as lipid mediator production,membrane remodeling,bioenergetics,and maintaining the body surface barrier.Notably,these enzymes p...BACKGROUND Phospholipase A2(PLA2)enzymes are pivotal in various biological processes,such as lipid mediator production,membrane remodeling,bioenergetics,and maintaining the body surface barrier.Notably,these enzymes play a significant role in the development of diverse tumors.AIM To systematically and comprehensively explore the expression of the PLA2 family genes and their potential implications in cholangiocarcinoma(CCA).METHODS We conducted an analysis of five CCA datasets from The Cancer Genome Atlas and the Gene Expression Omnibus.The study identified differentially expressed genes between tumor tissues and adjacent normal tissues,with a focus on PLA2G2A and PLA2G12B.Gene Set Enrichment Analysis was utilized to pinpoint associated pathways.Moreover,relevant hub genes and microRNAs for PLA2G2A and PLA2G12B were predicted,and their correlation with the prognosis of CCA was evaluated.RESULTS PLA2G2A and PLA2G12B were discerned as differentially expressed in CCA,manifesting significant variations in expression levels in urine and serum between CCA patients and healthy individuals.Elevated expression of PLA2G2A was correlated with poorer overall survival in CCA patients.Additionally,the study delineated pathways and miRNAs associated with these genes.CONCLUSION Our findings suggest that PLA2G2A and PLA2G12B may serve as novel potential diagnostic and prognostic markers for CCA.The increased levels of these genes in biological fluids could be employed as non-invasive markers for CCA,and their expression levels are indicative of prognosis,underscoring their potential utility in clinical settings.展开更多
基金Supported by Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17Shanghai East Hospital Clinical Research Project,No.DFLC2022019the Featured Clinical Discipline Project of Shanghai Pudong District,No.PWYts2021-06.
文摘BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.
基金Supported by the Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17Shanghai East Hospital Clinical Research Project,No.DFLC2022019and the Featured Clinical Discipline Project of Shanghai Pudong District,No.PWYts2021-06.
文摘BACKGROUND Phospholipase A2(PLA2)enzymes are pivotal in various biological processes,such as lipid mediator production,membrane remodeling,bioenergetics,and maintaining the body surface barrier.Notably,these enzymes play a significant role in the development of diverse tumors.AIM To systematically and comprehensively explore the expression of the PLA2 family genes and their potential implications in cholangiocarcinoma(CCA).METHODS We conducted an analysis of five CCA datasets from The Cancer Genome Atlas and the Gene Expression Omnibus.The study identified differentially expressed genes between tumor tissues and adjacent normal tissues,with a focus on PLA2G2A and PLA2G12B.Gene Set Enrichment Analysis was utilized to pinpoint associated pathways.Moreover,relevant hub genes and microRNAs for PLA2G2A and PLA2G12B were predicted,and their correlation with the prognosis of CCA was evaluated.RESULTS PLA2G2A and PLA2G12B were discerned as differentially expressed in CCA,manifesting significant variations in expression levels in urine and serum between CCA patients and healthy individuals.Elevated expression of PLA2G2A was correlated with poorer overall survival in CCA patients.Additionally,the study delineated pathways and miRNAs associated with these genes.CONCLUSION Our findings suggest that PLA2G2A and PLA2G12B may serve as novel potential diagnostic and prognostic markers for CCA.The increased levels of these genes in biological fluids could be employed as non-invasive markers for CCA,and their expression levels are indicative of prognosis,underscoring their potential utility in clinical settings.
