A biomimetic approach is used to generate a directed transversal transportation of micron-sized particles in liquids based on the principle of cilia-type arrays in coordinated motion. Rows of flaps mimicking planar ci...A biomimetic approach is used to generate a directed transversal transportation of micron-sized particles in liquids based on the principle of cilia-type arrays in coordinated motion. Rows of flaps mimicking planar cilia are positioned off-centre along an array of cavities covered with membranes that support the flaps. These membranes are deflected from a concave to a convex shape and vice versa by pneumatic actuation applying positive and negative pressures (relative to the ambient) inside the cavities. As a result, the flap on top of the membrane tilts to the left or right within such a pressure cycle, performing a beat stroke. Since each cavity can be addressed in the device individually and in rapid succession, waves of coordinated flap motion can be run along the wall. Such metachronal waves are generated and transport of particles along the cilia surface is achieved in both symplectic and antiplectic direction. It is shown that the initial tilt of the flaps relative to the wall-normal determines the direction of transport.展开更多
This paper presents a theoretical study of a non-linear rheological fluid transport in an axisymmetric tube by cilia. An attempt has been made to explain the role of cilia motion in the transport of fluid through the ...This paper presents a theoretical study of a non-linear rheological fluid transport in an axisymmetric tube by cilia. An attempt has been made to explain the role of cilia motion in the transport of fluid through the ductus efferent of the male reproductive tract. The Ostwald-de Waele power-law viscous fluid is considered to represent the rheological fluid. We analyze pumping by means of a sequence of cilia beats from rowto-row of cilia in a given row of cells and from one row of cells to the next(metachronal wave movement). For this purpose, we consider the conditions that the corresponding Reynolds number is small enough for inertial effects to be negligible, and the wavelengthto-diameter ratio is large enough so that the pressure can be considered uniform over the cross section. Analyses and computations of the fluid motion reveal that the time-average flow rate depends on ε, a non-dimensional measure involving the mean radius a of the tube and the cilia length. Thus, the flow rate significantly varies with the cilia length.Moreover, the flow rate has been reported to be close to the estimated value 6 × 10ml/h for human efferent ducts if ε is near 0.4. The estimated value was suggested by Lardner and Shack(Lardner, T. J. and Shack, W. J. Cilia transport. Bulletin of Mathematical Biology, 34, 325–335(1972)) for human based on the experimental observations of flow rates in efferent ducts of other animals, e.g., rat, ram, and bull. In addition, the nature of the rheological fluid, i.e., the value of the fluid index n strongly influences various flow-governed characteristics. An interesting feature of this paper is that the pumping improves the thickening behavior for small values of ε or in free pumping(?P = 0) and pumping(?P > 0) regions.展开更多
This study describes ciliary motion on the transport of fluids in human body with heat transfer. The mathematical model of the flow of a Jeffrey fluid in a tube of finite length is considered due to metachronal wave o...This study describes ciliary motion on the transport of fluids in human body with heat transfer. The mathematical model of the flow of a Jeffrey fluid in a tube of finite length is considered due to metachronal wave of cilia motion. Flow equations have been modeled and simplified using similarity variables. Exact solutions of the formulated problem have been obtained for velocity, temperature and pressure gradient and graphs for velocity, pressure rise pressure gradient and temperature profile have been plotted and studied for different values of specific physical parameters. Trapping phenomena and isotherms are presented at the end of the paper.展开更多
The aim of this study is to explain theoretically the role of ciliary motion on the transport of epididymal fluid through the ductus efferentes of the male reproductive track. For this purpose, a mathematical model ha...The aim of this study is to explain theoretically the role of ciliary motion on the transport of epididymal fluid through the ductus efferentes of the male reproductive track. For this purpose, a mathematical model has been developed for the flow of a non-Newtonian fluid in an axisymmetric tube due to metachronal wave of cilia motion for the more realistic consequences. Carreau viscous fluid model is considered to see the rheological effects on the pumping characteristics of the flow. Regular perturbation method has been employed to obtain the analytical expressions for the stream function, the velocity field and a relation between the pressure difference and the volume flow rate. It is found that the volume flow rate is influenced significantly by Weissenberg number We and the cilia length parameter ε. The computational results are presented graphically to see the effects of various physical parameters. Finally, the analysis is applied and compared with the observed value of the flow rate of spermatic fluid in the ductus efferentes of the male reproductive track. The volume flow rate is reported closed to the estimated value 6 × 10^-3 ml/h in the human ductus efferentes when We = 0.5 and e is near by 0.25.展开更多
BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple pri...BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.展开更多
BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study...BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study aims to investigate the application value of a combined machine learning(ML)based model based on the multiparameter magnetic resonance imaging for prediction of rectal metachronous liver metastasis(MLM).AIM To investigate the efficacy of radiomics based on multiparametric magnetic resonance imaging images of preoperative first diagnosed rectal cancer in predicting MLM from rectal cancer.METHODS We retrospectively analyzed 301 patients with rectal cancer confirmed by surgical pathology at Jingzhou Central Hospital from January 2017 to December 2023.All participants were randomly assigned to the training or validation queue in a 7:3 ratio.We first apply generalized linear regression model(GLRM)and random forest model(RFM)algorithm to construct an MLM prediction model in the training queue,and evaluate the discriminative power of the MLM prediction model using area under curve(AUC)and decision curve analysis(DCA).Then,the robustness and generalizability of the MLM prediction model were evaluated based on the internal validation set between the validation queue groups.RESULTS Among the 301 patients included in the study,16.28%were ultimately diagnosed with MLM through pathological examination.Multivariate analysis showed that carcinoembryonic antigen,and magnetic resonance imaging radiomics were independent predictors of MLM.Then,the GLRM prediction model was developed with a comprehensive nomogram to achieve satisfactory differentiation.The prediction performance of GLRM in the training and validation queue was 0.765[95%confidence interval(CI):0.710-0.820]and 0.767(95%CI:0.712-0.822),respectively.Compared with GLRM,RFM achieved superior performance with AUC of 0.919(95%CI:0.868-0.970)and 0.901(95%CI:0.850-0.952)in the training and validation queue,respectively.The DCA indicated that the predictive ability and net profit of clinical RFM were improved.CONCLUSION By combining multiparameter magnetic resonance imaging with the effectiveness and robustness of ML-based predictive models,the proposed clinical RFM can serve as an insight tool for preoperative assessment of MLM risk stratification and provide important information for individual diagnosis and treatment of rectal cancer patients.展开更多
BACKGROUND A significant association between increased age and an increased risk of metachronous gastric cancer(MGC)following curative endoscopic submucosal dissection(ESD)has previously been reported.AIM To determine...BACKGROUND A significant association between increased age and an increased risk of metachronous gastric cancer(MGC)following curative endoscopic submucosal dissection(ESD)has previously been reported.AIM To determine risk factors for the metachronous occurrence of early gastric cancer(EGC)in elderly individuals.METHODS This retrospective cohort study comprised 653 elderly patients(aged≥65 years)who underwent curative ESD for EGC between January 2014 and June 2020 at Nanjing Drum Tower Hospital.Comprehensive analyses were conducted to compare lifestyle habits,comorbidities,and Helicobacter pylori(H.pylori)infections as potential indicators.RESULTS During a median follow-up of 38 months,46 patients(7.0%,20.46/1000 person-years)developed MGC in the elderly cohort.The cumulative incidences of MGC at 2,3,and 5 years were 3.3%,5.3%,and 11.5%,respectively.In multivariate Cox regression analyses,the independent risk factors for MGC included metabolic dysfunctionassociated steatotic liver disease(MASLD)[hazard ratio(HR)=2.44,95%confidence interval(CI):1.15-5.17],persistent H.pylori infection(HR=10.38,95%CI:3.36-32.07),severe mucosal atrophy(HR=2.71,95%CI:1.45-5.08),and pathological differentiation of EGC(well/moderately differentiated vs poorly differentiated:HR=10.18,95%CI:1.30-79.65).Based on these risk factors,a risk stratification system was developed to categorize individuals into low(0-1 point),intermediate(2-3 points),and high(4-8 points)risk categories for MGC,with cumulative incidence rates of 12.3%,21.6%,and 45%,respectively.CONCLUSION Among elderly individuals,MASLD,persistent H.pylori infection,severe mucosal atrophy,and well/moderately differentiated EGC were associated with an increased risk of MGC.Elderly patients are recommended to adopt healthy lifestyle practices,and undergo regular endoscopic screening and H.pylori testing after curative ESD for EGC.展开更多
Rectal cancer is a major global health concern,and metachronous liver metastasis(MLM)significantly worsens patient prognosis.Advances in imaging and machine learning have led to the development of radiomics models,par...Rectal cancer is a major global health concern,and metachronous liver metastasis(MLM)significantly worsens patient prognosis.Advances in imaging and machine learning have led to the development of radiomics models,particularly those utilizing multiparametric magnetic resonance imaging,which are highly valuable in predicting MLM.These models analyze imaging features to provide insights that can aid clinical decision-making and potentially improve treatment outcomes and survival rates.However,realizing the full potential of radiomics models faces challenges in terms of accuracy,generalizability,and data depen-dency.This editorial comments on a study regarding radiomics prediction models for rectal cancer MLM published recently in the World Journal of Gastrointestinal Oncology,discusses the progress,challenges,and strategies for diagnostic models of MLM in rectal cancer,and proposes directions for future research.展开更多
BACKGROUND Multiple primary carcinoma(MPC)refers to two or more types of primary malignant tumors occurring simultaneously or sequentially in the same patient.Breast cancer is one of the most common malignant tumors a...BACKGROUND Multiple primary carcinoma(MPC)refers to two or more types of primary malignant tumors occurring simultaneously or sequentially in the same patient.Breast cancer is one of the most common malignant tumors affecting women.On the other hand,diffuse large B-cell lymphoma(DLBCL)is the most frequent form of non-Hodgkin’s lymphoma(NHL).In clinical practice,the simultaneous existence of metachronous primary breast cancer and lymphoma is rare.In this case,we highlight the significance of multidisciplinary management and advanced imaging techniques in the early identification and treatment of MPC cases.CASE SUMMARY In this study,we report a case of a 40-year-old female who was diagnosed with invasive ductal carcinoma of the breast(T3N1M0 stage IIIA LuminalB type)as the first primary cancer and DLBCL(stage IIIA)as the second primary cancer.The patient underwent the modified radical mastectomy for left breast cancer and received Rituximab,cyclophospha-mide,hydroxydaunorubicin,Oncovin(vincristine)and prednisolone regimen chemotherapy treatment for DLBCL.As of now,the patient is in stable condition.The successful diagnosis of the present patient highlights the need for multidisciplinary management and adoption of advanced imaging techniques to identify the second primary cancer,especially NHL.CONCLUSION Accurate diagnosis and management of metachronous MPC requires an interdisciplinary team and selection of an appropriate treatment plan.展开更多
BACKGROUND Metachronous multiple esophageal squamous cell carcinomas(ESCCs)may occur in some patients after endoscopic resection.Multiple dysplastic lesions in the esophagus increase risk of multiple squamous cell car...BACKGROUND Metachronous multiple esophageal squamous cell carcinomas(ESCCs)may occur in some patients after endoscopic resection.Multiple dysplastic lesions in the esophagus increase risk of multiple squamous cell carcinomas(SCCs).Endoscopic imaging technology such as narrow band imaging(NBI),can detect early SCC.Lugol chromoendoscopy is also the conventional standard technique for detecting superficial ESCC.However,little is known about the interval from the first SCC to the metachronous SCC.Effective methods to prevent multiple metachronous SCCs are needed in survivors of esophageal SCC.CASE SUMMARY A 56-year-old man showed a slightly elevated reddish area in the middle thoracic esophagus at 30 cm from the incisors on gastroscopy for routine examination.Esophageal mucosa lesion was about 2.5 cm.NBI and magnifying gastroscopy confirmed intra-epithelial papillary loop type B-1 according to the Japan Esophageal Society Classification.Lugol chromoendoscopy was used to evaluate the dysplastic squamous epithelium in the esophagus.Biopsy pathology revealed severe dysplastic squamous epithelium.Computed tomography showed no lymph node metastasis.His complete blood test and tumor markers were within reference values.He had no history of alcohol consumption and smoking.Mucosal lesion was dissected by endoscopic submucosal dissection(ESD).Postoperative pathological results showed moderately differentiated squamous carcinoma.No cancer thrombus was seen in the vasculature,and the surrounding cut edge was not involved.The patient underwent radiotherapy within 2 months after ESD.The multiple Lugol-voiding lesions disappeared,and enhanced chest computed tomography revealed no lymph node metastasis.CONCLUSION This is the first case of multiple dysplastic lesions of esophagus cured by radiotherapy.Radiotherapy after minimally invasive endoscopic treatment might be a safe and effective optional therapeutic strategy to prevent metachronous multiple esophageal SCCs.展开更多
In this article,we comment on the article by Long et al published in the recent issue of the World Journal of Gastrointestinal Oncology.Rectal cancer patients are at risk for developing metachronous liver metastasis(M...In this article,we comment on the article by Long et al published in the recent issue of the World Journal of Gastrointestinal Oncology.Rectal cancer patients are at risk for developing metachronous liver metastasis(MLM),yet early prediction remains challenging due to variations in tumor heterogeneity and the limitations of traditional diagnostic methods.Therefore,there is an urgent need for noninvasive techniques to improve patient outcomes.Long et al’s study introduces an innovative magnetic resonance imaging(MRI)-based radiomics model that integrates high-throughput imaging data with clinical variables to predict MLM.The study employed a 7:3 split to generate training and validation datasets.The MLM prediction model was constructed using the training set and subsequently validated on the validation set using area under the curve(AUC)and dollar-cost averaging metrics to assess performance,robustness,and generalizability.By employing advanced algorithms,the model provides a non-invasive solution to assess tumor heterogeneity for better metastasis prediction,enabling early intervention and personalized treatment planning.However,variations in MRI parameters,such as differences in scanning resolutions and protocols across facilities,patient heterogeneity(e.g.,age,comorbidities),and external factors like carcinoembryonic antigen levels introduce biases.Additionally,confounding factors such as diagnostic staging methods and patient comorbidities require further validation and adjustment to ensure accuracy and generalizability.With evolving Food and Drug Administration regulations on machine learning models in healthcare,compliance and careful consideration of these regulatory requirements are essential to ensuring safe and effective implementation of this approach in clinical practice.In the future,clinicians may be able to utilize datadriven,patient-centric artificial intelligence(AI)-enhanced imaging tools integrated with clinical data,which would help improve early detection of MLM and optimize personalized treatment strategies.Combining radiomics,genomics,histological data,and demographic information can significantly enhance the accuracy and precision of predictive models.展开更多
The main purpose of this article is to present a mathematical model of ciliary motion in an annulus. In this analysis, the peristaltic motion of non-Newtonian Jeffrey six constant fluid is observed in an annulus with ...The main purpose of this article is to present a mathematical model of ciliary motion in an annulus. In this analysis, the peristaltic motion of non-Newtonian Jeffrey six constant fluid is observed in an annulus with ciliated tips in the presence of heat and mass transfer. The effects of viscous dissipation are also considered. The flow equations of non-Newtonian fluid for the two-dimensional tube in cylindrical coordinates are simplified using the low Reynolds number and long wave-length approximations. The main equations for Jeffrey six constant fluid are considered in cylindrical coordinates system. The resulting nonlinear problem is solved using the regular perturbation technique in terms of a variant of small dimensionless parameter α. The results of the solutions for velocity, temperature and concentration field are presented graphically. B_k is Brinkman number, ST is soret number, and SH is the Schmidth number. Outcome for the longitudinal velocity, pressure rise, pressure gradient and stream lines are represented through graphs. In the history, the viscous-dissipation effect is usually represented by the Brinkman number.展开更多
This study investigates the cilia transport phenomenon from the perspectives of the heat transfer and variable viscosity in a bending channel. The rightward wall is maintained at a temperature of T0, and the leftward ...This study investigates the cilia transport phenomenon from the perspectives of the heat transfer and variable viscosity in a bending channel. The rightward wall is maintained at a temperature of T0, and the leftward wall has a temperature of T1. Each wall has a metachronal wave that travels along its wall. The structures of the ciliary assemblies are calculated by the well-known simplifying suppositions of the large wavelength and the small Reynolds number approximation. The flow phenomenon for the Newtonian fluid is described as a function of cilia and a metachronal wave velocity. The pressure rise is calculated with MATHEMATICA. The theme of the cilia beating flow is inspected with scheming plots, and its features are discussed at the end of the article.展开更多
AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric ...AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed the medical records of 433 patients(441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group(n = 257) and the H. pylori non-tested group(n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup(n = 120), the H. pylori-persistent subgroup(n = 42), and the H. pylori-negative subgroup(n = 95). Incidences of MGC and risk factors of MGC were identified.RESULTS Median follow-up duration after ESD was 30.00 mo(range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group(7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group(P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients. CONCLUSION H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.展开更多
Helicobacter pylori(H.pylori)plays an important role in gastric carcinogenesis,as the majority of gastric cancers develop from H.pylori-infected gastric mucosa.The rate of early gastric cancer diagnosis has increased ...Helicobacter pylori(H.pylori)plays an important role in gastric carcinogenesis,as the majority of gastric cancers develop from H.pylori-infected gastric mucosa.The rate of early gastric cancer diagnosis has increased in Japan and Korea,where H.pylori infection and gastric cancer are highly prevalent.Early intestinal-type gastric cancer without concomitant lymph node metastasis is usually treated by endoscopic resection.Secondary metachronous gastric cancers often develop because atrophic mucosa left untreated after endoscopic treatment confers a high risk of gastric cancer.The efficacy of H.pylori eradication for the prevention of metachronous gastric cancer remains controversial.However,in patients who undergo endoscopic resection of early gastric cancer,H.pylori eradication is recommended to suppress or delay metachronous gastric cancer.Careful and regularly scheduled endoscopy should be performed to detect minute metachronous gastric cancer after endoscopic resection.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for gastric cancer(GC),especially in East Asian populations.Most East Asian populations infected with H.pylori are at higher risk for GC than H.pylori...BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for gastric cancer(GC),especially in East Asian populations.Most East Asian populations infected with H.pylori are at higher risk for GC than H.pylori-positive European and United States populations.H.pylori eradication therapy reduces gastric cancer risk in patients after endoscopic and operative resection for GC,as well as in non-GC patients with atrophic gastritis.AIM To clarify the chemopreventive effects of H.pylori eradication therapy in an East Asian population with a high incidence of GC.METHODS PubMed and the Cochrane library were searched for randomized control trials(RCTs)and cohort studies published in English up to March 2019.Subgroup analyses were conducted with regard to study designs(i.e.,RCTs or cohort studies),country where the study was conducted(i.e.,Japan,China,and South Korea),and observation periods(i.e.,≤5 years and>5 years).The heterogeneity and publication bias were also measured.RESULTS For non-GC patients with atrophic gastritis and patients after resection for GC,4 and 4 RCTs and 12 and 18 cohort studies were included,respectively.In RCTs,the median incidence of GC for the untreated control groups and the treatment groups was 272.7(180.4–322.4)and 162.3(72.5–588.2)per 100000 person-years in non-GC cases with atrophic gastritis and 1790.7(406.5–2941.2)and 1126.2(678.7–1223.1)per 100000 person-years in cases of after resection for GC.Compared with non-treated H.pylori-positive controls,the eradication groups had a significantly reduced risk of GC,with a relative risk of 0.67[95%confidence interval(CI):0.47–0.96]for non-GC patients with atrophic gastritis and 0.51(0.36–0.73)for patients after resection for GC in the RCTs,and 0.39(0.30–0.51)for patients with gastritis and 0.54(0.44–0.67)for patients after resection in cohort studies.CONCLUSION In the East Asian population with a high risk of GC,H.pylori eradication effectively reduced the risk of GC,irrespective of past history of previous cancer.展开更多
To investigate predictive markers for metachronous and synchronous gastric cancer (GC), which can develop after endoscopic submucosal dissection (ESD). METHODSA total of 352 patients underwent ESD for early GC at NTT ...To investigate predictive markers for metachronous and synchronous gastric cancer (GC), which can develop after endoscopic submucosal dissection (ESD). METHODSA total of 352 patients underwent ESD for early GC at NTT West Osaka Hospital between June 2006 and February 2016. Exclusion criteria were as follows: Remnant stomach, unknown Helicobacter pylori status, and endoscopic observation of the whole stomach outside our hospital. We analyzed data from 192 patients comprising 109 patients with solitary GC (Group A) and 83 with metachronous and synchronous GC (Group B). We retrospectively investigated the clinicopathological and endoscopic characteristics, and endoscopic risk score as predictive markers for GC. RESULTSThe median age of Group B [72 years (interquartile range 63-78)] was significantly higher than that of Group A [66 years (interquartile range 61-74), respectively, P = 0.0009]. The prevalence of intestinal metaplasia in Group B tended to be higher than that in Group A (57.8% vs 45.0%, P = 0.08). The prevalence of gastric xanthoma (GX) in Group B was significantly higher than that in Group A (54.2% vs 32.1%, P = 0.003). The atrophy score in Group B was significantly higher than that in Group A (P = 0.005). Multivariate analysis revealed that higher age and the presence of GX were independently related to metachronous and synchronous GC [OR = 1.04 (1.01-1.08), P = 0.02; and OR = 2.11 (1.14-3.99), P = 0.02, respectively]. CONCLUSIONThe presence of GX is a useful predictive marker for metachronous and synchronous GC.展开更多
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance...To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.展开更多
The occurrence of both primary gastric lymphoma and gastric adenocarcinoma in the same patient is a rare entity. The possible causative factors of synchronous or metachronous occurrence of both malignancies and variet...The occurrence of both primary gastric lymphoma and gastric adenocarcinoma in the same patient is a rare entity. The possible causative factors of synchronous or metachronous occurrence of both malignancies and varieties in the treatment modalities are reviewed according to published cases in English language medical literature.展开更多
文摘A biomimetic approach is used to generate a directed transversal transportation of micron-sized particles in liquids based on the principle of cilia-type arrays in coordinated motion. Rows of flaps mimicking planar cilia are positioned off-centre along an array of cavities covered with membranes that support the flaps. These membranes are deflected from a concave to a convex shape and vice versa by pneumatic actuation applying positive and negative pressures (relative to the ambient) inside the cavities. As a result, the flap on top of the membrane tilts to the left or right within such a pressure cycle, performing a beat stroke. Since each cavity can be addressed in the device individually and in rapid succession, waves of coordinated flap motion can be run along the wall. Such metachronal waves are generated and transport of particles along the cilia surface is achieved in both symplectic and antiplectic direction. It is shown that the initial tilt of the flaps relative to the wall-normal determines the direction of transport.
文摘This paper presents a theoretical study of a non-linear rheological fluid transport in an axisymmetric tube by cilia. An attempt has been made to explain the role of cilia motion in the transport of fluid through the ductus efferent of the male reproductive tract. The Ostwald-de Waele power-law viscous fluid is considered to represent the rheological fluid. We analyze pumping by means of a sequence of cilia beats from rowto-row of cilia in a given row of cells and from one row of cells to the next(metachronal wave movement). For this purpose, we consider the conditions that the corresponding Reynolds number is small enough for inertial effects to be negligible, and the wavelengthto-diameter ratio is large enough so that the pressure can be considered uniform over the cross section. Analyses and computations of the fluid motion reveal that the time-average flow rate depends on ε, a non-dimensional measure involving the mean radius a of the tube and the cilia length. Thus, the flow rate significantly varies with the cilia length.Moreover, the flow rate has been reported to be close to the estimated value 6 × 10ml/h for human efferent ducts if ε is near 0.4. The estimated value was suggested by Lardner and Shack(Lardner, T. J. and Shack, W. J. Cilia transport. Bulletin of Mathematical Biology, 34, 325–335(1972)) for human based on the experimental observations of flow rates in efferent ducts of other animals, e.g., rat, ram, and bull. In addition, the nature of the rheological fluid, i.e., the value of the fluid index n strongly influences various flow-governed characteristics. An interesting feature of this paper is that the pumping improves the thickening behavior for small values of ε or in free pumping(?P = 0) and pumping(?P > 0) regions.
文摘This study describes ciliary motion on the transport of fluids in human body with heat transfer. The mathematical model of the flow of a Jeffrey fluid in a tube of finite length is considered due to metachronal wave of cilia motion. Flow equations have been modeled and simplified using similarity variables. Exact solutions of the formulated problem have been obtained for velocity, temperature and pressure gradient and graphs for velocity, pressure rise pressure gradient and temperature profile have been plotted and studied for different values of specific physical parameters. Trapping phenomena and isotherms are presented at the end of the paper.
文摘The aim of this study is to explain theoretically the role of ciliary motion on the transport of epididymal fluid through the ductus efferentes of the male reproductive track. For this purpose, a mathematical model has been developed for the flow of a non-Newtonian fluid in an axisymmetric tube due to metachronal wave of cilia motion for the more realistic consequences. Carreau viscous fluid model is considered to see the rheological effects on the pumping characteristics of the flow. Regular perturbation method has been employed to obtain the analytical expressions for the stream function, the velocity field and a relation between the pressure difference and the volume flow rate. It is found that the volume flow rate is influenced significantly by Weissenberg number We and the cilia length parameter ε. The computational results are presented graphically to see the effects of various physical parameters. Finally, the analysis is applied and compared with the observed value of the flow rate of spermatic fluid in the ductus efferentes of the male reproductive track. The volume flow rate is reported closed to the estimated value 6 × 10^-3 ml/h in the human ductus efferentes when We = 0.5 and e is near by 0.25.
基金Supported by Gansu Provincial Natural Science Foundation,No.21JR1RA010In-Hospital Research Fund of Gansu Provincial Hospital,No.23GSSYD-5.
文摘BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.
文摘BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study aims to investigate the application value of a combined machine learning(ML)based model based on the multiparameter magnetic resonance imaging for prediction of rectal metachronous liver metastasis(MLM).AIM To investigate the efficacy of radiomics based on multiparametric magnetic resonance imaging images of preoperative first diagnosed rectal cancer in predicting MLM from rectal cancer.METHODS We retrospectively analyzed 301 patients with rectal cancer confirmed by surgical pathology at Jingzhou Central Hospital from January 2017 to December 2023.All participants were randomly assigned to the training or validation queue in a 7:3 ratio.We first apply generalized linear regression model(GLRM)and random forest model(RFM)algorithm to construct an MLM prediction model in the training queue,and evaluate the discriminative power of the MLM prediction model using area under curve(AUC)and decision curve analysis(DCA).Then,the robustness and generalizability of the MLM prediction model were evaluated based on the internal validation set between the validation queue groups.RESULTS Among the 301 patients included in the study,16.28%were ultimately diagnosed with MLM through pathological examination.Multivariate analysis showed that carcinoembryonic antigen,and magnetic resonance imaging radiomics were independent predictors of MLM.Then,the GLRM prediction model was developed with a comprehensive nomogram to achieve satisfactory differentiation.The prediction performance of GLRM in the training and validation queue was 0.765[95%confidence interval(CI):0.710-0.820]and 0.767(95%CI:0.712-0.822),respectively.Compared with GLRM,RFM achieved superior performance with AUC of 0.919(95%CI:0.868-0.970)and 0.901(95%CI:0.850-0.952)in the training and validation queue,respectively.The DCA indicated that the predictive ability and net profit of clinical RFM were improved.CONCLUSION By combining multiparameter magnetic resonance imaging with the effectiveness and robustness of ML-based predictive models,the proposed clinical RFM can serve as an insight tool for preoperative assessment of MLM risk stratification and provide important information for individual diagnosis and treatment of rectal cancer patients.
基金Supported by the National Natural Science Foundation of China,No.81572338 and No.82170548C-class-sponsored research project of the Jiangsu Provincial Six Talent Peaks,No.WSN-078+2 种基金Jiangsu Province“333 High-level Talents Training Project”,No.2016-III-0126the Jiangsu Provincial Key Research and Development Program,No.BE2021601the Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.SJCX24_1037.
文摘BACKGROUND A significant association between increased age and an increased risk of metachronous gastric cancer(MGC)following curative endoscopic submucosal dissection(ESD)has previously been reported.AIM To determine risk factors for the metachronous occurrence of early gastric cancer(EGC)in elderly individuals.METHODS This retrospective cohort study comprised 653 elderly patients(aged≥65 years)who underwent curative ESD for EGC between January 2014 and June 2020 at Nanjing Drum Tower Hospital.Comprehensive analyses were conducted to compare lifestyle habits,comorbidities,and Helicobacter pylori(H.pylori)infections as potential indicators.RESULTS During a median follow-up of 38 months,46 patients(7.0%,20.46/1000 person-years)developed MGC in the elderly cohort.The cumulative incidences of MGC at 2,3,and 5 years were 3.3%,5.3%,and 11.5%,respectively.In multivariate Cox regression analyses,the independent risk factors for MGC included metabolic dysfunctionassociated steatotic liver disease(MASLD)[hazard ratio(HR)=2.44,95%confidence interval(CI):1.15-5.17],persistent H.pylori infection(HR=10.38,95%CI:3.36-32.07),severe mucosal atrophy(HR=2.71,95%CI:1.45-5.08),and pathological differentiation of EGC(well/moderately differentiated vs poorly differentiated:HR=10.18,95%CI:1.30-79.65).Based on these risk factors,a risk stratification system was developed to categorize individuals into low(0-1 point),intermediate(2-3 points),and high(4-8 points)risk categories for MGC,with cumulative incidence rates of 12.3%,21.6%,and 45%,respectively.CONCLUSION Among elderly individuals,MASLD,persistent H.pylori infection,severe mucosal atrophy,and well/moderately differentiated EGC were associated with an increased risk of MGC.Elderly patients are recommended to adopt healthy lifestyle practices,and undergo regular endoscopic screening and H.pylori testing after curative ESD for EGC.
文摘Rectal cancer is a major global health concern,and metachronous liver metastasis(MLM)significantly worsens patient prognosis.Advances in imaging and machine learning have led to the development of radiomics models,particularly those utilizing multiparametric magnetic resonance imaging,which are highly valuable in predicting MLM.These models analyze imaging features to provide insights that can aid clinical decision-making and potentially improve treatment outcomes and survival rates.However,realizing the full potential of radiomics models faces challenges in terms of accuracy,generalizability,and data depen-dency.This editorial comments on a study regarding radiomics prediction models for rectal cancer MLM published recently in the World Journal of Gastrointestinal Oncology,discusses the progress,challenges,and strategies for diagnostic models of MLM in rectal cancer,and proposes directions for future research.
文摘BACKGROUND Multiple primary carcinoma(MPC)refers to two or more types of primary malignant tumors occurring simultaneously or sequentially in the same patient.Breast cancer is one of the most common malignant tumors affecting women.On the other hand,diffuse large B-cell lymphoma(DLBCL)is the most frequent form of non-Hodgkin’s lymphoma(NHL).In clinical practice,the simultaneous existence of metachronous primary breast cancer and lymphoma is rare.In this case,we highlight the significance of multidisciplinary management and advanced imaging techniques in the early identification and treatment of MPC cases.CASE SUMMARY In this study,we report a case of a 40-year-old female who was diagnosed with invasive ductal carcinoma of the breast(T3N1M0 stage IIIA LuminalB type)as the first primary cancer and DLBCL(stage IIIA)as the second primary cancer.The patient underwent the modified radical mastectomy for left breast cancer and received Rituximab,cyclophospha-mide,hydroxydaunorubicin,Oncovin(vincristine)and prednisolone regimen chemotherapy treatment for DLBCL.As of now,the patient is in stable condition.The successful diagnosis of the present patient highlights the need for multidisciplinary management and adoption of advanced imaging techniques to identify the second primary cancer,especially NHL.CONCLUSION Accurate diagnosis and management of metachronous MPC requires an interdisciplinary team and selection of an appropriate treatment plan.
基金Supported by Jinhua City Science and Technology Plan Projects,No.2022-4-145.
文摘BACKGROUND Metachronous multiple esophageal squamous cell carcinomas(ESCCs)may occur in some patients after endoscopic resection.Multiple dysplastic lesions in the esophagus increase risk of multiple squamous cell carcinomas(SCCs).Endoscopic imaging technology such as narrow band imaging(NBI),can detect early SCC.Lugol chromoendoscopy is also the conventional standard technique for detecting superficial ESCC.However,little is known about the interval from the first SCC to the metachronous SCC.Effective methods to prevent multiple metachronous SCCs are needed in survivors of esophageal SCC.CASE SUMMARY A 56-year-old man showed a slightly elevated reddish area in the middle thoracic esophagus at 30 cm from the incisors on gastroscopy for routine examination.Esophageal mucosa lesion was about 2.5 cm.NBI and magnifying gastroscopy confirmed intra-epithelial papillary loop type B-1 according to the Japan Esophageal Society Classification.Lugol chromoendoscopy was used to evaluate the dysplastic squamous epithelium in the esophagus.Biopsy pathology revealed severe dysplastic squamous epithelium.Computed tomography showed no lymph node metastasis.His complete blood test and tumor markers were within reference values.He had no history of alcohol consumption and smoking.Mucosal lesion was dissected by endoscopic submucosal dissection(ESD).Postoperative pathological results showed moderately differentiated squamous carcinoma.No cancer thrombus was seen in the vasculature,and the surrounding cut edge was not involved.The patient underwent radiotherapy within 2 months after ESD.The multiple Lugol-voiding lesions disappeared,and enhanced chest computed tomography revealed no lymph node metastasis.CONCLUSION This is the first case of multiple dysplastic lesions of esophagus cured by radiotherapy.Radiotherapy after minimally invasive endoscopic treatment might be a safe and effective optional therapeutic strategy to prevent metachronous multiple esophageal SCCs.
文摘In this article,we comment on the article by Long et al published in the recent issue of the World Journal of Gastrointestinal Oncology.Rectal cancer patients are at risk for developing metachronous liver metastasis(MLM),yet early prediction remains challenging due to variations in tumor heterogeneity and the limitations of traditional diagnostic methods.Therefore,there is an urgent need for noninvasive techniques to improve patient outcomes.Long et al’s study introduces an innovative magnetic resonance imaging(MRI)-based radiomics model that integrates high-throughput imaging data with clinical variables to predict MLM.The study employed a 7:3 split to generate training and validation datasets.The MLM prediction model was constructed using the training set and subsequently validated on the validation set using area under the curve(AUC)and dollar-cost averaging metrics to assess performance,robustness,and generalizability.By employing advanced algorithms,the model provides a non-invasive solution to assess tumor heterogeneity for better metastasis prediction,enabling early intervention and personalized treatment planning.However,variations in MRI parameters,such as differences in scanning resolutions and protocols across facilities,patient heterogeneity(e.g.,age,comorbidities),and external factors like carcinoembryonic antigen levels introduce biases.Additionally,confounding factors such as diagnostic staging methods and patient comorbidities require further validation and adjustment to ensure accuracy and generalizability.With evolving Food and Drug Administration regulations on machine learning models in healthcare,compliance and careful consideration of these regulatory requirements are essential to ensuring safe and effective implementation of this approach in clinical practice.In the future,clinicians may be able to utilize datadriven,patient-centric artificial intelligence(AI)-enhanced imaging tools integrated with clinical data,which would help improve early detection of MLM and optimize personalized treatment strategies.Combining radiomics,genomics,histological data,and demographic information can significantly enhance the accuracy and precision of predictive models.
文摘The main purpose of this article is to present a mathematical model of ciliary motion in an annulus. In this analysis, the peristaltic motion of non-Newtonian Jeffrey six constant fluid is observed in an annulus with ciliated tips in the presence of heat and mass transfer. The effects of viscous dissipation are also considered. The flow equations of non-Newtonian fluid for the two-dimensional tube in cylindrical coordinates are simplified using the low Reynolds number and long wave-length approximations. The main equations for Jeffrey six constant fluid are considered in cylindrical coordinates system. The resulting nonlinear problem is solved using the regular perturbation technique in terms of a variant of small dimensionless parameter α. The results of the solutions for velocity, temperature and concentration field are presented graphically. B_k is Brinkman number, ST is soret number, and SH is the Schmidth number. Outcome for the longitudinal velocity, pressure rise, pressure gradient and stream lines are represented through graphs. In the history, the viscous-dissipation effect is usually represented by the Brinkman number.
文摘This study investigates the cilia transport phenomenon from the perspectives of the heat transfer and variable viscosity in a bending channel. The rightward wall is maintained at a temperature of T0, and the leftward wall has a temperature of T1. Each wall has a metachronal wave that travels along its wall. The structures of the ciliary assemblies are calculated by the well-known simplifying suppositions of the large wavelength and the small Reynolds number approximation. The flow phenomenon for the Newtonian fluid is described as a function of cilia and a metachronal wave velocity. The pressure rise is calculated with MATHEMATICA. The theme of the cilia beating flow is inspected with scheming plots, and its features are discussed at the end of the article.
基金Supported by the 2015 Yeungnam University Research Grant
文摘AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed the medical records of 433 patients(441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group(n = 257) and the H. pylori non-tested group(n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup(n = 120), the H. pylori-persistent subgroup(n = 42), and the H. pylori-negative subgroup(n = 95). Incidences of MGC and risk factors of MGC were identified.RESULTS Median follow-up duration after ESD was 30.00 mo(range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group(7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group(P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients. CONCLUSION H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.
文摘Helicobacter pylori(H.pylori)plays an important role in gastric carcinogenesis,as the majority of gastric cancers develop from H.pylori-infected gastric mucosa.The rate of early gastric cancer diagnosis has increased in Japan and Korea,where H.pylori infection and gastric cancer are highly prevalent.Early intestinal-type gastric cancer without concomitant lymph node metastasis is usually treated by endoscopic resection.Secondary metachronous gastric cancers often develop because atrophic mucosa left untreated after endoscopic treatment confers a high risk of gastric cancer.The efficacy of H.pylori eradication for the prevention of metachronous gastric cancer remains controversial.However,in patients who undergo endoscopic resection of early gastric cancer,H.pylori eradication is recommended to suppress or delay metachronous gastric cancer.Careful and regularly scheduled endoscopy should be performed to detect minute metachronous gastric cancer after endoscopic resection.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for gastric cancer(GC),especially in East Asian populations.Most East Asian populations infected with H.pylori are at higher risk for GC than H.pylori-positive European and United States populations.H.pylori eradication therapy reduces gastric cancer risk in patients after endoscopic and operative resection for GC,as well as in non-GC patients with atrophic gastritis.AIM To clarify the chemopreventive effects of H.pylori eradication therapy in an East Asian population with a high incidence of GC.METHODS PubMed and the Cochrane library were searched for randomized control trials(RCTs)and cohort studies published in English up to March 2019.Subgroup analyses were conducted with regard to study designs(i.e.,RCTs or cohort studies),country where the study was conducted(i.e.,Japan,China,and South Korea),and observation periods(i.e.,≤5 years and>5 years).The heterogeneity and publication bias were also measured.RESULTS For non-GC patients with atrophic gastritis and patients after resection for GC,4 and 4 RCTs and 12 and 18 cohort studies were included,respectively.In RCTs,the median incidence of GC for the untreated control groups and the treatment groups was 272.7(180.4–322.4)and 162.3(72.5–588.2)per 100000 person-years in non-GC cases with atrophic gastritis and 1790.7(406.5–2941.2)and 1126.2(678.7–1223.1)per 100000 person-years in cases of after resection for GC.Compared with non-treated H.pylori-positive controls,the eradication groups had a significantly reduced risk of GC,with a relative risk of 0.67[95%confidence interval(CI):0.47–0.96]for non-GC patients with atrophic gastritis and 0.51(0.36–0.73)for patients after resection for GC in the RCTs,and 0.39(0.30–0.51)for patients with gastritis and 0.54(0.44–0.67)for patients after resection in cohort studies.CONCLUSION In the East Asian population with a high risk of GC,H.pylori eradication effectively reduced the risk of GC,irrespective of past history of previous cancer.
文摘To investigate predictive markers for metachronous and synchronous gastric cancer (GC), which can develop after endoscopic submucosal dissection (ESD). METHODSA total of 352 patients underwent ESD for early GC at NTT West Osaka Hospital between June 2006 and February 2016. Exclusion criteria were as follows: Remnant stomach, unknown Helicobacter pylori status, and endoscopic observation of the whole stomach outside our hospital. We analyzed data from 192 patients comprising 109 patients with solitary GC (Group A) and 83 with metachronous and synchronous GC (Group B). We retrospectively investigated the clinicopathological and endoscopic characteristics, and endoscopic risk score as predictive markers for GC. RESULTSThe median age of Group B [72 years (interquartile range 63-78)] was significantly higher than that of Group A [66 years (interquartile range 61-74), respectively, P = 0.0009]. The prevalence of intestinal metaplasia in Group B tended to be higher than that in Group A (57.8% vs 45.0%, P = 0.08). The prevalence of gastric xanthoma (GX) in Group B was significantly higher than that in Group A (54.2% vs 32.1%, P = 0.003). The atrophy score in Group B was significantly higher than that in Group A (P = 0.005). Multivariate analysis revealed that higher age and the presence of GX were independently related to metachronous and synchronous GC [OR = 1.04 (1.01-1.08), P = 0.02; and OR = 2.11 (1.14-3.99), P = 0.02, respectively]. CONCLUSIONThe presence of GX is a useful predictive marker for metachronous and synchronous GC.
文摘To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.
文摘The occurrence of both primary gastric lymphoma and gastric adenocarcinoma in the same patient is a rare entity. The possible causative factors of synchronous or metachronous occurrence of both malignancies and varieties in the treatment modalities are reviewed according to published cases in English language medical literature.
