BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain...BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain unclear.AIM To explore the clinical characteristics and factors influencing comorbid anxiety and depression in patients with malignant liver,gallbladder,and pancreatic tumors.METHODS This study enrolled 150 participants,including 48 patients with early stage(IA-IB)hepatobiliary and pancreatic malignancies(Control Group 1),52 patients with middle-stage(IIA-IIIA)tumors(Observation Group),and 50 healthy individuals undergoing physical examination(Control Group 2).Anxiety and depression detection rates,and scores on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and Life Event Scale were compared across groups.The factors influencing emotion of each patient were collected and analyzed by group.RESULTS Anxiety and depression detection rates were significantly higher in the Observation Group(82.69%and 92.31%,respectively;P<0.05)than those in Control Groups 1(62.50%and 66.67%,respectively)and 2(10.00%and 8.00%,respectively).SAS and SDS scores showed similar trends.Life event stress scores and the presence of influencing factors,such as treatment side effects,pain,and economic burden,were also significantly elevated in the Observation Group.These findings suggest that psychological distress worsens as the disease progresses.CONCLUSION Patients with hepatobiliary and pancreatic malignancies are prone to comorbid anxiety and depression,with increasing severity in the later disease stages.Despite the relatively small sample size,our findings suggest the need for psychological assessments and interventions in comprehensive cancer care.Future studies should consider expanding the sample size to enhance generalizability.Strengthening psychosocial support may improve patient outcomes and quality of life.展开更多
Background:The mortalities of hepatobiliary malignancies are high.With the failure of conventional chemotherapy and unsatisfactory outcome of molecular targeted drugs,immune-based therapy has become a new focus of res...Background:The mortalities of hepatobiliary malignancies are high.With the failure of conventional chemotherapy and unsatisfactory outcome of molecular targeted drugs,immune-based therapy has become a new focus of research in hepatobiliary cancers treatment.Data sources:We performed a Pub Med search with relevant articles published up to May 2022 and the following keywords:cellular immunotherapy,hepatobiliary cancer,antigen receptor T cell therapy,and receptor-engineered T cell.Information of clinical trials was obtained from https://clinicaltrials.gov/.Results:Cell therapies for hepatobiliary malignancies are at early stage of development.The current review showed that cellular therapies are safe and feasible in patients.These findings provide an important platform for future lager scale clinical trials on immunotherapy in patients with hepatobiliary malignancies.Conclusions:With the continuous advances of cellular immunotherapy,the combination of cellular immunotherapy with surgery,chemotherapy and radiotherapy will be new therapeutic strategies for patients with hepatobiliary cancer.展开更多
Unprecedented advances have been achieved in hepatobiliary cancer treatment with immune checkpoint blockade(ICB).However,the efflcacy of ICB in patients with hepatobiliary malignancies is still limited.Resistance to i...Unprecedented advances have been achieved in hepatobiliary cancer treatment with immune checkpoint blockade(ICB).However,the efflcacy of ICB in patients with hepatobiliary malignancies is still limited.Resistance to immunotherapies is often orchestrated by complicated tumor-host-microenvironment interactions but could also occur after initial efflcacy,mostly when only partial responses are obtained.Clarification of cancer-resistance mechanisms will be beneficial to provide the rationale for the administration of personalized drugs.Here,we review the factors related to resistance to immune-targeted therapies in hepatobiliary malignancies and discuss the potential strategies for overcoming resistance and future directions of immunotherapy development.展开更多
Endoscopic stent placement is a common primary management therapy for benign and malignant biliary strictures.However,continuous use of stents is limited by occlusion and migration.Stent technology has evolved signifi...Endoscopic stent placement is a common primary management therapy for benign and malignant biliary strictures.However,continuous use of stents is limited by occlusion and migration.Stent technology has evolved significantly over the past two decades to reduce these problems.The purpose of this article is to review current guidelines in managing malignant and benign biliary obstructions,current endoscopic techniques for stent placement,and emerging stent technology.What began as a simple plastic stent technology has evolved significantly to include uncovered,partially covered,and fully covered self-expanding metal stents (SEMS) as well as magnetic,bioabsorbable,drug-eluting,and antireflux stents.展开更多
Over the last two decades,substantial progress has been made in the scope of molecular targeted therapy,leading to transformative advancements in the treatment of various malignancies,including biliary tract cancer(BT...Over the last two decades,substantial progress has been made in the scope of molecular targeted therapy,leading to transformative advancements in the treatment of various malignancies,including biliary tract cancer(BTC).BTC represents a heterogeneous group of aggressive tumors with historically poor prognoses.However,recent discoveries of novel molecular alterations in BTC have provided new avenues for targeted therapeutic interventions,exemplified by the approval of pemigatinib,specifically designed for FGFR2 gene fusions or rearrangements in advanced BTC.Furthermore,subsequent regulatory approvals and ongoing clinical trials focusing on specific gene mutations have considerably expanded the array of treatment options available,augmenting the potential for personalized treatment strategies.In light of these developments,this review aims to furnish a comprehensive and up-to-date account of the molecular characteristics and potential targeted therapies in BTC.By presenting insights into novel therapeutic approaches and outlining prospective directions for translational and clinical investigations,this review seeks to contribute to the ongoing progress and optimization of therapeutic approaches in managing BTC.展开更多
文摘BACKGROUND Hepatobiliary and pancreatic malignancies,with their aggressiveness and poor prognosis,often trigger anxiety and depression in patients,but the roles of disease stage and psychosocial factors in this remain unclear.AIM To explore the clinical characteristics and factors influencing comorbid anxiety and depression in patients with malignant liver,gallbladder,and pancreatic tumors.METHODS This study enrolled 150 participants,including 48 patients with early stage(IA-IB)hepatobiliary and pancreatic malignancies(Control Group 1),52 patients with middle-stage(IIA-IIIA)tumors(Observation Group),and 50 healthy individuals undergoing physical examination(Control Group 2).Anxiety and depression detection rates,and scores on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and Life Event Scale were compared across groups.The factors influencing emotion of each patient were collected and analyzed by group.RESULTS Anxiety and depression detection rates were significantly higher in the Observation Group(82.69%and 92.31%,respectively;P<0.05)than those in Control Groups 1(62.50%and 66.67%,respectively)and 2(10.00%and 8.00%,respectively).SAS and SDS scores showed similar trends.Life event stress scores and the presence of influencing factors,such as treatment side effects,pain,and economic burden,were also significantly elevated in the Observation Group.These findings suggest that psychological distress worsens as the disease progresses.CONCLUSION Patients with hepatobiliary and pancreatic malignancies are prone to comorbid anxiety and depression,with increasing severity in the later disease stages.Despite the relatively small sample size,our findings suggest the need for psychological assessments and interventions in comprehensive cancer care.Future studies should consider expanding the sample size to enhance generalizability.Strengthening psychosocial support may improve patient outcomes and quality of life.
基金supported by grants from the International Science and Technology Cooperation Projects(2016YFE0107100)the Capital Special Research Project for Health Development(2014-2-4012)+3 种基金the Beijing Natural Science Foundation(L172055 and 7192158)the National Ten-thousand Talent Programthe Fundamental Research Funds for the Central Universities(3332018032)the CAMS Innovation Fund for Medical Science(CIFMS)(2017-I2M-4-003 and 2018-I2M-3-001)。
文摘Background:The mortalities of hepatobiliary malignancies are high.With the failure of conventional chemotherapy and unsatisfactory outcome of molecular targeted drugs,immune-based therapy has become a new focus of research in hepatobiliary cancers treatment.Data sources:We performed a Pub Med search with relevant articles published up to May 2022 and the following keywords:cellular immunotherapy,hepatobiliary cancer,antigen receptor T cell therapy,and receptor-engineered T cell.Information of clinical trials was obtained from https://clinicaltrials.gov/.Results:Cell therapies for hepatobiliary malignancies are at early stage of development.The current review showed that cellular therapies are safe and feasible in patients.These findings provide an important platform for future lager scale clinical trials on immunotherapy in patients with hepatobiliary malignancies.Conclusions:With the continuous advances of cellular immunotherapy,the combination of cellular immunotherapy with surgery,chemotherapy and radiotherapy will be new therapeutic strategies for patients with hepatobiliary cancer.
基金supported by grants from the National Natural Science Foundation of China(81930041,31870907,91842103)the Natural Science Foundation of Zhejiang Province(Z19H100001)。
文摘Unprecedented advances have been achieved in hepatobiliary cancer treatment with immune checkpoint blockade(ICB).However,the efflcacy of ICB in patients with hepatobiliary malignancies is still limited.Resistance to immunotherapies is often orchestrated by complicated tumor-host-microenvironment interactions but could also occur after initial efflcacy,mostly when only partial responses are obtained.Clarification of cancer-resistance mechanisms will be beneficial to provide the rationale for the administration of personalized drugs.Here,we review the factors related to resistance to immune-targeted therapies in hepatobiliary malignancies and discuss the potential strategies for overcoming resistance and future directions of immunotherapy development.
文摘Endoscopic stent placement is a common primary management therapy for benign and malignant biliary strictures.However,continuous use of stents is limited by occlusion and migration.Stent technology has evolved significantly over the past two decades to reduce these problems.The purpose of this article is to review current guidelines in managing malignant and benign biliary obstructions,current endoscopic techniques for stent placement,and emerging stent technology.What began as a simple plastic stent technology has evolved significantly to include uncovered,partially covered,and fully covered self-expanding metal stents (SEMS) as well as magnetic,bioabsorbable,drug-eluting,and antireflux stents.
文摘Over the last two decades,substantial progress has been made in the scope of molecular targeted therapy,leading to transformative advancements in the treatment of various malignancies,including biliary tract cancer(BTC).BTC represents a heterogeneous group of aggressive tumors with historically poor prognoses.However,recent discoveries of novel molecular alterations in BTC have provided new avenues for targeted therapeutic interventions,exemplified by the approval of pemigatinib,specifically designed for FGFR2 gene fusions or rearrangements in advanced BTC.Furthermore,subsequent regulatory approvals and ongoing clinical trials focusing on specific gene mutations have considerably expanded the array of treatment options available,augmenting the potential for personalized treatment strategies.In light of these developments,this review aims to furnish a comprehensive and up-to-date account of the molecular characteristics and potential targeted therapies in BTC.By presenting insights into novel therapeutic approaches and outlining prospective directions for translational and clinical investigations,this review seeks to contribute to the ongoing progress and optimization of therapeutic approaches in managing BTC.
