Objective.T o assess the viability of surgical procedures on gynecologic malignant patients o f70years age and older.Methods.Between September1,1983to June30,1 999,57gynecologic malignant patients aged70years and olde...Objective.T o assess the viability of surgical procedures on gynecologic malignant patients o f70years age and older.Methods.Between September1,1983to June30,1 999,57gynecologic malignant patients aged70years and older were treated by surgical procedures.A retrospective study was perf ormed.All patients were analyzed for preexisting medical conditions,length of hospital stay,morbidi-ty,and mortality.Results.Thirty-four patients had a n extensive surgical procedure,while a local surgical procedure was done in23 patients.Forty-one patientshad one or more preexisting medical i llnesses.Minor surgical morbidity occurred in24patientsand majo r surgical morbidity occurred in6patients.There were no differen ces in the types of surgical procedures,mean hospital stay,preexisting medical illness and postoperative complications between the two groups of patients70 to75year older and over age75.The major postoperative complications all occ urred in the extensive surgical procedure group that were higher as compared wit h local operation and postoperative mean stay was also significant-ly length in former group.Conclusions.The extensive surgical procedure can be performed fo r elderly patients with gynecologic malignances.Careful preoperative evaluatio n,monitoring,and meticulous postoperative care are vital to the success.展开更多
Gastrointestinal(GI)cancers,which predominantly manifest in the stomach,colorectum,liver,esophagus,and pancreas,accounting for approximately 35%of global cancer-related mortality.The advent of liquid biopsy has introd...Gastrointestinal(GI)cancers,which predominantly manifest in the stomach,colorectum,liver,esophagus,and pancreas,accounting for approximately 35%of global cancer-related mortality.The advent of liquid biopsy has introduced a pivotal diagnostic modality for the early identification of premalignant GI lesions and incipient cancers.This non-invasive technique not only facilitates prompt therapeutic intervention,but also serves as a critical adjunct in prognosticating the likelihood of tumor recurrence.The wealth of circulating exosomes present in body fluids is often enriched with proteins,lipids,microRNAs,and other RNAs derived from tumor cells.These specific cargo components are reflective of processes involved in GI tumorigenesis,tumor progression,and response to treatment.As such,they represent a group of promising biomarkers for aiding in the diagnosis of GI cancer.In this review,we delivered an exhaustive overview of the composition of exosomes and the pathways for cargo sorting within these vesicles.We laid out some of the clinical evidence that supported the utilization of exosomes as diagnostic biomarkers for GI cancers and discussed their potential for clinical application.Furthermore,we addressed the challenges encountered when harnessing exosomes as diagnostic and predictive instruments in the realm of GI cancers.展开更多
BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine t...BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine the association of resilience with coping styles and quality of life in patients with malignancies.METHODS This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024.The Connor-Davidson Resilience Scale,Medical Coping Modes Questionnaire,Social Support Rating Scale,and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients’resilience,coping styles,social support,and quality of life,respectively.Pearson correlation analysis was conducted to assess the correlations.RESULTS A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age,education level,employment status,monthly household income,and disease staging(P<0.05).Further,patients with malignancies demonstrated scores of 17.49±1.20,17.27±1.46,and 11.19±1.29 points in terms of coping styles in confrontation,avoidance,and resignation dimensions,respectively.Subjective support,objective support,and support utilization scores in terms of social support were 10.67±1.80,11.26±2.08,and 9.24±1.14 points,respectively.The total resilience score and tenacity,self-improvement,and optimism dimension scores were positively correlatedwith the confrontation coping style score,whereas the total resilience score and tenacity and self-improvementscores were negatively associated with avoidance and resignation coping style scores(P<0.05).The total resiliencescore and the tenacity dimension score were positively associated with physical,role,cognitive,emotional,andsocial functions,as well as global health status(P<0.05),and were inversely related to fatigue,insomnia,andeconomic difficulties(P<0.05).CONCLUSIONThe resilience of patients with malignancies is positively associated with the confrontation dimension in the copingstyle,the total and various social support domain scores,and the overall quality of life.Clinical medical staff needto pay attention to the effect of medical coping styles and social support on the resilience level of patients withmalignancies to further improve their quality of life.展开更多
In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin famil...In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.展开更多
Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,th...Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.展开更多
Cystic lesions of the anterior mediastinum in children suggest a well-known group of benign lesions that are comparatively frequent.Thymic cysts(TCs)are mostly positioned in the anterior mediastinum and some patients ...Cystic lesions of the anterior mediastinum in children suggest a well-known group of benign lesions that are comparatively frequent.Thymic cysts(TCs)are mostly positioned in the anterior mediastinum and some patients in the neck.Benign TCs classified as congenital intra-thoracic mesothelial cysts are commonly asymptomatic and have slight clinical significance.Multilocular TC,which can mimic another anterior mediastinal cystic tumor and is seen in adults,is more clinically important.It is a sporadic mediastinal lesion thought to arise in the course of acquired inflammation.Congenital mediastinal cysts represent 3%-6%of all mediastinal tumors and 10%-18%of radiologically reported mediastinal masses.Mediastinal TCs are uncommon and it is hard to know their true incidence.About 60%of cases with mediastinal TCs are asymptomatic,and the remainder of patients complains of nonspecific symptoms(e.g.,chest pain,dyspnea,or cough).The literature suggests that most cysts are benign,but an indefinite percentage may have a neoplastic process and result in significant compressive symptoms over time.Clinical symptoms of TCs vary depending on the location.In addition,frequent symptoms at the appearance of enlarged benign thymic and mediastinal cysts generally contain compressive symptoms(e.g.,respiratory distress,thymic pain,and symptoms related to Horner syndrome,hoarseness,dysphonia,dyspnea,orthopnea,wheezing,and fever).Many TCs have cystic density and a neat border and are simple to diagnose with radiological imaging.However,some TCs are hard to identify before surgery and may be misidentified as thymomas depending on their site and computed tomography results.Excision by thoracotomy,median sternotomy,or video-assisted techniques is essential for conclusive diagnosis,management,and abolition of relapse of anterior mediastinal masses and TCs.Histopathologic examination may be required after surgery.Considering the extent of the mass and the preliminary inability to make a definitive diagnosis,en bloc excision of the cyst was thought to be preferred to circumvent likely complications(e.g.,perforation,spillage of the contents,or incomplete excision).展开更多
This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretat...This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.展开更多
BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a ...BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.展开更多
BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term...BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.展开更多
In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological interve...In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.展开更多
BACKGROUND Self-expandable metal stent(SEMS)as a bridge to surgery(BTS)has become a popular alternative to emergency surgery in the management of acute left-sided malignant colonic obstruction(MCO).However,it remains ...BACKGROUND Self-expandable metal stent(SEMS)as a bridge to surgery(BTS)has become a popular alternative to emergency surgery in the management of acute left-sided malignant colonic obstruction(MCO).However,it remains controversial for colonic stent as a BTS due to a lack of consensus and insufficient data.AIM To assess the clinical and oncological safety of SEMS insertion followed by elective resection for acute left-sided MCO.METHODS The data from 96 patients with acute left-sided MCO in our institution from January 2018 to May 2020 were analyzed retrospectively.They underwent colonic stenting as a bridge to elective surgery(BTS group:n=40)or emergency resection(ER group:n=56).Demographic characteristics,stoma rate,laparoscopy rate,postoperative complications,and oncological outcomes were compared between the two groups.RESULTS The two groups were comparable with regard to the demographics and tumor characteristics.The stoma rate was 7.5%in the BTS group vs 48.2%in the ER group(P<0.05).Primary anastomosis was performed in all patients in the BTS group,and only three patients underwent protective stoma in the BTS group.The BTS group had a significantly higher rate of laparoscopic surgery than the ER group(90%vs 57.1%,P<0.05),and the major postoperative complication rate was significantly higher in the ER group than in the BTS group(33.9%vs 15%,P=0.04).According to the Kaplan-Meier survival analysis and log rank test,no significant differences existed in the two groups with regard to the overall survival and disease-free survival.CONCLUSION The utilization of SEMS as a BTS is a useful alternative to emergency surgery in the treatment of acute left-sided MCO.SEMS insertion as a BTS can provide an effective and safe therapeutic option compared to emergency surgery.展开更多
Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,W...Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,Web of Science,and Google Scholar following PRISMA guidelines until September 2022.An update in December 2023 was conducted to ensure thorough coverage of the literature.Results:A total of 28 articles met the eligibility criteria,reporting 38 cases of brucellosis in patients with cancer.Among these cases,hematological cancers were the most common,comprising 66%of the cases,and B.melitensis was identified as the predominant species.The primary clinical manifestations of brucellosis infection included constitutional symptoms in a notable 60.5%of cases and febrile neutropenia in 21%.Additionally,six cases(15.8%)experienced relapse or recurrence of brucellosis,all of which were managed using a combination therapy of rifampin and doxycycline.While 28 patients successfully achieved remission from both brucellosis and their underlying neoplastic conditions,unfortunately,nine cases resulted in mortality attributed to septic shock,progressive liver failure,and massive embolism;no deaths directly related to brucellosis were reported.Among the non-surviving cases,hematologic malignancies were the most prevalent neoplastic conditions(77.7%).Conclusions:Brucellosis-cancer co-occurrence is rare but is not related to increasing mortality.The risk of relapse is higher in cancer patients,especially with hematologic malignancies.Screening,monitoring,and judicious antibiotic use can mitigate brucellosis risks in neoplastic patients.展开更多
AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective co...AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.展开更多
Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tu...Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.展开更多
BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progr...BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.展开更多
Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the per...Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.展开更多
BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MO...BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.展开更多
BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases an...BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases and 57000 deaths were reported worldwide in 2020.The main modalities for melanoma treatment include surgery,immunotherapy,targeted therapy,high-dose interferon,antitumor angiogenesis,chemotherapy,and radiotherapy.Due to China's special national conditions,the main pathological types and therapeutic effects are greatly different from those in Europe and the United States,so more studies are needed to determine the curative effects of such treatments in the Chinese population.AIM To explore their clinical characteristics,prognostic influencing factors and realworld data to provide a reference basis for further diagnosis and treatment.METHODS We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years.Univariate analysis was conducted using the log-rank test,while multivariate analysis was performed with the Cox proportional hazard regression model.The survival rate was calculated using the Kaplan-Meier method.RESULTS The male-to-female patient ratio was 1.04:1.Among the clinical classifications,melanoma of the limb accounted for 47.56%of cases,followed by melanoma of the skin(18.18%)and mucosal melanoma(18.05%).The 5-year survival rates for stage I-II,stage III,and stage IV patients were 54.65%,37.88%,and 28.58%,respectively.Univariate analysis revealed that age,tumor stage,treatment mode,platelet count at the first visit,and lactate dehydrogenase(LDH)level were significantly related to patient survival.Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year,3 years,and 5 years.Multivariate analysis demonstrated that tumor stage,chemotherapy,interferon therapy,and LDH level were independent risk factors affecting patient survival and prognosis.Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy,those of patients who received chemotherapy and interferon therapy were 30.0%and 44.5%lower,respectively.Additionally,patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels.CONCLUSION Melanoma is highly malignant,and its prognosis is influenced by numerous factors,resulting in an overall poor prognosis.This study identified several factors that impact patient prognosis,providing a foundation for individualized comprehensive treatment.展开更多
Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publicati...Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publication describes the impact of the choice of anesthetics on the results obtained.Methods:Pigs were euthanized at the end of the procedure,without recovery from anesthesia.Three anesthetic protocols were used:sevoflurane inhalation(ProtocolA,n=5),a combination of ketamine,medetomidine and diazepam by intravenous infusion(ProtocolB,n=5),and a combination of ketamine,diazepam,medetomidine,glucose,and noradrenaline(ProtocolC,n=5).All pigs received morphine for analgesia.AKI was induced by interrupting renal perfusion for 90 min.MH was diagnosed based on clinical and biological parameters.Results:All MH pigs belonged to ProtocolA.MH pigs showed significantly higher maximum rectal temperature(p=0.04),maximum expired carbon dioxide(CO_(2);p=0.04),maximum heart rate(HR;p=0.03),plasma concentration of creatinine and potassium(p<0.0001).Protocol A pigs had a significantly higher maximum HR(p=0.01)and hyperkalemia compared to the two other groups(ProtocolB,p=0.005 and ProtocolC,p<0.0001).Pigs from ProtocolA had a significantly lower minimum mean arterial pressure(MAP)than ProtocolC group(p=0.03)and MAP remained below 60 mmHg for longer(p=0.004).In ProtocolB,minimum glycemia was lower than other groups(p=0.01).Conclusion:Sevoflurane use was associated with the occurrence of MH,hemodynamic alterations and changes in plasma concentration of creatinine and potassium.These modifications can have a major impact on the validation of an experimental AKI model.展开更多
Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojeju...Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.展开更多
文摘Objective.T o assess the viability of surgical procedures on gynecologic malignant patients o f70years age and older.Methods.Between September1,1983to June30,1 999,57gynecologic malignant patients aged70years and older were treated by surgical procedures.A retrospective study was perf ormed.All patients were analyzed for preexisting medical conditions,length of hospital stay,morbidi-ty,and mortality.Results.Thirty-four patients had a n extensive surgical procedure,while a local surgical procedure was done in23 patients.Forty-one patientshad one or more preexisting medical i llnesses.Minor surgical morbidity occurred in24patientsand majo r surgical morbidity occurred in6patients.There were no differen ces in the types of surgical procedures,mean hospital stay,preexisting medical illness and postoperative complications between the two groups of patients70 to75year older and over age75.The major postoperative complications all occ urred in the extensive surgical procedure group that were higher as compared wit h local operation and postoperative mean stay was also significant-ly length in former group.Conclusions.The extensive surgical procedure can be performed fo r elderly patients with gynecologic malignances.Careful preoperative evaluatio n,monitoring,and meticulous postoperative care are vital to the success.
文摘Gastrointestinal(GI)cancers,which predominantly manifest in the stomach,colorectum,liver,esophagus,and pancreas,accounting for approximately 35%of global cancer-related mortality.The advent of liquid biopsy has introduced a pivotal diagnostic modality for the early identification of premalignant GI lesions and incipient cancers.This non-invasive technique not only facilitates prompt therapeutic intervention,but also serves as a critical adjunct in prognosticating the likelihood of tumor recurrence.The wealth of circulating exosomes present in body fluids is often enriched with proteins,lipids,microRNAs,and other RNAs derived from tumor cells.These specific cargo components are reflective of processes involved in GI tumorigenesis,tumor progression,and response to treatment.As such,they represent a group of promising biomarkers for aiding in the diagnosis of GI cancer.In this review,we delivered an exhaustive overview of the composition of exosomes and the pathways for cargo sorting within these vesicles.We laid out some of the clinical evidence that supported the utilization of exosomes as diagnostic biomarkers for GI cancers and discussed their potential for clinical application.Furthermore,we addressed the challenges encountered when harnessing exosomes as diagnostic and predictive instruments in the realm of GI cancers.
文摘BACKGROUND Resilience is an individual’s ability and psychological rebound capacity to adapt well after experiencing adversity,trauma,etc.Patients with strong resilience can face illnesses actively.AIM To determine the association of resilience with coping styles and quality of life in patients with malignancies.METHODS This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024.The Connor-Davidson Resilience Scale,Medical Coping Modes Questionnaire,Social Support Rating Scale,and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients’resilience,coping styles,social support,and quality of life,respectively.Pearson correlation analysis was conducted to assess the correlations.RESULTS A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age,education level,employment status,monthly household income,and disease staging(P<0.05).Further,patients with malignancies demonstrated scores of 17.49±1.20,17.27±1.46,and 11.19±1.29 points in terms of coping styles in confrontation,avoidance,and resignation dimensions,respectively.Subjective support,objective support,and support utilization scores in terms of social support were 10.67±1.80,11.26±2.08,and 9.24±1.14 points,respectively.The total resilience score and tenacity,self-improvement,and optimism dimension scores were positively correlatedwith the confrontation coping style score,whereas the total resilience score and tenacity and self-improvementscores were negatively associated with avoidance and resignation coping style scores(P<0.05).The total resiliencescore and the tenacity dimension score were positively associated with physical,role,cognitive,emotional,andsocial functions,as well as global health status(P<0.05),and were inversely related to fatigue,insomnia,andeconomic difficulties(P<0.05).CONCLUSIONThe resilience of patients with malignancies is positively associated with the confrontation dimension in the copingstyle,the total and various social support domain scores,and the overall quality of life.Clinical medical staff needto pay attention to the effect of medical coping styles and social support on the resilience level of patients withmalignancies to further improve their quality of life.
基金Supported by the 2023 Government-funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731D+1 种基金Natural Science Foundation of Hebei Province,No.H202423105Hebei Provincial Administration of Traditional Chinese Medicine,Scientific Research Project,No.2020014.
文摘In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.
文摘Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.
文摘Cystic lesions of the anterior mediastinum in children suggest a well-known group of benign lesions that are comparatively frequent.Thymic cysts(TCs)are mostly positioned in the anterior mediastinum and some patients in the neck.Benign TCs classified as congenital intra-thoracic mesothelial cysts are commonly asymptomatic and have slight clinical significance.Multilocular TC,which can mimic another anterior mediastinal cystic tumor and is seen in adults,is more clinically important.It is a sporadic mediastinal lesion thought to arise in the course of acquired inflammation.Congenital mediastinal cysts represent 3%-6%of all mediastinal tumors and 10%-18%of radiologically reported mediastinal masses.Mediastinal TCs are uncommon and it is hard to know their true incidence.About 60%of cases with mediastinal TCs are asymptomatic,and the remainder of patients complains of nonspecific symptoms(e.g.,chest pain,dyspnea,or cough).The literature suggests that most cysts are benign,but an indefinite percentage may have a neoplastic process and result in significant compressive symptoms over time.Clinical symptoms of TCs vary depending on the location.In addition,frequent symptoms at the appearance of enlarged benign thymic and mediastinal cysts generally contain compressive symptoms(e.g.,respiratory distress,thymic pain,and symptoms related to Horner syndrome,hoarseness,dysphonia,dyspnea,orthopnea,wheezing,and fever).Many TCs have cystic density and a neat border and are simple to diagnose with radiological imaging.However,some TCs are hard to identify before surgery and may be misidentified as thymomas depending on their site and computed tomography results.Excision by thoracotomy,median sternotomy,or video-assisted techniques is essential for conclusive diagnosis,management,and abolition of relapse of anterior mediastinal masses and TCs.Histopathologic examination may be required after surgery.Considering the extent of the mass and the preliminary inability to make a definitive diagnosis,en bloc excision of the cyst was thought to be preferred to circumvent likely complications(e.g.,perforation,spillage of the contents,or incomplete excision).
文摘This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.
文摘BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.
文摘BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.
基金Supported by the National Natural Science Foundation of China(71774049).
文摘In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.
文摘BACKGROUND Self-expandable metal stent(SEMS)as a bridge to surgery(BTS)has become a popular alternative to emergency surgery in the management of acute left-sided malignant colonic obstruction(MCO).However,it remains controversial for colonic stent as a BTS due to a lack of consensus and insufficient data.AIM To assess the clinical and oncological safety of SEMS insertion followed by elective resection for acute left-sided MCO.METHODS The data from 96 patients with acute left-sided MCO in our institution from January 2018 to May 2020 were analyzed retrospectively.They underwent colonic stenting as a bridge to elective surgery(BTS group:n=40)or emergency resection(ER group:n=56).Demographic characteristics,stoma rate,laparoscopy rate,postoperative complications,and oncological outcomes were compared between the two groups.RESULTS The two groups were comparable with regard to the demographics and tumor characteristics.The stoma rate was 7.5%in the BTS group vs 48.2%in the ER group(P<0.05).Primary anastomosis was performed in all patients in the BTS group,and only three patients underwent protective stoma in the BTS group.The BTS group had a significantly higher rate of laparoscopic surgery than the ER group(90%vs 57.1%,P<0.05),and the major postoperative complication rate was significantly higher in the ER group than in the BTS group(33.9%vs 15%,P=0.04).According to the Kaplan-Meier survival analysis and log rank test,no significant differences existed in the two groups with regard to the overall survival and disease-free survival.CONCLUSION The utilization of SEMS as a BTS is a useful alternative to emergency surgery in the treatment of acute left-sided MCO.SEMS insertion as a BTS can provide an effective and safe therapeutic option compared to emergency surgery.
文摘Objective:To explore the epidemiological trends and clinical presentations of brucellosis in patients diagnosed with different types of cancer.Methods:A systematic review was performed utilizing PubMed,Embase,Scopus,Web of Science,and Google Scholar following PRISMA guidelines until September 2022.An update in December 2023 was conducted to ensure thorough coverage of the literature.Results:A total of 28 articles met the eligibility criteria,reporting 38 cases of brucellosis in patients with cancer.Among these cases,hematological cancers were the most common,comprising 66%of the cases,and B.melitensis was identified as the predominant species.The primary clinical manifestations of brucellosis infection included constitutional symptoms in a notable 60.5%of cases and febrile neutropenia in 21%.Additionally,six cases(15.8%)experienced relapse or recurrence of brucellosis,all of which were managed using a combination therapy of rifampin and doxycycline.While 28 patients successfully achieved remission from both brucellosis and their underlying neoplastic conditions,unfortunately,nine cases resulted in mortality attributed to septic shock,progressive liver failure,and massive embolism;no deaths directly related to brucellosis were reported.Among the non-surviving cases,hematologic malignancies were the most prevalent neoplastic conditions(77.7%).Conclusions:Brucellosis-cancer co-occurrence is rare but is not related to increasing mortality.The risk of relapse is higher in cancer patients,especially with hematologic malignancies.Screening,monitoring,and judicious antibiotic use can mitigate brucellosis risks in neoplastic patients.
基金Supported by Natural Science Foundation of Hubei Province(No.2023BCB147,No.2023AFB1026).
文摘AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.
文摘Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.
文摘BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.
基金funded by the Jiangsu Graduate Student Practice and Innovation Program(No.SJCX23_0665).
文摘Objective:To analyze body composition measurements and explore their correlation with the nutritional risk screening score and neutrophil-to-lymphocyte ratio(NLR;an index of inflammation)to provide a basis for the perioperative and nutritional management of patients with gynecologic malignancy.Methods:This study included 77 patients with gynecologic malignancies confirmed by surgical pathology between December 2021 and January 2023.Preoperative body composition data were obtained using bioelectrical impedance analysis.Nutritional risk screening and assessment were performed.Differences in body composition by age,nutritional status,International Federation of Gynecology and Obstetrics(FIGO)stage,systemic inflammatory response,and type of gynecologic malignancy were compared.Results:The extracellular water ratio was significantly higher in patients with a high FIGO stage than in those with a low FIGO stage(t=4.047,P<0.001).Other body composition parameters were lower in patients with a high FIGO stage than in those with a low FIGO stage(P<0.05).Regarding the NLR,the extracellular water ratio was significantly higher in patients with a high NLR than in those with a low NLR(t=2.929,P=0.005).As the nutritional condition worsened,the extracellular water ratio increased(H=12.291,P=0.002),with no significant difference in other body composition parameters between patients with different nutritional conditions(H=5.118,P=0.077).Other body composition parameters decreased with the nutritional condition,which was statistically significant(P<0.05).Conclusions:Bioelectrical impedance analysis is an easy-to-perform,noninvasive,and reproducible measurement technique that can assess changes in body composition.Body composition analysis can effectively determine an individual’s nutritional and metabolic status,providing a reference for the management of patients with gynecologic malignancy,and potentially providing predictive biomarkers to stratify these patients.
文摘BACKGROUND Malignant obstructive jaundice(MOJ)is characterized by the presence of malignant tumors infiltrating or compressing the bile duct,causing poor bile drainage,generalized yellowing,pain,itching,and malaise.MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.AIM To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement,complication rates,and long-term patient outcomes.METHODS The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed.According to the treatment method,the patients were divided into an observation group(29 patients)and a control group(30 patients).General data,liver function indices,complications,adverse effects,and 3-year survival rates after different surgical treatments were recorded for the two groups.RESULTS There were no significant differences in baseline information(sex,age,tumor type,or tumor diameter)between the two groups(P>0.05).Alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels were significantly better in both groups after surgery than before surgery(P<0.05).The overall incidence of biliary bleeding,gastrointestinal bleeding,pancreatitis,and cholangitis was 6.9%in the observation group and 30%in the control group(P<0.05).No significant differences in the rates of blood transfusion,intensive care unit admission,or death within 3 years were observed between the two groups at the 1-month follow-up(P>0.05).The 3-year survival rates were 46.06%and 39.71%in the observation and control groups,respectively.CONCLUSION Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function,with minimal complications.This technique is a promising palliative approach for patients ineligible for radical surgery.However,further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.
基金Supported by Natural Science Foundation of Chongqing,No.CSTB2023NSCQ-MSX0829.
文摘BACKGROUND Melanoma is a highly malignant tumor that has an extremely poor prognosis.It is the primary cause of death among cutaneous malignancies,accounting for 75%of such fatalities;approximately 325000 new cases and 57000 deaths were reported worldwide in 2020.The main modalities for melanoma treatment include surgery,immunotherapy,targeted therapy,high-dose interferon,antitumor angiogenesis,chemotherapy,and radiotherapy.Due to China's special national conditions,the main pathological types and therapeutic effects are greatly different from those in Europe and the United States,so more studies are needed to determine the curative effects of such treatments in the Chinese population.AIM To explore their clinical characteristics,prognostic influencing factors and realworld data to provide a reference basis for further diagnosis and treatment.METHODS We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years.Univariate analysis was conducted using the log-rank test,while multivariate analysis was performed with the Cox proportional hazard regression model.The survival rate was calculated using the Kaplan-Meier method.RESULTS The male-to-female patient ratio was 1.04:1.Among the clinical classifications,melanoma of the limb accounted for 47.56%of cases,followed by melanoma of the skin(18.18%)and mucosal melanoma(18.05%).The 5-year survival rates for stage I-II,stage III,and stage IV patients were 54.65%,37.88%,and 28.58%,respectively.Univariate analysis revealed that age,tumor stage,treatment mode,platelet count at the first visit,and lactate dehydrogenase(LDH)level were significantly related to patient survival.Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year,3 years,and 5 years.Multivariate analysis demonstrated that tumor stage,chemotherapy,interferon therapy,and LDH level were independent risk factors affecting patient survival and prognosis.Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy,those of patients who received chemotherapy and interferon therapy were 30.0%and 44.5%lower,respectively.Additionally,patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels.CONCLUSION Melanoma is highly malignant,and its prognosis is influenced by numerous factors,resulting in an overall poor prognosis.This study identified several factors that impact patient prognosis,providing a foundation for individualized comprehensive treatment.
文摘Background:During the establishment of a model of acute kidney injury(AKI)in pigs,we observed a high prevalence of malignant hyperthermia(MH).These complications led us to refine the anesthetic protocol.This publication describes the impact of the choice of anesthetics on the results obtained.Methods:Pigs were euthanized at the end of the procedure,without recovery from anesthesia.Three anesthetic protocols were used:sevoflurane inhalation(ProtocolA,n=5),a combination of ketamine,medetomidine and diazepam by intravenous infusion(ProtocolB,n=5),and a combination of ketamine,diazepam,medetomidine,glucose,and noradrenaline(ProtocolC,n=5).All pigs received morphine for analgesia.AKI was induced by interrupting renal perfusion for 90 min.MH was diagnosed based on clinical and biological parameters.Results:All MH pigs belonged to ProtocolA.MH pigs showed significantly higher maximum rectal temperature(p=0.04),maximum expired carbon dioxide(CO_(2);p=0.04),maximum heart rate(HR;p=0.03),plasma concentration of creatinine and potassium(p<0.0001).Protocol A pigs had a significantly higher maximum HR(p=0.01)and hyperkalemia compared to the two other groups(ProtocolB,p=0.005 and ProtocolC,p<0.0001).Pigs from ProtocolA had a significantly lower minimum mean arterial pressure(MAP)than ProtocolC group(p=0.03)and MAP remained below 60 mmHg for longer(p=0.004).In ProtocolB,minimum glycemia was lower than other groups(p=0.01).Conclusion:Sevoflurane use was associated with the occurrence of MH,hemodynamic alterations and changes in plasma concentration of creatinine and potassium.These modifications can have a major impact on the validation of an experimental AKI model.
文摘Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)is emerging as a preferred approach for managing malignant gastric outlet obstruction.This technique offers a balance between the durability of surgical gastrojejunostomy(SGJ)and the minimally invasive nature of endoscopic methods.Compared to enteral stenting,EUS-GE shows superior outcomes,including higher long-term patency,lower symptom recurrence,and fewer reinterventions.It also demonstrates comparable or better efficacy than SGJ,with faster oral intake,shorter hospital stays,and reduced complications.However,EUS-GE requires specialized expertise,and long-term outcome data remain limited,so further research is needed to refine protocols and optimize patient selection.
