Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare r...Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastros-copy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following:genetic factors, dietary intake, intestinal flora, or lowgrade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.展开更多
AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological fi...AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels.展开更多
目的研究内镜黏膜下剥离术(ESD)治疗胃肠神经内分泌肿瘤(GI-NENs)及对血清血管内皮生长因子(VEGF)、嗜铬粒蛋白A(CgA)的影响。方法选择2012年1月至2018年5月收治的GI-NENs患者106例,依据随机数字表法分为ESD组和对照组,每组53例。ESD组...目的研究内镜黏膜下剥离术(ESD)治疗胃肠神经内分泌肿瘤(GI-NENs)及对血清血管内皮生长因子(VEGF)、嗜铬粒蛋白A(CgA)的影响。方法选择2012年1月至2018年5月收治的GI-NENs患者106例,依据随机数字表法分为ESD组和对照组,每组53例。ESD组行ESD治疗,对照组行内镜下黏膜切除术(EMR)治疗。观察2组病变切除、术中穿孔情况,术中出血量、手术时间及住院时间等手术相关指标。术前、术后7 d 2组血清VEGF、CgA水平,血清CD^+3CD^+4、CD^+3CD^+8、CD^+4/CD^+8等免疫指标水平。2组术后1年复发及3年生存情况。结果ESD组治愈性切除率、整块切除率均高于对照组(P<0.05);2组基底病灶残余率、术中穿孔率无差异(P>0.05)。ESD组术中出血量少于对照组,手术时间、住院时间均长于对照组(P<0.05)。术后7 d,ESD组VEGFA、VEGFB、VEGFC及CgA水平均低于对照组(P<0.05),ESD组CD^+3CD^+4、CD^+3CD^+8高于对照组,CD^+4/CD^+8低于对照组(P<0.05)。ESD组术后1年复发率低于对照组,3年生存率高于对照组(P<0.05)。结论ESD治疗GI-NENs,可有效切除病灶,降低VEGF、CgA水平,恢复机体免疫,且术后生存率高,复发率低,值得推荐于临床。展开更多
Biliary tract carcinomas are relatively rare,representing less than 1%of cancers.However,their incidence has increased in Japan and in industrialized countries like the USA.Biliary tract tumors have a poor prognosis a...Biliary tract carcinomas are relatively rare,representing less than 1%of cancers.However,their incidence has increased in Japan and in industrialized countries like the USA.Biliary tract tumors have a poor prognosis and a high mortality rate because they are usually detected late in the course of the disease;therapeutic treatment options are often limited and of minimal utility.Recent studies have shown the importance of serum and molecularmarkers in the diagnosis and follow up of biliary tract tumors.This review aims to introduce the main features of the most important serum and molecular markers of biliary tree tumors.Some considerable tumor markers are cancer antigen 125,carbohydrate antigen 19-9,carcinoembryonic antigen,chromogranin A,mucin 1,mucin 5,alpha-fetoprotein,claudins and cytokeratins.展开更多
文摘Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastros-copy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following:genetic factors, dietary intake, intestinal flora, or lowgrade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.
文摘AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels.
文摘目的研究内镜黏膜下剥离术(ESD)治疗胃肠神经内分泌肿瘤(GI-NENs)及对血清血管内皮生长因子(VEGF)、嗜铬粒蛋白A(CgA)的影响。方法选择2012年1月至2018年5月收治的GI-NENs患者106例,依据随机数字表法分为ESD组和对照组,每组53例。ESD组行ESD治疗,对照组行内镜下黏膜切除术(EMR)治疗。观察2组病变切除、术中穿孔情况,术中出血量、手术时间及住院时间等手术相关指标。术前、术后7 d 2组血清VEGF、CgA水平,血清CD^+3CD^+4、CD^+3CD^+8、CD^+4/CD^+8等免疫指标水平。2组术后1年复发及3年生存情况。结果ESD组治愈性切除率、整块切除率均高于对照组(P<0.05);2组基底病灶残余率、术中穿孔率无差异(P>0.05)。ESD组术中出血量少于对照组,手术时间、住院时间均长于对照组(P<0.05)。术后7 d,ESD组VEGFA、VEGFB、VEGFC及CgA水平均低于对照组(P<0.05),ESD组CD^+3CD^+4、CD^+3CD^+8高于对照组,CD^+4/CD^+8低于对照组(P<0.05)。ESD组术后1年复发率低于对照组,3年生存率高于对照组(P<0.05)。结论ESD治疗GI-NENs,可有效切除病灶,降低VEGF、CgA水平,恢复机体免疫,且术后生存率高,复发率低,值得推荐于临床。
文摘Biliary tract carcinomas are relatively rare,representing less than 1%of cancers.However,their incidence has increased in Japan and in industrialized countries like the USA.Biliary tract tumors have a poor prognosis and a high mortality rate because they are usually detected late in the course of the disease;therapeutic treatment options are often limited and of minimal utility.Recent studies have shown the importance of serum and molecularmarkers in the diagnosis and follow up of biliary tract tumors.This review aims to introduce the main features of the most important serum and molecular markers of biliary tree tumors.Some considerable tumor markers are cancer antigen 125,carbohydrate antigen 19-9,carcinoembryonic antigen,chromogranin A,mucin 1,mucin 5,alpha-fetoprotein,claudins and cytokeratins.
