1
|
Teoh AYB, Lakhtakia S, Tan DMY, Crinò SF, Dhir V, Kunda R, Ang TL, Ho KY, Aerts M, Memon SF, Chan SM, Chiu PWY, Conti Bellocchi MC, Messaoudi N, Ng SKK, Yip HC, Gabbrielli A, Khor CJL, Ramchandani M, Ng EKW. Partially covered versus uncovered pyloro-duodenal stents for unresectable malignant gastric outlet obstruction: Randomized controlled study. Dig Endosc 2024; 36:428-436. [PMID: 37522554 DOI: 10.1111/den.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES The aim of the current study was to compare the efficacy of partially covered duodenal stent (PCDS) vs. uncovered duodenal stent (UCDS) in patients suffering from unresectable primary malignant gastric outlet obstruction (GOO). METHODS This was a prospective international randomized controlled study conducted in 10 high-volume institutions. Consecutive patients suffering from malignant GOO were recruited. The primary outcome measurement was the reintervention rate. Secondary outcomes included technical and clinical success, 30-day adverse events, 30-day mortality, causes of stent dysfunction, and the duration of stent patency. RESULTS Between March 2017 and October 2020, 115 patients (59 PCDS, 56 UCDS) were recruited. The 1-year reintervention was not significantly different (PCDS vs. UDCS = 12/59, 20.3% vs. 14/56, 25%, P = 0.84). There was a trend to fewer patients with tumor ingrowth in the PCDS group (6/59 [10.2%]) vs. 13/56 [23.2%], P = 0.07). There were no significant differences in the technical success (100% vs. 100%, P = 1), clinical success (91.5% vs. 98.2%, P = 0.21), procedural time (21.5 [interquartile range [IQR] 17-30] vs. 20.0 [IQR 15-34.75], P = 0.62), hospital stay (4 [IQR 3-12] vs. 5 [IQR 3-8] days, P = 0.81), 30-day adverse events (18.6% vs. 14.3%, P = 0.62), or 30-day mortality (6.8% vs. 5.2%, P = 1.00). CONCLUSION The use of PCDS was associated with a lower risk of tumor ingrowth but did not improve on reintervention rates or stent patency. Both kinds of stents could be used in this group of patients.
Collapse
Affiliation(s)
- Anthony Yuen Bun Teoh
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sundeep Lakhtakia
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Damien Meng Yew Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital and Duke-NUS Medical School, Singapore City, Singapore
| | - Stefano Francesco Crinò
- Gastroenterology and Digestive Endoscopy Unit, Pancreas Institute, University Hospital of Verona, Verona, Italy
| | - Vinay Dhir
- Institute of Digestive and Liver Care, SL Raheja Hospital, Mumbai, India
| | - Rastislav Kunda
- Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Hepatopancreatobiliary Center, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Gastroenterology-Hepatology, Hepatopancreatobiliary Center, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore City, Singapore
| | - Khek Yu Ho
- Department of Medicine, National University of Singapore, Singapore City, Singapore
| | - Maridi Aerts
- Department of Gastroenterology-Hepatology, Hepatopancreatobiliary Center, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sana Fathima Memon
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Shannon Melissa Chan
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Philip Wai Yan Chiu
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Nouredin Messaoudi
- Department of Surgery, Hepatopancreatobiliary Center, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stephen Ka Kei Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hon Chi Yip
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Armando Gabbrielli
- Gastroenterology and Digestive Endoscopy Unit, Pancreas Institute, University Hospital of Verona, Verona, Italy
| | - Christopher Jen Lock Khor
- Department of Gastroenterology and Hepatology, Singapore General Hospital and Duke-NUS Medical School, Singapore City, Singapore
| | - Mohan Ramchandani
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Enders Kwok Wai Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
2
|
Acciuffi S, Hilal MA, Ferrari C, Al-Madhi S, Chouillard MA, Messaoudi N, Croner RS, Gumbs AA. Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter? Cancers (Basel) 2024; 16:1051. [PMID: 38473411 DOI: 10.3390/cancers16051051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. METHODS This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. RESULTS The open group had significantly higher estimated blood loss (620 mL vs. 320 mL, p < 0.001), longer operative time (273 vs. 216 min, p = 0.003), and longer hospital stays (16.9 vs. 6.81 days, p < 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2, p = 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min, p < 0.001), shorter ICU stays (0.63 vs. 1.64 days, p < 0.001), and shorter hospital stays (6.61 vs. 11.8 days, p < 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. CONCLUSION The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality.
Collapse
Affiliation(s)
- Sara Acciuffi
- Department of General-, Visceral-, Vascular- and Transplantation Surgery, University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Mohammed Abu Hilal
- Hepatobiliopancreatic, Robotic and Minimally Invasive Surgery Unit, Fondazione Poliambulanza Istituto Ospedaliero, Via Bissolati 57, 25124 Brescia, Italy
| | - Clarissa Ferrari
- Research and Clinical Trials Office, Fondazione Poliambulanza Istituto Ospedaliero, Via Bissolati 57, 25124 Brescia, Italy
| | - Sara Al-Madhi
- Department of General-, Visceral-, Vascular- and Transplantation Surgery, University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Marc-Anthony Chouillard
- Hepatobiliopancreatic Surgery, Université de Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France
| | - Nouredin Messaoudi
- Department of Hepatopancreatobiliary Surgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel and Europe Hospitals, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Roland S Croner
- Department of General-, Visceral-, Vascular- and Transplantation Surgery, University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Andrew A Gumbs
- Department of General-, Visceral-, Vascular- and Transplantation Surgery, University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
- Department of Advanced & Minimally Invasive Surgery, American Hospital of Tbilisi, 17 Ushangi Chkheidze Street, Tbilisi 0102, Georgia
| |
Collapse
|
3
|
Michiels E, Madhloum H, Van Lint S, Messaoudi N, Kunda R, Martens S, Giron P, Olsen C, Lefesvre P, Dusetti N, El Mohajer L, Tomasini R, Hawinkels LJ, Ahsayni F, Nicolle R, Arsenijevic T, Bouchart C, Van Laethem JL, Rooman I. High-resolution and quantitative spatial analysis reveal intra-ductal phenotypic and functional diversification in pancreatic cancer. J Pathol 2024; 262:76-89. [PMID: 37842959 DOI: 10.1002/path.6212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/23/2023] [Accepted: 09/02/2023] [Indexed: 10/17/2023]
Abstract
A 'classical' and a 'basal-like' subtype of pancreatic cancer have been reported, with differential expression of GATA6 and different dosages of mutant KRAS. We established in situ detection of KRAS point mutations and mRNA panels for the consensus subtypes aiming to project these findings to paraffin-embedded clinical tumour samples for spatial quantitative analysis. We unveiled that, next to inter-patient and intra-patient inter-ductal heterogeneity, intraductal spatial phenotypes exist with anti-correlating expression levels of GATA6 and KRASG12D . The basal-like mRNA panel better captured the basal-like cell states than widely used protein markers. The panels corroborated the co-existence of the classical and basal-like cell states in a single tumour duct with functional diversification, i.e. proliferation and epithelial-to-mesenchymal transition respectively. Mutant KRASG12D detection ascertained an epithelial origin of vimentin-positive cells in the tumour. Uneven spatial distribution of cancer-associated fibroblasts could recreate similar intra-organoid diversification. This extensive heterogeneity with functional cooperation of plastic tumour cells poses extra challenges to therapeutic approaches. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Collapse
Affiliation(s)
- Ellis Michiels
- Laboratory of Medical & Molecular Oncology (LMMO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Hediel Madhloum
- Laboratory of Medical & Molecular Oncology (LMMO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Silke Van Lint
- Laboratory of Medical & Molecular Oncology (LMMO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Nouredin Messaoudi
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rastislav Kunda
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sandrina Martens
- Laboratory of Medical & Molecular Oncology (LMMO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Cardio and Organ Systems, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Philippe Giron
- Centre for Medical Genetics, Clinical Sciences, Reproduction and Genetics Research Group, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Catharina Olsen
- Centre for Medical Genetics, Clinical Sciences, Reproduction and Genetics Research Group, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Pierre Lefesvre
- Department of Anatomo-Pathology, Universitair Ziekenhuis Brussel (UZB), Brussels, Belgium
| | - Nelson Dusetti
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille, Marseille University, Marseille, France
| | - Leila El Mohajer
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille, Marseille University, Marseille, France
| | - Richard Tomasini
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille, Marseille University, Marseille, France
| | - Lukas Jac Hawinkels
- Department of Gastroenterology and Hepatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Farah Ahsayni
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rémy Nicolle
- Centre de Recherche sur l'inflammation (CRI), INSERM, Paris, France
| | - Tatjana Arsenijevic
- Laboratory of Experimental Gastroenterology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
- Department of Gastroenterology, Hepatology and Digestive Oncology, HUB Bordet Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Christelle Bouchart
- Department of Radiation-Oncology, Université Libre de Bruxelles (ULB), Hospital Universitaire de Bruxelles (HUB) Institut Jules Bordet, Brussels, Belgium
| | - Jean-Luc Van Laethem
- Laboratory of Experimental Gastroenterology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
- Department of Gastroenterology, Hepatology and Digestive Oncology, HUB Bordet Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Ilse Rooman
- Laboratory of Medical & Molecular Oncology (LMMO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
4
|
Henault D, Stephen D, St-Hilaire PA, Messaoudi N, Vandenbroucke-Menu F, Simoneau E, Rong Z, Plasse M, Létourneau R, Roy A, Dagenais M, Lapointe R, Nguyen B, Mes-Masson AM, Soucy G, Turcotte S. Homogeneity in immune features between colorectal liver metastases better identifies patients with good prognosis compared to pathological response to preoperative chemotherapy. Oncoimmunology 2023; 12:2253642. [PMID: 37720689 PMCID: PMC10503458 DOI: 10.1080/2162402x.2023.2253642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/07/2023] [Accepted: 08/26/2023] [Indexed: 09/19/2023] Open
Abstract
In colorectal cancer liver metastases (CRLM), the density of tumor-infiltrating lymphocytes, the expression of class I major histocompatibility complex (MHC-I), and the pathological response to preoperative chemotherapy have been associated with oncological outcomes after complete resection. However, the prognostic significance of the heterogeneity of these features in patients with multiple CRLMs remains under investigation. We used a tissue microarray of 220 mismatch repair-gene proficient CRLMs resected in 97 patients followed prospectively to quantify CD3+ T cells and MHC-I by immunohistochemistry. Histopathological response to preoperative chemotherapy was assessed using standard scoring systems. We tested associations between clinical, immunological, and pathological features with oncologic outcomes. Overall, 29 patients (30.2%) had CRLMs homogeneous for CD3+ T cell infiltration and MHC-I. Patients with immune homogeneous compared to heterogeneous CRLMs had longer median time to recurrence (TTR) (30 vs. 12 months, p = .0018) and disease-specific survival (DSS) (not reached vs. 48 months, p = .0009). At 6 years, 80% of the patients with immune homogeneous CRLMs were still alive. Homogeneity of response to preoperative chemotherapy was seen in 60 (61.9%) and 69 (80.2%) patients according to different grading systems and was not associated with TTR or DSS. CD3 and MHC-I heterogeneity was independent of response to pre-operative chemotherapy and of other clinicopathological variables for their association with oncological outcomes. In patients with multiple CRLMs resected with curative intent, similar adaptive immune features seen across metastases could be more informative than pathological response to pre-operative chemotherapy in predicting oncological outcomes.
Collapse
Affiliation(s)
- David Henault
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Cancer Axis, Centre de recherche du Centre Hospitalier de l’Université de Montréal/Institut du cancer de Montréal, Montréal, Québec, Canada
| | - David Stephen
- Department of Pathology, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Pierre-Antoine St-Hilaire
- Cancer Axis, Centre de recherche du Centre Hospitalier de l’Université de Montréal/Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Nouredin Messaoudi
- Cancer Axis, Centre de recherche du Centre Hospitalier de l’Université de Montréal/Institut du cancer de Montréal, Montréal, Québec, Canada
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel) and Europe Hospitals, Brussels, Belgium
| | - Franck Vandenbroucke-Menu
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Eve Simoneau
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Zhixia Rong
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Marylène Plasse
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Richard Létourneau
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - André Roy
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Michel Dagenais
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Réal Lapointe
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Bich Nguyen
- Department of Pathology, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Anne-Marie Mes-Masson
- Cancer Axis, Centre de recherche du Centre Hospitalier de l’Université de Montréal/Institut du cancer de Montréal, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - G. Soucy
- Department of Pathology, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Simon Turcotte
- Hepato-Pancreato-Biliary Surgery Service, Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Cancer Axis, Centre de recherche du Centre Hospitalier de l’Université de Montréal/Institut du cancer de Montréal, Montréal, Québec, Canada
| |
Collapse
|
5
|
Teoh AYB, Napoleon B, Kunda R, Arcidiacono PG, Kongkam P, Larghi A, Van der Merwe S, Jacques J, Legros R, Thawee RE, Saxena P, Aerts M, Archibugi L, Chan SM, Fumex F, Kaffes AJ, Ma MTW, Messaoudi N, Rizzatti G, Ng KKC, Ng EKW, Chiu PWY. EUS-Guided Choledocho-duodenostomy Using Lumen Apposing Stent Versus ERCP With Covered Metallic Stents in Patients With Unresectable Malignant Distal Biliary Obstruction: A Multicenter Randomized Controlled Trial (DRA-MBO Trial). Gastroenterology 2023; 165:473-482.e2. [PMID: 37121331 DOI: 10.1053/j.gastro.2023.04.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND & AIMS Several studies have compared primary endoscopic ultrasound (EUS)-guided biliary drainage to endoscopic retrograde cholangiopancreatography (ERCP) with insertion of metal stents in unresectable malignant distal biliary obstruction (MDBO) and the results were conflicting. The aim of the current study was to compare the outcomes of the procedures in a large-scale study. METHODS This was a multicenter international randomized controlled study. Consecutive patients admitted for obstructive jaundice due to unresectable MDBO were recruited. Patients were randomly allocated to receive EUS-guided choledocho-duodenostomy (ECDS) or ERCP for drainage. The primary outcome was the 1-year stent patency rate. Other outcomes included technical success, clinical success, adverse events, time to stent dysfunction, reintervention rates, and overall survival. RESULTS Between January 2017 and February 2021, 155 patients were recruited (ECDS 79, ERCP 76). There were no significant differences in 1-year stent patency rates (ECDS 91.1% vs ERCP 88.1%, P = .52). The ECDS group had significantly higher technical success (ECDS 96.2% vs ERCP 76.3%, P < .001), whereas clinical success was similar (ECDS 93.7% vs ERCP 90.8%, P = .559). The median (interquartile range) procedural time was significantly shorter in the ECDS group (ECDS 10 [5.75-18] vs ERCP 25 [14-40] minutes, P < .001). The rate of 30-day adverse events (P = 1) and 30-day mortality (P = .53) were similar. CONCLUSION Both procedures could be options for primary biliary drainage in unresectable MDBO. ECDS was associated with higher technical success and shorter procedural time then ERCP. Primary ECDS may be preferred when difficult ERCPs are anticipated. This study was registered to Clinicaltrials.gov NCT03000855.
Collapse
Affiliation(s)
- Anthony Yuen Bun Teoh
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | - Rastislav Kunda
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel UZB, Vrije Universiteit Brussel VUB, Brussels, Belgium; Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Paolo Giorgio Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan, Italy
| | - Pradermchai Kongkam
- Division of Hospital and Ambulatory Medicine and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Alberto Larghi
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Schalk Van der Merwe
- Department of Gastroenterology and Hepatology, The University of Leuven, Leuven, Belgium
| | - Jeremies Jacques
- Gastroenterology Department, Dupuytren University Hospital, Limoges, France
| | - Romain Legros
- Gastroenterology Department, Dupuytren University Hospital, Limoges, France
| | | | - Payal Saxena
- Department of Gastroenterology, Royal Prince Alfred Hospital, Sidney, Australia
| | - Maridi Aerts
- Department of Gastroenterology-Hepatology, Universitair Ziekenhuis Brussel UZB, Vrije Universiteit Brussel VUB, Brussels, Belgium
| | - Livia Archibugi
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan, Italy
| | - Shannon Melissa Chan
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fabien Fumex
- Hopital Privé Jean Mermoz, Ramsay Santé, Lyon Cedex 08, France
| | - Arthur J Kaffes
- Department of Gastroenterology, Royal Prince Alfred Hospital, Sidney, Australia
| | - Mark Tsz Wah Ma
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nouredin Messaoudi
- Department of Surgery, Universitair Ziekenhuis Brussel UZB, Vrije Universiteit Brussel VUB, Brussels, Belgium
| | - Gianenrico Rizzatti
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Kelvin Kwok Chai Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Enders Kwok Wai Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Philip Wai Yan Chiu
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
6
|
Bronswijk M, Vanella G, van Wanrooij RLJ, Samanta J, Lauwereys J, Pérez-Cuadrado-Robles E, Dell'Anna G, Dhar J, Gupta V, van Malenstein H, Laleman W, Jaekers J, Topal H, Topal B, Crippa S, Falconi M, Besselink MG, Messaoudi N, Arcidiacono PG, Kunda R, Van der Merwe S. Same-session double EUS-guided bypass versus surgical gastroenterostomy and hepaticojejunostomy: an international multicenter comparison. Gastrointest Endosc 2023; 98:225-236.e1. [PMID: 36990124 DOI: 10.1016/j.gie.2023.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/16/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND AND AIMS Gastric outlet and biliary obstruction are common manifestations of GI malignancies and some benign diseases for which standard treatment would be surgical gastroenterostomy and hepaticojejunostomy (ie, "double bypass"). Therapeutic EUS has allowed for the creation of an EUS-guided double bypass. However, same-session double EUS-guided bypass has only been described in small proof-of-concept series and lacks a comparison with surgical double bypass. METHODS A retrospective multicenter analysis was performed of all consecutive same-session double EUS-guided bypass procedures performed in 5 academic centers. Surgical comparators were extracted from these centers' databases from the same time interval. Efficacy, safety, hospital stay, nutrition and chemotherapy resumption, long-term patency, and survival were compared. RESULTS Of 154 identified patients, 53 (34.4%) received treatment with EUS and 101 (65.6%) with surgery. At baseline, patients undergoing EUS exhibited higher American Society of Anesthesiologists scores and a higher median Charlson Comorbidity Index (9.0 [interquartile range {IQR}, 7.0-10.0] vs 7.0 [IQR, 5.0-9.0], P < .001). Technical success (96.2% vs 100%, P = .117) and clinical success rates (90.6% vs 82.2%, P = .234) were similar when comparing EUS and surgery. Overall (11.3% vs 34.7%, P = .002) and severe adverse events (3.8% vs 19.8%, P = .007) occurred more frequently in the surgical group. In the EUS group, median time to oral intake (0 days [IQR, 0-1] vs 6 days [IQR, 3-7], P < .001) and hospital stay (4.0 days [IQR, 3-9] vs 13 days [IQR, 9-22], P < .001) were significantly shorter. CONCLUSIONS Despite being used in a patient population with more comorbidities, same-session double EUS-guided bypass achieved similar technical and clinical success and was associated with fewer overall and severe adverse events when compared with surgical gastroenterostomy and hepaticojejunostomy.
Collapse
Affiliation(s)
- Michiel Bronswijk
- Department of Gastroenterology and Hepatology; Department of Gastroenterology and Hepatology, Imelda Hospital Bonheiden, Bonheiden, Belgium
| | | | - Roy L J van Wanrooij
- Department of Gastroenterology and Hepatology; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Jayanta Samanta
- Departments of Gastroenterology and GI Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Jonas Lauwereys
- Department of Gastroenterology and Hepatology; Department of Gastroenterology and Hepatology, Imelda Hospital Bonheiden, Bonheiden, Belgium
| | - Enrique Pérez-Cuadrado-Robles
- Department of Gastroenterology, Georges-Pompidou European Hospital, APHP, Centre, University of Paris Cité, Paris, France
| | | | - Jahnvi Dhar
- Departments of Gastroenterology and GI Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Vikas Gupta
- Departments of Gastroenterology and GI Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | | | - Wim Laleman
- Department of Gastroenterology and Hepatology
| | - Joris Jaekers
- Department of Visceral Surgery, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - Halit Topal
- Department of Visceral Surgery, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - Baki Topal
- Department of Visceral Surgery, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - Stefano Crippa
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute and University, Milan, Italy
| | - Massimo Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute and University, Milan, Italy
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Nouredin Messaoudi
- Department of Surgery, Department of Gastroenterology and Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Rastislav Kunda
- Department of Surgery, Department of Gastroenterology and Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | |
Collapse
|
7
|
Saber R, Henault D, Messaoudi N, Rebolledo R, Montagnon E, Soucy G, Stagg J, Tang A, Turcotte S, Kadoury S. Radiomics using computed tomography to predict CD73 expression and prognosis of colorectal cancer liver metastases. J Transl Med 2023; 21:507. [PMID: 37501197 PMCID: PMC10375693 DOI: 10.1186/s12967-023-04175-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/30/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Finding a noninvasive radiomic surrogate of tumor immune features could help identify patients more likely to respond to novel immune checkpoint inhibitors. Particularly, CD73 is an ectonucleotidase that catalyzes the breakdown of extracellular AMP into immunosuppressive adenosine, which can be blocked by therapeutic antibodies. High CD73 expression in colorectal cancer liver metastasis (CRLM) resected with curative intent is associated with early recurrence and shorter patient survival. The aim of this study was hence to evaluate whether machine learning analysis of preoperative liver CT-scan could estimate high vs low CD73 expression in CRLM and whether such radiomic score would have a prognostic significance. METHODS We trained an Attentive Interpretable Tabular Learning (TabNet) model to predict, from preoperative CT images, stratified expression levels of CD73 (CD73High vs. CD73Low) assessed by immunofluorescence (IF) on tissue microarrays. Radiomic features were extracted from 160 segmented CRLM of 122 patients with matched IF data, preprocessed and used to train the predictive model. We applied a five-fold cross-validation and validated the performance on a hold-out test set. RESULTS TabNet provided areas under the receiver operating characteristic curve of 0.95 (95% CI 0.87 to 1.0) and 0.79 (0.65 to 0.92) on the training and hold-out test sets respectively, and outperformed other machine learning models. The TabNet-derived score, termed rad-CD73, was positively correlated with CD73 histological expression in matched CRLM (Spearman's ρ = 0.6004; P < 0.0001). The median time to recurrence (TTR) and disease-specific survival (DSS) after CRLM resection in rad-CD73High vs rad-CD73Low patients was 13.0 vs 23.6 months (P = 0.0098) and 53.4 vs 126.0 months (P = 0.0222), respectively. The prognostic value of rad-CD73 was independent of the standard clinical risk score, for both TTR (HR = 2.11, 95% CI 1.30 to 3.45, P < 0.005) and DSS (HR = 1.88, 95% CI 1.11 to 3.18, P = 0.020). CONCLUSIONS Our findings reveal promising results for non-invasive CT-scan-based prediction of CD73 expression in CRLM and warrant further validation as to whether rad-CD73 could assist oncologists as a biomarker of prognosis and response to immunotherapies targeting the adenosine pathway.
Collapse
Affiliation(s)
- Ralph Saber
- MedICAL Laboratory, Polytechnique Montréal, Montréal, H3T 1J4, Canada
- Imaging and Engineering Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis R10.430, Montréal, QC, H2X 0A9, Canada
| | - David Henault
- Cancer Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis, Room R10.430, Montréal, QC, H2X 0A9, Canada
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Service, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montréal, QC, H2X 0C1, Canada
| | - Nouredin Messaoudi
- Cancer Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis, Room R10.430, Montréal, QC, H2X 0A9, Canada
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Service, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montréal, QC, H2X 0C1, Canada
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel) and Europe Hospitals, Brussels, Belgium
| | - Rolando Rebolledo
- Cancer Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis, Room R10.430, Montréal, QC, H2X 0A9, Canada
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Service, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montréal, QC, H2X 0C1, Canada
| | - Emmanuel Montagnon
- Imaging and Engineering Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis R10.430, Montréal, QC, H2X 0A9, Canada
| | - Geneviève Soucy
- Pahology Department, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montréal, QC, H2X 0C1, Canada
| | - John Stagg
- Cancer Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis, Room R10.430, Montréal, QC, H2X 0A9, Canada
| | - An Tang
- Imaging and Engineering Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis R10.430, Montréal, QC, H2X 0A9, Canada
- Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, H3T 1J4, Canada
| | - Simon Turcotte
- Cancer Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis, Room R10.430, Montréal, QC, H2X 0A9, Canada.
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Service, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montréal, QC, H2X 0C1, Canada.
| | - Samuel Kadoury
- MedICAL Laboratory, Polytechnique Montréal, Montréal, H3T 1J4, Canada.
- Imaging and Engineering Axis, Centre de recherche du Centre Hospitalier de l'Université de Montréal/Institut du cancer de Montréal, 900 rue Saint-Denis R10.430, Montréal, QC, H2X 0A9, Canada.
- Department of Computer and Software Engineering, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, H3T 1J4, Canada.
- Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, H3T 1J4, Canada.
| |
Collapse
|
8
|
Bouichrat N, Messaoudi N, Zerrouki D, Assarar I, Rouf S, Latrech H. Les particularités diagnostiques et thérapeutiques chez les patients suivies pour le syndrome des ovaires polykystiques. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
|
9
|
Jaruvongvanich V, Mahmoud T, Abu Dayyeh BK, Chandrasekhara V, Law R, Storm AC, Levy MJ, Vargas EJ, Marya NB, Abboud DM, Ghazi R, Matar R, Rapaka B, Buttar N, Truty MJ, Aerts M, Messaoudi N, Kunda R. Endoscopic ultrasound-guided gastroenterostomy for the management of gastric outlet obstruction: A large comparative study with long-term follow-up. Endosc Int Open 2023; 11:E60-E66. [PMID: 36644538 PMCID: PMC9839427 DOI: 10.1055/a-1976-2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
Background and study aims Gastric outlet obstruction (GOO) is traditionally managed with surgical gastroenterostomy (surgical-GE) and enteral stenting (ES). Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is now a third option. Large studies assessing their relative risks and benefits with adequate follow-up are lacking. We conducted a comparative analysis of patients who underwent EUS-GE, ES, or surgical-GE for GOO. Patients and methods In this retrospective comparative cohort study, consecutive patients presenting with GOO who underwent EUS-GE, ES, or surgical-GE at two academic institutions were reviewed and independently cross-edited to ensure accurate reporting. The primary outcome was need for reintervention. Secondary outcomes were technical and clinical success, length of hospital stay (LOS), and adverse events (AEs). Results A total of 436 patients (232 EUS-GE, 131 ES, 73 surgical-GE) were included. The median duration of follow-up of the entire cohort was 185.5 days (interquartile range 55.25-454.25 days). The rate of reintervention in the EUS-GE group was lower than in the ES and surgical-GE groups (0.9 %, 12.2 %, and 13.7 %, P < 0.0001). Technical success was achieved in 98.3 %, 99.2 %, and 100 % ( P = 0.58), and clinical success was achieved in 98.3 %, 91.6 %, and 90.4 % ( P < 0.0001) in the EUS-GE, ES, and surgical-GE groups, respectively. The EUS-GE group had a shorter LOS (2 days vs. 3 days vs. 5 days, P < 0.0001) and a lower AE rate than the ES and surgical-GE groups (8.6 % vs. 38.9 % vs. 27.4 %, P < 0.0001). Conclusion This large cohort study demonstrates the safety and palliation durability of EUS-GE as an alternative strategy for GOO palliation in select patients.
Collapse
Affiliation(s)
| | - Tala Mahmoud
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Barham K. Abu Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Vinay Chandrasekhara
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Ryan Law
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Andrew C. Storm
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J. Levy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Eric J. Vargas
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Neil B. Marya
- Division of Gastroenterology, University of Massachusetts Medical School, Worcester, Massachusetts, United States
| | - Donna M. Abboud
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Rabih Ghazi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Reem Matar
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Babusai Rapaka
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Navtej Buttar
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Mark J. Truty
- Division of Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Maridi Aerts
- Department of Gastroenterology-Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nouredin Messaoudi
- Department of Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Rastislav Kunda
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
10
|
Bailly A, Lecouey JL, Billebaud A, Chabod S, Kochetkov A, Krása A, Lecolley FR, Lehaut G, Marie N, Messaoudi N, Vittiglio G, Wagemans J. Study of Reactor Core Loading Monitoring at the GUINEVERE Facility. NUCL SCI ENG 2023. [DOI: 10.1080/00295639.2022.2148813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- A. Bailly
- Normandie Université, Laboratoire de Physique Corpusculaire de Caen, ENSICAEN, UNICAEN, CNRS/IN2P3, 1400 Caen, France
| | - J.-L. Lecouey
- Normandie Université, Laboratoire de Physique Corpusculaire de Caen, ENSICAEN, UNICAEN, CNRS/IN2P3, 1400 Caen, France
| | - A. Billebaud
- Université Grenoble-Alpes, Laboratoire de Physique Subatomique et de Cosmologie, CNRS/IN2P3, 53 avenue des Martyrs, 38026 Grenoble cedex, France
| | - S. Chabod
- Université Grenoble-Alpes, Laboratoire de Physique Subatomique et de Cosmologie, CNRS/IN2P3, 53 avenue des Martyrs, 38026 Grenoble cedex, France
| | - A. Kochetkov
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | - A. Krása
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | - F.-R. Lecolley
- Normandie Université, Laboratoire de Physique Corpusculaire de Caen, ENSICAEN, UNICAEN, CNRS/IN2P3, 1400 Caen, France
| | - G. Lehaut
- Normandie Université, Laboratoire de Physique Corpusculaire de Caen, ENSICAEN, UNICAEN, CNRS/IN2P3, 1400 Caen, France
| | - N. Marie
- Normandie Université, Laboratoire de Physique Corpusculaire de Caen, ENSICAEN, UNICAEN, CNRS/IN2P3, 1400 Caen, France
| | - N. Messaoudi
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | - G. Vittiglio
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | - J. Wagemans
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| |
Collapse
|
11
|
Jacoberger-Foissac C, Cousineau I, Bareche Y, Allard D, Chrobak P, Allard B, Pommey S, Messaoudi N, McNicoll Y, Soucy G, Koseoglu S, Masia R, Lake AC, Seo H, Eeles CB, Rohatgi N, Robson SC, Turcotte S, Haibe-Kains B, Stagg J. CD73 Inhibits cGAS-STING and Cooperates with CD39 to Promote Pancreatic Cancer. Cancer Immunol Res 2023; 11:56-71. [PMID: 36409930 PMCID: PMC9812927 DOI: 10.1158/2326-6066.cir-22-0260] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/07/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022]
Abstract
The ectonucleotidases CD39 and CD73 catalyze extracellular ATP to immunosuppressive adenosine, and as such, represent potential cancer targets. We investigated biological impacts of CD39 and CD73 in pancreatic ductal adenocarcinoma (PDAC) by studying clinical samples and experimental mouse tumors. Stromal CD39 and tumoral CD73 expression significantly associated with worse survival in human PDAC samples and abolished the favorable prognostic impact associated with the presence of tumor-infiltrating CD8+ T cells. In mouse transplanted KPC tumors, both CD39 and CD73 on myeloid cells, as well as CD73 on tumor cells, promoted polarization of infiltrating myeloid cells towards an M2-like phenotype, which enhanced tumor growth. CD39 on tumor-specific CD8+ T cells and pancreatic stellate cells also suppressed IFNγ production by T cells. Although therapeutic inhibition of CD39 or CD73 alone significantly delayed tumor growth in vivo, targeting of both ectonucleotidases exhibited markedly superior antitumor activity. CD73 expression on human and mouse PDAC tumor cells also protected against DNA damage induced by gemcitabine and irradiation. Accordingly, large-scale pharmacogenomic analyses of human PDAC cell lines revealed significant associations between CD73 expression and gemcitabine chemoresistance. Strikingly, increased DNA damage in CD73-deficient tumor cells associated with activation of the cGAS-STING pathway. Moreover, cGAS expression in mouse KPC tumor cells was required for antitumor activity of the CD73 inhibitor AB680 in vivo. Our study, thus, illuminates molecular mechanisms whereby CD73 and CD39 seemingly cooperate to promote PDAC progression.
Collapse
Affiliation(s)
- Célia Jacoberger-Foissac
- Faculty of Pharmacy, University of Montreal., Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Isabelle Cousineau
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Yacine Bareche
- Faculty of Pharmacy, University of Montreal., Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - David Allard
- Faculty of Pharmacy, University of Montreal., Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Pavel Chrobak
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Bertrand Allard
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Sandra Pommey
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal
| | - Nouredin Messaoudi
- Department of Surgery, University of Antwerp, Antwerp, Belgium., Department of Surgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel and Europe Hospitals, Brussels, Belgium
| | - Yannic McNicoll
- Surgery Department, Hôpital Jean-Talon, CIUSSS NIM, Montreal, Quebec, Canada
| | - Geneviève Soucy
- Pathology Service, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | | | - Ricard Masia
- Surface Oncology, Inc. Cambridge, Massachusetts, USA
| | | | - Heewon Seo
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Christopher B. Eeles
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Neha Rohatgi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Simon C. Robson
- Center for Inflammation Research, Gastroenterology, Departments of Medicine and Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Simon Turcotte
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal., Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada, Department of Computer Science, University of Toronto, Toronto, Ontario, Canada, Ontario Institute for Cancer Research, Toronto, Ontario, Canada, Vector Institute for Artificial Intelligence, Toronto, Ontario, Canada
| | - John Stagg
- Faculty of Pharmacy, University of Montreal., Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada., Institut du Cancer de Montréal.,Correspondence: 900 St-Denis Street, Montréal, QC, Canada, H2X 0A9; ; Tel: 514-890-8000 ex:25170
| |
Collapse
|
12
|
Kochetkov A, Krása A, Messaoudi N, Vittiglio G, Wagemans J, Bailly A, Billebaud A, Chabod S, Lecolley FR, Lecouey JL, Lehaut G, Marie N. Deep Subcriticality Determination Using the Source Jerk Integral Method in the SALMON Program. NUCL SCI ENG 2022. [DOI: 10.1080/00295639.2022.2146429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- A. Kochetkov
- SCK CEN, Belgian Nuclear Research Centre, Boeretang 200, BE-2400 Mol, Belgium
| | - A. Krása
- SCK CEN, Belgian Nuclear Research Centre, Boeretang 200, BE-2400 Mol, Belgium
| | - N. Messaoudi
- SCK CEN, Belgian Nuclear Research Centre, Boeretang 200, BE-2400 Mol, Belgium
| | - G. Vittiglio
- SCK CEN, Belgian Nuclear Research Centre, Boeretang 200, BE-2400 Mol, Belgium
| | - J. Wagemans
- SCK CEN, Belgian Nuclear Research Centre, Boeretang 200, BE-2400 Mol, Belgium
| | - A. Bailly
- Normandie Univiversity, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000, Caen, France
| | - A. Billebaud
- Université Grenoble-Alpes, LPSC, CNRS/IN2P3, 53 Avenue des Martyrs, 38026 Grenoble Cedex, France
| | - S. Chabod
- Université Grenoble-Alpes, LPSC, CNRS/IN2P3, 53 Avenue des Martyrs, 38026 Grenoble Cedex, France
| | - F. -R. Lecolley
- Normandie Univiversity, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000, Caen, France
| | - J. -L. Lecouey
- Normandie Univiversity, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000, Caen, France
| | - G. Lehaut
- Normandie Univiversity, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000, Caen, France
| | - N. Marie
- Normandie Univiversity, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000, Caen, France
| |
Collapse
|
13
|
Zhang LY, Kunda R, Aerts M, Messaoudi N, Pawa R, Pawa S, Robles-Medranda C, Oleas R, Al-Haddad MA, Obaitan I, Muniraj T, Fabbri C, Binda C, Anderloni A, Tarantino I, Bejjani M, Ghandour B, Singh V, Khashab MA. Novel 15-mm-long lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections located ≥10 mm from the luminal wall. Endoscopy 2022; 54:706-711. [PMID: 34905796 DOI: 10.1055/a-1682-7095] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) by cautery-enhanced lumen-apposing metal stents (LAMS) has largely been limited to collections located < 10 mm from the luminal wall. We present outcomes of the use of a novel 15-mm-long cautery-enhanced LAMS for drainage of PFCs located ≥ 10 mm away. METHODS This international, multicenter study analyzed all adults with PFCs located ≥ 10 mm from the luminal wall who were treated by EUS-guided drainage using the 15-mm-long cautery-enhanced LAMS. The primary outcome was technical success. Secondary outcomes included clinical success (decrease in PFC size by ≥ 50 % at 30 days and resolution of clinical symptoms without surgical intervention), complications, and recurrence. RESULTS 35 patients (median age 57 years; interquartile range [IQR] 47-64 years; 49 % male) underwent novel LAMS placement for drainage of PFCs (26 walled-off necrosis, 9 pseudocysts), measuring 85 mm (IQR 64-117) maximal diameter and located 11.8 mm (IQR 10-12.3; range 10-14) from the gastric/duodenal wall. Technical and clinical success were high (both 97 %), with recurrence in one patient (3 %) at a median follow-up of 123 days (58-236). Three complications occurred (9 %; one mild, two moderate). CONCLUSIONS The 15-mm-long cautery-enhanced LAMS was feasible and safe for drainage of PFCs located 10-14 mm from the luminal wall.
Collapse
Affiliation(s)
- Linda Y Zhang
- Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
| | - Rastislav Kunda
- Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maridi Aerts
- Department of Gastroenterology and Hepatology, Universitair Ziekenhuis Brussel (UZB)/Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Nouredin Messaoudi
- Department of Surgery, Universitair Ziekenhuis Brussel (UZB)/Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rishi Pawa
- Department of Gastroenterology, Wake Forest Baptist Medical Center, Winston Salem, North Carolina, United States
| | - Swati Pawa
- Department of Gastroenterology, Wake Forest Baptist Medical Center, Winston Salem, North Carolina, United States
| | - Carlos Robles-Medranda
- Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador
| | - Roberto Oleas
- Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador
| | - Mohammad A Al-Haddad
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Itegbemie Obaitan
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Thiruvengadam Muniraj
- Department of Gastroenterology and Hepatology, Yale University School of Medicine, New Haven, Connecticut, United States
| | - Carlo Fabbri
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli-Cesena, Italy
| | - Cecilia Binda
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli-Cesena, Italy
| | - Andrea Anderloni
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Ilaria Tarantino
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT, Palermo, Italy
| | - Michael Bejjani
- Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
| | - Bachir Ghandour
- Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
| | - Vikesh Singh
- Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
| | - Mouen A Khashab
- Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
| |
Collapse
|
14
|
Elmehraoui O, Berrabeh S, Messaoudi N, Derkaoui N, Zerrouki D, Rouf S, Latrech H. Monitoring of type 2 diabetic patients during the ‘Covid 19’ pandemic by teleconsultation. Ann Med Surg (Lond) 2022; 78:103689. [PMID: 35505685 PMCID: PMC9050607 DOI: 10.1016/j.amsu.2022.103689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Glycemic control in type 2 diabetic patients is a constant challenge. The objective of our study is to evaluate glycemic control in type 2 diabetic patients since the start of the "Covid-19" pandemic by comparing their glycemic and degenerative profiles in the pre-confinement,per and post-confinement periods. Patients and methods This is a descriptive and analytical,cross-sectional study,bringing together 720 type 2 diabetic patients followed by teleconsultation at the endocrinology,diabetology and nutrition department,from mid-March to mid-October 2020. Results The mean age of the patients was 62.5 ± 11.3 years, with a sex ratio (M / F) of 0.71,the average duration of diabetes was 10.6 ± 7, 4 years.The mean pre-lockdown Hba1c level was 8.5±1.9%.Only 137 patients have been able to do the HBa1c test since the start of lockdown,which averaged 8.4 ± 1.8%.Regarding the degenerative complications installed after containment,4.4% of the patients presented an acute coronary syndrome,2.2% a cerebrovascular accident,1.4% developed a stage 2 chronic renal disease,and a foot injury appeared in 5.1% of patients while no patient developed diabetic retinopathy among those who performed ophthalmic evaluation.In our series,the death rate was estimated at 1.8%.Drug therapy was adjusted in the majority of patients with initiation of insulin therapy in 7.2% of patients and intensification of insulin doses in 9.4% of patients. Conclusion At the heart of the pandemic Covid-19 crisis,teleconsultation has taken an essential place in the strategy of access to care, particularly the monitoring of chronic diseases,the results of our study are similar to those of other studies published during this pandemic. Glycemic control in type 2 diabetic patients is a constant challenge, particularly in a pandemic situation. At the heart of the Covid-19 pandemic crisis, teleconsultation has taken on an essential place in the access to care strategy. In our study, the mean Hba1c level did not increase during the teleconsultation period.
Collapse
|
15
|
Dewyse L, De Smet V, Verhulst S, Eysackers N, Kunda R, Messaoudi N, Reynaert H, van Grunsven LA. Improved Precision-Cut Liver Slice Cultures for Testing Drug-Induced Liver Fibrosis. Front Med (Lausanne) 2022; 9:862185. [PMID: 35433753 PMCID: PMC9007724 DOI: 10.3389/fmed.2022.862185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
In vitro models of human liver disease often fail to mimic the complex 3D structures and cellular organizations found in vivo. Precision cut liver slices (PCLS) retain the complex physiological architecture of the native liver and therefore could be an exceptional in vitro liver model. However, the production of PCLS induces a spontaneous culture-induced fibrogenic reaction, limiting the application of PCLS to anti-fibrotic compounds. Our aim was to improve PCLS cultures to allow compound-induced fibrosis induction. Hepatotoxicity in PCLS cultures was analyzed by lactate dehydrogenase leakage and albumin secretion, while fibrogenesis was analyzed by qRT-PCR and western blot for hepatic stellate cell (HSC) activation markers and collagen 6 secretion by enzyme-linked immunosorbent assays (ELISA). We demonstrate that supplementation of 3 mm mouse PCLS cultures with valproate strongly reduces fibrosis and improves cell viability in our PCLS cultures for up to 5 days. Fibrogenesis can still be induced both directly and indirectly through exposure to TGFβ and the hepatotoxin acetaminophen, respectively. Finally, human PCLS cultures showed similar but less robust results. In conclusion, we optimized PCLS cultures to allow for drug-induced liver fibrosis modeling.
Collapse
Affiliation(s)
- Liza Dewyse
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Vincent De Smet
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Internal Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Stefaan Verhulst
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nathalie Eysackers
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Rastislav Kunda
- Department of Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Nouredin Messaoudi
- Department of Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Hendrik Reynaert
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Leo A van Grunsven
- Department of Basic Biomedical Sciences, Liver Cell Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
16
|
Francois S, Aerts M, Reynaert H, Van Lancker R, Van Laethem J, Kunda R, Messaoudi N. Step-up approach in emphysematous hepatitis: A case report. World J Hepatol 2022; 14:464-470. [PMID: 35317184 PMCID: PMC8891666 DOI: 10.4254/wjh.v14.i2.464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/27/2021] [Accepted: 01/12/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Emphysematous hepatitis (EH) is a rare, rapidly progressive fulminant gas-forming infection of the liver parenchyma. It is often fatal and mostly affects diabetes patients.
CASE SUMMARY We report a case of EH successfully managed by a step-up approach consisting of aggressive hemodynamic support, intravenous antibiotics, and percutaneous drainage, ultimately followed by laparoscopic deroofing. Of 11 documented cases worldwide, only 1 of the patients survived, treated by urgent laparotomy and surgical debridement.
CONCLUSION EH is a life-threatening infection. Its high mortality rate makes timely diagnosis essential, in order to navigate treatment accordingly.
Collapse
Affiliation(s)
- Silke Francois
- Department of Gastroenterology, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Maridi Aerts
- Department of Gastroenterology and Hepatology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Hendrik Reynaert
- Department of Gastroenterology and Hepatology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Ruth Van Lancker
- Department of Intensive Care, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Johan Van Laethem
- Department of Infectious Diseaeses, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Rastislav Kunda
- Department of Surgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
| | - Nouredin Messaoudi
- Department of Surgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels 1090, Belgium
- Department of Surgery, Europe Hospitals, Brussels 1180, Belgium
| |
Collapse
|
17
|
Jamal O, Sekkach Y, Messaoudi N, Doghmi K. Profil clinique et étiologique du syndrome des agglutinines froides. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
18
|
Messaoudi N, Bouichrat N, Rami I, Derkaoui N, El Mehraoui O, Rouf S, Latrech H. La prévalence de la microangiopathie chez le patient diabétique de type 2. Annales d'Endocrinologie 2021. [DOI: 10.1016/j.ando.2021.08.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Kochetkov A, Aït Abderrahim H, Baeten P, Krása A, Messaoudi N, Vittiglio G, Wagemans J. Integral experiments in the VENUS-F reactor. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2021.108230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
20
|
Billebaud A, Lecouey JL, Chevret T, Chabod S, Doligez X, Kochetkov A, Krása A, Lecolley FR, Lehaut G, Marie N, Messaoudi N, Uyttenhove W, Vittiglio G, Wagemans J, Bécares V, Villamarin D, Mellier F. EXTENDED MSM METHOD TO ESTIMATE THE REACTIVITY OF A SUB-CRITICAL CORE DRIVEN BY AN ACCELERATOR BASED NEUTRON SOURCE. EPJ Web Conf 2021. [DOI: 10.1051/epjconf/202124708005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Modified Source Multiplication method is used to determine an unknown reactivity level of a reactor from a known one if one has access to the detector counting for both levels when the reactor is fed by a constant neutron source like an Am-Be source. When available, an accelerator driven source, in continuous mode, can be useful as its intensity can be tunable and then adapted to the experimental conditions. However, in that case, the MSM technique must be extended to account for an external source whose intensity, energy and angular distributions can vary from one measurement to another. In this paper, this Modified Multi-Source Multiplication (MMSM) method is applied to measurements done during the FREYA project in the GUINEVERE facility, operated with the GENEPI-3C accelerator providing a mixture of (D,T) and (D,D) neutrons. The monitoring of these sources through the detection of the associated charged particles allows the calculation of the MMSM factors and the estimate of the reactivity values. The results are compared in different configurations with the reactivity obtained with an Am-Be source or in dynamic measurements performed with GENEPI-3C. Their excellent agreement shows the possibility of using such accelerator-based neutron sources for MSM measurements when they are correctly monitored. This is of great interest for deep sub-critical level characterization for which detector count rates per source neutrons might be low.
Collapse
|
21
|
Krása A, Kochetkov A, Messaoudi N, Vittiglio G, Wagemans J. THE APPLICABILITY RANGE OF THE MODIFIED SOURCE MULTIPLICATION (MSM) METHOD TESTED IN THE FAST VENUS-F REACTOR. EPJ Web Conf 2021. [DOI: 10.1051/epjconf/202124708001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The MSM method is an experimental technique for determination of reactivity of a sub-critical reactor. It consists of one dynamic measurement followed by two static measurements, which use an extraneous neutron source. For the data analysis, the core averaged kinetic parameters need to be calculated as well as a spatially-dependent correction factor that corrects for the point kinetics approximation. In order to test the range for which the method is valid and to demonstrate the reliability of the correction factor calculations in a fast reactor, a dedicated experimental campaign was performed in the fast lead-bismuth VENUS-F reactor. The reactivity of a dozen of sub-critical configurations was measured with the MSM method using ten 235U fission chambers. The detectors were located at various distances from the active zone and from the extraneous neutron source, leading to a large range of values of a correction factor (calculated with the Monte Carlo MCNP5 code) used in the data analysis.
Collapse
|
22
|
Kochetkov A, Billebaud A, Chabod S, Krása A, Lecolley FR, Lecouey JL, Lehaut G, Marie N, Messaoudi N, Vittiglio G, Wagemans J. THE SOURCE JERK INTEGRALMETHOD FOR SUB-CRITICALITY MEASUREMENTS IN ADS. EPJ Web Conf 2021. [DOI: 10.1051/epjconf/202124708002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Three sub-critical (SC) core configurations were investigated in the VENUS-F zero power reactor coupled with the GENEPI-3C accelerator. The SC10 and SC12 were a mock-up of a MYRRHA start-up core and SC11 represented a more complex MYRRHA core loaded with various types of in-pile-sections. The sub-criticality of 11 variants of these VENUS-F cores was changed in several steps from -6$ down to -30$ using the safety and control rods. Their sub-criticalities were determined with the Source Jerk Integral (SJI) method using 11 fission chambers located all over the reactor. For the data analysis, the 8-group delayed neutron parameters from the JEFF-3.1.2 evaluated nuclear data library were used. Reliability and reproducibility of the experimental results were tested by repeating the measurements, swapping the detectors and varying the accelerator beam intensity, thus changing the detector count rates and verifying the validity of the dead time corrections. The obtained results are compared with MCNP calculations.
Collapse
|
23
|
Rodríguez IM, Hernández-Solís A, Messaoudi N, Van den Eynde G. The nuclear fuel cycle code ANICCA: Verification and a case study for the phase out of Belgian nuclear power with minor actinide transmutation. Nuclear Engineering and Technology 2020. [DOI: 10.1016/j.net.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
24
|
Messaoudi N, Cousineau I, Arslanian E, Henault D, Stephen D, Vandenbroucke-Menu F, Dagenais M, Létourneau R, Plasse M, Roy A, Lapointe R, Ysebaert D, Trudel D, Soucy G, Stagg J, Turcotte S. Prognostic value of CD73 expression in resected colorectal cancer liver metastasis. Oncoimmunology 2020; 9:1746138. [PMID: 32363113 PMCID: PMC7185220 DOI: 10.1080/2162402x.2020.1746138] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/27/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Immune checkpoint blockade has not yet been effective in patients with mismatch repair proficient metastatic colorectal cancer. Targeting immunosuppressive metabolic pathways is being explored as a new immunotherapeutic approach. We assessed whether CD73, the rate limiting enzyme that catalyzes the degradation of extracellular AMP into immunosuppressive adenosine, could be an immunological determinant of colorectal liver metastases (CRLMs). By immunofluorescence on tissue microarrays, intratumoral CD73 expression (tCD73) was analyzed in 391 CRLMs resected in 215 patients, and soluble CD73 (sCD73) was measured by ELISA in the pre-operative serum of 193 patients. High tCD73 was associated with worse pathological features, such as multiple and larger CRLMs, and poorer pathologic response to pre-operative chemotherapy. The median time to recurrence and disease-specific survival after CRLM resection was significantly shorter in patients with high tCD73 (11.0 and 46.4 months, respectively) compared with low tCD73 (19.0 and 61.5 months, respectively). tCD73 was strongly associated with patient outcomes independently of clinicopathological variables. sCD73 did not correlate with tCD73. Patients with high levels of sCD73 also had shorter disease-specific survival. Our results suggested that CD73 in CRLMs may be prognostically informative and may help select patients more likely to respond to adenosine pathway blocking agents.
Collapse
Affiliation(s)
- Nouredin Messaoudi
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
- Department of Surgery, University of Antwerp, Antwerp, Belgium
- Department of Surgery, University Hospital of Brussels (UZ Brussel) and Europe Hospitals, Brussels, Belgium
| | - Isabelle Cousineau
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Elizabeth Arslanian
- Department of Pathology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - David Henault
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - David Stephen
- Department of Pathology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Franck Vandenbroucke-Menu
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Michel Dagenais
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Richard Létourneau
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Marylène Plasse
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - André Roy
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Réal Lapointe
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Dirk Ysebaert
- Department of Surgery, University of Antwerp, Antwerp, Belgium
| | - Dominique Trudel
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Department of Pathology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Geneviève Soucy
- Department of Pathology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - John Stagg
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Simon Turcotte
- Cancer Axis, Centre de Recherche Du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Hepatopancreatobiliary Surgery & Liver Transplantation Service, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec, Canada
| |
Collapse
|
25
|
Allard D, Chrobak P, Allard B, Messaoudi N, Stagg J. Targeting the CD73-adenosine axis in immuno-oncology. Immunol Lett 2018; 205:31-39. [PMID: 29758241 DOI: 10.1016/j.imlet.2018.05.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
The ectonucleotidases CD39 and CD73 are cell surface enzymes that catabolize the breakdown of extracellular ATP into adenosine. As such, they constitute critical components of the extracellular purinergic pathway and play important roles in maintaining tissue and immune homeostasis. With the coming of age of cancer immunotherapy, ectonucleotidases and adenosine receptors have emerged as novel therapeutic targets to enhance antitumor immune responses. With early-phase clinical trials showing promising results, it is becoming increasingly important to decipher the distinct mechanisms-of-action of adenosine-targeting agents, identify patients that will benefit from these agents and rationally develop novel synergistic combinations. Given the broad expression of ectonucleotidases and adenosine receptors, a better understanding of cell-specific roles will also be key for successful implementation of this new generation of immuno-oncology therapeutics. We here review the latest studies on the roles of CD73 and adenosine in cancer with a focus on cell-specific function. We also discuss ongoing clinical trials and future avenues for adenosine-targeting agents.
Collapse
Affiliation(s)
- David Allard
- Centre de Recherche du Centre, Hospitalier l'Université de Montréal (CRCHUM) et Institut du Cancer de Montréal, Montréal, QC, Canada; Faculté de Pharmacie de l'Université de Montréal, Montréal, QC, Canada
| | - Pavel Chrobak
- Centre de Recherche du Centre, Hospitalier l'Université de Montréal (CRCHUM) et Institut du Cancer de Montréal, Montréal, QC, Canada; Faculté de Pharmacie de l'Université de Montréal, Montréal, QC, Canada
| | - Bertrand Allard
- Centre de Recherche du Centre, Hospitalier l'Université de Montréal (CRCHUM) et Institut du Cancer de Montréal, Montréal, QC, Canada; Faculté de Pharmacie de l'Université de Montréal, Montréal, QC, Canada
| | - Nouredin Messaoudi
- Centre de Recherche du Centre, Hospitalier l'Université de Montréal (CRCHUM) et Institut du Cancer de Montréal, Montréal, QC, Canada; University of Antwerp, Antwerp, Belgium
| | - John Stagg
- Centre de Recherche du Centre, Hospitalier l'Université de Montréal (CRCHUM) et Institut du Cancer de Montréal, Montréal, QC, Canada; Faculté de Pharmacie de l'Université de Montréal, Montréal, QC, Canada.
| |
Collapse
|
26
|
Henault D, Stephen D, St-Hilaire PA, Messaoudi N, Vandenbroucke-Menu F, Plasse M, Letourneau R, Roy A, Dagenais M, Lapointe RW, Nguyen B, Soucy G, Mes-Masson AM, Turcotte S. Prognostic immune scoring of colorectal cancer liver metastasis with MHC class-I expression combined to T cell quantification. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- David Henault
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - David Stephen
- Pathology Department, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Pierre-Antoine St-Hilaire
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Nouredin Messaoudi
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, CA
| | - Franck Vandenbroucke-Menu
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Marylene Plasse
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Richard Letourneau
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Andre Roy
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Michel Dagenais
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Real W. Lapointe
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Bich Nguyen
- Pathology Department, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Genevieve Soucy
- Pathology Department, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Anne-Marie Mes-Masson
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Simon Turcotte
- Hepato-pancreato-biliary Surgery Service and Research Centre, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| |
Collapse
|
27
|
Messaoudi N, Henault D, Stephen D, Cousineau I, St-Hilaire PA, Vandenbroucke-Menu F, Dagenais M, Letourneau R, Plasse M, Roy A, Lapointe RW, Nguyen B, Trudel D, Arslanian E, Soucy G, Mes-Masson AM, Stagg J, Turcotte S. Prognostic value of CD73 expression in resected colorectal cancer liver metastasis. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Nouredin Messaoudi
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - David Henault
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - David Stephen
- Pathology Department, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Isabelle Cousineau
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Pierre-Antoine St-Hilaire
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Franck Vandenbroucke-Menu
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Michel Dagenais
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Richard Letourneau
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Marylene Plasse
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Andre Roy
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Real W. Lapointe
- Hepato-pancreato-biliary Surgery Service, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Bich Nguyen
- Pathology Department, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Dominique Trudel
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Elizabeth Arslanian
- Pathology Department, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Genevieve Soucy
- Pathology Department, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Anne-Marie Mes-Masson
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - John Stagg
- Research Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Simon Turcotte
- Hepato-pancreato-biliary Surgery Service and Research Centre, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| |
Collapse
|
28
|
Lebrat JF, Aliberti G, D’Angelo A, Billebaud A, Brissot R, Brockmann H, Carta M, Destouches C, Gabrielli F, Gonzalez E, Hogenbirk A, Klein-Meulenkamp R, Le Brun C, Liatard E, Mellier F, Messaoudi N, Peluso V, Plaschy M, Thomas M, Villamarín D, Vollaire J. Global Results from Deterministic and Stochastic Analysis of the MUSE-4 Experiments on the Neutronics of Accelerator-Driven Systems. NUCL SCI ENG 2017. [DOI: 10.13182/nse05-100] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. F. Lebrat
- Commissariat à l’Energie Atomique Cadarache, Building 230, 13108 St Paul lez Durance, France
| | - G. Aliberti
- Argonne National Laboratory, Argonne, Illinois
| | | | - A. Billebaud
- Laboratoire de Physique Subatomique et de Cosmologie, Centre National de la Recherche Scientifique/Institut National de Physique Nucleaire et de Physique des Particules/Universite Joseph Fourier Grenoble, France
| | - R. Brissot
- Laboratoire de Physique Subatomique et de Cosmologie, Centre National de la Recherche Scientifique/Institut National de Physique Nucleaire et de Physique des Particules/Universite Joseph Fourier Grenoble, France
| | | | - M. Carta
- ENEA, Casaccia Research Center, Rome, Italy
| | - C. Destouches
- Commissariat à l’Energie Atomique Cadarache, Building 230, 13108 St Paul lez Durance, France
| | | | - E. Gonzalez
- Centro de Investigaciones Energéticas, Medioambientales y Technológicas, Madrid, Spain
| | - A. Hogenbirk
- The Nuclear Research and Consultancy Group, Petten, The Netherlands
| | | | - C. Le Brun
- Laboratoire de Physique Subatomique et de Cosmologie, Centre National de la Recherche Scientifique/Institut National de Physique Nucleaire et de Physique des Particules/Universite Joseph Fourier Grenoble, France
| | - E. Liatard
- Laboratoire de Physique Subatomique et de Cosmologie, Centre National de la Recherche Scientifique/Institut National de Physique Nucleaire et de Physique des Particules/Universite Joseph Fourier Grenoble, France
| | - F. Mellier
- Commissariat à l’Energie Atomique Cadarache, Building 230, 13108 St Paul lez Durance, France
| | | | - V. Peluso
- ENEA, Casaccia Research Center, Rome, Italy
| | | | - M. Thomas
- British Nuclear Fuels plc, United Kingdom
| | - D. Villamarín
- Centro de Investigaciones Energéticas, Medioambientales y Technológicas, Madrid, Spain
| | - J. Vollaire
- Laboratoire de Physique Subatomique et de Cosmologie, Centre National de la Recherche Scientifique/Institut National de Physique Nucleaire et de Physique des Particules/Universite Joseph Fourier Grenoble, France
| |
Collapse
|
29
|
Siah S, El Khatib K, Messaoudi N. Mécanismes et traitement de l’anémie aiguë chez le brûlé grave. Ann Burns Fire Disasters 2016; 29:108-110. [PMID: 28149231 PMCID: PMC5241189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 10/23/2015] [Indexed: 06/06/2023]
Abstract
Acute anaemia requiring blood transfusion frequently occurs in severe burn patients. It has two major sources: perioperative bleeding (efforts have to be made to reduce it) and "intensive care anaemia" (therefore useless blood sampling should be avoided). In these patients with abnormal haematopoiesis, treatment is based on blood transfusion, which has its own side effects. Consequently, a restrictive strategy should be applied.
Collapse
Affiliation(s)
- S Siah
- Service de Chirurgie Plastique et des Brûlés, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc; Université Mohamed V, Souissi, Rabat, Maroc
| | - K El Khatib
- Service de Stomatologie et de Chirurgie Maxillo-Facial, Hôpital Militaire d'Instruction Mohamed V, Rabat, M; Université Mohamed V, Souissi, Rabat, Maroc
| | - N Messaoudi
- Laboratoire d'Hématologie, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc; Université Mohamed V, Souissi, Rabat, Maroc
| |
Collapse
|
30
|
Benali A, Kahouli S, El Ouazzani H, Souhi H, Abderrahmani Rhorfi I, Abid A, Yahyaoui A, Zahid H, Messaoudi N. [Infectious pleurisy as first sign of multiple myeloma in a young 28 years old]. Rev Pneumol Clin 2015; 71:282-285. [PMID: 25727663 DOI: 10.1016/j.pneumo.2014.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/22/2014] [Accepted: 12/31/2014] [Indexed: 06/04/2023]
Abstract
Multiple myeloma is a malignant proliferation of plasma cells, mainly affecting the bone marrow. It rarely occurs in young patients. The medical observation study reveals multiple myeloma discovered through a purulent pleurisy in a 28-year-old subject. This patient was admitted to the pneumology service of the Mohamed V military hospital in Rabat for a fever and dyspnea evolving into a context of poor general condition. Clinical examination found a right pleural fluid effusion syndrome. The pleural puncture reveals a germ-free exudative purulent fluid without plasma cells. The myeloma diagnosis was suspected due to the combination of an aplastic normochromic normocytic anemia at 4.5g/dL of hemoglobin, an accelerated erythrocyte sedimentation rate, hypercalcemia, renal failure and osteolytic lesions located mainly in the skull and pelvis area, oriented by electrophoresis and serum protein immunosubstraction revealing a narrow peak in monoclonal beta-2 globulin at 70.56g/L with a lambda monoclonal gammopathy with immunoglobulin G, and confirmed by the myelogram showing a 74% rate of bone marrow plasma cells. The occurrence of myeloma at a young age is rare and the purulent pleurisy without plasma cells is a rare form of presentation and represents a poor prognosis.
Collapse
Affiliation(s)
- A Benali
- Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
| | - S Kahouli
- Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - H El Ouazzani
- Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - H Souhi
- Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - I Abderrahmani Rhorfi
- Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - A Abid
- Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - A Yahyaoui
- Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - H Zahid
- Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| | - N Messaoudi
- Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc
| |
Collapse
|
31
|
Messaoudi N, Vanlede K, Vervloessem D, Huyghe M, Leyman P. Thrombolysis for Severe Intestinal Ischemia due to Midgut Volvulus in a Neonate. European J Pediatr Surg Rep 2015; 3:74-7. [PMID: 26788452 PMCID: PMC4712059 DOI: 10.1055/s-0035-1558460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/03/2015] [Indexed: 11/23/2022] Open
Abstract
Intestinal malrotation complicated by the development of midgut volvulus presents a difficult management dilemma because of the risk of short bowel syndrome. Here, we present our experience with a case of severe intestinal ischemia after derotation in a newborn successfully managed using systemic tissue plasminogen activator. The present report supports the usefulness of thrombolysis as a therapeutic option for reperfusion of ischemic small bowel due to midgut volvulus in neonates.
Collapse
Affiliation(s)
- Nouredin Messaoudi
- Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
| | - Koen Vanlede
- Department of Pediatrics, Sint-Augustinus Hospital, Wilrijk, Belgium
| | - Dirk Vervloessem
- Department of Pediatric Surgery, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - Marc Huyghe
- Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
| | - Paul Leyman
- Department of General, Digestive and Pediatric Surgery, Sint-Augustinus Hospital, Wilrijk, Belgium
| |
Collapse
|
32
|
Jennane S, Hasnaoui N, Raissi A, Messaoudi N, Doghmi K, Mikdame M. Une convulsion fébrile révélant un purpura thrombotique thrombocytopénique. Rev Neurol (Paris) 2014; 170:556-7. [DOI: 10.1016/j.neurol.2014.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 10/25/2022]
|
33
|
Mortelmans D, Messaoudi N, Jaekers J, Bestman R, Pauli S, Van Cleemput M. Laparoscopic repair of intraperitoneal bladder rupture after blunt abdominal trauma. Urol J 2014; 11:1338-1340. [PMID: 24595949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 03/15/2012] [Accepted: 04/24/2012] [Indexed: 06/03/2023]
Affiliation(s)
| | | | - Joris Jaekers
- Department of General Surgery, Monica Hospital, Deurne, Belgium
| | - Raymond Bestman
- Department of General Surgery, Monica Hospital, Deurne, Belgium
| | - Steven Pauli
- Department of General Surgery, Monica Hospital, Deurne, Belgium
| | | |
Collapse
|
34
|
Abstract
Soccer players frequently experience acute and chronic groin pain. Sportsman's hernia is a common injury in professional soccer players, that causes inguinal pain. The authors discuss their experience with the management of sportsman's hernia in professional soccer players competing in national and international competition in a retrospective review of prospectively collected data. Between March 2004 and December 2009, seventy-one professional soccer players were surgically treated for sportsman's hernia. Average age at surgery was 24 years, and average duration of symptoms from onset to surgical repair was 11 months. Conservative treatment improved symptoms temporarily or to some extent in 18 athletes. All athletes underwent a bilateral open hernia repair with concurrent adductor tendon release. Average follow-up was 4 years, and average time to return to competitive sport was 4 months. At final follow-up, 95% of soccer players were still active, 48 at the same level and 19 at a lower level. Four athletes had stopped their careers because of another injury (n=2) or recurrence (n=2). Sportsman's hernia is a potentially career-ending injury in professional soccer players. Conservative management is often unsuccessful. An open surgical hernia repair combined with an adductor longus tenotomy relieves the symptoms caused by a sportsman's hernia and restores activity in 95% of athletes. This study offers insight into the management of sportsman's hernia and offers a successful treatment to salvage the careers of professional soccer players.
Collapse
|
35
|
Jans C, Messaoudi N, Pauli S, Van Riet RP, Declercq G. Results of surgical treatment of athletes with sportsman's hernia. Acta Orthop Belg 2012; 78:35-40. [PMID: 22523925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Chronic groin pain in athletes is a difficult diagnostic and therapeutic condition. Between March 2004 and December 2009, 241 male athletes (mean age: 25.8 years, range: 16-41) in whom chronic sportsman's hernia was diagnosed, were surgically treated using a standardised technique. In this retrospective study, charts were analyzed for preoperative duration of symptoms and prior treatment. Perioperative complications were noted. Patients were contacted and were asked to answer a telephone questionnaire: 162 patients agreed to be questioned as part of the current study. A surgical intervention with reinforcement of the posterior inguinal wall and tenotomy of the adductors has lead to satisfactory results in over 90% of athletes with chronic groin pain who failed to improve with conservative treatment.
Collapse
Affiliation(s)
- Christophe Jans
- Department of Orthopaedic Surgery, Monica Hospital, Stevenslei 20, 2100 Deurne, Belgium.
| | | | | | | | | |
Collapse
|
36
|
Ouzzif Z, Doghmi K, Bouhsain S, Dami A, El Machtani S, Tellal S, Messaoudi N, Mikdame M, El Maataoui A. Monoclonal gammopathies in a Moroccan military hospital. Rheumatol Int 2011; 32:3303-7. [PMID: 21881989 DOI: 10.1007/s00296-011-2093-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 08/21/2011] [Indexed: 12/01/2022]
Abstract
The aim of this study was to describe biological features and aetiology of monoclonal gammopathy diagnosed during a 10-year period in the biochemistry department of the Moroccan Military Hospital Mohamed V in Rabat. The study was performed from 1 January 2000 to 31 December 2009. The records of 261 patients living in the Rabat area in which either serum protein electrophoresis and serum and/or urine immunofixation were performed at the biochemistry department of Military Instruction Hospital in Rabat were analysed. A cohort of 182 (70%) men and 79 (30%) women, the mean ± SD (range) ages were 60.21 ± 12.56 years. All patients were Caucasian. Electrophoresis found that 211 (80.84%) of the patients had a monoclonal gammopathy. Immunofixation confirmed that 251 (96.17%) patients had a monoclonal band in serum. In our cohort, MM was the most frequent diagnosis, our patients were late diagnosed.
Collapse
Affiliation(s)
- Z Ouzzif
- Biochemistry Department, Military Hospital Instruction Mohamed V, Hay Ryad, Rabat, Morocco.
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
OBJECTIVES To investigate and analyse epidemiology, demographics and patterns of presentation of assault induced stab injuries in a main Belgian trauma centre. To evaluate surgical management, complications and postoperative follow-up of the stab wound victims. METHODS One hundred and seventy assaulted patients, hospitalised because of stab injuries from January 2000 to June 2007 are studied retrospectively. RESULTS Ninety-five percent of the assaults occurred on men and the mean age of the patients was 31.1 +/- 9.7 years. Ethnic minorities represent 77% of the patients hospitalised for assaults and 26.5% of all patients proved to be under toxic influence, predominantly from alcohol (21.8%). A decline of admissions of patients with stab injuries during the period 2002-2004 is recorded. However, the incidence doubled in the next two-year period. A weekend peak and circadian rhythm is apparent with more than 20% of the patients admitted between 4 and 6 am. The trunk is most frequently stabbed (54.5%) resulting in a laparotomy rate of 51%. One third of the patients who underwent thoraco-abdominal surgery revealed diaphragmatic injuries. Seventy-five percent of the patients left the hospital in a good condition while 2.4% had neuromuscular lesions. Two patients had serious vascular complications during follow-up. During the study period, no mortality was recorded. CONCLUSIONS Stab wounds were recorded mainly in young and middle-aged men from ethnic minorities, whereas almost 27% were under the influence of drugs. A conservative approach was generally used resulting in a low laparotomy and thoracotomy rate without affecting mortality. Neuromuscular lesions are important long-term complications of stab injuries.
Collapse
Affiliation(s)
- E. El-Abdellati
- Academic Surgical Centre Stuivenberg, University of Antwerp, Antwerp, Belgium
| | - N. Messaoudi
- Academic Surgical Centre Stuivenberg, University of Antwerp, Antwerp, Belgium
| | - R. Van Hee
- Academic Surgical Centre Stuivenberg, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
38
|
Messaoudi N, Lamaalmi F, Chakour M, Belmekki A, Naji M. [Coagulation factor XIII: more than just a fibrin stabilizer]. Ann Burns Fire Disasters 2011; 24:22-23. [PMID: 21991236 PMCID: PMC3187950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Indexed: 05/31/2023]
Abstract
The role played by coagulation factor XIII in the scarring process is considered. Identified in 1923, the role of factor XIII or the fibrin stabilizing factor in coagulation has been accurately described. Its role in scarring was defined as long ago as 1960 but continues to be unknown to haematologists and doctors treating burn patients. The aim of this paper is to cast more light on this role, which remains a mystery still to be unfolded.
Collapse
Affiliation(s)
- N Messaoudi
- Laboratoire d'Hématologie, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | | | | | | | | |
Collapse
|
39
|
Maleb A, Messaoudi N, Chbouki O, Daoudi N, Oumghar K, Lahmadi K, Elmoussaoui D, Ezzahraoui K, Ngoh AE, Benomar F, Abi R, Jeaidi A, Nazih M, Belmekki A, Chakour M. [Visceral leishmaniasis, pemphigus and immunosuppressive treatment: case report from Morocco]. Med Trop (Mars) 2011; 71:104. [PMID: 21585112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Atypical forms of visceral leishmaniasis associated with immunosuppressive treatment are difficult to diagnose and cause high mortality. The purpose of this report is to describe a case involving a 42-year-old patient living in a leishmaniasis-endemic area, who was undergoing immunosuppressive treatment using corticosteroids and methotrexate for pemphigus. Despite clinical and laboratory findings consistent with visceral leishmaniasis, detection of Leishmania bodies was a coincidental finding of cytological examination of bone marrow during workup for pancytopenia and associated clinical signs. This case argues in favor of systematic screening for this opportunistic parasitic disease before undertaking immunosuppressive treatment in patients presenting risk factors and consistent clinical/laboratory findings.
Collapse
|
40
|
De Cocker J, Messaoudi N, Stockman BA, Bossaert LL, Rodrigus IE. Preoperative prediction of intensive care unit stay following cardiac surgery☆. Eur J Cardiothorac Surg 2011; 39:60-7. [DOI: 10.1016/j.ejcts.2010.04.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 04/13/2010] [Accepted: 04/17/2010] [Indexed: 11/17/2022] Open
|
41
|
Riveline JP, Franc S, Biedzinski M, Jollois FX, Messaoudi N, Lagarde F, Lormeau B, Pichard S, Varroud-Vial M, Deburge A, Dresco E, Charpentier G. Sexual activity in diabetic patients treated by continuous subcutaneous insulin infusion therapy. Diabetes Metab 2010; 36:229-33. [PMID: 20303814 DOI: 10.1016/j.diabet.2010.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 12/31/2009] [Accepted: 01/06/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS As concerns over interference with sexual activity may be an obstacle to initiating pump therapy in diabetic patients, the aim of the study was to assess the impact of continuous subcutaneous insulin infusion (CSII) therapy on sexual activity. PATIENTS AND METHODS Patients filled out a questionnaire on their demographic data, diabetes history, pump-treatment history, metabolic control, inconvenience/convenience of the pump and catheter, and information on sexual activity. RESULTS A total of 271 diabetic patients (aged 44+/-17 years, 51% women, 22% single), treated with CSII for 4.2+/-5.9 years and with a diabetes duration of 19+/-11 years, filled out the questionnaire. Their HbA(1c) was 7.7+/-1.1%, with 2.4+/-2.1 mild hypoglycaemic episodes over the past week, and their frequency of sexual activity was: never 29.9%; <1/month 12.3%; >1/month and <1/week 18.2%; and >1/week 39.6%. Age and cohabitation were independently correlated with frequency of sexual activity (P<0.0001 and P<0.0003, respectively), but not diabetes duration or complications. To the question "Does the pump have an influence on your sexual activity?", The answer was "no" in 90% and "yes" in 10%. However, intercourse frequency was significantly decreased in the latter (P=0.04). On multivariate analyses, this negative influence of CSII was correlated with HbA(1c) (P<0.05), discomfort with the pump (P<0.05) and the number of mild hypoglycaemic episodes (P<0.01). CONCLUSION Frequency of sexual activity appears to be unaffected by pump therapy or diabetes, but is decreased by the expected characteristics-namely, age and being single. Also, only 10% of patients believe that CSII is an obstacle during sexual activity and, in particular, because of the catheter.
Collapse
Affiliation(s)
- J-P Riveline
- Service de diabétologie, centre hospitalier Sud-Francilien, 59, boulevard Henri-Dunant, 91100 Corbeil-Essonnes, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Messaoudi N, De Cocker J, Stockman BA, Bossaert LL, Rodrigus IER. Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac surgery? Eur J Cardiothorac Surg 2009; 36:35-9. [PMID: 19307134 DOI: 10.1016/j.ejcts.2009.02.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 02/01/2009] [Accepted: 02/02/2009] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Risk stratification allows preoperative assessment of cardiac surgical risk faced by individual patients and permits retrospective analysis of postoperative complications in the intensive care unit (ICU). The aim of this single-center study was to investigate the prediction of extended ICU stay after cardiac surgery using both the additive and logistic model of the European System for Cardiac Operative Risk Evaluation (EuroSCORE). METHODS A retrospective observational study was conducted. We collected clinical data of 1562 consecutive patients undergoing cardiac surgery over a 2-year period at the Antwerp University Hospital, Belgium. EuroSCORE values of all patients were obtained. The outcome measure was the duration of ICU stay in days. The predictive performance of EuroSCORE was analyzed by the discriminatory power of a receiver operating characteristic (ROC) curve. Each EuroSCORE value was used as a theoretical cut-off point to predict duration of ICU stay. Three subsequent ICU stays were defined as prolonged: more than 2, 5 and 7 days. ROC curves were constructed for both the additive and logistic model. RESULTS Patients had a median ICU stay of 2 days and a mean ICU stay of 5.5 days. Median additive EuroSCORE was 5 (range, 0-22) and logistic EuroSCORE was 3.94% (range, 0.00-87.00). In the additive EuroSCORE model, a predictive value of 0.76 for an ICU stay of >7 days, 0.72 for >5 days and 0.67 for >2 days was found. The logistic EuroSCORE model yielded an area under the ROC curve of 0.77, 0.75 and 0.68 for each ICU length of stay, respectively. CONCLUSIONS In our patient database, prolonged length of stay in the ICU correlated positively with EuroSCORE. The logistic model was more discriminatory than the additive in tracing extended ICU stay. The overall predictive performance of EuroSCORE is acceptable and most likely based on the presence of variables that are risk factors for both mortality and extended ICU stay. Hence, EuroSCORE is a useful predicting tool and provides both surgeons and intensivists with a good estimate of patient risk in terms of ICU stay.
Collapse
Affiliation(s)
- Nouredin Messaoudi
- Department of Cardiac Surgery, Antwerp University Hospital, Edegem, Belgium
| | | | | | | | | |
Collapse
|
43
|
Messaoudi N, De Cocker J, Van den Eynden G, Janssens A, Salgado RA, Van Marck EA, Van Schil PEY. A 61-year-old female patient with right-sided pleuritic chest pain and fatigue. Diagnosis: Inflammatory pseudotumour causing right pulmonary artery occlusion with subsequent infarction of the lung. Eur Respir J 2009; 33:1231-5. [PMID: 19407059 DOI: 10.1183/09031936.00091808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N Messaoudi
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | | | | | | | | | | | | |
Collapse
|
44
|
Messaoudi N, De Cocker J, Stockman B, Bossaert LL, Rodrigus IER. Prediction of Prolonged Length of Stay in the Intensive Care Unit After Cardiac Surgery: The Need for a Multi-institutional Risk Scoring System. J Card Surg 2009; 24:127-33. [DOI: 10.1111/j.1540-8191.2008.00716.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Abstract
A 21-year-old female patient presented with pneumonia and on chest roentgenogram a solitary pulmonary nodule was incidentally found. After an observation period she underwent left upper lobectomy because of documented tumor growth. Pathology showed an intrapulmonary glomus tumor of the proper type, which is a very rare occurrence. Literature review revealed only 11 published cases of this subtype. Radiological investigation is helpful for localization and characterization of the tumor. However, pathological examination is required for definitive diagnosis. Complete surgical excision is the treatment of choice. Although uncommon, glomus and carcinoid tumors should be considered in the differential diagnosis of solitary pulmonary nodules in young patients.
Collapse
Affiliation(s)
- Jeroen De Cocker
- Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem, Belgium
| | | | | | | |
Collapse
|