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Srivastava A, Nekarakanti PK, Kanchodu S, Srivastava S, Mishra PK, Saluja SS. Role of adjuvant therapy in resected periampullary adenocarcinoma: A propensity matched case-control study. Ann Hepatobiliary Pancreat Surg 2024:ahbps.24-032. [PMID: 38600673 DOI: 10.14701/ahbps.24-032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024] Open
Abstract
Backgrounds/Aims The published data had contradictory information on the role of adjuvant therapy on resected periampullary carcinomas (PACA). The study was performed to evaluate the survival benefit of adjuvant treatment. Methods This was a propensity score matched case-control study from a prospectively maintained database from 2004-2019. The study included patients with nonpancreatic PACA who underwent curative resection. The patients (cases) who received adjuvant chemotherapy were compared with patients (controls) who were observed alone after surgery. Results Of 510 patients with PACA, 230 patients (cases = 107, controls = 123) formed the unmatched study cohort. After propensity score matching, 140 patients (cases = 70, controls = 70) formed the matched study cohort. The median overall survival (OS) was similar in cases than controls in the unmatched population but doubled non-significantly in cases after matching (unmatched population, 54 months vs. 54 months, p-value = 0.624; matched population, 71 months vs. 36 months, p-value = 0.087). However, the median recurrence-free survival (RFS) was non significantly higher in the control group (unmatched population, 59 months vs. 38 months, p-value = 0.195; matched population, 53 months vs. 40 months, p-value = 0.797). In cox regression analysis, age < 60 years, advanced T stage, and presence of perineural invasion were independent factors for worse RFS, while tumor recurrence was an independent factor for poor OS. Conclusions Patients with nonpancreatic PACA may have an OS benefit from adjuvant chemotherapy, and this needs to be validated with large prospective randomized studies.
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Affiliation(s)
- Anurita Srivastava
- Department of Radiotherapy, Maulana Azad Medical College (MAMC), New Delhi, India
| | - Phani Kumar Nekarakanti
- Department of GI Surgery, Govind Ballabh Pant Institute of Post graduate Medical Education & Research (GIPMER), New Delhi, India
| | - Sudheer Kanchodu
- Department of GI Surgery, Govind Ballabh Pant Institute of Post graduate Medical Education & Research (GIPMER), New Delhi, India
| | - Siddharth Srivastava
- Department of Gastro Medicine, Govind Ballabh Pant Institute of Post graduate Medical Education & Research (GIPMER), New Delhi, India
| | - Pramod Kumar Mishra
- Department of GI Surgery, Govind Ballabh Pant Institute of Post graduate Medical Education & Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Department of GI Surgery, Govind Ballabh Pant Institute of Post graduate Medical Education & Research (GIPMER), New Delhi, India
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Dash M, Mahajan B, Dar GM, Sahu P, Saluja SS. An update on the cell-free DNA-derived methylome as a non-invasive biomarker for coronary artery disease. Int J Biochem Cell Biol 2024; 169:106555. [PMID: 38428633 DOI: 10.1016/j.biocel.2024.106555] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/22/2023] [Accepted: 02/25/2024] [Indexed: 03/03/2024]
Abstract
Cardiovascular diseases are the foremost contributor to global mortality, presenting a complex etiology and an expanding array of risk factors. Coronary artery disease characterized by atherosclerotic plaque build-up in the coronary arteries, imposes significant mortality and financial burdens, especially in low- and middle-income nations. The pathogenesis of coronary artery disease involves a multifaceted interplay of genetic, environmental, and epigenetic factors. Epigenetic regulation contributes to the dynamic control of gene expression without altering the underlying DNA sequence. The mounting evidence that highlights the pivotal role of epigenetic regulation in coronary artery disease development and progression, offering potential avenues for the development of novel diagnostic biomarkers and therapeutic targets. Abnormal DNA methylation patterns are linked to the modulation of gene expression involved in crucial processes like lipid metabolism, inflammation, and vascular function in the context of coronary artery disease. Cell-free DNA has become invaluable in tumor biology as a liquid biopsy, while its applications in coronary artery disease are limited, but intriguing. Atherosclerotic plaque rupture causes myocardial infarction, by depriving heart muscles of oxygen, releasing cell-free DNA from dead cardiac cells, and providing a minimally invasive source to explore tissue-specific epigenetic alterations. We discussed the methodologies for studying the global methylome and hydroxy-methylome landscape, their advantages, and limitations. It explores methylome alterations in coronary artery disease, considering risk factors and their relevance in coronary artery disease genesis. The review also details the implications of MI-derived cell-free DNA for developing minimally invasive biomarkers and associated challenges.
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Affiliation(s)
- Manoswini Dash
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; School of Medicine, Center for Aging, Tulane University, LA, United States
| | - Bhawna Mahajan
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
| | - Ghulam Mehdi Dar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Parameswar Sahu
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
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Ahmad E, Athar A, Nimisha, Zia Q, Sharma AK, Sajid M, Bharadwaj M, Ansari MA, Saluja SS. Harnessing nature's potential: Alpinia galanga methanolic extract mediated green synthesis of silver nanoparticle, characterization and evaluation of anti-neoplastic activity. Bioprocess Biosyst Eng 2024:10.1007/s00449-024-02993-7. [PMID: 38509420 DOI: 10.1007/s00449-024-02993-7] [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: 10/27/2023] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
With the advent of nanotechnology, the treatment of cancer is changing from a conventional to a nanoparticle-based approach. Thus, developing nanoparticles to treat cancer is an area of immense importance. We prepared silver nanoparticles (AgNPs) from methanolic extract of Alpinia galanga rhizome and characterized them by UV-Vis spectrophotometry, Fourier transform Infrared (FTIR) spectroscopy, Zetasizer, and Transmission electron Microscopy (TEM). UV-Vis spectrophotometry absorption spectrum showed surface plasmon between 400 and 480 nm. FTIR spectrum analysis implies that various phytochemicals/secondary metabolites are involved in the reduction, caping, and stabilization of AgNPs. The Zetasier result suggests that the particles formed are small in size with a low polydispersity index (PDI), suggesting a narrow range of particle distribution. The TEM image suggests that the particles formed are mostly of spherical morphology with nearly 20-25 nm. Further, the selected area electron diffraction (SAED) image showed five electron diffraction rings, suggesting the polycrystalline nature of the particles. The nanoparticles showed high anticancer efficacy against cervical cancer (SiHa) cell lines. The nanostructures showed dose-dependent inhibition with 40% killing observed at 6.25 µg/mL dose. The study showed an eco-friendly and cost-effective approach to the synthesis of AgNPs and provided insight into the development of antioxidant and anticancer agents.
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Grants
- BT/INF/22/SP33063/2019 Department of Biotechnology, Ministry of Science and Technology, India
- BT/INF/22/SP33063/2019 Department of Biotechnology, Ministry of Science and Technology, India
- BT/INF/22/SP33063/2019 Department of Biotechnology, Ministry of Science and Technology, India
- BT/INF/22/SP33063/2019 Department of Biotechnology, Ministry of Science and Technology, India
- BT/INF/22/SP33063/2019 Department of Biotechnology, Ministry of Science and Technology, India
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Affiliation(s)
- Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi-110002, India
| | - Alina Athar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi-110002, India
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi-110002, India
| | - Qamar Zia
- Department of Medical Laboratory Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Abhay Kumar Sharma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi-110002, India
| | - Mohammed Sajid
- Division of Molecular Genetics & Biochemistry, Molecular Biology Group, ICMR-National Institute of Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics & Biochemistry, Molecular Biology Group, ICMR-National Institute of Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | | | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi-110002, India.
- Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, 110002, India.
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Nimisha, Saluja SS, Sharma AK, Nekarakanti PK, Apurva, Kumar A, Sattar RSA, Anjum H, Batra VV, Husain SA. Molecular aspects of ABCB1 and ABCG2 in Gallbladder cancer and its clinical relevance. Mol Cell Biochem 2023; 478:2379-2394. [PMID: 36720839 DOI: 10.1007/s11010-023-04667-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/12/2023] [Indexed: 02/02/2023]
Abstract
The function of ABC transporters in the body is manifold; such as maintenance of homeostasis, effect on multi-drug resistance and their role in tumor initiation & progression. Evidence pointing towards the direct or indirect role of ABC transporter genes in particular; ABCB1 and ABCG2 in cancer genesis is increasing. However, their role in gallbladder cancer is unexplored. Therefore, we investigated the methylation status and expression pattern of ABCB1 and ABCG2in gallbladder carcinogenesis. The methylation and expression study of ABCB1/MDR1 and ABCG2/BCRP was performed in tumour and normal fresh tissue samples collected from 61 histopathologically diagnosed gallbladder cancer patients. The methylation status was analysed by Methylation-Specific PCR and expression was determined by Real-Time PCR and Immunohistochemistry. Hypomethylation of ABCB1 and ABCG2 was found in 44 (72.13%) and 48 (78.6%) cases, respectively. ABCB1 hypomethylation pattern showed association with female patients (p = 0.040) and GradeII tumors (p = 0.036) while, ABCG2 hypomethylation was more frequent in early tumors (T1-T2). The mRNA expression ofABCB1 and ABCG2 was up-regulated in 33 (54.10%) and 41 (67.21%) patients with fold change of 4.7 and 5.5, respectively. The mRNA expression of both genes showed association with Grade II tumours and the increased fold change of ABCG2 was higher in (T1-T2) depth of invasion (p = 0.02) and Stage I-II disease (p = 0.08). The protein expression on IHC was strongly positive for ABCB1/MDR1and ABCG2/BCRP in 32 (52.46%) and 45 (73.77%) patients, respectively. The protein expression in ABCG2 showed association with patients age > 50 years (p = 0.04) and GradeII differentiation (p = 0.07). Interestingly, the hypomethylation of both the genes showed significant correlation with increased expression. ABCB1/MDR1 and ABCG2/BCRP hypomethylation and overexpression could have a potential role in gallbladder cancer tumorigenesis especially in early stages. The epigenetic change might be a plausible factor for altered gene expression of ABCB1 and ABCG2 in gallbladder cancer.
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Affiliation(s)
- Nimisha
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Abhay Kumar Sharma
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Phani Kumar Nekarakanti
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Apurva
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Arun Kumar
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Real Sumayya Abdul Sattar
- Central Molecular Lab, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Hasib Anjum
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Vineeta Vijay Batra
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
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Sahu P, Sahoo R, Sahu AK, Saluja SS, Behera B. Repurposing phytochemicals of Citrullus colocynthis against maltase-glucoamylase using molecular docking, MMGBSA, MD simulation and linear regression to identify potential anti-diabetic compounds. J Biomol Struct Dyn 2023:1-10. [PMID: 37350097 DOI: 10.1080/07391102.2023.2225107] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Diabetes is a common lifestyle disorder found in populations of different age groups. Maltase-glucoamylase catalyses the release of the glucose molecule in the final enzymatic reaction of starch digestion; therefore, inhibition of maltase-glucoamylase is one of the approaches in the development of therapeutics for diabetes. Citrullus colocynthis is commonly recommended in Ayurveda for the treatment of diabetes. The current study applied a structure-based drug design approach to repurpose the phytochemicals of Citrullus colocynthis to identify potential inhibitors for maltase-glucoamylase. 70 phytochemicals of Citrullus colocynthis were screened against maltase-glucoamylase and top 5 molecules 8-p-hydroxybenzylisovitexin, isoorientin, cucurbitacin B, cucurbitacin E, and cucurbitacin I with significant binding energy of -10 kcal/mol, -9.9 kcal/mol, -9.6 kcal/mol, -9.2 kcal/mol, and -7.7 kcal/mol were identified. Furthermore, MMGBSA, pharmacokinetics properties and toxicity prediction were performed on the five identified molecules and top 3 molecules were selected for molecular dynamics (MD) simulation. It was observed from the structural flexibility and dynamic behaviour of the systems that conformational changes were noticed in the complexes as compared to its native state, which suggests that the 3 molecules, namely 8-p-hydroxybenzylisovitexin, isoorientin, and cucurbitacin I of Citrullus colocynthis may act as inhibitors for maltase-glucoamylase.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Parameswar Sahu
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Rosaleen Sahoo
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
- Biochemical Sciences Division, CSIR-National Chemical Laboratory, Pune, Maharashtra, India
| | - Abhishek Kumar Sahu
- Department of Bioinformatics, Centre for Post Graduate Studies, Odisha University of Agriculture and Technology, Bhubaneswar, Odisha, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Banshidhar Behera
- Department of Dravyaguna, Ayurvedic and Unani Tibbia College, New Delhi, India
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Ali A, Sharma AK, Mishra PK, Saluja SS. Clinical significance of SPOP and APC gene alterations in colorectal cancer in Indian population. Mol Genet Genomics 2023:10.1007/s00438-023-02029-x. [PMID: 37289229 DOI: 10.1007/s00438-023-02029-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
Speckle-Type Poz Protein (SPOP) involved in the regulation of proteasome-mediated degradation of several oncoproteins, resulting in cancer initiation and progression. Mutations in Adenomatous Polyposis Coli (APC) gene is reported in most sporadic and hereditary colorectal cancer (CRC). Identifying the cellular changes involved in carcinogenesis when APC is mutated is an important issue that needs attention. The tumor suppressive function of SPOP and APC has long been a major focus in the research field of colorectal cancer. However, the clinical significance of SPOP and APC gene alteration in CRC has not been established to date. Mutational analysis was performed by single-strand conformational polymorphism followed by Sanger sequencing, methylation status by methylation-specific PCR, and protein expression by immunohistochemistry on 142 tumor tissues along with their adjacent non-cancerous specimens. The overall survival (OS) and recurrence free survival (RFS) were estimated by Kaplan-Meier Curve. Mutation rates of APC and SPOP gene were 2.8% and 11.9% while that of promoter hypermethylation were 37% and 47%, respectively. The grade of differentiation and Lymph node metastasis were significantly correlated with APC methylation pattern (p ≤ 0.05). The down regulation of APC was more often seen in colonic cancer compared to rectal cancer (p = 0.07) and more commonly in T3-4 depth of invasion (p = 0.07) and in patients without lymphovascular and perineural invasion (p = 0.007, p = 0.08 respectively). The median overall survival and recurrence free survival (RFS) was 67 & 36 months while 3-yr and 5-yr OS and RFS were 61.1% & 56.4% and 49.2% & 44.8%, respectively. APC promoter methylation had a better overall survival (p = 0.035) while loss of SPOP expression had a worse survival (p = 0.09). Our findings reveal high percentage of SPOP gene mutations in CRC. A significant link is found between promoter hyper methylation and protein expression in all mutant cases of APC and SPOP, suggesting that both genes may be associated in the development of colorectal cancer in people of Indian decent. Hypermethylation of APC gene and loss of SPOP expression have shown an association with disease prognosis and could be further studied looking at its potential role in planning adjuvant treatment in CRC patients.
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Affiliation(s)
- Asgar Ali
- Central Molecular Lab, Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110002, India
| | - Abhay Kumar Sharma
- Central Molecular Lab, Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110002, India
| | - Pramod Kumar Mishra
- Central Molecular Lab, Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110002, India
- Department of GI Surgery, GIPMER, Academic Block, New Delhi, 110002, India
| | - Sundeep Singh Saluja
- Central Molecular Lab, Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110002, India.
- Department of GI Surgery, GIPMER, Academic Block, New Delhi, 110002, India.
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Dar GM, Ahmad E, Ali A, Mahajan B, Ashraf GM, Saluja SS. Genetic aberration analysis of mitochondrial respiratory complex I implications in the development of neurological disorders and their clinical significance. Ageing Res Rev 2023; 87:101906. [PMID: 36905963 DOI: 10.1016/j.arr.2023.101906] [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: 07/23/2022] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
Growing neurological diseases pose difficult challenges for modern medicine to diagnose and manage them effectively. Many neurological disorders mainly occur due to genetic alteration in genes encoding mitochondrial proteins. Moreover, mitochondrial genes exhibit a higher rate of mutation due to the generation of Reactive oxygen species (ROS) during oxidative phosphorylation operating in their vicinity. Among the different complexes of Electron transport chain (ETC), NADH: Ubiquinone oxidoreductase (Mitochondrial complex I) is the most important. This multimeric enzyme, composed of 44 subunits, is encoded by both nuclear and mitochondrial genes. It often exhibits mutations resulting in development of various neurological diseases. The most prominent diseases include leigh syndrome (LS), leber hereditary optic neuropathy (LHON), mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS), myoclonic epilepsy associated with ragged-red fibers (MERRF), idiopathic Parkinson's disease (PD) and, Alzheimer's disease (AD). Preliminary data suggest that mitochondrial complex I subunit genes mutated are frequently of nuclear origin; however, most of the mtDNA gene encoding subunits are also primarily involved. In this review, we have discussed the genetic origins of neurological disorders involving mitochondrial complex I and signified recent approaches to unravel the diagnostic and therapeutic potentials and their management.
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Affiliation(s)
- Ghulam Mehdi Dar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Asgar Ali
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Bhawna Mahajan
- Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Ghulam Md Ashraf
- Department of Medical Laboratory Sciences, College of Health Sciences, and Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates.
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India; Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India.
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Apurva, Abdul Sattar RS, Ali A, Nimisha, Kumar Sharma A, Kumar A, Santoshi S, Saluja SS. Molecular pathways in periampullary cancer: An overview. Cell Signal 2022; 100:110461. [PMID: 36096460 DOI: 10.1016/j.cellsig.2022.110461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/18/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022]
Abstract
Molecular alterations in oncogenes and tumor suppressors in various signaling pathways are basis for personalized therapy in cancer. Periampullary carcinoma behaves differently from pancreatic carcinoma both in prognosis and outcome, therefore it needs special attention. Pancreatic cancer have higher incidence of nodal spread and perineural &lymphovascular invasion suggesting it biologically more aggressive tumor compared to periampullary cancer. Since PAC tumors consist of heterogenous tissue of origin, they might contain different mutations in tumor associated genes and other changes in tissue composition among different subgroups clubbed together. Significant progress has been made in understanding the molecular nature of PAC in the previous two decades, and a large number of mutations and other genetic changes have been identified as being responsible for the disease. This review article targets to collate and discuss the molecular evolution of PAC and their implication in its outcome. As per literature, mitogen-activated protein kinase (MAPK), phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K), and Wnt signaling are the most common pathways involved in PAC. Mutations in KRAS, TP53, CTNNB1, SMAD4 and APC genes were the most frequently reported. I-subtype resembles colorectal cancer while the morphology of PB-type shows close resemblance to pancreatic tumors. The frequency of driver gene mutations is higher in I-type compared to PB-type of PAC indicating I-type to be genetically more unstable. The genetic landscape of PAC obtained from WES data highlighted PI3/AKT pathway to be a primary target in I-type and RAS/RAF in PB-type.
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Affiliation(s)
- Apurva
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Amity University, Noida, India
| | - Real Sumayya Abdul Sattar
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Asgar Ali
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Nimisha
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Abhay Kumar Sharma
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Arun Kumar
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | | | - Sundeep Singh Saluja
- Central Molecular Lab, GovindBallabhPant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of GI Surgery, GovindBallabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
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Ahmad E, Ali A, Nimisha, Kumar Sharma A, Ahmed F, Mehdi Dar G, Mohan Singh A, Apurva, Kumar A, Athar A, Parveen F, Mahajan B, Singh Saluja S. Molecular approaches in cancer. Clin Chim Acta 2022; 537:60-73. [DOI: https:/doi.org/10.1016/j.cca.2022.09.027] [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: 09/28/2023]
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Dar GM, Agarwal S, Kumar A, Nimisha, Apurva, Sharma AK, Verma R, Sattar RSA, Ahmad E, Ali A, Mahajan B, Saluja SS, Meher R. A non-invasive miRNA-based approach in early diagnosis and therapeutics of oral cancer. Crit Rev Oncol Hematol 2022; 180:103850. [DOI: 10.1016/j.critrevonc.2022.103850] [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: 08/03/2021] [Revised: 05/30/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
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Dar GM, Agarwal S, Kumar A, Nimisha, Apurva, Sharma AK, Verma R, Sattar RSA, Ahmad E, Ali A, Mahajan B, Saluja SS, Meher R. A non-invasive miRNA-based approach in early diagnosis and therapeutics of oral cancer. Crit Rev Oncol Hematol 2022; 180:103850. [DOI: https:/doi.org/10.1016/j.critrevonc.2022.103850] [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: 09/28/2023] Open
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Ahmad E, Ali A, Nimisha, Kumar Sharma A, Ahmed F, Mehdi Dar G, Mohan Singh A, Apurva, Kumar A, Athar A, Parveen F, Mahajan B, Singh Saluja S. Molecular approaches in cancer. Clin Chim Acta 2022; 537:60-73. [DOI: 10.1016/j.cca.2022.09.027] [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: 06/29/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/03/2022]
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Dahale AS, Srivastava S, Saluja SS, Sachdeva S, Dalal A, Varakanahalli S. Correction to: Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery. Indian J Gastroenterol 2022:10.1007/s12664-022-01309-5. [PMID: 36385354 DOI: 10.1007/s12664-022-01309-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Amol S Dahale
- Department of Gastroenterology, Dr. D Y Patil Medical College and Hospital, Pimpri, Pune, 411 018, India
| | - Siddharth Srivastava
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002, India.
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, G B Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110 002, India
| | - Sanjeev Sachdeva
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002, India
| | - Ashok Dalal
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002, India
| | - Shivakumar Varakanahalli
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002, India
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Saluja SS, Varshney VK, Kumar A, Sugumaran K, Aravinda PS, Mishra PK. Histopathological Changes in Liver of Patients With Chronic Pancreatitis Requiring Surgical Intervention and Their Clinical Significance. Pancreas 2022; 51:1320-1326. [PMID: 37099773 DOI: 10.1097/mpa.0000000000002181] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVES The histopathological changes in the liver and their clinical implication in chronic pancreatitis (CP) have not been studied well. We analyzed the incidence, risk factors, and long-term outcomes of these changes in CP. METHODS Chronic pancreatitis patients who underwent surgery with intraoperative liver biopsy from 2012 to 2018 formed the study group. Based on liver histopathology, 3 groups were formed: normal liver, group NL; fatty liver, group FL; and inflammation/fibrosis, group FS. The risk factors and long-term outcomes, including mortality, were evaluated. RESULTS Among 73 patients, 39 (53.4%) had idiopathic, and 34 (46.6%) had alcoholic CP. The median age was 32 years, 52 (71.2%) were males and comprised NL, n = 40 (55%); FL, n = 22 (30%); and FS, n = 11 (15%). The preoperative risk factors were comparable among NL and FL groups. Overall 14 of 73 patients (19.2%) (NL, 5 of 40; FL, 5 of 22; FS, 4 of 11 [P = 0.82]) had died at median follow-up of 36 months (range, 25-85 months). The main causes of mortality were tuberculosis and severe malnutrition secondary to pancreatic insufficiency. CONCLUSIONS The mortality is higher in patients with inflammation/fibrosis or steatosis in liver biopsy, and such patients need monitoring for progression of liver disease and pancreatic insufficiency.
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Affiliation(s)
| | | | - Ajay Kumar
- Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | - P S Aravinda
- From the Departments of Gastrointestinal Surgery
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Sattar RSA, Verma R, Nimisha, Kumar A, Dar GM, Apurva, Sharma AK, Kumari I, Ahmad E, Ali A, Mahajan B, Saluja SS. Diagnostic and prognostic biomarkers in colorectal cancer and the potential role of exosomes in drug delivery. Cell Signal 2022; 99:110413. [PMID: 35907519 DOI: 10.1016/j.cellsig.2022.110413] [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: 04/14/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/03/2022]
Abstract
Colorectal cancer (CRC) is third most common cancer with second most common cause of death worldwide. One fourth to one fifth of the CRC cases are detected at advance stage. Early detection of colorectal cancer might help in decreasing mortality and morbidity worldwide. CRC being a heterogeneous disease, new non-invasive approaches are needed to complement and improve the screening and management of CRC. Reliable and early detectable biomarkers would improve diagnosis, prognosis, therapeutic responses, and will enable the prediction of drug response and recurrence risk. Over the past decades molecular research has demonstrated the potentials of CTCs, ctDNAs, circulating mRNA, ncRNAs, and exosomes as tumor biomarkers. Non-invasive screening approaches using fecal samples for identification of altered gut microbes in CRC is also gaining attention. Exosomes can be potential candidates that can be employed in the drug delivery system. Further, the integration of in vitro, in vivo and in silico models that involve CRC biomarkers will help to understand the interactions occurring at the cellular level. This review summarizes recent update on CRC biomarkers and their application along with the nanoparticles followed by the application of organoid culture in CRC.
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Affiliation(s)
- Real Sumayya Abdul Sattar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Renu Verma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Arun Kumar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Ghulam Mehdi Dar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Apurva
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Abhay Kumar Sharma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Indu Kumari
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Asgar Ali
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Bhawna Mahajan
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
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Ahmad E, Ali A, Nimisha, Kumar Sharma A, Apurva, Kumar A, Dar GM, Sumayya Abdul Sattar R, Verma R, Mahajan B, Singh Saluja S. Molecular markers in cancer. Clin Chim Acta 2022; 532:95-114. [DOI: https:/doi.org/10.1016/j.cca.2022.05.029] [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: 09/28/2023]
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Ahmad E, Ali A, Nimisha, Kumar Sharma A, Apurva, Kumar A, Mehdi G, Sumayya Abdul Sattar R, Verma R, Mahajan B, Singh Saluja S. Molecular markers in cancer. Clin Chim Acta 2022; 532:95-114. [DOI: 10.1016/j.cca.2022.05.029] [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: 02/16/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 12/01/2022]
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Saluja SS, Nekarakanti PK, Mishra PK, Srivastava A, Singh K. Prospective Randomized Controlled Trial Comparing Adjuvant Chemotherapy vs. No Chemotherapy for Patients with Carcinoma of Gallbladder Undergoing Curative Resection. J Gastrointest Surg 2022; 26:398-407. [PMID: 34545545 DOI: 10.1007/s11605-021-05143-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/27/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Gallbladder carcinoma (GBC) has a dismal prognosis even after curative resection. The objective of the study was to evaluate the effect of adjuvant chemotherapy in patients with GBC undergoing curative resection in a randomized control trial (RCT). METHODS A single-center open-labeled prospective RCT was done from January 2012 to June 2018. R0 curative resected GBC patients were randomized in 1:1 to either surveillance alone (control group) or adjuvant chemotherapy (gemcitabine and cisplatin (GemCis group)) for 6 cycles. The primary outcome was disease-free survival (DFS), and the secondary outcomes were overall survival (OS) and toxicity profile. RESULTS On the evaluation of 362 patients with GBC, 50 patients were enrolled in each control or GemCis group. Per protocol (PP), it comprised 96 patients. The demographic and clinical profile was similar between the two groups except in the lower nodal stage where patients were higher in the control group (p = 0.01). Recurrences were similar between groups (control 44% vs GemCis 56%; p = 0.23). On the intention to treat (ITT), analyses of median DFS (not reached vs. 24 months, p = 0.14) and OS (not reached vs. 31 months, p = 0.10) were similar between groups. On PP, analyses of median DFS (not reached vs. 24 months, p = 0.16) and OS (not reached vs. 31 months, p = 0.09) were similar between groups. The common toxicity profile was hematological followed by gastrointestinal symptoms. CONCLUSIONS Adjuvant GemCis therapy for 6 cycles does not improve DFS or OS than R0 surgery alone patients with GBC. TRIAL REGISTRATION NCT02778308 ( https://www.clinicaltrials.gov ).
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
| | - Phani Kumar Nekarakanti
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Anurita Srivastava
- Department of Radiotherapy, Maulana Azad Medical College, New Delhi, India
| | - Kishore Singh
- Department of Radiotherapy, Maulana Azad Medical College, New Delhi, India
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Sattar RSA, Sumi MP, Nimisha, Apurva, Kumar A, Sharma AK, Ahmad E, Ali A, Mahajan B, Saluja SS. S1P signaling, its interactions and cross-talks with other partners and therapeutic importance in colorectal cancer. Cell Signal 2021; 86:110080. [PMID: 34245863 DOI: 10.1016/j.cellsig.2021.110080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/15/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023]
Abstract
Sphingosine-1-Phosphate (S1P) plays an important role in normal physiology, inflammation, initiation and progression of cancer. Deregulation of S1P signaling causes aberrant proliferation, affects survival, leads to angiogenesis and metastasis. Sphingolipid rheostat is crucial for cellular homeostasis. Discrepancy in sphingolipid metabolism is linked to cancer and drug insensitivity. Owing to these diverse functions and being a potent mediator of tumor growth, S1P signaling might be a suitable candidate for anti-tumor therapy or combination therapy. In this review, with a focus on colorectal cancer we have summarized the interacting partners of S1P signaling pathway, its therapeutic approaches along with the contribution of S1P signaling to various cancer hallmarks.
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Affiliation(s)
- Real Sumayya Abdul Sattar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Mamta P Sumi
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Apurva
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Arun Kumar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Abhay Kumar Sharma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Asgar Ali
- Department of Biochemistry, All India Institute of Medical Science (AIIMS), Patna, Bihar, India
| | - Bhawna Mahajan
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
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Saluja SS, Varshney VK, Bhat VS, Nekarakanti PK, Arora A, Sachdeva S, Mishra PK. Management of Obscurely Dilated Common Bile Duct with Normal Liver Function Tests: A Pragmatic Approach. World J Surg 2021; 45:2712-2718. [PMID: 34095958 DOI: 10.1007/s00268-021-06175-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Dilated common bile duct (CBD) (8-15 mm) with normal liver function tests is seen not infrequently, while management of such patients is ambiguous. We propose a treatment algorithm for this cohort of patients after observing them over a period of 8 years. METHODS Seventy-eight such patients were managed from 2009 to 2017 and categorized as: Group A-dilated CBD with post-cholecystectomy status (n = 15); B-dilated CBD with cholelithiasis (n = 34); C-dilated CBD without cholelithiasis (n = 16); D-dilated CBD with no cause identified and underwent CBD excision (n = 13). Causes for CBD dilatation were evaluated. The outcome of patients in Group B + C without any cause (n = 33) was compared with Group D. RESULT Median age, CBD diameter, bilirubin and alkaline phosphatase were 51 years (13-79), 10 mm (8-20), 0.6 mg/dl (0.2-2.5) and 126 IU (60-214), respectively. Group-A patients who did not manifest any cause of CBD dilatation were managed conservatively. The aetiology was identified in 17/50 patients in Group B & C [acute pancreatitis (n = 6), passed CBD calculi (n = 3), perivaterian diverticulum (n = 3), viral aetiology (n = 4) and tumour (n-1)]. In Group-C, 7 patients with no obvious cause underwent endoscopic sphincterotomy, pancreatoduodenectomy (n = 1), and the rest were managed conservatively (n = 8). There was no significant difference in the complication between Group B + C (without any cause) and Group D (3/33 vs. 1/13; p = 0.58) at a median follow-up of 72 months (30-90). CONCLUSION Dilated CBD with normal LFT's without apparent cause is mostly benign and of no consequence. Excision of the CBD is not required for most of these patients.
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India.
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India
| | - Vidya Sharada Bhat
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India
| | - Phani Kumar Nekarakanti
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India
| | - Asit Arora
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India
| | - Sanjeev Sachdeva
- Department of Gastroenterology, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, 110002, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, 110002, India
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Verma R, Sattar RSA, Nimisha, Apurva, Kumar A, Sharma AK, Sumi MP, Ahmad E, Ali A, Mahajan B, Saluja SS. Cross-talk between next generation sequencing methodologies to identify genomic signatures of esophageal cancer. Crit Rev Oncol Hematol 2021; 162:103348. [PMID: 33961993 DOI: 10.1016/j.critrevonc.2021.103348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/02/2021] [Revised: 04/22/2021] [Accepted: 05/01/2021] [Indexed: 02/07/2023] Open
Abstract
The asymptomatic behaviour of esophageal cancerous cells at early stages develops advanced clinical presentation of the disease, resulting in poor prognosis and curbed intervention of therapeutic modalities. The endeavours to detect diagnostic and prognostic markers have been proven futile at the clinical platform. While several biomarkers have been investigated, including CYFRA 21-1, carcinoembryonic antigen and squamous cell carcinoma antigen, their sensitivity has not proved consistently satisfactory across the various stages of esophageal cancer. Hence, there is an impending requirement of biomarkers for early diagnosis and better prognosis. In the recent past, next generation sequencing (NGS) tool has emerged as an important tool to highlight the hallmarks of esophageal cancer (EC). This review summarizes the changes/mutations occurred in tumor cells during carcinogenesis and addresses the contribution of NGS techniques, viz. whole genome sequencing (WGS), RNA-Sequencing and Exome sequencing (ES), in EC. Additionally, this review highlights the connection between the findings from these techniques. An effort has been made to emphasize the genes affected and involved signaling pathway in EC. Further, investigations of these mutated genes would not only shed light on the relevant genes to be studied but also help in the better management and cure through personalized therapy.
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Affiliation(s)
- Renu Verma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Real Sumayya Abdul Sattar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Apurva
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Arun Kumar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Abhay Kumar Sharma
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Mamta Parveen Sumi
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Asgar Ali
- Department of Biochemistry, All India Institute of Medical Science (AIIMS), Patna, Bihar, India
| | - Bhawna Mahajan
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India; Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
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Ahmad E, Ali A, Fatima MT, Nimisha, Apurva, Kumar A, Sumi MP, Sattar RSA, Mahajan B, Saluja SS. Ligand decorated biodegradable nanomedicine in the treatment of cancer. Pharmacol Res 2021; 167:105544. [PMID: 33722711 DOI: 10.1016/j.phrs.2021.105544] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022]
Abstract
Cancer is one of the major global health problems, responsible for the second-highest number of deaths. The genetic and epigenetic changes in the oncogenes or tumor suppressor genes alter the regulatory pathways leading to its onset and progression. Conventional methods are used in appropriate combinations for the treatment. Surgery effectively treats localized tumors; however, it fails to treat metastatic tumors, leading to a spread in other organs, causing a high recurrence rate and death. Among the different strategies, the nanocarriers-based approach is highly sought for, but its nonspecific delivery can cause a profound side effect on healthy cells. Targeted nanomedicine has the advantage of targeting cancer cells specifically by interacting with the receptors overexpressed on their surface, overcoming its non-specificity to target healthy cells. Nanocarriers prepared from biodegradable and biocompatible materials are decorated with different ligands by encapsulating therapeutic or diagnostic agents or both to target cancer cells overexpressing the receptors. Scientists are now utilizing a theranostic approach to simultaneously evaluate nanocarrier bio-distribution and its effect on the treatment regime. Herein, we have summarized the recent 5-year efforts in the development of the ligands decorated biodegradable nanocarriers, as a targeted nanomedicine approach, which has been highly promising in the treatment of cancer.
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Affiliation(s)
- Ejaj Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Asgar Ali
- Department of Biochemistry, All India Institute of Medical Science, Patna 810507, India
| | - Munazza Tamkeen Fatima
- Department of Pharmaceutical Science, College of Pharmacy, QU health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Apurva
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Arun Kumar
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Mamta P Sumi
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Real Sumayya Abdul Sattar
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India
| | - Bhawna Mahajan
- Department of Biochemistry, Govind Ballabh Pant, Postgraduate Institute of Medical, Education and Research (GIPMER), New Delhi 110002, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India; Department of GI Surgery, Govind Ballabh Pant, Postgraduate Institute of Medica, Education and Research (GIPMER), New Delhi 110002, India.
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Sumi MP, Mahajan B, Sattar RSA, Nimisha, Apurva, Kumar A, Sharma AK, Ahmad E, Ali A, Saluja SS. Elucidation of Epigenetic Landscape in Coronary Artery Disease: A Review on Basic Concept to Personalized Medicine. Epigenet Insights 2021; 14:2516865720988567. [PMID: 33598635 PMCID: PMC7863167 DOI: 10.1177/2516865720988567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022] Open
Abstract
Despite extensive clinical research and management protocols applied in the field of coronary artery diseases (CAD), it still holds the number 1 position in mortality worldwide. This indicates that we need to work on precision medicine to discover the diagnostic, therapeutic, and prognostic targets to improve the outcome of CAD. In precision medicine, epigenetic changes play a vital role in disease onset and progression. Epigenetics is the study of heritable changes that do not affect the alterations of DNA sequence in the genome. It comprises various covalent modifications that occur in DNA or histone proteins affecting the spatial arrangement of the DNA and histones. These multiple modifications include DNA/histone methylation, acetylation, phosphorylation, and SUMOylation. Besides these covalent modifications, non-coding RNAs-viz. miRNA, lncRNA, and circRNA are also involved in epigenetics. Smoking, alcohol, diet, environmental pollutants, obesity, and lifestyle are some of the prime factors affecting epigenetic alterations. Novel molecular techniques such as next-generation sequencing, chromatin immunoprecipitation, and mass spectrometry have been developed to identify important cross points in the epigenetic web in relation to various diseases. The studies regarding exploration of epigenetics, have led researchers to identify multiple diagnostic markers and therapeutic targets that are being used in different disease diagnosis and management. Here in this review, we will discuss various ground-breaking contributions of past and recent studies in the epigenetic field in concert with coronary artery diseases. Future prospects of epigenetics and its implication in CAD personalized medicine will also be discussed in brief.
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Affiliation(s)
- Mamta P Sumi
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Bhawna Mahajan
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
- Department of Biochemistry, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Real Sumayya Abdul Sattar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Nimisha
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Apurva
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Arun Kumar
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Abhay Kumar Sharma
- Department of Biochemistry, All India Institute of Medical Science, Patna, Bihar, India
| | - Ejaz Ahmad
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
| | - Asgar Ali
- Department of Biochemistry, All India Institute of Medical Science, Patna, Bihar, India
| | - Sundeep Singh Saluja
- Central Molecular Laboratory, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), University of Delhi, New Delhi, India
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Dahale AS, Srivastava S, Saluja SS, Sachdeva S, Dalal A, Varakanahalli S. Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery. Indian J Gastroenterol 2021; 40:287-294. [PMID: 33974228 PMCID: PMC8195754 DOI: 10.1007/s12664-021-01152-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Scope-induced duodenal perforation is a life-threatening complication and surgery remains the standard of care. With the advent of over-the-scope clip (OTSC), scope-induced perforations are increasingly managed conservatively, though there is no study comparing this form of non-surgical treatment with surgery. We aimed to compare OTSC and surgery in the management of scope-induced perforation of the duodenum. METHODS We retrospectively collected data of scope-induced duodenal perforation patients. Perforations identified and treated within 24 h of procedure were analyzed. Factors analyzed were spectrum, etiology, baseline parameters, perforation size, outcome, comorbidities, and duration of hospital stay. RESULTS A total of 25 patients had type I duodenal perforations, out of whom five were excluded due to delayed diagnosis and treatment. Of the twenty, eight were treated with OTSC placement while the rest underwent surgery. Age was comparable and the majority were females. Baseline parameters and comorbidities were similar in both the groups. The median size of perforation was 1.5 cm in both the OTSC group and the surgical group. All patients were treated with standard of care according to institutional protocols. Patients in the OTSC group were started orally after 48 h of OTSC placement, while in the surgery group median time to oral intake was 7 days. Two patients in the surgical group died while there was no mortality in the OTSC group (p = 0.48). Median hospital stay was shorter in the OTSC group (2 days vs. 22 days, p = 0.003). CONCLUSIONS OTSC is a feasible and better option in type I duodenal perforations with a shorter hospital stay.
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Affiliation(s)
- Amol S. Dahale
- Department of Gastroenterology, Dr. D Y Patil Medical College and Hospital, Pimpri, Pune, 411 018 India
| | - Siddharth Srivastava
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002 India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, G B Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110 002 India
| | - Sanjeev Sachdeva
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002 India
| | - Ashok Dalal
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002 India
| | - Shivakumar Varakanahalli
- Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002 India
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Tulsyan S, Hussain S, Mittal B, Saluja SS, Tanwar P, Rath GK, Goodman M, Kaur T, Mehrotra R. A systematic review with in silico analysis on transcriptomic profile of gallbladder carcinoma. Semin Oncol 2020; 47:398-408. [DOI: 10.1053/j.seminoncol.2020.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/21/2020] [Indexed: 01/17/2023]
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Saluja SS, Mishra PK, Kiran S, Shah HJ, Chandrasekar S, Nayeem M, Sharma A, Varshney VK. Impact of lymph node staging systems in predicting outcome in patients with ampullary cancer. Ann Hepatobiliary Pancreat Surg 2020; 24:484-495. [PMID: 33234752 PMCID: PMC7691202 DOI: 10.14701/ahbps.2020.24.4.484] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/02/2022] Open
Abstract
Backgrounds/Aims Lymph node (LN) metastasis though, is a poor prognostic factor for ampullary carcinoma (APC), the impact of Lymph node ratio (LNR) and Logarithm odds of positive lymph node (LODDS) in the long-term survival remains controversial. We evaluated the factors affecting the long-term outcome in APC patients with emphasis on LNR and LODDS. Methods The prospectively collected data of 198 patients who underwent pancreatoduodenectomy for APC was analyzed after excluding 12 patients for various reasons. Factors affecting Disease specific survival (DSS) and Recurrence free survival (RFS) were analyzed with special reference to LN positivity, LNR and LODDS. Results Out of 186, 117 (62.9%) patients were alive at a median follow-up of 39.5 months and 72 (38.7%) developed recurrence. The overall 5-year DSS was 59.3% & RFS 54.9%. Univariate analysis showed T-stage, tumor differentiation, perineural invasion, LN positivity, LNR and LODDS was significantly affected DSS and RFS. On multivariate analysis, perineural invasion, LN positivity, LNR and LODDS lost its significance for DSS and RFS. AUC for prediction of DSS and RFS for LNR was 0.654 (p<0.001) & 0.629 (p=0.003) respectively and for LODDS, it was 0.697 (p<0.001) & 0.677 (p=0.001) respectively. Sensitivity and specificity of LNR (0.1) for DSS were 37.7% & 83.8% and for RFS were 36.1% & 83.3%; for LODDS (-1.00), sensitivity and specificity for DSS was 62.3% and 67.5% and for RFS it was 59.7% and 66.7% respectively. Conclusions LNR and LODDS although independently seem to affect the RFS and DSS, albeit have a low sensitivity and specificity in predicting DSS and RFS.
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Shashi Kiran
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Harsh J Shah
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Sandip Chandrasekar
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Mohammed Nayeem
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Aditya Sharma
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
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Sharma A, Saluja SS, Nag HH, Sharma M, Sakhuja P. Neuroendocrine Carcinoma of the Gallbladder. Am Surg 2020; 88:2768-2770. [PMID: 32935998 DOI: 10.1177/0003134820951466] [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: 11/15/2022]
Affiliation(s)
- Aditya Sharma
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Hirdaya Hulas Nag
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Monika Sharma
- Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Puja Sakhuja
- Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Rehman AU, Iqbal MA, Sattar RSA, Saikia S, Kashif M, Ali WM, Medhi S, Saluja SS, Husain SA. Elevated expression of RUNX3 co-expressing with EZH2 in esophageal cancer patients from India. Cancer Cell Int 2020; 20:445. [PMID: 32943993 PMCID: PMC7488393 DOI: 10.1186/s12935-020-01534-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 10/20/2019] [Accepted: 09/01/2020] [Indexed: 12/22/2022] Open
Abstract
Background Runt related transcription factor3 (RUNX3) is considered as a tumor suppressor gene (TSG) that functions through the TGF-β dependent apoptosis. Promoter methylation of the CpG islands of RUNX3 and overexpression of enhancer of zeste homolog 2 (EZH2) has been suggested to downregulate RUNX3 in cancer. Methods Here, we studied the expression of RUNX3 and EZH2 in 58 esophageal tumors along with paired adjacent normal tissue. mRNA levels, protein expressions and cellular localizations of EZH2 and RUNX3 were analyzed using real-time PCR and immunohistochemistry, respectively. DNA methylation was further assessed by the methylation specific-PCR. Results Compared to normal tissue, a significant increase in expression of RUNX3 mRNA in 31/57 patient’s tumor tissue (p < 0.04) was observed. The expression of EZH2 was found to be upregulated compared to normal, and a significant positive correlation between EZH2 and RUNX3 expression was observed (p = 0.002). 22 of the 27 unmethylated cases at the promoter region of the RUNX3 had elevated RUNX3 protein expression (p < 0.001). Conclusion The data presented in this study provide new insights into the biology of RUNX3 and highlights the need to revisit our current understanding of the role of RUNX3 in cancer.
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Affiliation(s)
- Asad Ur Rehman
- Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025 India
| | | | | | - Snigdha Saikia
- Department of Bioengineering and Technology, Guist, Gauhati University, Guwahati, India
| | | | - Wasif Mohammad Ali
- Department of Surgery, JN Medical College and Hospital, AMU, Aligarh, UP India
| | - Subhash Medhi
- Department of Bioengineering and Technology, Guist, Gauhati University, Guwahati, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, G B Pant Hospital & Maulana Azad Medical College, New Delhi, India
| | - Syed Akhtar Husain
- Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025 India
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Sachan A, Saluja SS, Nekarakanti PK, Nimisha, Mahajan B, Nag HH, Mishra PK. Raised CA19-9 and CEA have prognostic relevance in gallbladder carcinoma. BMC Cancer 2020; 20:826. [PMID: 32867709 PMCID: PMC7457344 DOI: 10.1186/s12885-020-07334-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/13/2019] [Accepted: 08/24/2020] [Indexed: 02/08/2023] Open
Abstract
Background Role of tumor markers in gall bladder carcinoma (GBC) is not well established. We evaluated the prognostic value of carbohydrate antigen 19–9 (CA19–9) and carcinoma embryonic antigen (CEA) in patients with GBC. Methods Of the 225 patients of GBC enrolled,176 patients were included in the study (excluded 49 patients with jaundice). Patients were divided into 3 groups; resectable n = 92, unresectable n = 17, metastatic n = 67. The clinico-pathological characteristics, tumor markers and survival data were analysed. The cutoff values of CA19–9 & CEA for predicting metastases were computed using receiver operating characteristic curve. Kaplan Meir survival and Cox regression analysis were done for factors predicting survival and recurrence. Results The median value of Ca19–9 was significantly higher in metastatic group [resectable: 21.3, unresectable: 53.9 and metastatic: 79; p < 0.001] but not for CEA [3.5, 7.8 and 5 ng/ml (p = 0.20)]. A cutoff value of 72 IU/ml for CA19–9, 5 ng/ml for CEA had a sensitivity and specificity of 52 and 80%, 51 and 72% respectively for detection of metastatic disease. Median, 3-year & 5-year survival were significantly lower in patients with CEA > 4 (p = 0.041), Ca19.9 > 37 (p = 0.019), T3/T4 (p = 0.001), node positive (p = 0.001) and presence of perineural invasion (p = 0.001). However, on multivariate analysis, only Ca19.9 > 37 predicted recurrence (p = 0.002, HR 5.8). Conclusions Raised CA19.9 and CEA predict metastatic disease in patients with GBC without jaundice with a high specificity and may help in prognostication of the patient. CA19–9 was better than CEA in prediction of tumor burden and in predicting recurrence.
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Affiliation(s)
- Ashish Sachan
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India.
| | - Phani Kumar Nekarakanti
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Nimisha
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Bhawna Mahajan
- Department of Biochemistry, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Hirdaya H Nag
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Pramod K Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Room no 218, Jawahar Lal Nehru Marg, New Delhi, 110002, India
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Saluja SS, Manipadam JM, Batra VV, Puri AS, Mishra PK. Eosinophilic Jejunitis: Is There a Place for Diagnostic Laparoscopy? Am Surg 2020. [DOI: 10.1177/000313481307901207] [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: 11/16/2022]
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Affiliation(s)
- Vasanth Kumar
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Rajesh Rajalingam
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Barjesh Chander Sharma
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery Academic Block G B Pant Hospital New Delhi, India
| | - Sunil Kumar Puri
- Department of Radiology Academic Block G B Pant Hospital New Delhi, India
| | - Ankur Arora
- Department of Radiology Academic Block G B Pant Hospital New Delhi, India
| | | | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery Academic Block G B Pant Hospital New Delhi, India
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Deepak B, Varshney VK, Singh S, Trehan VK, Saluja SS. Budd-Chiari Syndrome with Inferior Vena Cava-Right Atrial Junction Obstruction: A Rare Presentation Managed by a Novel Technique. Am Surg 2020. [DOI: 10.1177/000313481908501215] [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: 11/15/2022]
Affiliation(s)
- Balachandra Deepak
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Safal Singh
- Department of Cardiology Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Vijay Kumar Trehan
- Department of Cardiology Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
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Affiliation(s)
- Pramod Kumar Mishra
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Neeraj Goel
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Garima Durga
- Department of Pathology Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Hridaya Hulas Nag
- Department of Gastrointestinal Surgery Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
| | - Poonam Narang
- Department of Radiology Gobind Ballabh Pant Hospital & Maulana Azad Medical College New Delhi, India
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Saluja SS, Kumar A, Govind H, Varshney VK, Khullar R, Mishra PK. Splenectomy with endotherapy in non-cirrhotic portal fibrosis related portal hypertension: Can it be an alternative to proximal spleno-renal shunt? Ann Hepatobiliary Pancreat Surg 2020; 24:168-173. [PMID: 32457262 PMCID: PMC7271099 DOI: 10.14701/ahbps.2020.24.2.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/12/2019] [Revised: 02/01/2020] [Accepted: 03/04/2020] [Indexed: 01/08/2023] Open
Abstract
Backgrounds/Aims Proximal splenorenal shunt (PSRS) is usually done in symptomatic non-cirrhotic portal fibrosis (NCPF). The outcomes of splenectomy with endotherapy in non-bleeder NCPF patients has not been well studied. We here by aimed to study the post-surgical outcomes on short and long-term basis between PSRS and splenectomy among non-bleeder NCPF patients. Methods The consecutive non-bleeder NCPF patients whom underwent either splenectomy or PSRS from 2008 to 2016 were enrolled. The patients were followed up post-surgery clinically and biochemical investigations, Doppler ultrasound and upper gastrointestinal endoscopy were done as required. The peri-operative parameters compared were operative time, blood loss, hospital stay and morbidity. The long-term outcome measures compared were incidence of portal hypertension (PHTN) related bleed, change in grade of varices, shunt patency, shunt complications and thrombosis of spleno-portal axis. Results Among 40 patients with non-bleeder status, 24 underwent splenectomy and 16 underwent PSRS. The baseline characteristics including indication of surgery, biochemical investigations and grade of varices were comparable between PSRS and splenectomy. The peri-operative morbidity was not significantly different between two groups. The median follow up duration was 42 months (12-72 months), the decrement in grade of varices was significantly higher in PSRS group (p=0.03), symptomatic PHTN related UGIB was non-significant between PSRS and splenectomy (p=0.5). In PSRS group, 3 (18.3%) patients had shunt thrombosis (n=1) & encephalopathy (n=2) while in splenectomy group two patients developed thrombosis of splenoportal axis. Conclusions Splenectomy with endotherapy is alternative to PSRS in non-bleeder NCPF patients with indications for surgery.
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ajay Kumar
- Department of Gastromedicine, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Hari Govind
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Rahul Khullar
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Tiwari RR, Wahabi K, Perwez A, Bhat ZI, Hasan SS, Saluja SS, Rizvi MA. Implication of alterations in Parkin gene among North Indian patients with colorectal cancer. Turk J Gastroenterol 2020; 31:211-220. [PMID: 32343233 DOI: 10.5152/tjg.2020.18823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIMS Alterations in Parkin (PRKN) have been described in many cancers; however, the molecular mechanism that contributes to loss of Parkin expression in colorectal cancer (CRC) remains unclear. The aim of this study was to investigate the involvement of PRKN mutation and loss of heterozygosity (LOH) in loss of Parkin expression. To understand the role of PRKN in cancer progression, we also evaluated the association of Parkin expression with clinicopathological parameters in North Indian population. MATERIALS AND METHODS We studied 219 CRC samples and their adjacent normal tissues (control) obtained from North Indian patients with CRC. The expression of Parkin was analyzed by immunohistochemistry (IHC). PRKN mutations were analyzed by single-stranded conformational polymorphism (SSCP) and sequencing. For loss of heterozygosity (LOH), we employed two intragenic, D6S305 and D6S1599, and one telomeric marker, D6S1008. RESULTS In our study, we found four novel somatic mutations, namely, C166G, K413N, R420P (exon 4), and V425E (exon 11). Both mutation in Parkin (p = 0.0014) and LOH (p = 0.0140) were significantly associated with loss of Parkin expression. Additionally, Parkin mutations were not associated with the clinicopathological parameters of the patients. Furthermore, both, LOH in Parkin and Parkin expression were significantly correlated with different clinicopathological variables (p<0.05). CONCLUSION Our results indicate that Parkin expression is not regulated by a single mechanism, but both mutation and LOH contribute to loss of Parkin expression. We also provide evidence of involvement of Parkin in metastasis and cancer progression. We, therefore, suggest Parkin as a potential prognostic marker and warrant further analysis in this direction.
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Affiliation(s)
- Raj Ranjan Tiwari
- Department of Biosciences, Genome Biology Laboratory, Jamia Millia Islamia, New Delhi, India;School of Sciences, Indira Gandhi National Open University (IGNOU), New Delhi, India
| | - Khushnuma Wahabi
- Department of Biosciences, Genome Biology Laboratory, Jamia Millia Islamia, New Delhi, India
| | - Ahmad Perwez
- Department of Biosciences, Genome Biology Laboratory, Jamia Millia Islamia, New Delhi, India
| | - Zafar Iqbal Bhat
- Department of Biosciences, Genome Biology Laboratory, Jamia Millia Islamia, New Delhi, India
| | - Syed Shamimul Hasan
- School of Sciences, Indira Gandhi National Open University (IGNOU), New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital, New Delhi, India
| | - Moshahid Alam Rizvi
- Department of Biosciences, Genome Biology Laboratory, Jamia Millia Islamia, New Delhi, India
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Deepak B, Varshney VK, Singh S, Trehan VK, Saluja SS. Budd-Chiari Syndrome with Inferior Vena Cava-Right Atrial Junction Obstruction: A Rare Presentation Managed by a Novel Technique. Am Surg 2019; 85:e611-e613. [PMID: 31908245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Varshney VK, Gupta RK, Saluja SS, Tyagi I, Mishra PK, Batra VV. Analysis of clinicopathological and immunohistochemical parameters and correlation of outcomes in gastrointestinal stromal tumors. Indian J Cancer 2019; 56:135-143. [PMID: 31062732 DOI: 10.4103/ijc.ijc_352_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. We analyzed the clinicopathological features, resectability, immunohistochemical markers, and various factors predictive of disease recurrence and survival. MATERIALS AND METHODS Retrospective analysis of prospectively maintained database of GIST patients managed from 2005 to 2016 was done. Size, site, malignant potential, nuclear pleomorphism, histopathological variety, immunohistochemical markers, type of surgery, and adjuvant imatinib therapy were analyzed. RESULTS Ninety-two patients with GIST were analyzed. Immunohistochemistry showed positivity for c-kit (82.4%), DOG1 (75%), and PDGFR-α (79%). Among 16 patients with c-kit-negative tumors, 10 patients were positive for DOG1, PDGFR-α, or both. The most common primary site was stomach (44, 47.8%) followed by small bowel (17, 18.5%) and duodenum (14, 15.2%). Of 92 patients, 80 (87%) underwent R0 resection with organ sparing resection in 56 (70%) patients. Seventeen (21.3%) patients showed recurrence at a median follow-up of 6 years. Median and 5-year overall survival (OS) was 36 months (12-120) and 75%, respectively, and 5-year RFS was 81.8%. On univariate analysis, size, mitotic activity, malignant potential, and nuclear pleomorphism were predictors of recurrence. However, on multivariate analysis, only nuclear pleomorphism was significant. CONCLUSIONS GISTs had a wide spectrum of presentation, and immunohistopathological features with organ sparing resection were conceivable in maximum. Nuclear pleomorphism may be considered as an important variable to predict recurrence in addition to malignant potential of tumors.
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Affiliation(s)
- Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Rakesh Kumar Gupta
- Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ila Tyagi
- Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Vineeta V Batra
- Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Saluja SS, Srivastava S, Govind SH, Dahale A, Sharma BC, Mishra PK. Endoscopic cystogastrostomy versus surgical cystogastrostomy in the management of acute pancreatic pseudocysts. J Minim Access Surg 2019; 16:126-131. [PMID: 30777987 PMCID: PMC7176009 DOI: 10.4103/jmas.jmas_109_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Studies comparing surgical versus endoscopic drainage of pseudocyst customarily include patients with both acute and chronic pseudocysts and the endoscopic modalities used for drainage are protean. We compared the outcomes following endoscopic cystogastrostomy (ECG) and surgical cystogastrostomy (SCG) in patients with acute pseudocyst. Methods: Seventy-three patients with acute pseudocyst requiring drainage from 2011 to 2014 were analysed (18 patients excluded: transpapillary drainage n = 15; cystojejunostomy n = 3). The remaining 55 patients were divided into two groups, ECG n = 35 and SCG n = 20, and their outcomes (technical success, successful drainage, complication rate and hospital stay) were compared. Results: The technical success (31/35 [89%] vs. 20/20 [100%] P = 0.28), complication rate (10/35 [28.6%] vs. 2/20 [10%]; P = 0.17) and median hospital stay (6.5 days [range 2–12] vs. 5 days [range 3–12]; P = 0.22) were comparable in both the groups, except successful drainage which was higher in surgical group (27/35 [78%] vs. 20/20 [100%] P = 0.04). The conversion rate to surgical procedure was 17%. The location of cyst towards tail of pancreas and presence of necrosis were the main causes of technical failure and failure of successful endoscopic drainage, respectively. Conclusion: Surgical drainage albeit remains the gold standard for management of pseudocyst drainage; endoscopic drainage should be considered a first-line treatment in patients with acute pseudocyst considering the reasonably good success rate.
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Siddharth Srivastava
- Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - S Hari Govind
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Amol Dahale
- Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Barjesh Chander Sharma
- Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Parasar K, Varshney VK, Mishra PK, Saluja SS. Gall Bladder Carcinoma in Patients with Portal Hypertension. Am Surg 2018. [DOI: 10.1177/000313481808401204] [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: 11/15/2022]
Affiliation(s)
- Kunal Parasar
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery Govind Ballabh Pant Institute of Post Graduate Medical Education and Research New Delhi, India
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Parasar K, Varshney VK, Mishra PK, Saluja SS. Gall Bladder Carcinoma in Patients with Portal Hypertension. Am Surg 2018; 84:e510-e513. [PMID: 30606359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Mehrotra R, Tulsyan S, Hussain S, Mittal B, Singh Saluja S, Singh S, Tanwar P, Khan A, Javle M, Hassan MM, Pant S, De Aretxabala X, Sirohi B, Rajaraman P, Kaur T, Rath GK. Genetic landscape of gallbladder cancer: Global overview. Mutat Res 2018; 778:61-71. [PMID: 30454684 DOI: 10.1016/j.mrrev.2018.08.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 12/13/2022]
Abstract
Gallbladder cancer (GBC) is a rare malignancy of biliary tract cancer (BTC), characterized by late presentation and poor prognosis. It exhibits wide geographical as well as ethnical variations. So, diverse epidemiology along with etiological factors have been discussed in the current article. Present review unravels the germ line polymorphisms contributing to GBC susceptibility through candidate gene approach and GWAS. GBC is enriched with multiple mutations consisting of both passenger and driver mutations. The identification of the hotspot driver mutations which are involved in the etiopathogenesis of this cancer is necessary, before targeted therapies could be implemented clinically. Thus, this review sheds lights on both traditional low throughput methods along with high throughput NGS used to determine somatic mutations in cancer. With the advent of GWAS and high throughput sequencing methods, it is possible to comprehend the mutational landscape of this enigmatic disease. This article is the first one to provide insights into the genetic heterogeneity of GBC along with somatic mutational data from Catalogue of Somatic Mutations in Cancer (COSMIC) database. In addition, management of tumor heterogeneity as a therapeutic challenge has been discussed. Future goals involve liquid biopsy based research for better clinical management of the disease. Therefore, research efforts involving discovery of non- invasive markers for early stage cancer detection along with novel therapies should be directed.
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Affiliation(s)
- Ravi Mehrotra
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Noida, India.
| | - Sonam Tulsyan
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Noida, India
| | - Showket Hussain
- Division of Molecular Oncology, National Institute of Cancer Prevention and Research, Noida, India
| | - Balraj Mittal
- Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Lucknow, India
| | - Sundeep Singh Saluja
- Department of Surgical Gastroenterology & Hepatology, GB Pant Hospital, New Delhi, India
| | - Sandeep Singh
- Clinical Epidemiology, Biostatics and Bioinformatics Academic Medical Center, Amsterdam, Netherlands
| | - Pranay Tanwar
- Laboratory Oncology Unit, Rotary Cancer Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Asiya Khan
- Laboratory Oncology Unit, Rotary Cancer Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Centre, USA
| | - Manal M Hassan
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Centre, USA
| | - Shubham Pant
- Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, MD Anderson Cancer Centre, USA
| | | | - Bhawna Sirohi
- New India Cancer Charity Initiative, Research and Education in Cancer and Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Preetha Rajaraman
- U.S. Health Attache, India & Regional Representative, South Asia, Office of Global Affairs, DHHS, New Delhi, Delhi, India
| | | | - G K Rath
- Laboratory Oncology Unit, Rotary Cancer Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Parasar K, Saluja SS, Varshney VK, Deepak B, Mishra PK. Early recurrence after laparoscopic radical cholecystectomy in a patient with gallbladder cancer. J Minim Access Surg 2018; 15:74-76. [PMID: 29794366 PMCID: PMC6293673 DOI: 10.4103/jmas.jmas_97_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Laparoscopic radical cholecystectomy for gallbladder cancer (GBC) has been performed at various oncology centres reporting its technical feasibility. Considering GBC an aggressive malignancy, laparoscopic radical cholecystectomy should be dealt with caution. We recently encountered a case of carcinoma gallbladder who underwent laparoscopic radical cholecystectomy elsewhere and presented with early recurrence. The patient's records were evaluated and he underwent re-resection. Hereby, we discuss the factors that could lead to early recurrence after laparoscopic radical cholecystectomy and measures that can be taken to prevent it.
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Affiliation(s)
- Kunal Parasar
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - B Deepak
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Kumar B, Bhat ZI, Bansal S, Saini S, Naseem A, Wahabi K, Burman A, Kumar GT, Saluja SS, Rizvi MMA. Association of mitochondrial copy number variation and T16189C polymorphism with colorectal cancer in North Indian population. Tumour Biol 2017; 39:1010428317740296. [PMID: 29182103 DOI: 10.1177/1010428317740296] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Globally, colorectal cancer is the third most common type of cancer. Genetic instability leading to cancer development is one of the major causes for development of cancer. Alterations in mitochondrial genome, that is, mutations, single-nucleotide polymorphisms, and copy number variations are known to contribute in cancer development. The aim of our study was to investigate association of mitochondrial T16189C polymorphism and copy number variation with colorectal cancer in North Indian population. DNA isolated from peripheral blood of 126 colorectal cancer patients and 114 healthy North Indian subjects was analyzed for T16189C polymorphism and half of them for mitochondrial copy number variation. Genotyping was done using polymerase chain reaction-restriction fragment length polymorphism, and copy number variation was estimated using real-time polymerase chain reaction, numbers of mitochondrial copies and found to be significantly higher in colorectal cancer patients than healthy controls (88 (58-154), p = 0.001). In the regression analysis, increased mitochondrial copy number variation was associated with risk of colorectal cancer (odds ratio = 2.885, 95% confidence interval = 1.3-6.358). However, T16189C polymorphism was found to be significantly associated with the risk of rectal cancer (odds ratio = 5.213, p = 0.001) and non-significantly with colon cancer (odds ratio = 0.867, p = 0.791). Also, false-positive report probability analysis was done to validate the significant findings. Our results here indicate that mitochondrial copy number variation may be playing an important role in the development of colorectal cancer, and detection of mitochondrial copy number variation can be used as a biomarker for predicting the risk of colorectal cancer in North Indian subjects.
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Affiliation(s)
- Bhupender Kumar
- 1 Department of Biochemistry, Institute of Home Economics, University of Delhi, New Delhi, India
| | - Zafar Iqbal Bhat
- 2 Genome Biology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Savita Bansal
- 1 Department of Biochemistry, Institute of Home Economics, University of Delhi, New Delhi, India
| | - Sunil Saini
- 3 School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Afreen Naseem
- 2 Genome Biology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Khushnuma Wahabi
- 2 Genome Biology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Archana Burman
- 1 Department of Biochemistry, Institute of Home Economics, University of Delhi, New Delhi, India
| | - Geeta Trilok Kumar
- 1 Department of Biochemistry, Institute of Home Economics, University of Delhi, New Delhi, India
| | - Sundeep Singh Saluja
- 4 Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi, India
| | - M Moshahid Alam Rizvi
- 2 Genome Biology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
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Rehman AU, Saikia S, Iqbal MA, Ahmad I, Sadaf, Anees A, Aravinda PS, Mishra PK, Hedau S, Saluja SS, Medhi S, Husain SA. Decreased expression of MGMT in correlation with aberrant DNA methylation in esophageal cancer patients from North India. Tumour Biol 2017. [DOI: 10.1177/1010428317705770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Asad Ur Rehman
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Snigdha Saikia
- Department of Bioengineering and Technology, Gauhati University Institute of Science and Technology (GUIST), Gauhati University, Guwahati, India
| | | | - Istaq Ahmad
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Sadaf
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Afzal Anees
- Department of Surgery, J.N. Medical College Hospital, Aligarh Muslim University (AMU), Aligarh, India
| | - PS Aravinda
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi, India
| | - Suresh Hedau
- Department of Cellular and Molecular Biology Virus Diseases, Institute of Cytology & Preventive Oncology (ICPO), Noida, India
| | - Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi, India
| | - Subhash Medhi
- Department of Bioengineering and Technology, Gauhati University Institute of Science and Technology (GUIST), Gauhati University, Guwahati, India
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Shahzad N, Khan W, MD S, Ali A, Saluja SS, Sharma S, Al-Allaf FA, Abduljaleel Z, Ibrahim IAA, Abdel-Wahab AF, Afify MA, Al-Ghamdi SS. Phytosterols as a natural anticancer agent: Current status and future perspective. Biomed Pharmacother 2017; 88:786-794. [DOI: 10.1016/j.biopha.2017.01.068] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/04/2017] [Accepted: 01/10/2017] [Indexed: 01/05/2023] Open
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Saluja SS, Varshney VK, Mishra PK, Srivastava S, Meher R, Saxena P. Step-Down Approach for Pharyngoesophageal Corrosive Stricture: Outcome and Analysis. World J Surg 2017; 41:2053-2061. [PMID: 28265737 DOI: 10.1007/s00268-017-3966-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pharyngoesophageal stricture (PES) is an Achilles' heel in the management of corrosive injury. Advances in endoscopic techniques were utilized in its management. We classified the stricture as per its dilatability and then planned their treatment. METHODS PES was sub-categorized based on endoscopic dilatation and availability of cervical oesophagus: group-1 stricture with available cervical oesophagus; group-2 stricture with some part of upper oesophagus made available after endoscopic dilatation and anastomosis in cervico-pharyngeal area; group-3 stricture not amenable for dilatation, anastomosis done at the pharynx. Endoscopic dilatation was performed using through-the-scope pyloric balloon. Number and duration of dilatation sessions before surgery, incidence of tracheostomy, time and incidence for re-stricture and present status of swallowing were evaluated. RESULTS Of 226 patients managed, 46 underwent oesophageal replacement for PES. Group 1, 2 and 3 had 12, 14 and 20 patients, respectively. An average 3 (2-4) preoperative balloon dilatation sessions were performed over 6-8 weeks. Tracheostomy was required in 1, 0, 8 patients (p = 0.010), and median hospital stay was 10, 9 and 13 days (p = 0.09) in group 1, 2, 3, respectively. Re-stricture developed in 4/12, 4/14, 9/20 patients with average sessions of dilatation required in post-operative period was 4, 3.5 and 8 in group 1, 2, 3, respectively. >90% of patients are taking normal diet in each group. CONCLUSION We attempted to avoid the high anastomosis by dilating the PES and step down the level of anastomosis in two-third patients. We thereby avoided tracheostomy, aspiration and swallowing problems related to high strictures.
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Affiliation(s)
- Sundeep Singh Saluja
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, 1, Jawahar Lal Nehru Marg, New Delhi, 110002, India.
| | - Vaibhav Kumar Varshney
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, 1, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Pramod Kumar Mishra
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, 1, Jawahar Lal Nehru Marg, New Delhi, 110002, India
| | - Siddharth Srivastava
- Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ravi Meher
- Department of Otorynolaryngology, Lok Nayak Hospital, New Delhi, India
| | - Pritul Saxena
- Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Singh A, Mishra PK, Saluja SS, Talikoti MA, Kirtani P, Najmi AK. Prognostic Significance of HER-2 and p53 Expression in Gallbladder Carcinoma in North Indian Patients. Oncology 2016; 91:354-360. [PMID: 27784017 DOI: 10.1159/000450999] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/11/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/OBJECTIVE Proto-oncogenes (HER-2) and tumor suppressor genes (p53) are commonly deregulated in gallbladder cancer (GBC). Available literature discloses skewed data from endemic Asian countries, especially north India. This study evaluates the prognostic significance of HER-2 and p53 in GBC patients from two major hospitals. METHODS Sixty resectable tumor and control specimens were prospectively collected from December 2012 to January 2016. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and p53 protein expression. The criterion for HER-2 positivity was set at >30% tumor cells showing complete, membranous staining while p53 positivity was established at <50% tumor cells showing complete nuclear staining. Clinicopathological correlations were drawn with major clinical outcomes. RESULTS It was observed that 36.67% (22/60) tumor cases and 5% (3/60) control cases showed strong HER-2 overexpression significantly correlating with sex, T-stage, nodal spread and distant metastasis (p < 0.05), while 33.3% (20/60) positivity was observed for p53 in tumor cases and 1.7% (1/60) in control cases. Multivariate analysis showed HER-2 (p = 0.04; hazard ratio: 2.36; 95% confidence interval: 1.04-5.33) and p53 (p = 0.03; hazard ratio: 5.63; 95% confidence interval: 1.21-26.26) expression to be independent prognostic factors. CONCLUSION Our study thus suggests the plausible role of HER-2 and p53 expression in worse prognosis of GBC in a north Indian population.
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Affiliation(s)
- Anjali Singh
- Department of Pharmaceutical Medicine, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
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Saluja SS, Manipadam JM, Mishra PK, Sachdeva S, Solanki N, Shah H. Young onset colorectal cancer: How does it differ from its older counterpart? Indian J Cancer 2016; 51:565-9. [PMID: 26842197 DOI: 10.4103/0019-509x.175350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Colorectal cancer in the young has been a debated topic in literature with conflicting reports as to its pattern of occurrence and survival as compared to the older age group. MATERIALS AND METHODS Retrospective study to analyze the clinicopathological characteristics, treatment modalities and survival of sporadic young-onset colorectal cancer (YOCR) patients (<40 years) and compare them with the older group (>40 years). RESULTS Of 172 patients managed, 72 (42%) were in the YOCR group. Among 72 patients, six were excluded because of hereditary syndromes. Incontinence (P = 0.02) and obstruction at time of presentation (P = 0.03) was significantly more common in the YOCR group. Left sided disease was more common in YOCR group (47/66) compared to the older group (65/100), but the difference was not statistically significant (P = 0.45). The proportion of rectal cancers was significantly more in the YOCR group (39/47) compared to the older group (39/65) (P = 0.01). Significant difference in resectability was noted in the left sided (YOCR 26/47 vs. older 49/65 P = 0.04) and the rectal cancers (YOCR 18/39 vs. Older 29/39 P = 0.02). The survival was similar among the two groups. CONCLUSIONS Sporadic colorectal cancers in the young are more advanced and less resectable when compared to older population. Genetic studies are needed to elaborate the reasons for left sided predominance and aggressiveness of sporadic colorectal cancers in the younger subgroups.
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Affiliation(s)
| | | | - P K Mishra
- Department of Gastrointestinal Surgery, GB Pant Hospital, New Delhi, India
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Ali A, Mehdi SJ, Hajela K, Saluja SS, Mishra PK, Sameer AS, Rizvi MMA. Allelic loss at PTEN locus leads to progression of colorectal carcinoma among North Indian patients. Biomarkers 2016; 21:716-720. [PMID: 27098297 DOI: 10.3109/1354750x.2016.1172115] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We evaluated the loss of heterozygosity (LOH) at 10q23.3 locus of microsatellite markers; D10S198, D10S192, and D10S541 of PTEN gene in 223 North Indian colorectal cancer (CRC) specimens. DNA was isolated and microsatellite-specific markers polymerase chain reaction was performed. Out of total 223 cases 102 showed LOH for at least one of the locus. In addition, thereto a significant association was found with the clinicopathologic features like grade of differentiation, clinical stage, invasion, lymph node invasion, and the clinical outcome (p < 0.05). These data argue that the given markers to check the possible LOH of PTEN gene at locus 10q23.3 could be considered as one of the diagnostic markers in CRC.
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Affiliation(s)
- Asgar Ali
- a Department of Biochemistry , AIIMS , Patna , India
| | - Syed Jafar Mehdi
- b Department of Biosciences, Genome Biology Lab , Jamia Millia Islamia , New Delhi , India
| | - Krishnan Hajela
- c School of Life Sciences , Devi Ahilya Vishwavidyalaya , Indore , India
| | - Sundeep Singh Saluja
- d Department of Gastrointestinal Surgery , G. B. Pant Hospital , New Delhi , India
| | - Pramod Kumar Mishra
- d Department of Gastrointestinal Surgery , G. B. Pant Hospital , New Delhi , India
| | - Aga Syed Sameer
- e Basic Medical Sciences, College of Medicine-Jeddah, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - M Moshahid Alam Rizvi
- b Department of Biosciences, Genome Biology Lab , Jamia Millia Islamia , New Delhi , India
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