1
|
Zhang TW, Zhang P, Nie D, Che XY, Fu TT, Zhang Y. Efficacy of concurrent chemoradiotherapy with thalidomide and S-1 for esophageal carcinoma and its influence on serum tumor markers. World J Gastrointest Oncol 2023; 15:1262-1270. [PMID: 37546558 PMCID: PMC10401474 DOI: 10.4251/wjgo.v15.i7.1262] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/02/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Although the current conventional treatment strategies for esophageal carcinoma (EC) have been proven effective, they are often accompanied by serious adverse events. Therefore, it is still necessary to continue to explore new therapeutic strategies for EC to improve the clinical outcome of patients.
AIM To elucidate the clinical efficacy of concurrent chemoradiotherapy (CCRT) with thalidomide (THAL) and S-1 (tegafur, gimeracil, and oteracil potassium capsules) in the treatment of EC as well as its influence on serum tumor markers (STMs).
METHODS First, 62 patients with EC treated at the Zibo 148 Hospital between November 2019 and November 2022 were selected and grouped according to the received treatment. Among these, 30 patients undergoing CCRT with cis-platinum and 5-fluorouracil were assigned to the control group (Con), and 32 patients receiving CCRT with THAL and S-1 were assigned to the research group (Res). Second, inter-group comparisons were carried out with respect to curative efficacy, incidence of drug toxicities, STMs [carbohydrate antigen 125 (CA125) and macrophage inflammatory protein-3α (MIP-3α)], angiogenesis-related indicators [vascular endothelial growth factor (VEGF); VEGF receptor-1 (VEGFR-1); basic fibroblast growth factor (bFGF); angiogenin-2 (Ang-2)], and quality of life (QoL) [QoL core 30 (QLQ-C30)] after one month of treatment.
RESULTS The analysis showed no statistical difference in the overall response rate and disease control rate between the two patient cohorts; however, the incidences of grade I–II myelosuppression and gastrointestinal reactions were significantly lower in the Res than in the Con. Besides, the post-treatment CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels in the Res were markedly lower compared with the pre-treatment levels and the corresponding post-treatment levels in the Con. Furthermore, more evident improvements in QLQ-C30 scores from the dimensions of physical, role, emotional, and social functions were determined in the Res.
CONCLUSION The above results demonstrate the effectiveness of THAL + S-1 CCRT for EC, which contributes to mild side effects and significant reduction of CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels, thus inhibiting tumors from malignant progression and enhancing patients’ QoL.
Collapse
Affiliation(s)
- Tian-Wei Zhang
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| | - Peng Zhang
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| | - Dong Nie
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| | - Xin-Yu Che
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| | - Tian-Tai Fu
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| | - Yan Zhang
- Department of Hematology and Radiotherapy, Zibo 148 Hospital, Zibo 255300, Shandong Province, China
| |
Collapse
|
2
|
Xue LY, Fu TT, Ding H, Zhu YL, Shen YH, Sun HC, Wang WP. [Predictive value of two-dimentional shear wave elastography in posthepatoectomy liver failure]. Zhonghua Yi Xue Za Zhi 2020; 100:3075-3080. [PMID: 33105958 DOI: 10.3760/cma.j.cn112137-20200228-00506] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the value of two-dimensional shear wave elastography (2D SWE) combined with clinical biochemical data in predicting posthepatoectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods: A total of 274 HCC patients who underwent hepatectomy in Zhongshan Hospital Fudan University from January 2015 to January 2016 were retrospectively collected, including 235 males and 39 females, age 19-80 (56±11) years. All patients were confirmed to be HCC by postoperative pathology. The preoperative 2D SWE examination, laboratory examination results and intraoperative indicators were analyzed. According to the occurrence of PHLF after surgery, single factor analysis and multiple logistic regression analysis were performed on the above indicators to obtain a binary logistic regression model, and evaluate the diagnostic effect of the model on PHLF. In addition, 103 HCC patients from October 2019 to January 2020 were retrospectively collected as an external validation set, including 89 males and 14 females, age 23-80 (55±11) years old. Results: The liver stiffness measurement (LSM) obtained from 2D SWE, INR and Laminin (LN) were independent predictors of PHLF. The formula of prediction model PM=-15.451+0.095×LSM+11.7×INR+0.012×LN was obtained by combining above three factors. The area under the curve (AUC) of PHLF was 0.82, which was higher than that of end-stage liver disease model (MELD) score and Child-Pugh grading diagnosis of PHLF. The AUC of PHLF predicted by PM in the external validation group was 0.81. Conclusion: 2D SWE is helpful for clinicians to evaluate liver reserve function preoperatively and to predict the occurrence of PHLF in patients with HCC.
Collapse
Affiliation(s)
- L Y Xue
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - T T Fu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - H Ding
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Y L Zhu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Y H Shen
- Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - H C Sun
- Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W P Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| |
Collapse
|
3
|
Zhu YL, Ding H, Fu TT, Xu ZT, Xue LY, Chen SY, Wang WP. [Diagnostic accuracy of liver and spleen stiffness by two dimensional shear wave elastography for portal hypertension in hepatitis B-related cirrhosis]. Zhonghua Yi Xue Za Zhi 2020; 100:1654-1657. [PMID: 32486601 DOI: 10.3760/cma.j.cn112137-20191029-02340] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the diagnostic accuracy of liver and spleen stiffness measured by two dimensional shear wave elastography (2D-SWE) in hepatitis B-related cirrhosis. Methods: The clinical data of fifty-eight hepatitis B-related cirrhosis patients were collected in Zhongshan Hospital, Fudan University from September 2017 to April 2018. Pearson's correlation analyses were used to assess the relationship between liver/spleen stiffness (L-SWE and S-SWE) and hepatic venous pressure gradient (HVPG), as well as the comparison with serological model. The SWE diagnostic performances of Liver (L-SWE), Spleen (S-SWE) were also evaluated. Results: Of all 58 patients, 47 were found HVPG ≥10 mmHg, diagnosed as clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH), which patients are at increased risk of developing complications. Thirty-four patients were found HVPG≥12 mmHg, diagnosed as SPH, which patients were at increased risk of variceal bleeding. Moderate positive correlation was found between L-SWE and HVPG (r=0.42, P<0.01), and S-SWE were significantly correlated with HVPG (r=0.68, P<0.01), while serological models and HVPG were slightly correlated (r=0.36 and 0.28, all P<0.01). The area under the receiver operating characteristic curves of L-SWE, S-SWE and the combination for CSPH were 0.78, 0.88 and 0.89. When L-SWE was>12.86 kPa or S-SWE was>35.73 kPa, patients were at increased risk of developing complications. The area under the receiver operating characteristic curves for SPH were 0.68, 0.81 and 0.77 and the S-SWE had the highest specificity, so when S-SWE was>41.5 kPa, patients were at increased risk of variceal bleeding. Conclusion: L-SWE and S-SWE are reliable and promising non-invasive parameters to assess CSPH and SPH.
Collapse
Affiliation(s)
- Y L Zhu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - H Ding
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - T T Fu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Z T Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - L Y Xue
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - S Y Chen
- Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W P Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| |
Collapse
|
4
|
Fu TT, Yao Z, Ding H, Xu ZT, Yang MR, Yu JH, Wang WP. [Computer-aided assessment of liver fibrosis progression in patients with chronic hepatitis B: an exploratory research]. Zhonghua Yi Xue Za Zhi 2019; 99:491-495. [PMID: 30786344 DOI: 10.3760/cma.j.issn.0376-2491.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish automatic liver fibrosis classification models by using traditional machine learning and deep learning methods and preliminaryly evaluate the efficiency. Methods: Gray scale ultrasound images and corresponding elastic images of 354 patients, 247 males and 107 females, mean age (54±12) years undergoing partial hepatectomy in Zhongshan Hospital of Fudan University from November 2014 to January 2016 were enrolled in this study. By using traditional machine learning and deep learning methods, an automatic classification model of liver fibrosis stages (S0 to S4) were established through feature extraction and classification of ultrasound image data sets and the accuracy in different classification categories of each model were calculated, by using liver biopsy as the reference standard. Results: Pathological examination showed 73 cases in pathological stage S0, 40 cases in S1, 49 cases in S2, 41 cases in S3, and 151 cases in S4. The traditional machine classification model based on support vector machine (SVM) classifier and sparse representation classifier and the deep learning classification model based on LeNet-5 neural network, their accuracy rates in the two categories (S0/S1/S2 and S3/S4) were 89.8%, 91.8% and 90.7% respectively; the accuracy rates in the three categories (S0/S1 and S2/S3 and S4) were 75.3%, 79.4% and 82.8% respectively; the accuracy in the three categories (S0 and S1/S2/S3 and S4) were 79.3%, 82.7% and 87.2% respectively. Conclusions: Computer-aided assessment of liver fibrosis progression in patients with chronic hepatitis B has a high accuracy, and can achieve a more detailed classification. This method is expected to be applied in the non-invasive evaluation of liver fibrosis in patients with hepatitis B in clinical work in the future.
Collapse
Affiliation(s)
- T T Fu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, Shanghai 200032, China
| | - Z Yao
- Department of Electronic Engineering, Fudan University, Shanghai 200433, China
| | - H Ding
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, Shanghai 200032, China
| | - Z T Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, Shanghai 200032, China
| | - M R Yang
- Department of Electronic Engineering, Fudan University, Shanghai 200433, China
| | - J H Yu
- Department of Electronic Engineering, Fudan University, Shanghai 200433, China
| | - W P Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, Shanghai 200032, China
| |
Collapse
|
5
|
Fu TT, Thayer DW. Comparison of batch and semicontinuous cultures for production of protein from mesquite wood by Brevibacterium sp. JM98A. Biotechnol Bioeng 1975; 17:1749-60. [PMID: 1106791 DOI: 10.1002/bit.260171205] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The production of protein by a Brevibacterium sp. JM98A using mesquite wood as the substrate was compared in batch and semicontinuous cultures. A 14 liter glass fermentor with automatic pH, temperature, and foam control was used for the study. A pH range of 6.6 to 7.2 was optimum for the growth of JM98A. The batch and semicontinuous cultures were compared on the basis of viable cell counts, protein production, CMC-Ase (beta-1,4-glucanase) activity, and filter paper cellulase (beta-1,4-glucan cellobiohydrolyase) activity. Total hexose, cellulose, and reducing sugar consumption were measured. The semicontinuous process yielded 2.97 times as much protein in 72 hr as the batch cultures. Most of the biomass resulted from the utilization of soluble sugars rather than from the degradation of cellulose during the semicontinuous process.
Collapse
|