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Ye GY, Zhang ZZ, Zhu CC, Cong ZJ, Cui Z, Chen L, Zhao G. Long Non-Coding RNA LINC01569 Promotes Proliferation and Metastasis in Colorectal Cancer by miR-381-3p/RAP2A Axis. Front Oncol 2021; 11:727698. [PMID: 34422671 PMCID: PMC8378226 DOI: 10.3389/fonc.2021.727698] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/19/2021] [Indexed: 01/05/2023] Open
Abstract
Background Long non-coding RNAs (lncRNAs) display regulatory function flexibly in tumor onset and developments. Our study aimed to delve into the roles of lncRNA LINC01569 (LINC01569) in colorectal cancer (CRC) progression to study the potential mechanisms. Methods The genetic expression profiles of miR-381-3p and LINC01569 were measured by RT-PCR. The subcellular localization of LINC01569 in CRC cells was identified using subcellular fractionation location. Loss-of-function assays were performed to explore the potential effects of LINC01569 on CRC progression. Dual-luciferase reporter analysis was employed to verify the binding connections among LINC01569, miR-381-3p, and RAP2A. Results LINC01569 expression was distinctly increased in CRC. Curiously, if LINC01569 is removed, CRC cells will not migrate, proliferate, and invade remarkably. Molecular mechanism exploration uncovered that LINC01569 acted as a ceRNA competing with RAP2A to bind with miR-381-3p. Furthermore, rescue experiments corroborated the fact that miR-381-3p suppression reversed the inhibitory actions of LINC01569 knockdown on the expression of RAP2A and CRC progression. Conclusion Overall, our findings indicate that LINC01569 plays a key role in CRC development by means of aiming at the miR-381-3p/RAP2A axis and can be equivalent to an underlying medicinal target to save CRC patients.
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Affiliation(s)
- Guang-Yao Ye
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zi-Zhen Zhang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chun-Chao Zhu
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi-Jie Cong
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhe Cui
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lu Chen
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Gang Zhao
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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2
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Hao L, Liu Y, Xie T, Wang T, Guo HL, Pan J, Wang D, Bi YW, Ji JT, Xin L, Du TT, Lin JH, Zhang D, Zeng XP, Zou WB, Chen H, Li BR, Liao Z, Cong ZJ, Shi RH, Li ZS, Hu LH. Risk Factors and Nomogram for Pancreatic Stone Formation in Chronic Pancreatitis over a Long-Term Course: A Cohort of 2,153 Patients. Digestion 2021; 101:473-483. [PMID: 31238312 DOI: 10.1159/000500941] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/11/2018] [Accepted: 05/13/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pancreatic stones are pathognomonic of chronic pancreatitis (CP). This study aimed to determine the incidence, identify risk factors, and develop a nomogram for pancreatic stones in CP patients. METHODS Patients with CP admitted to our center from January 2000 to December 2013 were enrolled. Cumulative rates of pancreatic stones after the onset of CP and after the diagnosis of CP were calculated. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on the training cohort, risk factors were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively. RESULTS With a total of 2,153 CP patients, pancreatic stones were detected in 1,626 (75.5%) patients, with a median follow-up of 7.8 years. Age at the onset of CP, body mass index, smoking, diabetes mellitus, pancreatic pseudocyst, biliary stricture, severe acute pancreatitis, and type of pain were identified risk factors for pancreatic stones development. The nomogram with these 8 factors achieved good accuracy. CONCLUSIONS The nomogram achieved an individualized prediction of pancreatic stones development in CP. It may help the management of pancreatic stones.
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Affiliation(s)
- Lu Hao
- Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yu Liu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Teng Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hong-Lei Guo
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun Pan
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Dan Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ya-Wei Bi
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun-Tao Ji
- Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting-Ting Du
- Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jin-Huan Lin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Di Zhang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wen-Bin Zou
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hui Chen
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bai-Rong Li
- Department of Gastroenterology, Air Force General Hospital, Beijing, China
| | - Zhuan Liao
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Rui-Hua Shi
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Liang-Hao Hu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China, .,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China,
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Liu Y, Wang D, Hao L, Wang T, Zhang D, Yang HY, Ma JY, Li J, Zhang LL, Lin K, Chen C, Guo HL, Bi YW, Xin L, Zeng XP, Chen H, Xie T, Liao Z, Cong ZJ, Li ZS, Hu LH. Risk Factors Analysis and Nomogram Development for Pancreatic Pseudocyst in Idiopathic Chronic Pancreatitis. Pancreas 2020; 49:967-974. [PMID: 32658083 DOI: 10.1097/mpa.0000000000001610] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The study concerns identifying risk factors and developing nomogram for pancreatic pseudocyst (PPC) in idiopathic chronic pancreatitis (ICP) to facilitate early diagnosis. METHODS From January 2000 to December 2013, ICP patients admitted to our center were enrolled. Cumulative incidence of PPC was determined by Kaplan-Meier method. Patients were randomized into training group and validation group in a 2:1 ratio. Risk factors of PPC were determined through Cox proportional hazards regression model based on training cohort. The nomogram was constructed according to risk factors. RESULTS Totally, 1633 ICP patients were included with a median follow-up duration of 9.8 years. Pancreatic pseudocyst was observed in 14.7% (240/1633) of patients after ICP onset. The cumulative incidences of PPC were 8.2%, 10.4%, and 12.9% at 3, 5, and 10 years after ICP onset, respectively. Male sex, smoking history, history of severe acute pancreatitis, and chronic pain at/before diagnosis of ICP and complex pathologic changes in main pancreatic duct were recognized as risk factors of PPC development. The nomogram constructed with these risk factors achieved good concordance indexes. CONCLUSIONS Risk for PPC could be estimated through the nomogram. High-risk patients were suggested to be followed up closely to help early diagnosis of PPC.
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Affiliation(s)
- Yu Liu
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Dan Wang
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Lu Hao
- Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Teng Wang
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Di Zhang
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Huai-Yu Yang
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Jia-Yi Ma
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Juan Li
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Ling-Ling Zhang
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Kun Lin
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Cui Chen
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Hong-Lei Guo
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Ya-Wei Bi
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing
| | - Lei Xin
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Xiang-Peng Zeng
- Department of Digestive Diseases, 900 Hospital of the Joint Logistics Team, Fuzhou
| | - Hui Chen
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing
| | - Zhuan Liao
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zhao-Shen Li
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Liang-Hao Hu
- From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
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4
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Liu Y, Wang D, Cai YL, Zhang T, Chen HL, Hao L, Wang T, Zhang D, Yang HY, Ma JY, Li J, Zhang LL, Chen C, Guo HL, Bi YW, Xin L, Zeng XP, Chen H, Xie T, Liao Z, Cong ZJ, Li ZS, Hu LH. Classification of Early-Onset and Late-Onset Idiopathic Chronic Pancreatitis Needs Reconsideration. Sci Rep 2020; 10:10448. [PMID: 32591619 PMCID: PMC7320187 DOI: 10.1038/s41598-020-67306-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/05/2020] [Indexed: 12/23/2022] Open
Abstract
Bimodal classification of idiopathic chronic pancreatitis (ICP) into early-onset (<35 years) and late-onset (>35 years) ICP was proposed in 1994 based on a study of 66 patients. However, bimodal distribution wasn’t sufficiently demonstrated. Our objective was to examine the validity and relevance of the age-based bimodal classification of ICP. We analyzed the distribution of age at onset of ICP in our cohort of 1633 patients admitted to our center from January 2000 to December 2013. Classify ICP patients into early-onset ICP(a) and late-onset ICP(a) according to different cut-off values (cut-off value, a = 15, 25, 35, 45, 55, 65 years old) for age at onset. Compare clinical characteristics of early-onset ICP(a) and late-onset ICP(a). We found slightly right skewed distribution of age at onset for ICP in our cohort. There were differences between early-onset and late-onset ICP with respect to basic clinical characteristics and development of key clinical events regardless of the cut off age at onset i.e. 15, 25, 35, 45 or even higher. The validity of the bimodal classification of early-onset and late-onset ICP could not be established in our large patient cohort and therefore such a classification needs to be reconsidered.
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Affiliation(s)
- Yu Liu
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Dan Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Yi-Li Cai
- School of Basic medical sciences, The Second Military Medical University, Shanghai, 200433, China
| | - Tao Zhang
- School of Basic medical sciences, The Second Military Medical University, Shanghai, 200433, China
| | - Hua-Liang Chen
- School of Basic medical sciences, The Second Military Medical University, Shanghai, 200433, China
| | - Lu Hao
- Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Teng Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Di Zhang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Huai-Yu Yang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Jia-Yi Ma
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Juan Li
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Ling-Ling Zhang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Cui Chen
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Hong-Lei Guo
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Ya-Wei Bi
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Hui Chen
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, 210000, China
| | - Zhuan Liao
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, 200120, China
| | - Zhao-Shen Li
- School of Basic medical sciences, The Second Military Medical University, Shanghai, 200433, China
| | - Liang-Hao Hu
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China.
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5
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Liu Y, Wang D, Guo HL, Hao L, Wang T, Zhang D, Yang HY, Ma JY, Li J, Zhang LL, Lin K, Chen C, Han X, Lin JH, Bi YW, Xin L, Zeng XP, Chen H, Xie T, Liao Z, Cong ZJ, Wang LS, Xu ZL, Li ZS, Hu LH. Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis. J Gastroenterol Hepatol 2020; 35:343-352. [PMID: 31318997 DOI: 10.1111/jgh.14785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/25/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Diabetes mellitus (DM) is a common complication of idiopathic chronic pancreatitis (ICP), which impairs the quality of life for patients. This study aimed to identify risk factors and develop nomogram for DM in ICP to help early diagnosis. METHODS Idiopathic chronic pancreatitis patients admitted to our center from January 2000 to December 2013 were included. Cumulative rates of DM were calculated by Kaplan-Meier method. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on training cohort, risk factors for DM were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively. RESULTS Totally, 1633 patients with ICP were finally enrolled. The median follow-up duration was 9.8 years. DM was found in 26.3% (430/1633) of patients after the onset of CP. Adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct were identified risk factors for DM development. The nomogram achieved good concordance indexes in the training and validation cohorts, respectively, with well-fitted calibration curves. CONCLUSIONS Risk factors were identified, and nomogram was developed to determine the risk of DM in ICP patients. Patients with one or more of the risk factors including adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct have higher incidence of DM.
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Affiliation(s)
- Yu Liu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Dan Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hong-Lei Guo
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lu Hao
- Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Teng Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Di Zhang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Huai-Yu Yang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jia-Yi Ma
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Juan Li
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ling-Ling Zhang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Kun Lin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Cui Chen
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xu Han
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jin-Huan Lin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ya-Wei Bi
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hui Chen
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhuan Liao
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Li-Sheng Wang
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Guangdong, China
| | - Zheng-Lei Xu
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Guangdong, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Liang-Hao Hu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
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6
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Xie T, Hao L, Liu Y, Zhang D, Bi YW, Wang T, Zeng XP, Xin L, Pan J, Wang D, Ji JT, Du TT, Lin JH, Zou WB, Chen H, Guo HL, Li BR, Cong ZJ, Liao Z, Wan R, Li ZS, Hu LH. Risk factor for diabetes mellitus in pediatric chronic pancreatitis patients. Medicine (Baltimore) 2019; 98:e17984. [PMID: 31770208 PMCID: PMC6890329 DOI: 10.1097/md.0000000000017984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Pediatric patients suffer from chronic pancreatitis (CP), especially those with diabetes mellitus (DM). This study aimed to identify the incidence of and risk factors for DM in pediatric CP.CP patients admitted to our center from January 2000 to December 2013 were assigned to the pediatric (<18 years old) and adult group according to their age at onset of CP. Cumulative rates of DM and risk factors for both groups were calculated and identified.The median follow-up duration for the whole cohort was 7.6 years. In these 2153 patients, 13.5% of them were pediatrics. The mean age at the onset and the diagnosis of CP in pediatrics were 11.622 and 19.727, respectively. DM was detected in 13.1% patients and 31.0% patients in the pediatric group and adult group, respectively. Age at the onset of CP, smoking history, body mass index (BMI), and etiology of CP were identified risk factors for DM in pediatrics.DM was detected in 13.1% pediatric patients. Age at the onset of CP, smoking history, BMI, and etiology of CP were identified risk factors for the development of DM in pediatric CP patients. The high-risk populations were suggested to be monitored frequently. They could also benefit from a lifestyle modification.
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Affiliation(s)
- Ting Xie
- Department of Gastroenterology, Shanghai General Hospital of Nanjing Medical University, Shanghai
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing
| | - Lu Hao
- Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
- Endoscopy Center, Changhai Hospital
| | - Yu Liu
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Di Zhang
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Ya-Wei Bi
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Teng Wang
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Lei Xin
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Jun Pan
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Dan Wang
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | | | | | - Jin-Huan Lin
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Wen-Bin Zou
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Hui Chen
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Hong-Lei Guo
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Bai-Rong Li
- Department of Gastroenterology, Air Force General Hospital, Beijing
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zhuan Liao
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Rong Wan
- Department of Gastroenterology, Shanghai General Hospital of Nanjing Medical University, Shanghai
| | - Zhao-Shen Li
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
| | - Liang-Hao Hu
- Department of Gastroenterology, Gongli Hospital
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai
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7
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Zeng XP, Liu TT, Hao L, Xin L, Wang T, He L, Pan J, Wang D, Bi YW, Ji JT, Liao Z, Du TT, Lin JH, Zhang D, Guo HL, Chen H, Zou WB, Li BR, Cong ZJ, Wang LS, Xu ZL, Xie T, Liu MH, Deng AM, Li ZS, Hu LH. Autoantibody detection is not recommended for chronic pancreatitis: a cross-sectional Study of 557 patients. BMC Gastroenterol 2019; 19:31. [PMID: 30764766 PMCID: PMC6376735 DOI: 10.1186/s12876-019-0947-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/30/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Autoimmune factor was regarded as one of the risk factors in the pathogenesis of chronic pancreatitis (CP), especially for autoimmune pancreatitis (AIP). However, whether autoimmune factor plays a role in non-AIP CP or not was unknown. METHODS Hospitalized patients with non-AIP CP from January 2010 to October 2016 were detected for 22 autoantibodies at the time of hospital admission. Autoantibodies with frequency > 0.5% were enrolled to calculate the frequency in historial healthy controls through literature search in PubMed. Differentially expressed autoantibodies were determined between patients and historial healthy controls, and related factors were identified by multivariate logistic regression analysis. RESULTS In a total of 557 patients, 113 cases were detected with 19 kinds of positive autoantibodies, among them anti-β2-glycoprotein I (β2-GPI) antibody was most frequent (9.16%). Compared with historial healthy controls, the frequencies of serum β2-GPI and anti SS-B antibody in patients were significantly higher, while frequencies of anti-smooth muscle antibody and anticardiolipin antibody were significantly lower (all P < 0.05). Multivariate logistic regression analysis result showed that diabetes mellitus (OR = 2.515) and common bile duct stricture (OR = 2.844) were the risk factors of positive β2-GPI antibody in patients while diabetes mellitus in first-/second-/third-degree relatives (OR = 0.266) was the protective factor. There were no related factors for other three differentially expressed autoantibodies. CONCLUSIONS Four autoantibodies were expressed differentially between patients with non-AIP CP and historial healthy controls. Due to limited significance for diagnosis and treatment of chronic pancreatitis, autoantibodies detection is not recommended conventionally unless suspected of AIP.
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Affiliation(s)
- Xiang-Peng Zeng
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting-Ting Liu
- 0000 0004 0369 1660grid.73113.37Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lu Hao
- grid.452517.0Department of Gastroenterology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lei Xin
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Teng Wang
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lin He
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun Pan
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Dan Wang
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ya-Wei Bi
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun-Tao Ji
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhuan Liao
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting-Ting Du
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jin-Huan Lin
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Di Zhang
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hong-Lei Guo
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hui Chen
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wen-Bin Zou
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bai-Rong Li
- grid.413440.6Department of Gastroenterology, Air Force General Hospital, Beijing, China
| | - Zhi-Jie Cong
- 0000 0004 0368 8293grid.16821.3cDepartment of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Li-Sheng Wang
- 0000 0004 1759 7210grid.440218.bDepartment of Gastroenterology, Shenzhen People’s Hospital, Shenzhen, China
| | - Zheng-Lei Xu
- 0000 0004 1759 7210grid.440218.bDepartment of Gastroenterology, Shenzhen People’s Hospital, Shenzhen, China
| | - Ting Xie
- 0000 0004 1761 0489grid.263826.bDepartment of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ming-Hao Liu
- 0000 0001 2267 2324grid.488137.1Department of Gastroenterology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - An-Mei Deng
- 0000 0004 0369 1660grid.73113.37Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhao-Shen Li
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Liang-Hao Hu
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- 0000 0004 0369 1660grid.73113.37Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
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8
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Hao L, Liu Y, Wang T, Guo HL, Wang D, Bi YW, Xin L, He L, Lin JH, Zhang D, Zeng XP, Zou WB, Chen H, Xie T, Li BR, Cong ZJ, Wang LS, Liao Z, Xu ZL, Li ZS, Hu LH. Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis. J Gastroenterol Hepatol 2019; 34:466-473. [PMID: 30552715 DOI: 10.1111/jgh.14569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/02/2018] [Revised: 11/29/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is a first-line treatment for chronic pancreatitis (CP) patients with pancreatic stones. However, the performance of P-EWSL in geriatric patients remains unclear. We aimed to evaluate the safety and efficacy of P-ESWL for them. METHODS This prospective study was conducted in painful CP patients who underwent P-ESWL. Patients aged over 65 years were included in geriatric group; patients aged under 65 years were assigned to control group. For the long-term follow-up investigation, geriatric patients were matched with patients from the control group in a 1:1 ratio. Primary outcomes were complications of P-ESWL and pain relief. Secondary outcomes included stone clearance, physical and mental health, quality of life score, changes in exocrine and endocrine pancreatic function, and survival. RESULTS From March 2011 to March 2016, P-ESWL was performed in 1404 patients (72 in the geriatric group and 1332 in the control group). No significant differences were observed in complications of P-ESWL between the two groups (P = 0.364). Among the 67 (67/72, 93.1%) geriatric patients who underwent follow up for 4.02 years, complete pain relief was achieved in 53 patients, which was not significantly different from that of matched controls (54/70; P = 0.920). The death in the geriatrics was significantly higher (P = 0.007), but none of them were correlated with P-ESWL. CONCLUSIONS P-ESWL is safe and effective for geriatric CP patients with pancreatic stones. It can promote significant pain relief and stone clearance and improve quality of life and mental and physical health.
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Affiliation(s)
- Lu Hao
- Department of Gastroenterology, Hainan Branch of Chinese PLA General Hospital, Sanya, China.,Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Yu Liu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Teng Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hong-Lei Guo
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Dan Wang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Ya-Wei Bi
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lin He
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Jin-Huan Lin
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Di Zhang
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Wen-Bin Zou
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Hui Chen
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Bai-Rong Li
- Department of Gastroenterology, Air Force General Hospital, Beijing, China
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Li-Sheng Wang
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Shenzhen, China
| | - Zhuan Liao
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zheng-Lei Xu
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Shenzhen, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Liang-Hao Hu
- Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.,Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
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9
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Hao L, Wang LS, Liu Y, Wang T, Guo HL, Pan J, Wang D, Bi YW, Ji JT, Xin L, Du TT, Lin JH, Zhang D, Zeng XP, Zou WB, Chen H, Xie T, Li BR, Liao Z, Cong ZJ, Xu ZL, Li ZS, Hu LH. The different course of alcoholic and idiopathic chronic pancreatitis: A long-term study of 2,037 patients. PLoS One 2018; 13:e0198365. [PMID: 29883461 PMCID: PMC5993321 DOI: 10.1371/journal.pone.0198365] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background Chronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas. This study aimed to compare the natural course of alcoholic chronic pancreatitis (ACP) and idiopathic chronic pancreatitis (ICP). Methods CP patients admitted to our center from January 2000 to December 2013 were enrolled. Characteristics were compared between ACP and ICP patients. Cumulative rates of diabetes mellitus (DM), steatorrhea, pancreatic stone, pancreatic pseudocyst, biliary stricture, and pancreatic cancer after the onset and the diagnosis of CP were calculated, respectively. The cumulative rates of DM and steatorrhea after diagnosis of pancreatic stone were also calculated. Results A total of 2,037 patients were enrolled. Among them, 19.8% (404/2,037) were ACP and 80.2% (1,633/2,037) were ICP patients. ACP and ICP differs in many aspects, especially in gender, age, smoking, complications, morphology of pancreatic duct, and type of pain. The development of DM, steatorrhea, PPC, pancreatic stone, and biliary stricture were significantly earlier and more common in ACP patients. No significant difference was observed for pancreatic cancer development. There was a rather close correlation between exocrine/endocrine insufficiency and pancreatic stone in ACP patients, which was much less correlated in ICP patients. Conclusion The long-term profile of ACP and ICP differs in some important aspects. ACP patients usually have a more severe course of CP. These differences should be recognized in the diagnosis and treatment of CP.
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Affiliation(s)
- Lu Hao
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Li-Sheng Wang
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Guangdong, China
| | - Yu Liu
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Teng Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hong-Lei Guo
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun Pan
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Dan Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ya-Wei Bi
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jun-Tao Ji
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting-Ting Du
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jin-Huan Lin
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Di Zhang
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiang-Peng Zeng
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wen-Bin Zou
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hui Chen
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ting Xie
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Bai-Rong Li
- Department of Gastroenterology, Air Force General Hospital, Beijing, China
| | - Zhuan Liao
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhi-Jie Cong
- Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zheng-Lei Xu
- Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Guangdong, China
- * E-mail: (LHH); (ZSL); (ZLX)
| | - Zhao-Shen Li
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
- * E-mail: (LHH); (ZSL); (ZLX)
| | - Liang-Hao Hu
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
- Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China
- * E-mail: (LHH); (ZSL); (ZLX)
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10
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Cong ZJ, Hu LH, Ji JT, Xing JJ, Shan YQ, Li ZS, Yu ED. A long-term follow-up study on the prognosis of endoscopic submucosal dissection for colorectal laterally spreading tumors. Gastrointest Endosc 2016; 83:800-7. [PMID: 26341853 DOI: 10.1016/j.gie.2015.08.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 08/19/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Colorectal laterally spreading tumors (LSTs) are divided into homogeneous (LST-G-H), nodular mixed (LST-G-M), flat elevated (LST-NG-F), and pseudodepressed (LST-NG-PD) subtypes. We hypothesized that based on the rates of advanced histology, the recurrence rates of the LST-NG-PD and LST-G-M groups may be higher than those of the other subgroups. METHODS Endoscopic submucosal dissection (ESD) was performed in 156 patients with a total of 177 LSTs. The clinicopathological features and long-term prognosis of ESD according to specific subtype were investigated. RESULTS LSTs were most commonly found in the rectum, and the highest percentage of rectal lesions was observed in the LST-G-M group (71.1% vs overall 55.4%, P = .032). The LST-G-M lesions were larger (60 ± 22 mm vs 40 ± 33 mm, P = .034) than the LST-G-H lesions. The LST-G-M group also demonstrated more high-grade intraepithelial neoplasias (32.2% vs 10.8%, P = .003) and submucosal carcinomas (13.6% vs 1.5%, P = .010) compared with the LST-G-H group. The LST-NG-PD group exhibited the highest incidence of submucosally invasive cancer (16.7%). The overall perforation rate was 2.3%. The perforation rate in the LST-NG group was higher than that in the LST-G group (5.7% vs 0.8%, P = .047). All recurrences (7.7%) were found by colonoscopy without any detection of cancers, and no difference was found among the subtypes. CONCLUSIONS No significant differences were observed among subgroups with 44.4 ± 16.3 months of follow-up. Considering that all recurrences were discovered by colonoscopy and most could be cured by repeated ESD, the LSTs of all subgroups require more intensive follow-up compared with smaller adenomatous lesions.
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Affiliation(s)
- Zhi-Jie Cong
- Department of Colorectal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Liang-Hao Hu
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jun-Tao Ji
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jun-Jie Xing
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yong-Qi Shan
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zhao-Shen Li
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - En-Da Yu
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
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11
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Cong ZJ, Hu LH, Zhong M, Chen L. Diverting stoma with anterior resection for rectal cancer: does it reduce overall anastomotic leakage and leaks requiring laparotomy? Int J Clin Exp Med 2015; 8:13045-13055. [PMID: 26550227 PMCID: PMC4612912] [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] [Received: 04/19/2015] [Accepted: 08/03/2015] [Indexed: 06/05/2023]
Abstract
Anastomotic leakage (AL) after resection for rectal carcinoma accelerates morbidity and mortality rates, extends hospital stay, and increases treatment costs, particularly when requiring laparotomy. The role of a protective diverting stoma (DS) in avoiding leakage has repeatedly been discussed, but prospective randomized studies on this subject are rare and their results contradictory. The MEDLINE database was searched for studies of AL requiring laparotomy and of the associated rate of protective DSs in initial anterior resection (AR) to review these studies systematically. The collected data were used to determine the average rate of AL requiring laparotomy after rectal cancer surgery in the DS group compared with that in the non-DS group. A total of 930 abstracts were retrieved from MEDLINE; 15 articles on AR and 22 on low/ultralow AR (LAR) were included in the review and analysis. The overall rate of AL requiring laparotomy was 6.57% (813/12, 376) in the AR studies and 4.13% (157/3, 802) in the LAR studies. In the AR studies, the pooled AL rate in the DS group was higher than that in the non-DS group (12.30% vs. 9.16%, P < 0.001). However, the pooled rate of AL requiring laparotomy in the DS group was lower than that in the non-DS group (3.69% vs. 7.42%, P < 0.001). In the LAR studies, the pooled AL rate in the DS group was lower than that in the non-DS group (7.74% vs. 9.64%, P = 0.045). The pooled rate of AL requiring laparotomy in the DS group was also lower than that in the non-DS group (2.67% vs. 5.21%, P < 0.001). By contrast, the pooled rate of definitive stomas and mortality caused by AL did not have any statistical difference between the DS and non-DS groups in both AR studies (definitive stomas: 0% vs. 0.65%; mortality: 0.95% vs. 1.19%) and LAR studies (definitive stomas: 1.03% vs. 1.01%; mortality: 0.35% vs. 0.36%). Protective DSs significantly decrease the rate of AL in LAR. AL requiring surgical correction was significantly reduced in the DS group in both AR and LAR studies. Protective DSs did not affect the definitive stomas and mortality rate; this lack of an effect warrants further high-quality clinical trials.
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Affiliation(s)
- Zhi-Jie Cong
- Department of General Surgery, Colorectal Surgery Team, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical UniversityShanghai, China
| | - Liang-Hao Hu
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical UniversityShanghai, China
| | - Ming Zhong
- Department of General Surgery, Colorectal Surgery Team, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China
| | - Lu Chen
- Department of General Surgery, Colorectal Surgery Team, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China
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12
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Wang ZS, Cong ZJ, Luo Y, Mu YF, Qin SL, Zhong M, Chen JJ. Decreased expression of interleukin-36α predicts poor prognosis in colorectal cancer patients. Int J Clin Exp Pathol 2014; 7:8077-8081. [PMID: 25550854 PMCID: PMC4270616] [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] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
Interleukin-36α (IL-36α), previously designated as IL-1F6, has been found to have a pathogenic role in psoriasis. However, possible functions of IL-36α in cancer remain unclear. In present study, we investigate the possible role of interleukin-36α involved in the pathogenesis of colorectal cancer. IL-36α expression was detected in 345 colorectal cancer tissue samples by immunohistochemical staining, and its relation with clinicopathologic parameters and prognosis of colorectal cancer patients were analyzed. IL-36α was highly expressed in nearly half of all tested colorectal cancer patients. However, low expression level of IL-36α significantly correlated with larger tumor size and advanced TNM stage. Kaplan-Meier survival analysis showed that low expression level of IL-36α resulted in a remarkably poor prognosis of colorectal cancer patients. Multivariate Cox's analysis revealed that the IL-36α expression level was a significant and independent prognostic factor for overall survival rate of colorectal cancer patients. Thus, our study may provide insight into the application of IL-36α as a novel predictor of prognosis and a potential therapeutic drug for colorectal cancer.
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Affiliation(s)
- Zheng-Shi Wang
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Zhi-Jie Cong
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Yang Luo
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Yi-Fei Mu
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Shao-Lan Qin
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Ming Zhong
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
| | - Jian-Jun Chen
- Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200240, P.R. China
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Cong ZJ, Hu LH, Bian ZQ, Ye GY, Yu MH, Gao YH, Li ZS, Yu ED, Zhong M. Systematic review of anastomotic leakage rate according to an international grading system following anterior resection for rectal cancer. PLoS One 2013; 8:e75519. [PMID: 24086552 PMCID: PMC3783382 DOI: 10.1371/journal.pone.0075519] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 08/13/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND A generally acceptable definition and a severity grading system for anastomotic leakages (ALs) following rectal resection were not available until 2010, when the International Study Group of Rectal Cancer (ISGRC) proposed a definition and a grading system for AL. METHODS A search for published data was performed using the MEDLINE database (2000 to December 5, 2012) to perform a systematic review of the studies that described AL, grade AL according to the grading system, pool data, and determine the average rate of AL for each grade after anterior resection (AR) for rectal cancer. RESULTS A total of 930 abstracts were retrieved; 40 articles on AR, 25 articles on low AR (LAR), and 5 articles on ultralow AR (ULAR) were included in the review and analysis. The pooled overall AL rate of AR was 8.58% (2,085/24,288); the rate of the asymptomatic leakage (Grade A) was 2.57%, that of AL that required active intervention without relaparotomy (Grade B) was 2.37%, and that of AL that required relaparotomy (Grade C) was 5.40%. The pooled rate of AL that required relaparotomy was higher in AR (5.40%) than in LAR (4.70%) and in ULAR (1.81%), which could be attributed to the higher rate of protective defunctioning stoma in LAR (40.72%) and ULAR (63.44%) compared with that in AR (30.11%). CONCLUSIONS The new grading system is simple that the ALs of each grade can be easily extracted from past publications, therefore likely to be accepted and applied in future studies.
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Affiliation(s)
- Zhi-Jie Cong
- Department of Colorectal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China
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