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| 1 | Lipoprotein-associated phospholipase A2 prognostic role in atherosclerotic complications显示文摘Atherosclerosis manifests itself clinically at advanced stages when plaques undergo hemorrhage and/or rupture with superimposed thrombosis, thus abruptly stopping blood supply. Identification of markers of plaque destabilization at a pre-clinical stage is, therefore, a major goal of cardiovascular research. Promising results along this line were provided by studies investigating the lipoprotein-associated phospholipase A2(Lp-PLA2), a member of phospholipase A2 proteins family that plays a key role in the metabolism of pro-inflammatory phospholipids, as oxidized low-density lipoproteins, and in the generation of pro-atherogenic metabolites, including lysophosphatidylcholine and oxidized free fatty acids. We herein review the experimental and clinical studies supporting use of Lp-PLA2 activity for predicting cardiovascular events. To his end we considered not only Lp-PLA2 activity and mass, but also Lp-PLA2 gene variations and their association with incident coronary artery disease, stroke, and cardiovascular mortality. Based on these evidences the major scientific societies have included in their guidelines the measurement of Lp-PLA2 activity among the biomarkers that are useful in risk stratification of adult asymptomatic patients at intermediate cardiovascular risk. The results of two recently published major clinical trials with the LpPLA2 inhibitor darapladib, which seem to challenge the pathogenic role of Lp-PLA2, will also be discussed. | Giuseppe Maiolino Valeria Bisogni Giacomo Rossitto Gian Paolo Rossi | 2015 | World Journal of Cardiology2015，7，10： | 66 |
| 2 | Oxidative stress, cardiolipin and mitochondrial dysfunction in nonalcoholic fatty liver disease显示文摘Nonalcoholic fatty liver disease(NAFLD) is today considered the most common form of chronic liver disease, affecting a high proportion of the population worldwide. NAFLD encompasses a large spectrum of liver damage, ranging from simple steatosis to steatohepatitis, advanced fibrosis and cirrhosis. Obesity, hyperglycemia, type 2 diabetes and hypertriglyceridemia are the most important risk factors. The pathogenesis of NAFLD and its progression to fibrosis and chronic liver disease is still unknown. Accumulating evidence indicates that mitochondrial dysfunction plays a key role in the physiopathology of NAFLD, although the mechanisms underlying this dysfunction are still unclear. Oxidative stress is considered an important factor in producing lethal hepatocyte injury associated with NAFLD. Mitochondrial respiratory chain is the main subcellular source of reactive oxygen species(ROS), which may damage mitochondrial proteins, lipids and mitochondrial DNA. Cardiolipin, a phospholipid located at the level of the inner mitochondrial membrane, plays an important role in several reactions and processes involved in mitochondrial bioenergetics as well as in mitochondrial dependent steps of apoptosis. This phospholipid is particularly susceptible to ROS attack. Cardiolipin peroxidation has been associated with mitochondrial dysfunction in multiple tissues in several physiopathological conditions, including NAFLD. In this review, we focus on the potential roles played by oxidative stress and cardiolipin alterations in mitochondrial dysfunction associated with NAFLD. | Giuseppe Paradies Valeria Paradies Francesca M Ruggiero Giuseppe Petrosillo | 2014 | World Journal of Gastroenterology2014，20，39： | 50 |
| 3 | Management of negative pressure wound therapy in the treatment of diabetic foot ulcers显示文摘Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs. | Marco Meloni Valentina Izzo Erika Vainieri Laura Giurato Valeria Ruotolo Luigi Uccioli | 2015 | World Journal of Orthopedics2015，6，4： | 33 |
| 4 | A Stable, Wideband Tunable, Near Transform-Limited, Graphene- Mode-Locked, Ultrafast Laser显示文摘We report an ultrafast laser mode-locked with a graphene saturable absorber.The linear dispersions of the Dirac electrons in graphene enable wideband tunability.We get-1 ps pulses,tunable between 1525 and 1559 nm,with stable mode-locking,insensitive to environmental perturbations. | Zhipei Sun Daniel Popa Tawfique Hasan Felice Torrisi Fengqiu Wang Edmund J.R.Kelleher John C.Travers Valeria Nicolosi Andrea C.Ferrari | 2010 | Nano Research2010，3，9： | 24 |
| 5 | Helicobacter pylori and oral pathology:Relationship with the gastric infection显示文摘Helicobacter pylori(H.pylori)has been found in the oral cavity and stomach,and its infection is one of the most frequent worldwide.We reviewed the literature and conducted a Topic Highlight,which identified studies reporting an association between H.pylori-infection in the oral cavity and H.pylori-positive stomach bacterium.This work was designed to determine whether H.pylori is the etiologic agent in periodontal disease,recurrent aphthous stomatitis(RAS),squamous cell carcinoma,burning and halitosis.Record selection focused on the highest quality studies and meta-analyses.We selected 48 articles reporting on the association between saliva and plaque and H.pylori-infection.In order to assess periodontal disease data,we included 12 clinical trials and 1 meta-analysis.We evaluated 13 published articles that addressed the potential association with RAS,and 6 with squamous cell carcinoma.Fourteen publications focused on our questions on burning and halitosis.There is a close relation between H.pylori infection in the oral cavity and the stomach.The mouth is the first extra-gastric reservoir.Regarding the role of H.pylori in the etiology of squamous cell carcinoma,no evidence is still available. | Isabel Adler Andrea Muio Silvia Aguas Laura Harada Mariana Diaz Adriana Lence Mario Labbrozzi Juan Manuel Muio Boris Elsner Alejandra Avagnina Valeria Denninghoff | 2014 | World Journal of Gastroenterology2014，20，29： | 21 |
| 6 | Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis显示文摘AIM:To evaluate the natural history of human cytomegalovirus(HCMV) infection in a series of 28 ulcerative colitis patients in whom the search for HCMV was positive.METHODS:A series of 85 patients with moderate-severe ulcerative colitis flare-up were evaluated for a HCMV search by performing a haematoxylin and eosin stain,immunohistochemical assay and nested polymerase chain reaction on rectal biopsies.Among 85 screened patients(19 of whom were steroid resistant/dependant),28 were positive for HCMV;after remission the patients were followed up clinically and histologically.RESULTS:Among the 22 patients with complete followup,in 8(36%) patients HCMV-DNA persisted in the intestinal specimens.Among the HCMV positive patients,4(50%) experienced at least one moderate-severe flare-up of colitis without evidence of peripheral HCMV.Among the 14 HCMV negative patients,3 with pouches developed pouchitis and 5 out of 11(45%) experienced a colitis flare-up.CONCLUSION:Our preliminary results suggest that HCMV may remain in the colon after an acute colitis flareup despite remission;it seems that the virus is not responsible for the disease relapse. | Valeria Criscuoli Maria Rosa Rizzuto Luigi Montalbano Elena Gallo Mario Cottone | 2011 | World Journal of Gastroenterology2011，17，5： | 20 |
| 7 | Helicobacter pylori infection and extragastric disorders in children: A critical update显示文摘Helicobacter pylori(H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in thelast decades, abetted by modern clinical practices, may have other health consequences. | Lucia Pacifico John F Osborn Valeria Tromba Sara Romaggioli Stefano Bascetta Claudio Chiesa | 2014 | World Journal of Gastroenterology2014，20，6： | 18 |
| 8 | 关于城市蔓延和交通规划的政治与政策显示文摘文章从分析什么是可持续的城市形态入手,探讨了城市住区形态、交通设施和环境影响之间密切的相互作用关系。通过对荷兰、意大利和美国的实例研究,作者关注在西方社会中有关推动规划合理化和民主化过程的城市政策和政治基础;反映了他们为控制城市蔓延,正在寻求多种模式和手段以及多样化的解决方案。 | Federico Oliva Marco Facchinetti Valeria Fedeli 刘川 | 2002 | 国外城市规划2002，17，6： | 17 |
| 9 | Neo-adjuvant chemo(radio)therapy in gastric cancer: Current status and future perspectives显示文摘In the last 20 years, several clinical trials on neoadjuvant chemotherapy and chemo-radiotherapy as a therapeutic approach for locally advanced gastric cancer have been performed. Even if more data are necessary to define the roles of these approaches, the results of preoperative treatments in the combined treatment of gastric adenocarcinoma are encouraging because this approach has led to a higher rate of curative surgical resection. Owing to the results of most recent randomized phase III studies, neoadjuvant chemotherapy for locally advanced resectable gastric cancer has satisfied the determination of level I evidence. Remaining concerns pertain to the choice of the optimal therapy regimen, strict patient selection by accurate pre-operative staging, standardization of surgical procedures, and valid criteria for response evaluation. New well-designed trials will be necessary to find the best therapeutic approach in pre-operative settings and the best way to combine old-generation chemotherapeutic drugs with new-generation molecules. | Alberto Biondi Maria C Lirosi Domenico D'Ugo Valeria Fico Riccardo Ricci Francesco Santullo Antonia Rizzuto Ferdinando CM Cananzi Roberto Persiani | 2015 | World Journal of Gastrointestinal Oncology2015，7，12： | 13 |
| 10 | 欧洲卒中组织(ESO)关于无活动能力的急性缺血性卒中患者静脉血栓栓塞的预防指南显示文摘背景静脉血栓栓塞(venous thromboembolism, VTE)包括深静脉血栓形成(deep vein thrombosis, DVT)和肺栓塞,是无活动能力的急性缺血性卒中患者的常见并发症。本文阐述了欧洲卒中组织(European Stroke Organisation, ESO)关于无活动能力的急性缺血性卒中患者VTE预防的指南。有关出血性卒中的指南已发表。方法一个多学科小组确定了相关问题并使用推荐意见分级评估、制定和评价系统根据随机对照试验证据制定推荐意见。本文经过ESO内部及外部评审,并得到ESO指南委员会和ESO执行委员会批准。结果我们发现的主要是中等质量证据,包括评估梯度压力弹力袜(graduated compression stocking, GCS)、间歇充气加压装置(intermittent pneumatic compression, IPC)以及使用普通肝素(unfractionated heparin, UFH)、低分子量肝素(low molecular weight heparin, LMWH)和类肝素进行预防性抗凝治疗的随机对照试验和系统评价,但未发现评估神经肌肉电刺激(neuromuscular electrical stimulation, NES)的随机试验。我们推荐临床医生对无活动能力的患者使用IPC,但不应使用GCS。在无活动能力的缺血性卒中患者中,如果降低VTE风险的益处足以抵消其使用导致的颅内外出血风险增高,则应考虑使用UFH(5 000 U,2~3次/d)、LMWH或类肝素进行预防性抗凝治疗。如果确定具有预防性抗凝治疗的指征,应考虑使用LMWH或类肝素而非UFH,因为前两者能更明显地降低DVT风险,使用更加便利,人员成本更低,患者舒适度更高(每天仅需注射1次),但这些优势应与LMWH和类肝素的更高颅外出血风险、更高药物成本以及在肾功能不全老年患者中使用的相关风险进行权衡。结论IPC、UFH或LMWH和类肝素可降低无活动能力的急性缺血性卒中患者的VTE风险,但需要进一步研究来评价NES是否有效。其中证据最强的预防手段是IPC。需要更好的方法在卒中发病后最初数周内根据VTE风险和抗凝药的出血风险对患者进行分层。 | Martin Dennis Valeria Caso L Jaap Kappelle Aleksandra Pavlovic Peter Sandercock 刘品一 黄丽丽 徐运 | 2017 | 国际脑血管病杂志2017，25，3： | 11 |
| 11 | Thymosin alpha 1:A comprehensive review of the literature显示文摘Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies,as an enhancer of vaccine response,and as a means of curbing morbidity and mortality in sepsis and numerous infections.Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells.In this review,we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1.Considering the known biochemical properties including antibacterial and antiviral properties,timehonored applications,and the new promising findings regarding the use of thymosin,we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2. | Asimina Dominari Donald Hathaway III Krunal Pandav Wanessa Matos Sharmi Biswas Gowry Reddy Sindhu Thevuthasan Muhammad Adnan Khan Anoopa Mathew Sarabjot Singh Makkar Madiha Zaidi Michael Maher Mourad Fahem Renato Beas Valeria Castaneda Trissa Paul John Halpern Diana Baralt | 2020 | World Journal of Virology2020，9，5： | 11 |
| 12 | Cardiovascular and metabolic effects of Berberine显示文摘Berberine(BBR) is a natural alkaloid isolated from the Coptis Chinensis.While this plant has been used in Ay-urvedic and Chinese medicine for more than 2500 years,interest in its effects in metabolic and cardiovascular disease has been growing in the Western world in the last decade.Many papers have been published in these years reporting beneficial effects in carbohydrate and lip-id metabolism,endothelial function and the cardiovascu-lar system.In this review,we report a detailed analysis of the scientific literature regarding this topic,describing the effects and the underlying mechanisms of BBR on carbohydrate and lipid metabolism,endothelial function and the cardiovascular system. | Flora Affuso Valentina Mercurio Valeria Fazio Serafino Fazio | 2010 | World Journal of Cardiology2010，2，4： | 10 |
| 13 | Radiomics and machine learning applications in rectal cancer:Current update and future perspectives显示文摘The high incidence of rectal cancer in both sexes makes it one of the most common tumors,with significant morbidity and mortality rates.To define the best treatment option and optimize patient outcome,several rectal cancer biological variables must be evaluated.Currently,medical imaging plays a crucial role in the characterization of this disease,and it often requires a multimodal approach.Magnetic resonance imaging is the first-choice imaging modality for local staging and restaging and can be used to detect high-risk prognostic factors.Computed tomography is widely adopted for the detection of distant metastases.However,conventional imaging has recognized limitations,and many rectal cancer characteristics remain assessable only after surgery and histopathology evaluation.There is a growing interest in artificial intelligence applications in medicine,and imaging is by no means an exception.The introduction of radiomics,which allows the extraction of quantitative features that reflect tumor heterogeneity,allows the mining of data in medical images and paved the way for the identification of potential new imaging biomarkers.To manage such a huge amount of data,the use of machine learning algorithms has been proposed.Indeed,without prior explicit programming,they can be employed to build prediction models to support clinical decision making.In this review,current applications and future perspectives of artificial intelligence in medical imaging of rectal cancer are presented,with an imaging modality-based approach and a keen eye on unsolved issues.The results are promising,but the road ahead for translation in clinical practice is rather long. | Arnaldo Stanzione Francesco Verde Valeria Romeo Francesca Boccadifuoco Pier Paolo Mainenti Simone Maurea | 2021 | World Journal of Gastroenterology2021，27，32： | 10 |
| 14 | T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease显示文摘AIM:To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration.METHODS:A case-control study was performed.Cases were 25 obese children with biopsy-proven NAFLD.Controls were 25 obese children matched for age and gender,without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin.Hepatic fat fraction (HFF) by MRI was obtained using a modification of the Dixon method.RESULTS:HFF ranged from 2% to 44% [mean,19.0% (95% CI,15.1-27.4)] in children with NAFLD,while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5),P < 0.0001].HFF was highly correlated with histological steatosis (r=0.883,P < 0.0001) in the NAFLD children.According to the histological grade of steatosis,the mean HFF was 8.7% (95% CI,6.0-11.6) for mild,21.6% (15.3-27.0) for moderate,and 39.7% (34.4-45.0) for severe fatty liver infiltration.With a cutoff of 4.85%,HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%.All control children had HFF lower than 4.85%;thus,the specificity was 100%.After 12 mo,children with weight loss displayed a significant decrease in HFF.CONCLUSION:MRI is an accurate methodology for liver fat quantification in pediatric NAFLD. | Lucia Pacifico Michele Di Martino Carlo Catalano Valeria Panebianco Mario Bezzi Caterina Anania Claudio Chiesa | 2011 | World Journal of Gastroenterology2011，17，25： | 9 |
| 15 | Role of magnetic resonance imaging in the detection and characterization of solid pancreatic nodules: An update显示文摘Pancreatic ductal adenocarcinoma is the most common malignant tumor of the pancreas. The remaining pancreatic tumors are a diverse group of pancreatic neoplasms that comprises cystic pancreatic neoplasms, endocrine tumors and other uncommon pancreatic tumors. Due to the excellent soft tissue contrast resolution, magnetic resonance imaging(MRI) is frequently able to readily separate cystic from noncystic tumors. Cystic tumors are often easy to diagnose with MRI; however, noncystic non-adenocarcinoma tumors may show a wide spectrum of imaging features, which can potentially mimic ductal adenocarcinoma. MRI is a reliable technique for the characterization of pancreatic lesions. The implementation of novel motionresistant pulse sequences and respiratory gating techniques, as well as the recognized benefits of MR cholangiopancreatography, make MRI a very accurate examination for the evaluation of pancreatic masses. MRI has the distinctive ability of non-invasive assessment of the pancreatic ducts, pancreatic parenchyma, neighbouring soft tissues, and vascular network in one examination. MRI can identify different characteristics of various solid pancreatic lesions, potentially allowing the differentiation of adenocarcinoma from other benign and malignant entities. In this review we describe the MRI protocols and MRI characteristics of various solid pancreatic lesions. Recognition of these characteristics may establish the right diagnosis or at least narrow the differential diagnosis, thus avoiding unnecessary tests or procedures and permitting better management. | Najwa Al Ansari Miguel Ramalho Richard C Semelka Valeria Buonocore Silvia Gigli Francesca Maccioni | 2015 | World Journal of Radiology2015，7，11： | 9 |
| 16 | Adipose tissue and vascular inflammation in coronary artery disease显示文摘Obesity has become an important public health issue in Western and developing countries,with well known metabolic and cardiovascular complications.In the last decades,evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological consequences.As a consequence of the expansion of fat depots,in obese subjects,adipose tissue cells develope a phenotypic modification,which turns into a change of the secretory output.Adipocytokines produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling,vascular biology and,moreover,participate to the systemic inflammatory response,which characterizes obesity and metabolic syndrome.This might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events.A great number of adipocytokines have been described recently,linking inflammatory mileu and vascular pathology.The understanding of these pathways is crucial not only from a pathophysiological point of view,but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic targets.The aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease. | Enrica Golia Giuseppe Limongelli Francesco Natale Fabio Fimiani Valeria Maddaloni Pina Elvira Russo Lucia Riegler Renatomaria Bianchi Mario Crisci Gaetano Di Palma Paolo Golino Maria Giovanna Russo Raffaele Calabrò Paolo Calabrò | 2014 | World Journal of Cardiology2014，6，7： | 8 |
| 17 | Esophageal testing: What we have so far显示文摘Gastroesophageal reflux disease(GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry(HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation. Esophageal 24-h p H-metry with or without combined impedance is usually performed in patients with negative endoscopy and reflux symptoms who have a poor response to anti-reflux medical therapy to assess esophageal acid exposure and symptom-reflux correlations. In particular, esophageal 24-h impedance and p H monitoring can detect acid and non-acid reflux events. Endo FLIP is a recent technique poorly applied in clinical practice, although it provides a large amount of information about the esophagogastric junction. In the coming years, laryngopharyngeal symptoms could be evaluated with up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal p H-metry. Future studies are required of these techniques to evaluate their diagnostic accuracy and usefulness, although the available data are promising. | Nicola de Bortoli Irene Martinucci Lorenzo Bertani Salvatore Russo Riccardo Franchi Manuele Furnari Salvatore Tolone Giorgia Bodini Valeria Bolognesi Massimo Bellini Vincenzo Savarino Santino Marchi Edoardo Vincenzo Savarino | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 8 |
| 18 | Evaluation of chronic kidney disease in chronic heart failure: From biomarkers to arterial renal resistances显示文摘Chronic kidney disease and its worsening are recurring conditions in chronic heart failure(CHF) which are independently associated with poor patient outcome.The heart and kidney share many pathophysiological mechanisms which can determine dysfunction in each organ. Cardiorenal syndrome is the condition in which these two organs negatively affect each other, therefore an accurate evaluation of renal function in the clinical setting of CHF is essential. This review aims to revise the parameters currently used to evaluate renal dysfunction in CHF with particular reference to the usefulness and the limitations of biomarkers in evaluating glomerular dysfunction and tubular damage. Moreover, it is reported the possible utility of renal arterial resistance index(a parameter associated with abnormalities in renal vascular bed) for a better assesment of kidney disfunction. | Massimo Iacoviello Marta Leone Valeria Antoncecchi Marco Matteo Ciccone | 2015 | World Journal of Clinical Cases2015，3，1： | 8 |
| 19 | Treatment of peri-anal fistula in Crohn's disease显示文摘Anal fistulas are a common manifestation of Crohn's disease(CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently em-ployed. However, at the moment, none of these tech-niques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medi-cal therapy and those causing disabling symptoms. Ut-most attention should be paid to correcting the balance between eradication of the fistula and the preservationof fecal continence. | Giuseppe S Sica Sara Di Carlo Giorgia Tema Fabrizio Montagnese Giovanna Del Vecchio Blanco Valeria Fiaschetti Giulia Maggi Livia Biancone | 2014 | World Journal of Gastroenterology2014，20，37： | 8 |
| 20 | Do pathological variables have prognostic significance in rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and surgery?显示文摘AIM To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and surgery.METHODS Tumor regression grade(TRG) according to the Dworak system and yT NM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced(c TNM stage Ⅱ and Ⅲ) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival(DFS) and cancer specific survival(CSS) was analyzed by Kaplan Meier and Cox-regression analyses.RESULTS cN + status, mucinous histotype or poor differentiation in the pre-treatment biopsy were significantly associated with lower pathological response(low Dworak grade and TNM remaining unchanged/upstaging). Cases showing acellular mucin pools in surgical specimens all had unremarkable clinical courses with no deaths or recurrences during follow-up. Dworak grade had prognostic significance for DFS and CSS. However, compared to the 5-tiered system, a simplified twotiered grading system, in which grades 0, 1 and 2 were grouped as absent/partial regression and grades 3 and 4 were grouped as total/subtotal regression, was more reproducible and prognostically informative. The twotiered Dworak system, yN stage, craniocaudal extension of the tumor and radial margin status were significant independent prognostic variables. CONCLUSION Our data suggest that caution should be applied in using a conservative approach in rectal carcinomas with c N+ status, extensive/lower involvement of the rectum and mucinous histotype or poor differentiation. Although Dworak TRG is prognostically significant, a simplified two-tiered system could be preferable. Finally, cases with acellular mucin pools should be carefully evaluated to definitely exclude residual mucinous carcinoma. | Luca Reggiani Bonetti Simona Lionti Federica Domati Valeria Barresi | 2017 | World Journal of Gastroenterology2017，23，8： | 7 |
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