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Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical features of patients with cardiac metastases from digestive system tumors. Methods This retrospective study collected and analyzed the medical records of patients with cardiac metastases from digestive system tumors who received treatments in the Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and January 2021. Kaplan-Meier method was used for survival analysis. Results A total of 19 patients were identified. The primary tumors were esophageal squamous cell carcinoma ( n = 7), gastric or gastroesophageal junction adenocarcinoma (n = 6), hepatobiliary cancers ( n = 3 ) and colorectal cancers ( n = 3 ). 16 patients had pericardial metastases, 2 patients had right atrium metastases, and 1 patient had left ventricle metastasis. The most common symptom was dyspnea, which was present in 8 cases. 7 patients received locoregional treatment, while 11 patients underwent systemic therapies. The median overall survival from diagnosis of primary cancer was 31.4 months, and the median overall survival time from diagnosis of cardiac metastasis was 4.7 months. Conclusion Cardiac metastasis from digestive system tumors is associated with low incidence and a poor prognosis. Systemic treatment remains the cornerstone of management, while novel anti-tumor drugs may improve therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Objective To investigate the association of biliary, pancreatic, and ampullary tumors with the onset of acute pancreatitis (AP) and the clinical features of tumor-induced AP by retrospectively analyzing the clinical data of patients with tumor-induced AP. Methods Related clinical data were collected from the patients with AP who were admitted to The First Affiliated Hospital of Zhengzhou University from January 2013 to August 2021. The etiological composition of AP was analyzed, as well as the change in the incidence rate of tumor-induced AP; the clinical features of AP were compared between tumor-induced and non-tumor-induced AP and between the tumors at different locations to explore the pathogenesis of tumor-induced AP. For normally distributed continuous data, the t-test was used for comparison between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups. For non-normally distributed continuous data, the Mann-Whitney U test was used for comparison between two groups; the Kruskal-Wallis H test was used for comparison between multiple groups, and the Wilcoxon rank-sum test was used for further comparison between two groups. The chi-square test or the Fisher's exact test was used for comparison of dichotomous categorical data between groups, and the goodness-of-fit test was used for comparison of polytomous categorical data between groups. The receiver operating characteristic (ROC) curve was used to evaluate the differential factors for pancreatic tumor-induced AP, and a multivariate logistic regression analysis was used to investigate the independent predictive factors for tumor-induced AP. Results A total of 8106 patients with AP were enrolled, among whom 84 patients (1.04%) had tumor-induced AP (tumor group). The tumor group had a significantly higher mean age than the non-tumor group (t=6.050, P < 0.001). The mean time from initial onset of AP to tumor diagnosis was 7.38 months. Among the 84 patients with tumor-induced AP, 75 (89.2%) had mild AP (MAP), 8 (9.5%) had moderate severe AP, and 1(1.2%) had severe AP; as for the origin of tumor, 11(13.1%) had tumor originating from the lower biliary tract, 13(15.5%) had tumor originating from the ampulla, and 60(71.4%) had tumor originating from the pancreas. Recurrence of AP (risk ratio [RR]=8.362, 95% confidence interval [CI]: 3.162-22.115, P < 0.001), pancreatic duct dilatation (RR=10.996, 95%CI: 3.871-31.236, P < 0.001), bile duct dilatation (RR=7.738, 95%CI: 2.521-23.752, P < 0.001), and leukocyte count (RR=0.766, 95%CI: 0.666-0.881, P < 0.001) were independent predictive factors for tumor-induced AP. Conclusion Tumor-induced AP is common in middle-aged and elderly men, with the clinical manifestations of MAP, easy recurrence, pancreatic duct dilatation/bile duct dilatation, and a persistent increase in the tumor marker CA19-9. Imaging examination of the biliary, pancreatic, and ampullary regions should be enhanced for AP with the above characteristics and no apparent trigger, and follow-up should be strengthened to avoid the missed diagnosis of tumor and the influence on prognosis. [ABSTRACT FROM AUTHOR]

Tumour necrosis factor-related apoptosis-inducing ligands (TRAIL) can inhibit tumour proliferation, infiltration and metastasis by specifically recognising tumour cell death receptors and inducing and initiating various apoptotic mechanisms. TRAIL is not sensitive to the treatment of digestive malignancies such as oesophageal, gastric and colorectal cancers. TRAIL can improve its anti-cancer ability by combining some small molecular compounds or by regulating the expression of apoptosis-related proteins. However, its exact mechanism of action is not yet clear. This article reviews the research progress of tumor necrosis factor-related apoptosis-inducing ligand in the treatment of digestive system tumors. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinicopathological features and prognostic factors of periampullary carcinomas( PACs) in the pre-jaundice stage. Methods A retrospective analysis was performed for the clinical data of 518 patients with PACs who were admitted from January 2012 to December 2017,and according to jaundice symptom and serum total bilirubin on admission,they were divided into pre-jaundice group with 125 patients and jaundice group with 393 patients. The two groups were compared in terms of clinical data,pathological features,and 5-year survival rate,and prognostic factors were analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to calculate survival rates and plot survival curves. The log-rank test was used for univariate analysis,and the Cox proportional-hazards regression model was used for multivariate analysis. Results Compared with the jaundice group,the pre-jaundice group had a significantly higher proportion of patients with the manifestation of abdominal distension and pain,a significantly longer duration of abdominal distension and pain,and significant increases in red blood cell count,albumin,and prealbumin( χ2= 14. 786,Z =-6. 023,t =-2. 247,-4. 688,and-3. 873,all P < 0. 05),as well as significantly lower alanine aminotransferase,aspartate aminotransferase,gamma-glutamyl transpeptidase,and alkaline phosphatase( Z =-75. 647,-55. 567,-52. 583,and-61. 501,all P < 0. 05). The detection rates of space-occupying lesions by ultrasound,computed tomography,magnetic resonance imaging/magnetic resonance cholangiopancreatography,and endoscopic retrograde cholangiopancreatography were 45. 0%,77. 7%,79. 2%,and 100%,respectively. As for pathology,compared with the jaundice group,the pre-jaundice group had a significantly longer mean tumor diameter,a significant difference in the proportion of patients with different primary sites,and significantly lower T stage and positive rate of pancreatic invasion( Z =-3. 063,χ2=10. 641,3. 991,and 4. 708,all P < 0. 05). The pre-jaundice group had a significantly higher 5-year survival rate than the jaundicegroup( χ2= 4. 582,P < 0. 05). The multivariate analysis showed that intravascular tumor thrombus,degree of tumor differentiation,and adjuvant chemotherapy were independent influencing factors for the prognosis of PACs. Conclusion PACs patients in the pre-jaundice stage has better clinicopathological features and long-term( ≥5 years) survival rate than those with jaundice,and therefore,early identification,diagnosis,and treatment can improve the survival rate of patients with PACs. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61 cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P<0.05). Conclusions The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient′ prognosis was radical treatment to every primary cancer. [ABSTRACT FROM AUTHOR]

Objective To compare the effectiveness and safety of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early gastrointestinal cancer and precancerous lesions, and to discuss the therapeutic value of ESD in the treatment of early gastrointestinal cancer and precancerous lesions. Methods A total of 225 patients with early gastrointestinal cancer and precancerous lesionswas were the study objects in the hospital from March 2014 to October 2016, which were divided into ESD group(n=115)and EMR group(n=110)according to different operation ways. The surgical time, intraoperative blood loss, hospitalization time, wound healing time, postoperative pain degree, postoperative complication rate, postoperative complete resection rate and recurrence rate, QLQ-C30 life quality scores followed-up 3, 6, 12 months were compared between two groups. Results The postoperative pain degree of ESD group was significantly lower than that of EMR group, the difference was statistically significan(Z=6.683, P=0.004). The postoperative complication rate of ESD group was significantly lower than that of EMR group, the postoperative complete resection rate of ESD group was significantly higher than that of EMR group, the differences were statistically significan(χ2=10.352, 7.528, P=0.000, 0.005). Following-up 3, 6, 12 months, there were no statistical significance of recurrence rate between two groups(P>0.05), the QLQ-C30 life quality scores of ESD group was significantly higher than that of EMR group, the differences were statistically significan(t=6. 634, 4.128, 5.776, P=0.000, 0.000, 0.000). Conclusion ESD has better effectiveness and safety in the treatment of early gastrointestinal cancer and precancerous lesions. [ABSTRACT FROM AUTHOR]

Objective To analyze the preventive effect of mecobalamin combined with glutathione on neurotoxicity induced by FOLFOX4 chemotherapy. Methods Ninety-four patients receiving FOLFOX4 chemotherapy between January 2012 and December 2013 were randomized into experimental group and control group. Patients in the experimental group were given mecobalamin tablets and glutathione injection during chemotherapy while the patients in control group received glutathione injection only. The status of neurotoxicity was evaluated by the Levi neurotoxicity criteria 1992. Results After six cycles of chemotherapy, the incidence of grade Ⅰ-Ⅱ neurotoxicity in the experimental and control groups were 34.7% (17/49) and 55.6%(25/45), respectively (P=0.042), the incidence of grade Ⅲ neurotoxicity in the experimental and control groups were 2.0%(1/49) and 13.3%(6/45), the difference is also statistically significant (P=0.037). After nine cycles of chemotherapy, significantly less grade Ⅰ-Ⅱ neurotoxicity was observed in the experimental group (44.6%) than that in the control group(70.3%, P=0.019). Incidence of grade Ⅲ neurotoxicity in the experimental group was significantly lower(4.26%) than that in the control group(18.9%, P=0.031). Conclusion Mecobalamin combined with glutathione can significantly reduce the incidence and severity of neurotoxicity induced by FOLFOX4 chemotherapy, therefore, worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical features of patients with cardiac metastases from digestive system tumors. Methods: This retrospective study collected and analyzed the medical records of patients with cardiac metastases from digestive system tumors who received treatments in the Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and January 2021. Kaplan-Meier method was used for survival analysis. Results: A total of 19 patients were identified. The primary tumors were esophageal squamous cell carcinoma ( n =7), gastric or gastroesophageal junction adenocarcinoma ( n =6), hepatobiliary cancers ( n =3) and colorectal cancers ( n =3). 16 patients had pericardial metastases, 2 patients had right atrium metastases, and 1 patient had left ventricle metastasis. The most common symptom was dyspnea, which was present in 8 cases. 7 patients received locoregional treatment, while 11 patients underwent systemic therapies. The median overall survival from diagnosis of primary cancer was 31.4 months, and the median overall survival time from diagnosis of cardiac metastasis was 4.7 months. Conclusion: Cardiac metastasis from digestive system tumors is associated with low incidence and a poor prognosis. Systemic treatment remains the cornerstone of management, while novel anti-tumor drugs may improve therapeutic efficacy.

Objective: To compare the clinical characteristics and outcomes of patients with lung cancer, gastrointestinal (GI) cancer and urologic cancer with venous thromboembolism (VTE). Methods: From January 2003 to January 2013, 192 lung cancer, GI cancer and urologic cancer patients with VTE were retrospectively evaluated for the clinical characteristics and outcomes. Results: Among 192 patients, 82 cases of lung cancer, 78 cases of GI cancer, 32 cases of urologic cancer were involved. The Eastern Cooperative oncology Group Performance Status score of GI cancer group was significantly higher than those of the lung cancer and urologic cancer groups[(2.4±1.1) vs (2.0±1.4), (1.8±1.0), both P <0.05]. The proportion of smoking patients in lung cancer group was significantly higher than that in GI cancer and urologic cancer groups (79.3% vs 30.8%, 53.1%, both P <0.05), while the proportion of operation was significantly lower than that in the latter two groups (35.4% vs 53.8%, 68.8%, both P <0.05). Pathological types of cancer were mostly adenocarcinoma, and the proportion of adenocarcinoma in lung cancer and GI cancer groups was significantly higher than that in urologic cancer group (76.9%, 73.8% vs 37.9%, both P <0.001). The proportion of moderately and/or poorly differentiated histodifferentiation in the first two groups was significantly higher than that of urologic cancer group (90.0%, 95.7% vs 40.0%, both P <0.001). The proportion of patients with TNM stage Ⅲ-Ⅳ in lung cancer group was significantly higher than that of the urological cancer group (87.0% vs 64.3%, P <0.05). The incidence of VTE in lung cancer group was significantly higher than those of GI cancer and urologic cancer groups within 6 months after tumor diagnosis, chemotherapy and operation (79.3% vs 60.3%, 46.9%; 76.5% vs 48.6%, 36.4%; 92.3% vs 57.9%, 59.1%; all P <0.05). The case fatality rate within one year in lung cancer and GI cancer groups was significantly higher than that in urologic cancer group (51.2%, 52.6% vs 18.8%, both P <0.01). The median survival time of the lung cancer and GI cancer groups was significantly shorter than that of the urological cancer group ( P =0.001, 0.010, respectively). Conclusions: Adenocarcinoma, advanced cancer, and poor histodifferentiation are risk factors of VTE in cancer patients. Most events of VTE occur within 6 months after a diagnosis of cancer. The prognosis of lung cancer and GI cancer complicated with VTE is worse than that of urologic cancer with VTE.

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P <0.05). Conclusions: The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.