Background
Bacterial contamination status may differ under different biliary drainage conditions. The purpose of this study was to determine the impact of qualitative and quantitative biliary ...bacterial contamination on the incidence of infection complications in patients undergoing pancreatoduodenectomy.
Methods
Patients undergoing pancreatoduodenectomy for periampullary diseases with different biliary drainage conditions, such as external drainage (ED), internal drainage (ID), and no drainage (ND), were included. Bile was collected intraoperatively, and biliary contamination status was qualified and quantified using bacterium-specific ribosomal RNA-targeted reverse transcription–quantitative polymerase chain reaction (RT-qPCR). The impact of biliary contamination status on infection complications was analyzed.
Results
A total of 152 patients were included (38 with ED, 40 with ID, and 74 with ND). The positive rate of microorganisms in bile was higher in the ID group (98%) compared with the ED group (82%,
p
= 0.021) and the ND group (65%,
p
< 0.001). The number of microorganisms detected in bile samples was higher in the ID group compared with the ED group (median 489,788 vs. 5375 bacteria/mL of bile,
p
< 0.001). With multivariate analysis, soft pancreas, intraoperative bleeding (> 600 mL), and biliary contamination by
Atopobium
cluster were identified as independent risk factors for infection complications. Biliary contamination by
Atopobium
cluster was significantly higher in the ID group compared with the other groups.
Conclusions
Biliary bacterial contamination is more frequently induced by ID than either ED or ND. In addition to the previously known risk factors, biliary contamination with
Atopobium
cluster may be one of the risk factors of infection complications following pancreatoduodenectomy.
Background
Reports show
miR
-
23b
to be a cancer-related biomarker in various cancer types. Interestingly, it has a dual role of oncogenic and tumor-suppressive functions, depending on the cancer ...type. This study focused on the unknown association of
miR
-
23b
-
3p
with hepatocellular carcinoma (HCC).
Methods
Expression of
miR
-
23b
-
3p
was measured in nine HCC cell lines and 125 resected human HCC samples by TaqMan microRNA assays. To detect its downstream target,
miR
-
23b
-
3p
mimic and inhibitor constructs were transfected and analyzed.
Results
HepG2, a high
miR
-
23b
-
3p
-expressing cell line, was transfected with a
miR
-
23b
-
3p
inhibitor construct, whereas SK-Hep1, a low
miR
-
23b
-
3p
-expressing cell line, was transfected with a mimic construct. Proliferation of HCC cells was activated by
miR
-
23b
-
3p
overexpression and diminished by its knockdown. Then, 125 clinical HCC samples were examined to measure
miR
-
23b
-
3p
expression. Tumor expression of
miR
-
23b
-
3p
was upregulated in 48 cases (38%) and downregulated in 77 cases (62%). The upregulated cases were correlated with elderly patients (
P
= 0.015). These patients also showed significantly poor overall survival hazard ratio (HR), 3.10; 95% conflidence interval (CI), 1.57–6.29;
P
= 0.001 in a multivariate analysis. Furthermore, mitochondrial metabolism-related genes (
MICU3
and
AUH
) were detected as specific binding targets.
Conclusion
The study showed that
miR
-
23b
-
3p
functions as an oncogenic microRNA in HCC cell lines. Its overexpression in resected HCC tissues was a significant prognostic factor of overall survival. Both
MICU3
and
AUH
may be candidate gene targets of
miR
-
23b
-
3p
.
Background
Esophageal squamous cell carcinoma (ESCC) has a poor prognosis despite advances in multidisciplinary treatments and immune checkpoint inhibitors. We previously reported that neural ...pentraxin receptor (NPTXR), a transmembrane protein mainly expressed in the brain and involved in synaptic transmission, is implicated in gastric cancer malignancy. This study evaluated the expression and function of NPTXR in ESCC, the therapeutic potential of monoclonal antibody (mAb) against NPTXR, and its prognostic value in ESCC patients.
Methods
The study involved analyzing the NPTXR expression in 21 ESCC cell lines and total 371 primary ESCC tissue samples using quantitative reverse-transcription polymerase chain reaction and immunohistochemistry. The impact of NPTXR on the malignant behavior of ESCC was examined using small interfering RNA-mediated knockdown and a subsequent assessment of cell proliferation, apoptosis, and adhesion. This study further investigated the efficacy of anti-NPTXR mAb in vitro and associations between the expression of NPTXR messenger RNA (mRNA) and protein with clinicopathological factors and the prognosis.
Results
NPTXR was overexpressed in several ESCC cell lines and primary ESCC tissues. Knockdown of NPTXR in ESCC cells resulted in reduced proliferation, increased apoptosis, and decreased cell adhesion. The mAb against NPTXR significantly inhibited ESCC cell proliferation in vitro. A high NPTXR expression in patient tissues was correlated with a worse overall survival, suggesting its potential as a prognostic biomarker.
Conclusions
NPTXR influences the malignant behavior of ESCC cells. Anti-NPTXR mAb may be a promising therapeutic agent, and its expression in ESCC tissues may serve as a prognostic biomarker.
Background
The association between neoadjuvant therapy (NAT) and nutritional status in pancreatic cancer (PC) is unknown.
Objective
The aim of this study was to assess the impact of NAT on ...nutritional status.
Methods
Overall, 161 patients who underwent pancreatoduodenectomy for PC between August 2010 and March 2017 were enrolled and were divided into two groups: the neoadjuvant group (NAG;
n
= 67) and the control group (CG;
n
= 94). Based on relative dose intensity (RDI), patients in the NAG group were further divided into RDI ≥ 80% (
n
= 39) and RDI < 80% (
n
= 19). Changes in nutritional index, inflammatory index, and inflammation-based prognostic scores during NAT and the perioperative period were assessed.
Results
Retinol-binding protein, prealbumin, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutrition index significantly worsened in the NAG after NAT (
p
= 0.007,
p
= 0.03,
p
= 0.04,
p
= 0.007, and
p
= 0.004, respectively). The recovery of rapid turnover proteins after postoperative day 5 was significantly worse in the NAG compared with the CG (
p
< 0.05), but tended to be more prompt in the RDI ≥ 80% group among the NAG. There was no significant difference in the incidence of postoperative complications, length of hospital stay, and time to postoperative adjuvant therapy between the NAG and the CG.
Conclusions
NAT for PC could aggravate nutritional status and hamper its postoperative recovery. Furthermore, malnutrition might decrease tolerance of NAT. These findings suggest the importance of nutritional support for patients with NAT in PC.
Purposes
The aim of this study was to explore predictive factors for portal or splenic vein thrombosis (VT) that might cause serious problems after distal pancreatectomy (DP).
Methods
A total of 230 ...patients who underwent DP between 2008 and 2017 were retrospectively reviewed to identify predictive factors for portal or splenic VT.
Results
Ultimately, 164 patients were analyzed. Portal or splenic VT was significantly correlated with age < 65 years old, benign tumor, laparoscopic surgery, preservation of the inferior mesenteric vein (IMV) and left gastric vein (LGV), preservation of the IMV only, no drainage vein, length of the residual splenic vein (RSV) ≥ 26 mm, vessel dissection with a linear stapler, and intra-abdominal abscess (all
P
< 0.05). Furthermore, a multivariate analysis indicated that the length of the RSV (odds ratio OR: 9.15,
P
= 0.03) was an independent predictive factor for portal VT and that the length of the RSV (OR: 37.9,
P
< 0.01), vessel dissection with a linear stapler (OR: 6.49,
P
= 0.03), and intra-abdominal abscess (OR: 23.0,
P
= 0.02) were independent predictive factors for splenic VT.
Conclusion
As the length of the RSV was significantly associated with portal or splenic VT, a follow-up imaging diagnosis might be recommended for such cases.
Long non-coding RNAs (lncRNAs) were shown to be the crucial regulators of the many diseases. In this study, the expressions of lncRNAs were investigated in resected 158 hepatocellular carcinomas ...(HCCs) to evaluate the effects of their expression levels on prognosis. The expression levels of HULC and MALAT1 were shown to be significantly higher in the normal background tissue of HCC than those in the normal liver tissue of metastatic liver tumor without hepatitis (HULC: fold change 14.9, P = 1.7e-06; MALAT1: fold change 17.5, P = 1.2e-06. The formation of capsule was shown to be correlated with the increased expression of HULC (P = 0.041), while the size of HCC under 2 cm was correlated with a decrease in MALAT1 expression (P = 0.019). The levels of serum alpha-fetoprotein above 20 ng/mL indicated a decreased expression of both HULC and MALAT1 (HULC: P = 0.017; MALAT1: P = 0.0036). The increase in the expression levels of MALAT1 in HCC tissues was significantly correlated with better overall survival (HULC: P = 0.099, MALAT1: P = 0.028). Thus, the expression of these lncRNAs in HCC potentially correlates with the HCC malignancy and they represent potential prognostic biomarkers of the resected HCC.
Background
We aimed to clarify the role of potassium voltage-gated channel subfamily J member 15 (
KCNJ15)
in esophageal squamous cell carcinoma (ESCC) cells and its potential as a prognosticator in ...ESCC patients.
Methods
KCNJ15
transcription levels were evaluated in 13 ESCC cell lines and polymerase chain reaction (PCR) array analysis was conducted to detect coordinately expressed genes with
KCNJ15
. The biological functions of
KCNJ15
in cell invasion, proliferation, migration, and adhesion were validated through small interfering RNA-mediated knockdown experiments. Cell proliferation was further evaluated through the forced expression experiment.
KCNJ15
expression was detected in 200 ESCC tissues by quantitative real-time reverse transcription PCR (qRT-PCR) and analyzed in 64 representative tissues by immunohistochemistry. Correlations between
KCNJ15
expression levels and clinicopathological features were also analyzed.
Results
The
KCNJ15
expression levels varied widely in ESCC cell lines and correlated with
COL3A1
,
JAG1
, and
F11R
. Knockdown of
KCNJ15
expression significantly repressed cell invasion, proliferation, and migration of ESCC cells
in vitro
. Furthermore, overexpression of KCNJ15 resulted in increased cell proliferation. Patients were stratified using the cut-off value of
KCNJ15
messenger RNA (mRNA) levels in 200 ESCC tissues using receiver operating characteristic curve analysis; the high
KCNJ15
expression group had significantly shorter overall and disease-free survival times. In multivariable analysis, high expression of
KCNJ15
was identified as an independent poor prognostic factor. Staining intensity of in situ KCNJ15 protein expression tended to be associated with
KCNJ15
mRNA expression levels.
Conclusions
KCNJ15
is involved in aggressive tumor phenotypes of ESCC cells and its tissue expression levels may be useful as a prognosticator of patients with ESCC.
Background
The clinical role of peritoneal lavage cytology (CY) in pancreatic ductal adenocarcinoma (PDAC) remains controversial, partly due to its low sensitivity. This study aimed to develop a new ...biomarker, defined as peritoneal lavage tumor DNA (ptDNA), using DNAs extracted from peritoneal lavage samples from patients with PDAC.
Methods
Samples were collected intraoperatively from 89 PDAC patients who underwent pancreatectomy between 2012 and 2017. Droplet digital polymerase chain reaction (PCR) was used to measure ptDNA for detection of
KRAS
mutations. The ptDNA status and clinical characteristics were retrospectively evaluated.
Results
Positive ptDNA was found in 41 patients, including all 9 patients positive for CY (CY+) and 32 patients negative for CY (CY−). The mutant allele frequency was significantly higher in the CY+ patients than in the CY− patients. The disease-free survival (DFS) and overall survival (OS) were significantly poorer in the high-ptDNA group than in the low-ptDNA group (median DFS, 11.0 vs. 18.8 months;
p
= 0.007; median OS, 28.7 vs not reached;
p
= 0.001). The survival curves of DFS and OS in the CY+ group were almost equal to those in the CY− and high-ptDNA group. In a multivariable analysis, ptDNA was an independent predictive factor for DFS (
p
= 0.025) and OS (
p
= 0.047). The estimated cumulative incidence of peritoneal recurrence was 45.5% in the high-ptDNA group. The ptDNA biomarker had a much higher sensitivity for peritoneal recurrence than CY, whereas CY had higher specificity.
Conclusions
As a promising biomarker, ptDNA may predict poor prognosis and peritoneal recurrence in PDAC, resolving the controversy surrounding CY.