Dissertations / Theses on the topic 'Upper digestive tract cancer'
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Sharpe, Katharine H. "Socioeconomic inequalities in lung and upper aero-digestive tract cancer incidence in Scotland." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/8887/.
Full textThe risk associated with LUADT cancer for study participants in the highest category of multiple low socioeconomic circumstances was more than three-times greater when compared to their affluent counterparts (RR 3.35 95% CI 2.26, 4.97); this elevated risk remained at 86% compared to those with no socioeconomic disadvantage, even after full adjustment for smoking, alcohol, diet and exercise behaviours. When looking at single socioeconomic status (SES) indicators, only those who rented accommodation from a local authority remained at a 50% increased risk of LUADT cancer even after adjustment for all the behaviours (RR 1.50 95% CI 1.05, 2.16). This study demonstrated that smoking is a major inequality issue and a significant cancer risk which is socially patterned. Further analytical research is required to fully understand the pathways and mechanisms between socioeconomic circumstance and lung and upper aerodigestive cancer risk.
Gupta, Bhawna. "Life-course approach to behavioural risk factors and quality of life for cancers of the upper aero-digestive tract in an Indian population: a case-control study." Thesis, Griffith University, 2018. http://hdl.handle.net/10072/371971.
Full textThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Dentistry and Oral Health and Menzies Health Institute Queensland
Griffith Health
Full Text
Väkeväinen, Satu. "Local acetaldehyde production as a pathogenetic factor for upper digestive tract cancers in humans." Helsinki : University of Helsinki, 2002. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/vakevainen/.
Full textCui, Yan. "Polymorphism of xeroderma pigmentosum group G and dietary flavonoid intake on the risk of lung and upper aero-digestive tract cancers." Diss., Restricted to subscribing institutions, 2005. http://proquest.umi.com/pqdweb?did=954047411&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
Full textChen, Jun 1969. "The association between dietary intake and the risk of cancers of the upper aero-digestive tract : a case-control study in Brazil." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29422.
Full textShaikh, Mushfiq Hassan. "The Role of Human Papillomaviruses in the Aetiopathogenesis of Head and Neck Cancer in South Asia, and Approaches to Treatment." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/366967.
Full textThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Dentistry and Oral Health
Griffith Health
Full Text
DALMARTELLO, MICHELA. "A LATENT VARIABLE APPROACH TO DIETARY PATTERNS RESEARCH." Doctoral thesis, Università degli Studi di Milano, 2019. http://hdl.handle.net/2434/612183.
Full textPatronieri, Alexandre Tadeu. "Tendências de incidência do câncer das vias aéreas e digestivas superiores segundo 18 registros de câncer de base populacional com destaque ao município de São Paulo. 1969-1999." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-07032007-095710/.
Full textIntroduction: Upper Aerodigestive Tract Cancer comprises a group of neoplasms which spread over many anatomic regions. Considering most of the locations, the worst risk coefficients are tobacco and alcohol. Taken the coefficients are known, prevention and precocious detection campaigns are expected to lessen the incidence statistics. Objectives. To estimate the trends on lip, oral cavity (tongue and mouth), salivary gland, oropharyngeal, nasopharyngeal and hypopharyngeal cancer incidences in some locations worldwide between 1969 - 1999. Methods Incidence coefficient data of eighteen records from the Population Database Cancer Registry which had its history published in Cancer Incidence in Five Continents has been analysed applying polynomial regression models. Results There has been a statistically significant increase to the number of oral cavity cancer in Sao Paulo among women; in European countries as well as in some North American cities, the increase was detected among both men and women. On the other hand, there has been a decrease in Puerto Rico, Mumbai and Singapore. The incidence of lip cancer decreased in most locations (among men). However, an increase has been detected in North Europe and in Iowa, USA (among women). Oropharyngeal cancer has increased in number among men in Europe and Iowa, USA; it decreased in number in Cali, Quebec, and other areas in Ásia. Hypopharyngeal cancer has shown to be an increasing trend in many Europeans countries among men, but a decreasing one in Sweden, England, Singapore and Puerto Rico. Conclusion Oral cavity and oropharyngeal neoplasms trends proceed grow in many locations. Finally, the need for prevention and precocious detection campaigns is urgent.
Paget-Bailly, Sophie. "Facteurs de risque professionnels des cancers des voies aéro-digestives supérieures : Synthèse des données épidémiologiques et analyse d’une étude cas-témoins, l’étude Icare." Thesis, Paris 11, 2012. http://www.theses.fr/2012PA11T061/document.
Full textBackground: There is sufficient evidence that asbestos causes laryngeal cancer, but overall the role of occupational exposures in the etiology of head and neck cancer (HNC) remains largely unknown. Although several studies have reported associations between occupational exposures and HNC, it is difficult to draw firm conclusions. Objectives: (1) To summarize available epidemiologic data on occupational exposures and cancers of the oral cavity (OC), pharynx and larynx (the most frequent HNC); (2) using data from a large case-control study, to identify occupations and industries with an increased risk of HNC, then to investigate the role of some suspected occupational exposures (asbestos, mineral wools (MW), cement dust, silica). Methods: (1) A literature research and a series of meta-analyses were performed. (2) The Icare study is a French population-based case-control study including 2415 HNC cases and 3555 controls. Complete and detailed occupational histories were collected. Analyses by job title were conducted. Job exposure matrices, developed by the Occupational Health Department of the French Institute for Public Health Surveillance (InVS), were used to assess lifetime occupational exposure to asbestos, MW, cement dust and silica. Results: Significantly increased meta-relative risks (meta-RR) were obtained considering laryngeal cancer and exposures to polycyclic aromatic hydrocarbons (PAH), engine exhausts, working in the textile industry and the rubber industry, and for cancer of the OC and pharynx and exposures to asbestos, PAH and engine exhausts. Significantly increased risks were found for several jobs and industries, some of them entailing exposures to agents for which meta-RR were increased. Analyses for specific occupational exposures confirmed the association between asbestos and laryngeal cancer and showed an association with the risk of oral cavity and pharyngeal cancer. An association with exposure to cement dust was also suggested. The results did not support an association between HNC risk and exposure to MW or silica. Conclusion: This work emphasizes the role of occupational exposures in HNC. Overall, our results suggest associations between HNC and exposure to asbestos, PAH, cement dust, and work in the rubber industry
Ventayol-García, Tania. "Clonal expansion in the human upper gastrointestinal tract." Thesis, Queen Mary, University of London, 2013. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8694.
Full textAllison, Paul J. "An investigation of prognostic determinants among upper aerodigestive tract cancer patients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq44347.pdf.
Full textO'Rorke, Michael Anthony. "Physical activity, nutrition and the prevention of upper gastrointestinal tract cancer." Thesis, Queen's University Belfast, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.546406.
Full textBarnard, Desire. "Nucleotide sequence variation and expression levels of TP53 in cancers of the upper gastro-intestinal tract." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50046.
Full textENGLISH ABSTRACT: The work presented in this thesis deals with the association between cancers of the upper gastro-intestinal tract and the tumor suppressor gene, TP53, and can be divided into three parts: (i) the analysis of the mutational spectrum of TP53 with respect to laryngeal cancer, (ii) the analysis of the mutational spectrum of TP53 with respect to esophageal cancer and (iii) the analysis of TP53 transcriptional levels in esophageal cancer. Laryngeal cancer (LC) is the 6th most common cancer in the world and the 2nd most common respiratory cancer, with approximately 500 000 new cases per annum detected worldwide. Over the last few years, LC has become increasingly prevalent within the Coloured Community of the Western Cape. The mechanisms of tumorigenesis in LC remain unknown, although smoking and alcohol consumption are considered to be major risk factors. Mutations within the gene TP53 have been strongly implicated as playing a role in cancer development, as they are frequently found in several cancer types. We therefore screened exons 5 - 8 of TP53 for mutations in DNA from tumor biopsies (n=44) and blood samples (n=42) from Coloured LC patients, using polymerase chain reaction - single strand conformation polymorphism (PCR-SSCP) analysis and direct sequencing. Blood samples from a healthy, matched control group (n=40) were included in the study as controls. Significant correlations were found between the occurrence of LC and age and smoking, whereas daily meat consumption was a possible protective factor. In tumor-derived samples, mutations were found in 3 of the exons under investigation, representing 25% of the samples. The mutations were unique to the tumor biopsies, indicating a somatic origin for mutations. The data confirms that the region between codons 175 and 273 of TP53 is a mutational hotspot for cancers in general. This study reports 6 novel mutations within this same region. Esophageal cancer (EC) has a very high incidence in South Africa, relative to the rest of the world, and is particularly common amongst the Black Transkei population. The goal of this study was to determine whether there are differences in the TP53 mutational pattern observed in the Coloured Western Cape community as compared to that observed in the Black Transkei community. This required the analysis of the molecular structure of TP53, specifically exons 5 - 8, in a group of Coloured EC patients (n=44) treated at Tygerberg Hospital, Cape Town, South Africa. DNA obtained from tumor biopsies and blood (from patients) as well as from apparently healthy surrounding tissue was screened via PCR-SSCP and direct sequencing analysis. Only 4 nucleotide changes were observed from a total of 124 sequences obtained, of which two were novel to esophageal squamous cell carcinoma. These 4 nucleotide alterations were found only within the tumor biopsy sample set, representing 9% of the tumors investigated. This study revealed that the mutational spectrum of TP53 within the Coloured population of the Western Cape greatly differs from that of the Black community of the Transkei. This suggests that a different set of etiological factors are involved in the tumorigenic process for each of these distinct geographical communities, which is the subject of an epidemiological study undertaken by the MRC. The final part of this thesis deals with the quantification and comparison of TP53 transcription levels in esophageal cancer tumor tissue to the TP53 levels in healthy esophageal tissue obtained from patients from a unique geographical and ethnic background. The cohort used in this study consisted of Coloured patients (n=2) treated at Tygerberg Hospital. The LightCycler system was implemented in order to try to accurately quantify TP53 mRNA levels. Unfortunately, the desired results were unattainable due to unforeseen difficulties encountered during the study. These difficulties included the insufficient preservation of samples for RNA based studies. Several recommendations were made concerning future similar studies, including an improved planning strategy as well as the employment of an RNA stabilizing agent. Additionally, a few important contributions were made through this study, including the design and optimization of TP53 primers specifically intended for future RNA studies. These primers would enable the identification of the presence of TP53 RNA species as well as the absence of DNA contamination in a single PCR amplification step. Other contributions include the development of a well-optimized RNA extraction method for the extraction of RNA from tough tissues (such as the human esophageal tissue used in this study). This method makes the extraction of large quantities of RNA from small amounts of tough tissue types possible. In conclusion, this study has made a significant contribution to the field of cancer research, by shedding light on the TP53 mutational spectrum with regards to laryngeal as well as esophageal cancer in a population unique to the Western Cape. The first part of this thesis has been published in Cancer Genetics and Cytogenetics (Barnard, D., K. Lehmann, E.G. Haal, P.O. van Heiden, and l.C. Victor. 2003. The spectrum of mutations in TP53 in laryngeal cancer patients from a high-incidence population shows similarities to many of the known mutational hotspots. Cancer Genetics and Cytogenetics 145:126-132), of which a copy can be found in Appendix I. This work has also been presented (by D. Barnard) at an international conference entitled "Cancer of the Esophagus and Gastric Cardia: From Gene to Cure", held in Amsterdam, the Netherlands during the period 13 - 15 December 2002.
AFRIKAANSE OPSOMMING: Die werk wat in hierdie tesis voorgelê word handel oor die assosiasie tussen kankers van die boonste gastrointestinale weg en die tumor suppressor geen, TP53, en kan in 3 dele gedeel word, (i) die analise van die mutasiespektrum van TP53 in laringiale kanker (LK), (ii) die analise van die mutasiespektrum van TP53 in slukderm kanker (SK) en (iii) die analise van die transkripsievlakke van TP53 in SK. Laringeal kanker (LK) is die 6de algemeenste kanker in die wêreld en die 2de algemeenste respiratoriese kanker, met "n benaderde 500 000 nuwe gevalle jaarliks wêreldwyd. Oor die afgelope paar jare het LK "n toenemende probleem geraak, veral in die Kleurling gemeenskap van die Wes Kaap. Die meganismes van die tumorvorming in LK is onbekend, alhoewel rook-en alkoholgebruik vername risiko faktore is. Die voorkoms van mutasies in TP53 is verskeie kere aangetoon in verskillende kanker tipes en daar word vermoed dat dit "n rol speel in tumorvorming. In hierdie studie is dus na mutasies in eksons 5 - 8 van TP53 gesoek in tumor biopsie weefsel (n=44) en bloed isolate (n=42) van Kleurling LK pasiënte d.m.v. polimerase ketting reaksie - enkelstring konformasie polimorfisme (PKR-ESKP) analisering en direkte volgorde bepaling. Bloed monsters van "n vergelykbare groep (n=40) is ook in die studie ingesluit as "n kontrole. Betekenisvolle positiewe korrelasies is gevind tussen die voorkoms van LK en ouderdom sowel as rook. Daarmee saam is daaglikse vleisinname as potensiële beskermende faktor gevind. In tumor biopsies is mutasies in 3 van die ondersoekte eksons gevind, wat 25% van die biopsie monsters verteenwoordig. Hierdie mutasies is uniek aan die tumor biopsie weefsels en dui op "n somatiese oorsprong van mutasies. Hierdie bevindinge bevestig dat die gedeelte tussen kodons 173 - 273 van TP53 "n hipermuteerbare gebied geassosieer met kankers is. Hierdie studie bevestig 6 nuwe mutasies. Daar is 'n hoë insidensie van slukderm kanker (SK) in Suid Afrika relatief tot die res van die wêreld. Hierdie soort kanker word veral gevind by die Swart populasie van die Transkei. Die doel van hierdie studie was om verskille tussen die TP53 mutasie patroon van die Kleurling gemeenskap van die Wes Kaap en die Swart gemeenskap van die Transkei te vergelyk. Hiervoor is die molekulêre struktuur van TP53, veral eksons 5 - 8, in 'n groep Kleurling SK pasiënte (n=42) wat behandel is by Tygerberg Hospitaal, Kaapstad, Suid Afrika, geanaliseer. Analisering is gedoen deur DNS van tumor, bloed en ook oënskynlike gesonde aangrensende weefsel van dieselfde pasiënte te onderwerp aan PKR-ESKP analise en direkte volgorde bepaling. Slegs 4 nukleotied veranderings is gevind in 124 volgorde bepalings, waarvan 2 nuwe veranderings is in SK. Hierdie 4 nukleotied veranderinge verteenwoordig 9% van al die tumors wat ondersoek is in die studie. Hierdie studie bewys dat die mutasiespektrum van TP53 in die Kleurling gemeenskap van die Wes Kaap grootliks verskil van die Swart gemeenskap van die Transkei. Dit impliseer dat verskillende etiologiese faktore moontlik 'n rol mag speel op die tumorvormingsproses in die 2 afsonderlike geografiese gemeenskappe. Hierdie is die onderwerp van 'n epidemiologiese studie wat deur die MNR onderneem word. Die laaste deel van hierdie tesis handel oor die kwantifisering en vergelyking van TP53 transkripsievlakke in SK tumor weefsel teenoor TP53 vlakke in gesonde slukderm weefsel van pasiënte in 'n unieke geografiese en etniese agtergrond. Die studie populasie in hierdie projek het bestaan uit Kleurling pasiënte (n=2) wat by Tygerberg hospitaal behandel is. Die "LightCycler" sisteem is gebruik vir die akkurate kwantifisering van TP53 boodskapper RNS vlakke. Ongelukkig is die verlangde resultate nie gekry nie as gevolg van onvoorsiene probleme wat ondervind is tydens die studie. Hierdie probleme sluit in die onvoldoende preserv RNS studies. Hierdie inleiers maak dit nou moontlik om die teenwoordigheid van TP53 RNS spesies sowel as die afwesigheid van DNS kontaminasie in een PKR amplifikasie stap te kan identifiseer. 'n Ander belangrike bydrae is die ontwikkeling van 'n goed geoptimaliseerde RNS ekstraksie metode vir moeilike starre weelfsel tipes (soos menslike slukderm weefsel in hierdie studie) en maak die ekstraksie van groot hoeveelhede RNS uit klein hoeveelhede van moeilik hanteerbare weefsel tipes moontlik. Om saam te vat, hierdie studie het betekenisvolle bydraes gemaak tot die veld van kankernavorsing deur die ontrafeling van die TP53 mutasiespektrum in beide laringeale sowel as slukderm kanker, in 'n populasie uniek aan die Wes Kaap. Die eerste deel van hierdie tesis is gepubliseer in Cancer Geneties and Cytogenetics (Barnard, D., K. Lehmann, E. G. Hoal, P. D. van Heiden, and T. C. Victor. 2003. The spectrum of mutations in TP53 in laryngeal cancer patients from a high-incidence population shows similarites to many of the known mutational hotspots. Cancer Genetics and Cytogenetics 145: 126-132) en 'n afskrif van die artikel is ingesluit in Appendix I. Hierdie werk is ook voorgedra (deur D. Barnard) by 'n internasionale kongres getiteld "Cancer of the Esophagus and Gastric Cardia: From Gene to Cure", wat in Amsterdam, Nederland gehou is gedurende 13 - 15 Desember 2002
Paterson, Stuart. "Studies of dietary nitrate induced nitrosative stress in the upper gastrointestinal tract." Thesis, University of Glasgow, 2008. http://theses.gla.ac.uk/394/.
Full textReva, T. V. "Some aspects of the pathology of the upper digestive tract in patients with gastroesophageal reflux disease on the background of hypothyroidism." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18599.
Full textDehestani, Fatemeh. "The relationship between dispositional optimism and quality of life in upper aerodigestive tract cancer patients /." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31220.
Full textPrior to treatment, an association between dispositional optimism and QOL was observed for the global, pain, swallowing, senses and feeling ill domains. However, no such associations were observed following treatment.
Zhao, Wei, and 趙煒. "BRAF mutation and aberrant methylation of gene promoters in the pathogenesis of gastrointestinal tract adenocarcinoma." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36718464.
Full textCrole, Martina Rachel. "Comparative morphology and functional significance of mechanical and sensory structures in the upper digestive tract of the ostrich (Struthio camelus) and emu (Dromaius novaehollandiae)." Thesis, University of Pretoria, 2013. http://hdl.handle.net/2263/40274.
Full textThesis (PhD)--University of Pretoria, 2013.
gm2014
Anatomy and Physiology
Unrestricted
Held, Maria. "Epidemiological studies of Helicobacter pylori and its relation to cancer and precancerous lesions in the upper gastrointestinal tract /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-944-7/.
Full textRouzaud, Gabrielle C. M. "Digestive metabolism of glucosinolates : a novel approach using urinary markers for estimating the release of glucosinolate breakdown products in the gastro-intestinal tract of mammals." Thesis, Robert Gordon University, 2001. http://hdl.handle.net/10059/602.
Full textSeisen, Thomas. "Caractérisation de l’évolution des tumeurs urothéliales de la voie excrétrice urinaire supérieure après néphrourétérectomie totale A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node Upper Tract Urothelial Carcinoma." Thesis, Sorbonne université, 2018. http://www.theses.fr/2018SORUS486.
Full textAlthough radical nephroureterectomy remains currently considered as the standard of care for upper tract urothelial carcinoma (UTUC), there is a high risk of postoperative recurrence, which can occur either within the bladder or the surgical field and/or distant sites. The aim of our study was to investigate and better characterize these events. With regards to intra-vesical recurrence, a systematic review and meta-analysis was conducted to identify all significant clinical and pathological predictors. Moreover, an additional cohort study suggested that, from a biological perspective, such an event could be related to the presence of the FGFR3 mutation detected from urinary DNA. With regards to locoregional and/or distant recurrence, a central pathology review of UTUC patients with pT3 disease showed that there may be a prognostic interest in stratifying these individuals based on the extent of local invasion (pT3a vs. pT3b) to propose a risk-adapted strategy for postoperative management. Nonetheless, an US hospital-based registry study revealed that all patients with pT3-T4 and/or pN+ UTUC could derive an overall survival benefit from adjuvant chemotherapy. Finally, a preliminary analysis from a large French cohort of UTUC patients established that the 2 mm TMA technique can be used to assess the prognostic interest of determining PDL1 expression on tumor cells with 28.8 antibody and PD-1 expression on TILs with NAT105 antibody, both at the 5% threshold for positivity
Vilmann, Peter. "Endoscopic ultrasonography with curved array transducer in diagnosis of cancer in and adjacent to the upper gastrointestinal tract : scanning and guided fine needle aspiration biopsy /." Copenhagen : Munksgaard, 1998. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=007939492&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
Full textBertrand, Gérald. "Caractérisation et ciblage thérapeutique d'une sous-population de cellules souches cancéreuses dans un modèle cellulaire de carcinome épidermoïde de la tête et du cou résistant à l'irradiation par photon et ions carbone." Thesis, Lyon 1, 2013. http://www.theses.fr/2013LYO10118/document.
Full textHead and neck squamous cell carcinomas (HNSCC) have a poor prognosis, due to their resistance to standard treatments. In most cases, locoregional recurrence or metastases occur. This study has focused on the role of cancer stem cells (CSC) in the radioresistance of the SQ20B HNSCC cell line and their therapeutic targeting in association with photon or carbon ions irradiation. A subpopulation of SQ20B-CSC has been isolated by cell sorting based on 3 specific characteristics of HNSCC-CSC : Hoechst 33342 exclusion, CD44 expression and high aldehyde dehydrogenase activity (ALDH). SQ20B/SP/CD44high/ALDHhigh cells show the CSC characteristics (in vitro and in vivo tumorigenesis, high radioresistance). The response of CSC to both types of irradiation was compared to the non-“stem cells” SQ20B/SP/CD44low sub-population. The observed radioresistance involves a decrease in apoptotic cell death, an increase in proliferative capacities and an overexpression of the Bmi1 self-renewing signaling pathway. The radiosensitizing effects of 3 molecules targeting the CSC has been demonstrated : an induction of apoptotic cell death by the inhibition of the G2/M phase arrest after a treatment with UCN01 ; an inhibition of proliferative capacities using the all-trans-retinoic acid (ATRA) which induce their differentiation ; and an inhibition of Bmi1 by artesunate. These treatments, alone or in combination (UCN01+ATRA) have a synergistic effect with photon or carbon ion irradiation to overcome CSC radioresistance. Preclinical and clinical studies should confirm the benefit of targeting CSC and improve the control of tumor escape in patients with radioresistant HNSCC cancers
Queiroz, Morgana Terezinha Alves de 1966. "Endoscopia digestiva alta na rede pública de saúde = diagnósticos de lesões do tubo digestivo alto em uma população de atendimento primário na região sudoeste do município de Campinas, São Paulo - Brasil = Endoscopy in public health : diagnoses of lesions in the upper digestive tract in a population of primary care in the region southwest of the city of Campinas, São Paulo - Brazil." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308570.
Full textDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A endoscopia digestiva alta (EDA) é um dos exames mais indicados para a investigação das doenças do trato digestivo alto. Normalmente, é executada em hospitais de alta complexidade e em clínicas especializadas; porém a sua grande demanda tem feito com que estes exames sejam realizados com maior frequência em centros de média complexidade. Dessa forma, este estudo teve por objetivos analisar retrospectivamente os diagnósticos de EDA realizados numa população de atendimento primário da região sudoeste do município de Campinas, São Paulo, Brasil, no período de 2000 a 2007, definindo a taxa de exames normais e a prevalência das principais doenças no tubo digestivo alto e correlacionando esses diagnósticos com faixa etária, gênero e origem de atendimento; estabelecer a prevalência do Helicobacter pylori em um segmento da população estudada, de acordo com as doenças diagnosticadas; e, finalmente, oferecer subsídios para a implantação de um modelo de atendimento primário de EDA na rede pública. Este estudo foi desenvolvido a partir dos laudos de EDA arquivados no setor especializado do referente serviço e que foram analisados de modo descritivo e estatístico. A pesquisa para H. pylori foi realizada em 2.822 (56,44%) dos pacientes, através da histologia e/ou teste da urease. A qualidade do serviço foi determinada pela ausência de complicações e pela resposta a um questionário ilustrativo aplicado a uma parcela dos pacientes. As análises estatísticas foram realizadas pelo SAS (Statistical Analysis System), o nível de significância 5% (p<0,05), utilizando-se testes Qui-quadrado e exato de Fisher, e regressão logística para os cálculos de razões de risco (Odds ratio). Na análise descritiva geral observou-se que a maioria dos exames foi realizada no gênero feminino; com idade de 40 a 49 anos, independente do gênero.As mulheres tiveram dois picos prevalentes nas faixas etárias 18-29 anos e 40-49 anos; entre os homens a prevalência foi a partir de 60 anos.A maior frequência das doenças no segmento esofágico, no total de EDAs, foi de 25,96%;entre estas, esofagites 21,32% (597 do tipo erosiva e 469 do tipo não erosiva),neoplasias esofágicasmalignas 0,30% (três do tipoprecoce e 12 do tipoavançada). No segmento gástrico,a prevalência foi 79,74%, sendo gastrites crônicas 75,82%, úlcera gástrica9,10% e neoplasias malignas gástricas 0,58% (dez do tipo precoce e 19 do tipo avançada). Já nosegmento duodenal,o índice de anormalidades foide 32,96%, sendoúlcera duodenal19,34% e duodenites 17,74%. Entre os pacientes que realizaram a pesquisa para H. pylori, notou-se prevalência significativa naqueles com úlcera duodenal (49.07%). Exames endoscópicos normais foram verificados em 604 pacientes (12,08%) com valores estatisticamente representativos na faixa etária de 18 a 29 anos e no gênero feminino. Assim, após o estudo, chegou-se à conclusão de que é viável a implantação da EDA diagnóstica no atendimento primário de saúde, com equipe bem estruturada, favorecendo a ausência de índice de complicação decorrente do procedimento, o que também foi confirmado pela avaliação favorável expressa voluntariamente por alguns pacientes
Abstract: Upper digestive tract endoscopy (UDTE) is one of the most highly indicated exams for the investigation of upper digestive tract diseases. It is normally performed in high-complexity hospitals and specialized clinics; however, the high demand for UDTE examinations and the growing number of professionals specializing in endoscopic techniques have resulted in a higher availability of these procedures at medium-complexity healthcare facilities. So, the objectives of this study were to analyze the diagnoses obtained from UDTE examinations performed in a population of primary care patients from the Southwestern region of Campinas, São Paulo, Brazil, in the period from 2000 to 2007, defining the percentage of normal examinations and the prevalence of main diseases of the upper digestive tract and correlating these diagnoses with age, gender and source of referral; to establish the prevalence of Helicobacter pylori in one segment of the studied population based on the diagnosed diseases; and to offer supporting data for the implementation of a UDTE primary care model in the public healthcare system. The design of this retrospective study was based on the UDTE reports filed with the specialized department that offers the service. Descriptive and statistical analyses were performed on these reports. The quality of the service was assessed, based on the absence of complications and on the answers given to an illustrative questionnaire applied to a portion of the patients who underwent UDTE examinations. The statistical analyses were performed with the SAS (Statistical Analysis System) software, with a significance level of 5% (p<0.05). The tests applied were Chi-square and Fisher's exact test, as well as logistic regression for the calculation of odds ratios. During the general descriptive analysis, it was observedthat the majority of examinations was conducted on female patients; and on patients ages 40-49, irrespective of gender. There were two peaks of age prevalence among women (18-29 and 40-49 y.o.); among men, the prevalent age groupwas 60 y.o. and older. Among the 5,000 analyzed UDTE examinations, the prevalence of esophageal segment disease was 25.96%, including erosive and non-erosive esophagitis(21.32%); and early and advanced esophageal cancer (0.30%). Prevalence of disease in the gastric segment was 79.74%, including chronic gastritis (75.82%), gastric ulcers (9.10%) and gastric cancer (0.58%). In the duodenal segment, the rate of abnormalities was 32.96%, including duodenal ulcers (19.34%) and duodenitis (17.74%). Out of the 5,000 examinations, a total of 2,822 patients (56.44%) were selected for H. pylori testing using the histological and/or urease methods, to investigate the correlation of this bacterium with gastric and duodenal ulcers, as well as gastritis identified as micronodular after endoscopic examination. Normal endoscopic examinations were assessed from 604 patients (12.08%), which presented statistically representative values for the 18-29 years old age group and the female gender. In conclusion, with this study, the implementation of diagnostic UDTE using a well-structured medical team is a viable option in primary healthcare. Besides, according to the favorable assessments expressed voluntarily by some patients, the procedure does not produce complications
Mestrado
Clinica Medica
Mestre em Clinica Medica
Caravaca, Mora Oscar Mauricio. "Development of a novel method using optical coherence tomography (OCT) for guidance of robotized interventional endoscopy." Thesis, Strasbourg, 2020. http://www.theses.fr/2020STRAD004.
Full textThere exists an unmet clinical need to provide doctors with a new method that streamlines minimally invasive endoscopic treatment of colorectal cancer to single operator procedures assisted by in-situ and real-time accurate tissue characterization for informed treatment decisions. A promising solution to this problem has been developed at the ICube laboratory, in which the flexible interventional endoscope (Karl Storz) was completely robotized, so allowing a single operator to independently telemanipulate the endoscope and two insertable therapeutic instruments with a joint control unit. However, the robot-assisted flexible endoscope is subject to the same diagnostic accuracy limitations as standard endoscopy systems. It has been demonstrated that endoscopic optical coherence tomography (OCT) has a good potential for imaging disorders in the gastrointestinal tract and differentiating healthy tissue from diseased. Neither OCT, nor the robotized endoscope can solve the limitations of current standard of care for colon cancer management alone. Combining these two technologies and developing a new platform for early detection and treatment of cancer is the main interest of this work, with the aim of developing a state-of-the-art OCT imaging console and probe integrated with the robotized endoscope. The capabilities of this new technology for imaging of the interior of the large intestine were tested in pre-clinical experiments showing potential for improvement in margin verification during minimally invasive endoscopic treatment in the telemanipulation mode
Forn-ChiaLin and 林逢嘉. "RUNX3 And Pin1 Regulate β-catenin/cyclin D1 in Cancers of Upper Digestive Tract." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/k6p2h5.
Full text國立成功大學
臨床醫學研究所
103
Cancer is one of major health issues. Gastric cancer and esophageal squamous cell carcinoma (ESCC) are common and fatal malignancy. Despite multi-modality therapies, most patients eventually die from the disease or treatment-related complications. More comprehensive investigations of carcinogenesis and tumor progression are necessary for developing novel diagnostic and therapeutic strategies for these cancers. RUNX3 is recognized as a tumor suppressor. The tumor suppressive functions of RUNX3 were first reported in gastric epithelial cells. RUNX3 was inactivated by gene silencing or protein mislocalization in more than 80% of gastric cancers. Although restoration of RUNX3 in gastric cancer cells could inhibit tumorigenesis through regulating several target genes, the mechanisms were not clearly understood. The role of RUNX3 in regulating β-catenin and cyclin D1 in gastric cancer was studied in my thesis. RUNX3 repressed Akt1 expression through transcriptional inhibition. Two RUNX3-binding sites on Akt1 promoter were identified. The inhibition of Akt1 facilitated β-catenin degradation followed by cyclin D1 downregulation. The data suggested loss of RUNX3 in gastric cancer promoted tumorigenesis through Akt1/β-catenin/cyclin D1 signaling pathway. β-catenin and cyclin D1 are well known substrates of Pin1 which is a peptidyl-prolyl isomerase and promotes oncogenesis by regulating multiple oncogenic signaling at various levels. Pin1/β-catenin/cyclin D1 signaling pathway in ESCC was investigated. The experimental evidences were provided that Pin1 knockdown inhibited expression of β-catenin/cyclin D1 and tumorigenesis of ESCC cells. The inhibited tumorigenesis in cells with Pin1 knockdown was partially recovered by cyclin D1 restoration. In addition, high Pin1 expression was correlated with poor prognosis of ESCC patients. The results supported that Pin1 may promote ESCC aggressiveness through β-catenin and cyclin D. In summary, β-catenin and cyclin D1 are repressed by tumor suppressor RUNX3 but positively regulated by Pin1 in cancers of upper digestive tract. The results of my thesis can help people understand carcinogenic mechanisms and provide rationales for developing novel target therapy of cancer in the future.
Li, Yi Chen, and 李宜珍. "Cellular and molecular mechanisms of malignant transformation in cancer cells of upper digestive track chronically exposed to areca nut." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/22upac.
Full textLI, WEN-ZONG, and 李文宗. "Age-period-cohort analysis of common digestive tract cancer in Taiwan." Thesis, 1990. http://ndltd.ncl.edu.tw/handle/10948909496666562650.
Full text"NEOPLASMS OF THE UPPER DIGESTIVE TRACT OF CATTLE ASSOCIATED TO SPONTANEOUS INTAKE OF BRACKEN FERN(Pteridium aquilinum)." Tese, Biblioteca Digital de Teses e Dissertações da UFSM, 2005. http://coralx.ufsm.br/tede/tde_busca/arquivo.php?codArquivo=403.
Full textChang, Yu-Li, and 張由俐. "Molecular Basis Of Digestive Tract Cancer From Genome Aberration Analysis To Exploring A Novel Mechanism." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/jr7qr7.
Full text高雄醫學大學
醫學研究所博士班
104
Digestive cancer is a disease which is usually genomic or somaitc anomalies leading to uncontrollable abnormal cell growth, often invasive or diffused into other parts of the body. According to WHO, the 2015 bulletin released worldwide in cancer incidence and mortality of the main reasons for the investigation. In the next 20 years, the number of new cases will rise 70% more than the current number. Digestive cancer is among the most common forms of cancer, and two types of digestive cancer are considered to be the most deadly in Taiwan. Its association with the mechanisms of cancer development and disease progression is still a very important direction to explore. Here we try to find how the non-coding RNA molecules, gene mutation, and expression change are related to occurrence and progression of digestive cancer. There are two main topics in this thesis. The first part of the research topic is divided into two sections, i.e. (1) the esophagus chromosome analysis and utilization of the HRM method for analyzing oral cancer and colorectal cancer related gene mutations and (2) the focus on the X chromosome XIST related small RNA molecule for exploring a novel mechanism. In section one of the first part, we focused on the detection of cytogenetic alterations in esophageal cancer (EC) which demonstrated high anomalous frequency. A total of 40 cases of primary EC and their paired nearby nontumor tissues were collected. The comparative genomic hybridization (CGH) is the technique that brings out the gains and losses of chromosome fragments and was applied to determine the aberrations from the tissue DNA. In noncancer tissues, the gains were at 19p (5/40, 13%), 20q (5/40, 13%), and losses at 9p (13/40, 33%), 2q (10/40, 25%), 12q (10/40, 25%), 13q (10/40, 25%), 5q (9/40, 23%), 6q (9/40, 23%), 7q (9/40, 23%), and 8p (9/40, 23%). In the 40 cases of primary EC, the gains were at 8q (10/40, 25%), 3q (9/40, 23%), 2q (7/40, 18%), and 13q (7/40, 18%), and the losses were at 1q (8/40, 20%), 4q (8/40, 20%), 3p (7/40, 18%), 5q (7/40, 18%), and 18q (7/40, 18%) in comparison with paired nearby noncancerous tissues. We found that the loss aberrations were on 1q, 2p, 3p, 5q, 6q, 9p, 11p, 15q, 16q, 18q, 21q and gains on 20p in both tumor and nontumor tissues; nevertheless, -4p, -7q, -8p, -10q, -12q, -13q, -14q and +17p, +19q, +22q were only found in nontumor tissues and +1q, +2pq, +3q, -4q, +4q, +5q, 7p, +8q, +10q, +12q, +13q, +14q -17p, -19pq, -22q in EC. From these results, we suggest that most of the tissues near the cancer parts of EC may be considered as a precancerous region. Changes in cancer and non-cancer tissues may be caused by abnormal chromosomal changes in genes. The appearance of some of anomalous hot spots in non-cancer tissue has not been reported in medical literature so far; therefore, we believe that the alterations between cancer and non-cancer tissues may play a role in the development of EC in the Taiwanese population. In section two of the first part, we know that there are anomalous frequency regions in the chromosomes of the genes in oral squamous cell carcinoma (OSCC) in the Taiwanese population, and that TNFAIP3 acts as a negative regulator of the NF-?羠 pathway, and in lymphoma and autoimmune diseases, it is frequently inactivated by mutations and/or deletions. We investigated the prevalence of inactivation of TNFAIP3 in oral squamous cell carcinoma (OSCC). DNA was extracted from 81 cases of OSCC and 50 peripheral blood samples from normal controls. A high-resolution melting (HRM) analysis was used to characterize TNFAIP3 mutations, and the results were confirmed by direct DNA sequencing. Three mutations and three single-nucleotide polymorphisms (SNPs) were found to be associated with OSCC; the TNFAIP3 mutation occurred in 3.7% (3/81) of OSCC cases examined. p.E361K was identified as a novel mutation. A novel SNP, p.P714S differed from one reported previously (p.P714A) (rs369155845) at that site. We also identified five SNPs in 50 normal Taiwanese individuals, and two of them [c.296-15C>T (rs377482653) and c.305A>G (p.N102S) (rs146534657)] were not found in our OSCC tissue. HRM facilitated screening of genetic changes. In addition, our results indicate that the prevalence of the TNFAIP3 mutation is low in OSCC. Then, we investigated the driver gene mutations associated with colorectal cancer (CRC) in the Taiwanese population. In this study, 103 patients with CRC were evaluated. The samples consisted of 66 men and 37 women with a median age of 59 years and an age range of 26-86 years. We used high-resolution melting analysis (HRM) and direct DNA sequencing to characterize the mutations in 13 driver genes of CRC-related pathways. The HRM assays were conducted using the LightCycleⓇ 480 Instrument provided with the software LightCyclerⓇ480 Gene Scanning Software Version 1.5. We also compared the clinicopathological data of CRC patients with the driver gene mutation status. Of the 103 patients evaluated, 73.79% had mutations in one of the 13 driver genes. We discovered 18 novel mutations in APC, MLH1, MSH2, PMS2, SMAD4 and TP53 that have not been previously reported. Additionally, we found 16 de novo mutations in APC, BMPR1A, MLH1, MSH2, MSH6, MUTYH and PMS2 in cancerous tissues previously reported in the dbSNP database; however, these mutations could not be detected in peripheral blood cells. The APC mutation correlates with lymph node metastasis (34.69% vs 12.96%, P=0.009) and cancer stage (34.78% vs 14.04%, P=0.013). No association was observed between other driver gene mutations and clinicopathological features. Furthermore, having two or more driver gene mutations correlates with the degree of lymph node metastasis (42.86% vs 24.07%, P=0.043). Our findings confirm that there is a certain degree of importance regarding the 13 CRC-related pathway driver genes in the development of CRC in Taiwanese patients. The second part involves the following points : X-inactive-specific transcript (XIST), a long non-coding RNA, is essential for the initiation of X-chromosome inactivation. However, little is known about other roles of XIST in the physiological process in eukaryotic cells. In this study, the bioinformatics approaches revealed that XIST could be processed into a PIWI-interacting small RNA XPi2. The XPi2 RNA was confirmed by Northern blot assay, and its expression was gender-independent, suggesting that the role of XPi2 was beyond X-chromosome inactivation. The pull-down assay combined LC-MS-MS identified two XPi2-associated proteins, nucleolin and hnRNP A1, which were related to the formation of G-quadruplex. Moreover, the microarray data showed that the knockdown of XPi2 down-regulated the KRAS pathway. Consistently, we tested the expression of ten genes including KRAS, which were regulated by G-quadruplex formation and found that the knockdown of XPi2 caused a dramatic decrease in the transcription level of KRAS among the ten genes. The results of CD/NMR assay also supported the interaction of XPi2 and the polypurine-polypyrimidine element of KRAS. Accordingly, XPi2 may modulate the KRAS expression by attenuating G-quadruplex formation. Our present work sheds light on the novel role of Piwi-interacting RNA XPi2 in modulating the G-quadruplex formation which may play some roles in the KRAS related carcinogenesis. Based on the aforementioned results, we collected and studied 31 (62n) clinical cases of colorectal cancer and confirmed that there was correlation between XPi2 and KRAS, which led to the development of colorectal cancer, one of digestive cancers.
Areia, Miguel Laranjeira Rodrigues de. "Research on the cost-effectiveness of upper digestive endoscopy for the diagnostic of early gastric cancer." Doctoral thesis, 2014. https://repositorio-aberto.up.pt/handle/10216/77163.
Full textAreia, Miguel Laranjeira Rodrigues de. "Research on the cost-effectiveness of upper digestive endoscopy for the diagnostic of early gastric cancer." Tese, 2014. https://repositorio-aberto.up.pt/handle/10216/77163.
Full textChen, Chi-Cheng, and 陳至正. "The Role of Androgen Receptor in Upper Urinary Tract Urothelial Cancer and Target for Treatment." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/gv2e93.
Full textHung, Yun-Ju, and 洪韻如. "Effects of Substance Use and Alcohol Metabolizing Genes on Second Primary Cancer of Upper Aerodigestive Tract." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/47369317865138597077.
Full text高雄醫學大學
公共衛生學研究所
101
Background: The medical technique is in advance in recent years, but it does not improve the survival rate of the patients with upper aerodigestive tract cancer. The main reason is the occurrence of second primary cancer. Purpose: The aim of the present study was to explore the effect of substance use and alcohol metabolizing genes on the incidence and diagnostic age of second primary cancer of upper aerodigestive tract. Furthermore, we analyzed the association between second primary cancer of upper aerodigestive tract and death. Material and methods: This was a concurrent cohort study. 399 patients with upper aerodigestive tract cancer were recruited in Kaohsiung Medical University Chung-Ho Memorial Hospital from June, 1992 to April, 2011. When the patients were diagnosed as first primary cancer of upper aerodigestive tract, we collected their blood samples, consulted their clinical medical records, and interviewed them with questionnaire. And then the patients were followed up to ascertain the occurrence of second primary cancer of upper aerodigestive tract and the occurrence of death. Results: 59 out of the 399 recruited patients suffered from second primary cancer of upper aerodigestive tract when the study ended. The incidence risk of metachronous second primary cancer in betel-quid lifetime exposure ≧800 quid-year chewers was 3.8 (95% C.I. of aHR: 1.1-13.3) times higher than in non-chewers. The incidence risk of second primary cancer of oral cavity in betel-quid starting age <20 years chewers, in betel-quid daily quantity ≧30 quid/day chewers, and in betel-quid lifetime exposure ≧800 quid-year chewers were respectively 5.4 (95% C.I. of aHR: 1.2-24.6), 4.4 (95% C.I. of aHR: 1.0-18.9), and 5.4 (95% C.I. of aHR: 1.3-22.7) times higher than in non-chewers. In addition, the early-onset risk of metachronous second primary cancer and second primary cancer of oral cavity were respectively 4.9 (95% C.I. of aHR: 1.3-19.4) and 10.5 times (95% C.I. of aHR: 1.0-111.9) higher in betel-quid starting age <20 years chewers than in non-chewers. The incidence risk of synchronous second primary cancer, second primary cancer of pharynx, and second primary cancer of esophagus were respectively 33.1 (95% C.I. of aHR: 2.0-536.2), 41.3 (95% C.I. of aHR: 1.8-927.2), 10.7 (95% C.I. of aHR: 1.1-100.9) times higher in alcohol drinkers with ADH1B G/G genotype and ALDH2 A/A+A/G genotype than in non-drinkers. Patients with second primary cancer of upper aerodigestive tract experienced a 4.5-fold (95% C.I. of aHR: 2.4-8.3) higher death risk than those who did not suffer from second primary cancer of upper aerodigestive tract. Conclusions: We found that betel-quid consumption characteristics were associated with the incidence and diagnostic age of second primary cancer of oral cavity, and that alcohol drinkers with ADH1B G/G genotype and ALDH2 A/A+A/G genotype had the higher incidence risk of second primary cancer of pharynx and esophagus. Moreover, people who were attacked by second primary cancer of upper aerodigestive tract had higher death risk than those without second primary cancer of upper aerodigestive tract.
Feijó, Diogo Alves Ribeiro. "O Papel das Próteses Endoscópicas no Tratamento das Deiscências do Trato Digestivo Superior." Master's thesis, 2020. http://hdl.handle.net/10316/97663.
Full textIntrodução: A deiscência anastomótica do trato digestivo superior é uma complicação cirúrgica severa que frequentemente acarreta elevadas taxas de mortalidade. A colocação de próteses metálicas endoscópicas tem constituído, nos últimos anos, uma alternativa à terapêutica cirúrgica, mas a sua eficácia não é ainda verdadeiramente conhecida. O presente estudo pretende avaliar a taxa de sucesso e segurança das próteses endoscópicas no encerramento das deiscências pós-cirúrgicas do trato digestivo superior, bem como os fatores preditivos de sucesso associados.Métodos: Foram analisados retrospetivamente vinte e dois doentes com deiscência ou fístula anastomótica após cirurgias do trato digestivo superior submetidos a tratamento endoscópico com colocação de prótese no Serviço de Gastrenterologia do CHUC, entre 2014 e 2019. Foi considerado sucesso terapêutico quando o encerramento completo da deiscência/fístula foi conseguido e insucesso no caso de não encerramento.Resultados: Da amostra, 59,1% eram mulheres e a idade média foi 57,1 ± 13,5 anos. A eficácia técnica deste estudo foi de 100% e a taxa de sucesso terapêutico (eficácia clínica) foi de 59,1% (13/22). A taxa de sucesso foi superior em indivíduos com menos comorbilidades (p=0,393) e com idade inferior a 61,5 anos (p=0,026), bem como em doentes com um orifício de deiscência inferior a 10 mm (p=0,143). A prótese bariátrica teve a maior taxa de sucesso de entre todas as próteses (85,7%), seguida da prótese totalmente coberta (75,0%) e da parcialmente coberta (36,4%) (p=0,113). A necessidade de colocação de 2ª prótese (58,3%) (p=0,099) e um número superior de próteses por doente (2,4 ± 0,9) (p=0,014) foram mais frequentes no grupo com insucesso terapêutico. O departamento de endoscopia esteve associado a maior taxa de sucesso (80,0%), seguido do serviço de medicina intensiva (25,0%) e do bloco operatório (0%) (p=0,07). A taxa de mortalidade global foi de 18,2% (4/22). Conclusão: O tratamento endoscópico das deiscências pós-cirúrgicas do trato digestivo superior é uma abordagem eficaz e segura, sobretudo em doentes jovens e com poucas comorbilidades. A dimensão do orifício de deiscência parece ser um fator importante para o encerramento. O diagnóstico e a colocação de prótese de forma precoce, bem como a dimensão do orifício de deiscência, aparentam ser os fatores mais importantes no sucesso da terapêutica endoscópica desta patologia.
Background: Anastomotic dehiscence of the upper digestive tract is a severe surgical complication that often leads to high mortality rates. The placement of metallic stents has been an alternative to surgical therapy in recent years, but its true efficacy is not yet known. The present study intends to evaluate the success rate and safety of metallic stents in the closure of upper digestive tract dehiscences, as well as the associated predictive success factors.Methods: We present a retrospective analysis of twenty-two patients who suffered from anastomotic dehiscence or fistula after surgery of the upper digestive tract and undergone endoscopic treatment with metallic stent placement at CHUC Gastroenterology Department between 2014 and 2019. It was considered therapeutic success when the complete closure of dehiscence / fistula was achieved and failure in case of non-closure.Results: 59.1% were women and the average age was 57.1 ± 13.5 years. The technical efficacy of this study was 100% and the therapeutic success rate (clinical efficacy) was 59.1% (13/22). The success rate was higher in individuals with less comorbidities (p=0.393) and under 61.5 years of age (p=0.026), as well as in patients with a dehiscence size of less than 10 mm (p=0.143). The bariatric stents had the highest success rate of all stents (85.7%), followed by the fully covered stents (75.0%) and the partially covered stents (36.4%) (p = 0.113). The need for placing a second stent (58.3%) (p=0.099) and a higher number of stents per patient (2.4 ± 0.9) (p=0.014) were more frequent in the group with therapeutic failure. The endoscopy department was associated with a higher success rate (80.0%), followed by the intensive care unit (25.0%) and the operating room (0%) (p=0.07). The overall mortality rate was 18.2% (4/22).Conclusion: The endoscopic treatment of post-surgical dehiscences of the upper digestive tract is an effective and safe approach, especially in younger patients with few comorbidities. The size of the dehiscence appears to be an important factor affecting its closure. Early diagnosis and placement of the stent, as well as the size of the dehiscence, appear to be the most important factors in the success of endoscopic therapy for this pathology.
Wang, Li-Jen, and 王俐人. "Validation study of ICD code of cancer registry database for primary upper urinary tract urothelial invasive carcinomas in a medical center and patients’survival analysis." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/8sz589.
Full text國立臺灣大學
公共衛生碩士學位學程
105
Objectives 1. To validate the diagnosis of ICD codes for primary upper urinary tract urothelial invasive carcinomas (UTUC) of cancer registry database of Linkou Chang Gung Memorial Hospital 2. To analyze survival of validated primary UTUC patients and its predictive factors Methods Primary UTUC records in cancer registry database of Linkou Chang Gung Memorial from 1997 to 2011 were obtained after institutional review board approval. The medical chart of each patient was reviewed for validation for primary UTUC of ICD codes in cancer registry database. Demographic features and tumor characteristics were recorded for validated primary UTUC patients. Multivariate analyses using Cox proportional hazard model was performed for predictive factors of survival for primary UTUC patients. Results There are 1170 primary UTUC patients in cancer registry database of Linkou Chang Gung Memorial Hospital from 1997 to 2011 who have sufficient information in medical records for validation. Of the 1170 patients, 1132 patients have been validated as having primary UTUC, and the positive predictive value of this cancer registry database for primary UTUC is 96.8 %. There are 38 patients with false positive diagnoses of primary UTUC, including 16 patients of lower urinary tract urothelial carcinomas (UC), 2 patients of upper urinary tract carcinoma in situ, 2 patients of ureteral stump cancer, 3 patients of UC with unclear location, and 15 patients of urinary tract diseases other than UC. Multivariate analyses of overall survival of validated primary UTUC patients show older age group at diagnosis, male, synchronous UC in the renal pelvis and ureter, no surgery, stage grouping as regional or distant cancer are significant factors for death due to all causes. Multivariate analyses of cancer specific survival of validated primary UTUC patients show older age group at diagnosis, male, cancer diagnosed at 2004-2011, no surgery, and stage grouping as regional or distant cancer are significant predictors for death due to UC. Conclusion Cancer registry database of Linkou Chang Gung Memorial Hospital is an accurate secondary database for primary UTUC by its high positive predictive value. In order to decrease false positive diagnosis in cancer registry database for primary UTUC, other urinary tract diseases other than UC should be validated for their diagnoses and UC should be checked for whether it is primary or recurrent, located at upper or lower urinary tract and for carcinoma in situ or invasive carcinoma. For UTUC patients of females, staging grouping as localized or regional cancer, and younger age group at diagnoses, they should undergo surgery and a high probability for survival could be thereafter expected.
Li, Jian-Ri, and 李建儀. "Expression of Hyaluronic Acid Synthase-1 Related Signal Transduction Molecules Correlate Cancer Local Recurrence and Distant Metastases in Upper Urinary Tract Transitional Cell Carcinoma." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/95601099160945869089.
Full text國立中興大學
醫學科技研究所
97
Background & Aims: Hyaluronic acid synthase type 1(HAS-1) was considered a key enzyme in the tumor proliferation and migration. We investigate the potential association between HAS-1 and clinical tumor grade, stage, chemotherapy response, tumor metastases and local recurrence. The molecular biologic cancer proliferation and migration pathway through HAS-1 was also studied. Methods: From January 2008 to March 2009, a total 32 patients who have urothelial carcinoma and received nephroureterectomy or cystectomy were enrolled. We analyzed the HAS-1 and CD44 mRNA expression of the tumor samples using the polymerase chain reaction (PCR). The clinical stage, tumor grading, angiolymphatic invasion, existence of carcinoma in situ, development of distant metastases or local recurrence were collected. We also selected urothelial carcinoma cell lines T24, TSGH, TCCSUP, RT4, 5637, J82 to investigate the correlation between cell proliferation, migration and HAS-1 expression. The possible pathway of cell proliferation through HAS-1 was studied. Results: HAS-1 mRNA PCR showed overexpression in high grade and high clinical stage tissue samples. Recurrence developed in those whose tumor tissue HAS-1 overexpression without adjuvant chemotherapy. CD44 mRNA did not showed overexpression among these tissues. In the cell line study, HAS-1 overexpression was not found. CD44 and VEGF overexpression were observed in T24 and J82 cell line and the the cell motility were also better in these two cell lines. Conclusions: HAS-1 expression combined with clinical pathological stage could offer better decision making in the adjuvant chemotherapy. Downstream CD44 and related markers need more data to support the signal transduction pathway. In cell line studies, the bladder cancer proliferation and migration pathway may correlate with the hypothetic key factor, CD44. T24 and J82 cell lines showed much more malignant behavior and were suitable for further studies.