Neoplasms

Digestive System Diseases

Gland and Hormone Related Diseases

All Conditions

Rare Diseases

Pancreatic Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Endocrine Gland Neoplasms

Gastrointestinal Diseases

Pancreatic Diseases

Endocrine System Diseases

Pancreatic Cancer

pathologically confirmed pancreatic cancer patients

people without no neoplastic lesions and other organic diseases

The pancreatic cancer cohort and the healthy cancer-free patient cohort were divided according to pathology reports

Pathological

Lu Y Yuhua, phd

Chen Q QiYang, master

Lu Yuhua, phd

Chen Qiyang, master

Chen Q Qiyang, master

Background ： Pancreatic cancer is the most malignant tumor in the digestive system, with low level of early diagnosis and poor prognosis. There is a lack of high sensitive and specific molecular markers in the diagnosis, treatment and prognosis of pancreatic cancer.

Objective： To explore the expression of IGHD in pancreatic cancer and its correlation with clinical parameters, and to explore its prognostic value in patients with pancreatic cancer.

Methods： In this study, qRT-PCR was used to detect IGHD expression in peripheral blood. The expression of IGHD in pancreatic cancer and healthy individuals was compared. The PCR results were combined with clinical data of patients. To compare the expression of IGHD in different pancreatic cancer stages and evaluate whether IGHD expression in peripheral blood can be a potential biomarker for the diagnosis of pancreatic cancer, chi-square test was used to analyze the factors influencing the expression level of IGHD. Kaplan-Meier was used to analyze patient prognosis, and further Cox regression analysis was used to analyze the factors influencing patient prognosis and independent risk factors.

Methods：The expressions of IGHD in peripheral blood of about 30 patients with pancreatic cancer and more than 30 healthy controls were detected by qRT-PCR, and the differences of IGHD were analyzed.The expression of IGHD in pancreatic cancer and healthy individuals was compared. The PCR results were combined with clinical data of patients. To compare the expression of IGHD in different pancreatic cancer stages and evaluate whether IGHD expression in peripheral blood can be a potential biomarker for the diagnosis of pancreatic cancer, chi-square test was used to analyze the factors influencing the expression level of IGHD. Kaplan-Meier was used to analyze patient prognosis, and further Cox regression analysis was used to analyze the factors influencing patient prognosis and independent risk factors.

Pancreatic cancer is a disease of digestive system with a high degree of malignancy. The level of early diagnosis and therapeutic effect are limited by the research status of pancreatic adenocarcinoma. Conventional CT, MRI and other methods have a limited level of early diagnosis of pancreatic cancer, and EUS and endoscope-guided needle biopsy are in the stage of clinical trials. Studies on novel markers involve protein, miRNA, exosome, methylation, protein and genomics, but there is no mature and practical diagnostic method. Based on the current diagnosis, treatment and prognosis level of pancreatic cancer, I made a bold attempt to study the expression of IGHD in pancreatic cancer and their relationship with clinical parameters and prognosis level, so as to screen molecular markers conducive to diagnosis, treatment and prognosis of pancreatic cancer and provide data support for improving the diagnosis and treatment level of pancreatic cancer.

Peripheral blood from pancreatic cancer patients and healthy cancer-free patients

Expression and Clinical Significance of IGHD in Pancreatic Cancer

IGHD was highly expressed in pancreatic cancer patients , but low in the healthy cancer-free patients.

Patients with high expression of IGHD had lower prognosis. High expression of IGHD, T stage (T3T4), lymphatic metastasis and distant metastasis are independent risk factors for poor prognosis in patients with pancreatic cancer.

Expression level of IGHD in peripheral blood cells is a potential biomarker for the diagnosis of pancreatic cancer

Affiliated Hospital of Nantong University

Colonic Neoplasms

Colorectal Neoplasms

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Herbal and Botanical

All Drugs and Chemicals

Cola

All patients with operable colon cancer who will undergo laparoscopic conventional colectomy

All patients with operable colon cancer who will undergo laparoscopic complete mesocolic excision

Laparoscopic colectomy with only lymph node dissection up to level 2 lymph nodes D2.

laparoscopic conventional colectomy

Laparoscopic colectomy with lymphovascular dissection from level 3 lymph nodes or more D3.

laparoscopic complete mesocolic excision

Ahmed E Ahmed, Professor

Mena Z Helmy, Ass prof.

Mostafa F Mohammed, Ass lecturer

The investigators will assess and compare Surgical, pathological and oncological outcomes between two laparoscopic procedures conventional colectomy versus complete mesocolic excision for operable colon cancer cases in Upper Egypt

Colon cancer is considered a huge clinical surgical burden accounting for 10% of cancer cases and deaths all over the world with consideration that surgery and adjuvant chemotherapy(if indicated) are the main lines of treatment .

When Werner Hohenberger and colleagues described complete mesocolic excision (CME) in 2009; resection along the embryological and lymphovascular planes with appropriate resection margins, they did it for years before describing it with suggestion of improved disease outcomes and overall survival compared to the conventional colectomy (CC).

The principles of CME were described after the significant improvement of rectal adenocarcinoma surgical outcomes with establishment of total mesorectal excision (TME) in which tumor resection is associated with dissection of mesorectal fascial embryologic and lymphovascular planes.

CME includes the same principles of the CC with maximizing lymph node dissection level into (D3 extended lymphadenectomy instead of D1 and D2 in conventional colectomy) and central vascular ligation (CVL) of the main feeding vessel(s) at their origin, with suggested improved disease-free and overall survival with suggested superior pathological and oncological results in the specimen.

Some surgeons consider that CME; with D3 extended lymphadenectomy and CVL is the optimal or standard surgical method in primary cancer colon based on suggested reduced local recurrence and improved disease-free and overall survival.

Although CME has a theoretical advantages and promising early results, it is not widely adopted as the standard in some areas. CME is technically more demanding than CC and suggested to be associated with more intraoperative visceral injuries and non-surgical complications and many doubts persist about safety and efficacy of the procedure.

The questions of interest and research, should CME be regarded as the optimal procedure for colon cancer cases? And also another question; is conventional colectomy suboptimal?

Comparison Between Results of 2 Laparoscopic Surgical Procedures in Operable Colon Cancer Cases in Upper Egypt

Surgical, Pathological and Oncological Outcomes of Laparoscopic Conventional Colectomy Versus Complete Mesocolic Excision for Operable Colon Cancer Cases in Upper Egypt

It is not yet known if there will be a plan to make IPD available.

Histopathological examination of the resected colon with lymph node status and number

Amount in cubic cm and nature of it with its management

Yes/No with Reporting the postoperative complications; according to the Clavien-Dindo Grading System

Reporting operative time with measurements in minutes

Yes/No with measurement in Cubic Cm and how managed

According to primary tumor, regional nodes, metastasis (TNM) staging system

Reporting Yes/No with amount in cm3 and management

Carcinoembryonic antigen (CEA) level by ng/mL

Type of anastomosis (intra- or extracorporeal)

cecum, appendix, ascending colon, hepatic flexure or at splenic flexure, transverse and descending colon and sigmoid colon

Yes/No Cardiopulmonary complications type and how managed

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Expression and Clinical Significance of IGHD in Pancreatic Cancer	NCT05327400	Gene Expression	Pathological	18 Years - 80 Years	Affiliated Hospital of Nantong University
Comparison Between Results of 2 Laparoscopic Surgical Procedures in Operable Colon Cancer Cases in Upper Egypt	NCT05421702	Colon Cancer St... Colon Cancer St...	laparoscopic co... laparoscopic co...	-	Sohag University

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