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| 1 | Complications of radiofrequency ablation of hepatic tumors:Frequency and risk factors显示文摘Radiofrequency ablation(RFA)has become an important option in the therapy of primary and secondary hepatic tumors.Surgical resection is still the best treatment option,but only a few of these patients are candidates for surgery:multilobar disease,insufficient liver reserve that will lead to liver failure after resection,extra-hepatic disease,proximity to major bile ducts and vessels,and co-morbidities.RFA has a low mortality and morbidity rate and is considered to be safe.Thus,complications occur and vary widely in the literature.Complications are caused by thermal damage,direct needle injury,infection and the patient’s co-morbidities.Tumor type,type of approach,number of lesions,tumor localization,underlying hepatic disease,the physician’s experience,associated hepatic resection and lesion size have been described as factors significantly associated with complications.The physician in charge should promptly recognize high-risk patients more susceptible to complications,perform a close post procedure follow-up and manage them early and adequately if they occur.We aim to describe complications from RFA of hepatic tumors and their risk factors,as well as a few techniques to avoid them.This way,others can decrease their morbidity rates with better outcomes. | Alexandre Zanchenko Fonseca Stephanie Santin Luiz Guilherme Lisboa Gomes Jaques Waisberg Marcelo Augusto Fontenelle Ribeiro Jr. | 2014 | World Journal of Hepatology2014，6，3： | 24 |
| 2 | Liver-first approach of colorectal cancer with synchronous hepatic metastases: A reverse strategy显示文摘Recently, there has been a change in the strategy of how synchronous colorectal hepatic metastases are attributed to the development of more valuable protocols of chemotherapy and radiotherapy for neoadjuvant treatment of colorectal neoplasms and their hepatic metastases. There is a consensus that patients with synchronous colorectal hepatic metastases have lower survival than those with metachronous colorectal hepatic metastases. Currently, controversy remains concerning the best approach is sequence in a patient with colorectal cancer and synchronous hepatic metastases resection. To obtain a better patient selection, the authors have suggested the initial realization of systemic chemotherapy in the circumstance of patients with colorectal tumor stage Ⅳ, since these patients have a systemic disease. The rationale behind this liver-first strategy is initially the control of synchronous hepatic metastases of colorectal carcinoma, which can optimize a potentially curative hepatic resection and longstanding survival. The liver-first strategy procedure is indicated for patients with colorectal hepatic metastases who require downstaging therapy to make a curative liver resection possible. Thus, the liver-first strategy is considered an option in cases of rectal carcinoma in the early stage and with limited or advanced synchronous colorectal hepatic metastases or in case of patients with asymptomatic colorectal carcinoma, but with extensive liver metastases. Patients undergoing systemic chemotherapy and with progression of neoplastic disease should not undergo hepatic resection, because it does not change the prognosis and may even make it worse. To date, there have been no randomized controlled trials on surgical approach of colorectal synchronous hepatic metastases, despite the relatively high number of available manuscripts on this subject. All of these published studies are observational, usually retrospective, and often non-comparative. The patient selection criteria for the liver-first strategy should be individualized, and the approach of these patients should be performed by a multidisciplinary team so its benefits will be fully realized. | Jaques Waisberg Ivan Gregorio Ivankovics | 2015 | World Journal of Hepatology2015，7，11： | 15 |
| 3 | Wnt-/-β-catenin pathway signaling in human hepatocellular carcinoma显示文摘The molecular basis of the carcinogenesis of hepatocellular carcinoma(HCC) has not been adequately clarified, which negatively impacts the development of targeted therapy protocols for this overwhelming neoplasia. The aberrant activation of signaling in the HCC is primarily due to the deregulated expression of the components of the Wnt-/-β-catenin. This leads to the activation of β-catenin/T-cell factor-dependent target genes that control cell proliferation, cell cycle, apoptosis, and cell motility. The deregulation of the Wnt pathway is an early event in hepatocarcinogenesis. An aggressive phenotype was associated with HCC, since this pathway is implicated in the proliferation, migration, and invasiveness of cancer cells, regarding the cell's own survival. The disruption of the signaling cascade Wnt-/-β-catenin has shown anticancer properties in HCC's clinical evaluations of therapeutic molecules targeted for blocking the Wnt signaling pathway for the treatment of HCC, and it represents a promising perspective. The key to bringing this strategy in to clinical practice is to identify new molecules that would be effective only in tumor cells with aberrant signaling β-catenin. | Jaques Waisberg Gabriela Tognini Saba | 2015 | World Journal of Hepatology2015，7，26： | 9 |
| 4 | Biliary carcinoembryonic antigen levels in diagnosis of occult hepatic metastases from colorectal carcinoma显示文摘AIM: To prospectively explore the role of carcinoembryonic antigen (CEA) in gallbladder bile in patients with colorectal carcinoma and the morphological and clinical features of neoplasia and the occurrence of hepatic metastases.METHODS: CEA levels in the gallbladder and peripheral blood were studied in 44 patients with colorectal carcinoma and 10 patients with uncomplicated cholelithiasis. CEA samples were collected from the gallbladder bile and peripheral blood during the operation, immediately before extirpating the colorectal neoplasia or cholecystectomy.Values of up to 5 ng/ml were considered normal for bile and serum CEA.RESULTS: In the 44 patients with colorectal carcinoma who underwent operation with curative intent, the average level of serum CEA was 8.5 ng/ml (range: 0.1 to 111.0 ng/ml) and for bile CEA it was 74.5 ng/ml (range: 0.2 to 571.0ng/ml). In the patients with uncomplicated cholelithiasis who underwent cholecystectomy, the average level of serum CEA was 1.9 ng/ml (range: 1.0 to 3.5 ng/ml) and for bile CEA it was 1.2 ng/ml (range: 0.3 to 2.9 ng/ml).The average duration of follow-up time was 16.5 months (range: 6 to 48 months). Four patients who underwent extirpation of the colorectal carcinoma without evidence of hepatic metastasis and with an average bile CEA value of 213.2 ng/ml presented hepatic metastases between three and seventeen months after removal of the primary colorectal neoplasia. Three of them successfully underwent extirpation of the hepatic lesions.CONCLUSION: High CEA levels in gallbladders of patients undergoing curative operation for colorectal carcinoma may indicate the presence of hepatic metastases. Such patients must be followed up with special attention to the diagnosis of such lesions. | Jaques Waisberg Rogério T.Palma Luís Contim Neto Lourdes C.Martins Maurício S.L.Oliveira Carlos A. Nagashima Antonio C.Godoy Fabio S.Goffi | 2003 | World Journal of Gastroenterology2003，9，7： | 5 |
| 5 | Prognostic significance of vascular endothelial growth factor polymorphisms in colorectal cancer patients显示文摘AIM To investigate the associations of the genetic polymor-phisms of vascular endothelial growth factor A(VEGF-A)-1498C>T and-634G>C, with the survival of patients with colorectal cancer(CRC). METHODS A prospective cohort consisting of 131 Brazilians patients consecutively operated on with a curative intention as a result of sporadic colorectal carcinoma was studied. DNA was extracted from peripheral blood and its amplification and allelic discrimination for each genetic polymorphism was performed using the technique of polymerase chain reaction(PCR) in real-time. The real-time PCR technique was used to identify the VEGF-A-1498C>T(rs833031) and-634G>C(rs2010963) polymorphisms. Genotyping was validated for VEGF-A-1498C>T polymorphism in 129 patients and for VEGF-A-634G>C polymorphism in 118 patients. The analysis of association between categorical variables was performed using logistic regression, survival by Kaplan-Meier method and multivariate analysis by the Cox regression method. RESULTS In the univariate analysis there was a significant association(OR = 0.32; P = 0.048) between genotype CC of the VEGF-A-1498C>T polymorphism and the presence of CRC liver metastasis. There was no association between VEGF-A-1498C>T polymorphism and VEGF-A-634G>C polymorphism with further clinical or anatomopathologic variables. The genotype CC of the VEGF-A-1498C>T polymorphism was significantly correlated with the 5-year survival(P = 0.032), but not significant difference(P = 0.27) was obtained with the VEGF-A-634G>C polymorphism with the 5-year survival in the univariate analysis. The genotype CT(HR = 2.79) and CC(HR = 4.67) of the polymorphism VEGF-A-1498C>T and the genotype CC(HR = 3.76) of the polymorphism VEGF-A-634C>G acted as an independent prognostic factor for the risk of death in CRC patients. CONCLUSION The CT and CC genotypes of the VEGF-A-1498C>T and the CC genotype of the VEGF-A-634C>G polymorphisms are prognostic factors of survival in Brazilians patients with sporadic colorectal carcinoma. | Gilmar Ferreira do Espírito Santo Bianca Borsatto Galera Elisabeth Carmen Duarte Elisabeth Suchi Chen Lenuce Azis Amilcar Sabino Damazo Gabriela Tognini Saba Flávia de Sousa Gehrke Ismael Dale Cotrim Guerreiro da Silva Jaques Waisberg | 2017 | World Journal of Gastrointestinal Oncology2017，9，2： | 4 |
| 6 | Detection of anti-Helicobacter pyloriantibodies in serum and duodenal fluid in peptic gastroduodenal disease显示文摘AIM: To study the diagnosis of He/icobacterpy/ori(H pylori) infection through the determination of serum levels of anti-H pylori IgG and IgA antibodies, and the levels of anti- H pylori IgA antibodies in duodenal fluid. METHODS: Data were collected from 93 patients submitted to upper digestive endoscopy due to dyspeptic symptoms. The patients were either negative (group A) or positive (group B) to Hpyloriby means of both histological detection and urease tests. Before endoscopy, peripheral blood was collected for the investigation of anti-H pylori IgG and IgA antibodies. To perform the urease test, biopsies were obtained from the gastric antrum. For the histological evaluation, biopsies were collected from the gastric antrum (greater and lesser curvatures) and the gastric body. Following this, duodenal fluid was collected from the first and second portions of the duodenum. For the serological assaying of anti-Hpy/oriIgG and IgA, and anti-Hpy/oriIgA in duodenal fluids, the ELISA method was utilized. RESULTS: The concentration of serum IgG showed sensitivity of 64.0%, specificity of 83.7%, positive predictive value of 82.0%, negative predictive value of 66.6% and accuracy of 73.1% for the diagnosis of H pyloriinfection. For the same purpose, serum IgA showed sensitivity of 72.0%, specificity of 65.9%, positive predictive value of 72.0%, negative predictive value of 67.4% and accuracy of 69.8%. If the serological tests were considered together, i.e. when both were positive or negative, the accuracy was 80.0%, sensitivity was 86.6%, specificity was 74.2%, positive predictive value was 74.2% and negative predictive value was 86.6%. When values obtained in the test for detecting IgA in the duodenal fluid were analyzed, no significant difference (P=0.43) was observed between the values obtained from patients with or without Hpyloriinfection. CONCLUSION: The results of serum IgG and IgA tests for H pylori detection when used simultaneously, are more efficient in accuracy, sensitivity and negative predictive value, than those when used alone. The concentration of IgA antibodies in duodenal fluid is not useful in identifying patients with or without H pylori. | Angelo Locateili Wilson Roberto Catapani Claudio Rufino Gomes Junior Claudilene Battistin Paula Silva Jaques Waisberg | 2004 | World Journal of Gastroenterology2004，10，20： | 3 |
| 7 | Esophagogastric anastomosis with invagination into stomach:New technique to reduce fistula formation显示文摘AIM: To present a new technique of cervical esophagogastric anastomosis to reduce the frequency of fistula formation. METHODS: A group of 31 patients with thoracic and abdominal esophageal cancer underwent cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube. In the region elected for anastomosis, a transverse myotomy of the esophagus was carried out around the entire circumference of the esophagus. Afterwards, a 4-cm long segment of esophagus was invaginated into the stomach and anastomosed to the anterior and the posterior walls. RESULTS: Postoperative minor complications occurred in 22 (70.9%) patients. Four (12.9%) patients had serious complications that led to death. The discharge of saliva was at a lower region, while attempting to leave the anastomosis site out of the alimentary transit. Three (9.7%) patients had fistula at the esophagogastric anastomosis, with minimal leakage of air or saliva and with mild clinical repercussions. No patients had esophago- gastric fistula with intense saliva leakage from either the cervical incision or the thoracic drain. Fibrotic stenosis of anastomoses occurred in seven (22.6%) patients. All these patients obtained relief from their dysphagia with endoscopic dilatation of the anastomosis.CONCLUSION: Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula with mild clinical repercussions. | Alexandre Cruz Henriques Carlos Alberto Godinho Roberto Saad Jr Daniel Reis Waisberg Aline Biral Zanon Manlio Basilio Speranzini Jaques Waisberg | 2010 | World Journal of Gastroenterology2010，16，45： | 2 |
| 8 | Neuroendocrine gastric carcino- ma expressing somatostain: a highly malignant, rare tumor 显示文摘 | Waisberg J de Matos LL Pezzolo S | 2006 | World J Gastroentero12006，12，24： | 1 |
| 9 | Molecular andcellular mechanisms of cadmium carcinogenesis显示文摘 | Waisberg M Joseph P Hale | 2003 | Toxicology2003，192，23： | 1 |
| 10 | Molecular and cellularmechanims of cadmium carcinogenesis显示文摘 | WAISBERG M JOSEPH P HALE B | 2003 | Toxicology2003，192，23： | 1 |
| 11 | Molecular and cellular mecha-nisms of cadmium carcinogenesis显示文摘 | WAISBERG M JOSEPH P HALE B | 2003 | Toxicology2003，192，23： | 1 |
| 12 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | WAISBERG M JOSEPH P HALE B | 2003 | Toxicology2003，5，192： | 1 |
| 13 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | Waisberg M Joseph P Hale B | 2003 | Toxicology2003，192，23： | 1 |
| 14 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | WAISBERG M JOSEPH P HALE B | 2003 | Toxicology2003，192，1： | 1 |
| 15 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | Waisberg M Joseph P Hale B | 2003 | Toxicology2003，192，： | 1 |
| 16 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | Waisberg M Joseph P Hale B | 2003 | Toxicology2003，192，23： | 1 |
| 17 | The role of surgery in the treatment of primary gastric lymphoma显示文摘 | Waisberg J Bromberg S H Franco M I F | 2000 | Int Surg2000，85，： | 1 |
| 18 | Molecular and cellular mechanisms of cadmium carcinogenesis显示文摘 | Waisberg M Joseph P Hale B 2003 | 2003 | Toxicol2003，192，23： | 1 |
| 19 | Molecular andcellular mechanisms of cadmium carcinogenesis显示文摘 | WAISBERG M JOSEPH P HALE B | 2003 | Toxicology2003，192，23： | 1 |
| 20 | Infectious endocarditis from Streptococcus bovis associated with colonic carcinoma:Case report and literature review显示文摘 | Waisberg J Matheus C O Pimenta J | 2002 | Arquivos de Gastroenterologia2002，39，3： | 1 |
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