99 research outputs found
Les Anomalies en Endoscopies Digestives Hautes Ă Bangui
La pathologie digestive haute est riche et variĂ©e. Les signes fonctionnels digestifs constituent les motifs frĂ©quents de consultation tant en mĂ©decine gĂ©nĂ©rale quâen gastro-entĂ©rologie. Lâendoscopie constitue lâexamen de rĂ©fĂ©rence pour le diagnostic et dans certains cas pour le traitement des pathologies digestives. Nous voulons dĂ©terminer les anomalies rencontrĂ©es en fibroscopie haute Ă Bangui. MĂ©thodologie : Il sâagissait dâune Ă©tude transversale dâune durĂ©e de deux ans incluant les patients des deux sexes ayant rĂ©alisĂ© lâendoscopie digestive haute (EDH) dont le compte rendu Ă©tait complet.
RĂ©sultats : Au total 1233 anomalies ĆsogastroduodĂ©nales ont Ă©tĂ© observĂ©es. Les anomalies les plus frĂ©quentes Ă©taient lâincontinence cardiale (467 cas soit 37,88%) et les anomalies inflammatoires (443 cas soit 35,93%). Six cas de cancer (0,61%) Ă©taient observĂ©s au niveau gastrique.
Les lĂ©sions Ă©taient observĂ©es dans lâestomac dans 980 cas (79,48%), Ćsophage dans 196 cas (15,9%). Les lĂ©sions duodĂ©nales Ă©taient observĂ©es dans 57 cas (4,62%). Les anomalies gastriques Ă©taient dominĂ©es par les gastrites dans 417 cas (42,55%) alors que les lĂ©sions Ćsophagiennes et duodĂ©nales Ă©taient dominĂ©es respectivement par les varices Ćsophagiennes dans 139 cas (70,92%) et les ulcĂšres dans 55 cas (96,49%).
Conclusion : La pathologie digestive haute est frĂ©quente Ă Bangui. Les anomalies endoscopiques sont multiples dont les frĂ©quentes sont les varices Ćsophagiennes et lâincontinence cardiale. Lâextension de lâendoscopie dans les autres formations sanitaires sera bĂ©nĂ©fique pour lâamĂ©lioration de la prise en charge des patients
Introduction: The upper digestive pathology is rich and varied. Digestive functional signs are frequent reasons for consultation in both general medicine and gastroenterology. Endoscopy is the reference examination for the diagnosis and in some cases for the treatment of digestive pathologies. We want to determine the anomalies encountered in upper fibroscopy in Bangui. Methodology: This was a cross-sectional study lasting two years including patients of both sexes who had performed upper digestive endoscopy (EDH), the report of which was complete.
Results: A total of 1233 esogastroduodenal abnormalities were observed. The most common anomalies were cardiac incontinence (467 cases or 37.88%) and inflammatory anomalies (443 cases or 35.93%). Six cases of cancer (0.61%) were observed at the gastric level.
The lesions were observed in the stomach in 980 cases (79.48%), esophagus in 196 cases (15.9%). Duodenal lesions were observed in 57 cases (4.62%). Gastric abnormalities were dominated by gastritis in 417 cases (42.55%) while esophageal and duodenal lesions were respectively dominated by esophageal varices in 139 cases (70.92%) and ulcers in 55 cases (96.49%). %).
Conclusion: Upper digestive pathology is common in Bangui. Endoscopic abnormalities are numerous, the most common of which are esophageal varices and cardiac incontinence. The extension of endoscopy in other health facilities will be beneficial for improving patient car
Les LĂ©sions en Endoscopies Digestives Hautes Ă Bangui
Introduction: La pathologie digestive haute est riche et variĂ©e. Lâendoscopie digestive haute constitue lâexamen de rĂ©fĂ©rence pour le diagnostic des pathologies digestives. Nous voulons dĂ©terminer lâimportance des lĂ©sions rencontrĂ©es en fibroscopie digestive haute Ă Bangui RĂ©sultats: Au total 1233 lĂ©sions ĆsogastroduodĂ©nales ont Ă©tĂ© observĂ©es. Les anomalies les plus frĂ©quentes Ă©taient lâincontinence cardiale (467 cas soit 37,88%) et les anomalies inflammatoires (443 cas soit 35,93%). Six cas de cancer (0,61%) Ă©taient observĂ©s au niveau gastrique. Les lĂ©sions Ă©taient observĂ©es dans lâestomac dans 980 cas (79,48%), Ćsophage dans 196 cas (15,9%). Les lĂ©sions duodĂ©nales Ă©taient observĂ©es dans 57 cas (4,62%). Les anomalies gastriques Ă©taient dominĂ©es par les gastrites dans 417 cas (42,55%) alors que les lĂ©sions Ćsophagiennes et duodĂ©nales Ă©taient dominĂ©es respectivement par les varices Ćsophagiennes dans 139 cas (70,92%) et les ulcĂšres dans 55 cas (96,49%). Conclusion: La pathologie digestive haute est frĂ©quente Ă Bangui. Les anomalies endoscopiques sont multiples dont les frĂ©quentes sont les varices Ćsophagiennes et lâincontinence cardiale. Lâextension de lâendoscopie dans les autres formations sanitaires sera bĂ©nĂ©fique pour lâamĂ©lioration de la prise en charge des patients.
Introduction: Upper digestive pathology is rich and varied. Upper digestive endoscopy is the reference examination for the diagnosis of digestive pathologies. We want to determine the importance of the lesions encountered in upper digestive fibroscopy in Bangui. Results: A total of 1233 esogastroduodenal lesions were observed. The most common abnormalities were heart incontinence (467 cases or 37.88%) and inflammatory abnormalities (443 cases or 35.93%). Six cases of cancer (0.61%) were observed at the gastric level. Lesions were observed in the stomach in 980 cases (79.48%), esophagus in 196 cases (15.9%). Duodenal lesions were observed in 57 cases (4.62%). Gastric abnormalities were dominated by gastritis in 417 cases (42.55%) while esophageal and duodenal lesions were dominated by esophageal varices in 139 cases (70.92%) and ulcers in 55 cases (96.49%) respectively. Conclusion: Upper digestive pathology is common in Bangui. Endoscopic abnormalities are multiple, the frequent of which are esophageal varices and heart incontinence. The extension of endoscopy in other health facilities will be beneficial for the improvement of patient care
Les Anomalies en Endoscopies Digestives Hautes Ă Bangui
La pathologie digestive haute est riche et variĂ©e. Les signes fonctionnels digestifs constituent les motifs frĂ©quents de consultation tant en mĂ©decine gĂ©nĂ©rale quâen gastro-entĂ©rologie. Lâendoscopie constitue lâexamen de rĂ©fĂ©rence pour le diagnostic et dans certains cas pour le traitement des pathologies digestives. Nous voulons dĂ©terminer les anomalies rencontrĂ©es en fibroscopie haute Ă Bangui. MĂ©thodologie : Il sâagissait dâune Ă©tude transversale dâune durĂ©e de deux ans incluant les patients des deux sexes ayant rĂ©alisĂ© lâendoscopie digestive haute (EDH) dont le compte rendu Ă©tait complet.
RĂ©sultats : Au total 1233 anomalies ĆsogastroduodĂ©nales ont Ă©tĂ© observĂ©es. Les anomalies les plus frĂ©quentes Ă©taient lâincontinence cardiale (467 cas soit 37,88%) et les anomalies inflammatoires (443 cas soit 35,93%). Six cas de cancer (0,61%) Ă©taient observĂ©s au niveau gastrique.
Les lĂ©sions Ă©taient observĂ©es dans lâestomac dans 980 cas (79,48%), Ćsophage dans 196 cas (15,9%). Les lĂ©sions duodĂ©nales Ă©taient observĂ©es dans 57 cas (4,62%). Les anomalies gastriques Ă©taient dominĂ©es par les gastrites dans 417 cas (42,55%) alors que les lĂ©sions Ćsophagiennes et duodĂ©nales Ă©taient dominĂ©es respectivement par les varices Ćsophagiennes dans 139 cas (70,92%) et les ulcĂšres dans 55 cas (96,49%).
Conclusion : La pathologie digestive haute est frĂ©quente Ă Bangui. Les anomalies endoscopiques sont multiples dont les frĂ©quentes sont les varices Ćsophagiennes et lâincontinence cardiale. Lâextension de lâendoscopie dans les autres formations sanitaires sera bĂ©nĂ©fique pour lâamĂ©lioration de la prise en charge des patients
Introduction: The upper digestive pathology is rich and varied. Digestive functional signs are frequent reasons for consultation in both general medicine and gastroenterology. Endoscopy is the reference examination for the diagnosis and in some cases for the treatment of digestive pathologies. We want to determine the anomalies encountered in upper fibroscopy in Bangui. Methodology: This was a cross-sectional study lasting two years including patients of both sexes who had performed upper digestive endoscopy (EDH), the report of which was complete.
Results: A total of 1233 esogastroduodenal abnormalities were observed. The most common anomalies were cardiac incontinence (467 cases or 37.88%) and inflammatory anomalies (443 cases or 35.93%). Six cases of cancer (0.61%) were observed at the gastric level.
The lesions were observed in the stomach in 980 cases (79.48%), esophagus in 196 cases (15.9%). Duodenal lesions were observed in 57 cases (4.62%). Gastric abnormalities were dominated by gastritis in 417 cases (42.55%) while esophageal and duodenal lesions were respectively dominated by esophageal varices in 139 cases (70.92%) and ulcers in 55 cases (96.49%). %).
Conclusion: Upper digestive pathology is common in Bangui. Endoscopic abnormalities are numerous, the most common of which are esophageal varices and cardiac incontinence. The extension of endoscopy in other health facilities will be beneficial for improving patient car
Aspects Paracliniques et Ătiologiques des Ascites au CHUSC de Bangui
Introduction : lâAscite est un signe clinique trĂšs frĂ©quent en en hospitalisation dans le service dâhĂ©patogastroentĂ©rologie et de la mĂ©decine interne. Les Ă©tiologies sont nombreuses. Objectif : contribuer Ă une meilleure prise en charge de lâascite Ă Bangui. Patients et mĂ©thodes : nous avions rĂ©alisĂ© une Ă©tude transversale descriptive pendant 30 mois dans le service dâhĂ©patogastroentĂ©rologie du CHUASC (Centre Hospitalo-universitaire de lâAmitiĂ© Sino-Centrafricaine de Bangui). Les patients de deux sexes hospitalisĂ©s pour ascite chez lesquels le diagnostic Ă©tiologique Ă©tait connu. RĂ©sultats : Pendant la pĂ©riode dâĂ©tude, 1210 patients Ă©taient hospitalisĂ©s dont 204 prĂ©sentaient une ascite (16,85%), parmi lesquels 170 (14,9%) avaient rĂ©pondu Ă nos critĂšres dâinclusion. Lâascite Ă©tait pauvre en protĂ©ine (Ë 25 g/l) dans 136 cas (80%) et riche en protĂ©ine (Ë 25 g/l) dans34 cas (20%).La moyenne des Globules Blancs dans le liquide dâascite Ă©tait de 76,94 Ă©lĂ©ments blancs/mm3 avec des extrĂȘmes de 39 et 678/mm3. Le portage du VHB (virus de lâhĂ©patite B) Ă©tait plus frĂ©quent dans 67 cas (39, 40%).Le foie remaniĂ© Ă©tait plus frĂ©quent dans 108 cas (63,5%). Les Ă©tiologies de lâascite les plus frĂ©quentes Ă©taient la cirrhose dĂ©compensĂ©e dans 138 cas (81,17%), Les sujets de sexe masculin Ă©taient plus exposĂ©s Ă la cirrhose dĂ©compensĂ©e sur le mode ascitique.la carcinose pĂ©ritonĂ©ale dans 15 cas (8,8%) et la tuberculose pĂ©ritonĂ©ale dans 12 cas (7,1%). La cause plus frĂ©quente de la carcinose pĂ©ritonĂ©ale Ă©tait le Carcinome HĂ©patocellulaire dans 13 cas (7,65%). Les principaux facteurs de risque Ă©taient le Virus de lâHĂ©patite B retrouvĂ© dans 55 cas (32,5%) et la consommation dâalcool dans 130 cas (76,5%). Conclusion : les ascites sont dâĂ©tiologies cirrhotique associĂ©es au virus de lâhĂ©patite B et les hommes sont plus concernĂ©e, une politique de vaccination universelle contre le VHB est nĂ©cessaire et prometteuse.
Introduction : Ascites is a very common clinical sign in hospitalization in the hepatogastroenterology and internal medicine department. The etiologies are numerous. Objective : to contribute to better management of ascites in Bangui. Patients and methods: we carried out a descriptive cross-sectional study over 30 months in the hepatogastroenterology department of the CHUASC (Centre Hospitalo-universitaire de l'AmitiĂ© Sino-Centrafricaine de Bangui). Patients of both sexes hospitalized for ascites in whom the diagnosis etiology was known. Results: During the study period, 1210 patients were hospitalized, 204 of whom presented with ascites (16.85%), of whom 170 (14.9%) met our inclusion criteria. Ascites was low in protein (Ë 25 g/l) in 136 cases (80%) and high in protein (Ë 25 g/l) in 34 cases (20%). ascites was 76.94 white cells/mm3 with extremes of 39 and 678/mm3. HBV (hepatitis B virus) carriage was more common in 67 cases (39.40%). Liver remodeling was more common in 108 cases (63.5%). The most revealed etiologies of ascites were decompensated cirrhosis in 138 cases (81.17%), Male subjects were more exposed to decompensated cirrhosis in the ascites mode. %) and peritoneal tuberculosis in 12 cases (7.1%). The most common cause of peritoneal carcinomatosis was Hepatocellular Carcinoma in 13 cases (7.65%). The main risk factors were the Hepatitis B virus found in 55 cases (32.5%) and alcohol consumption in 130 cases (76.5%) Conclusion : ascites are of cirrhotic etiology associated with hepatitis B virus and men are more concerned, a vaccination policy against HBV is necessary and promising
Aspects Paracliniques et Ătiologiques des Ascites au CHUSC de Bangui
Introduction : lâAscite est un signe clinique trĂšs frĂ©quent en en hospitalisation dans le service dâhĂ©patogastroentĂ©rologie et de la mĂ©decine interne. Les Ă©tiologies sont nombreuses. Objectif : contribuer Ă une meilleure prise en charge de lâascite Ă Bangui. Patients et mĂ©thodes : nous avions rĂ©alisĂ© une Ă©tude transversale descriptive pendant 30 mois dans le service dâhĂ©patogastroentĂ©rologie du CHUASC (Centre Hospitalo-universitaire de lâAmitiĂ© Sino-Centrafricaine de Bangui). Les patients de deux sexes hospitalisĂ©s pour ascite chez lesquels le diagnostic Ă©tiologique Ă©tait connu. RĂ©sultats : Pendant la pĂ©riode dâĂ©tude, 1210 patients Ă©taient hospitalisĂ©s dont 204 prĂ©sentaient une ascite (16,85%), parmi lesquels 170 (14,9%) avaient rĂ©pondu Ă nos critĂšres dâinclusion. Lâascite Ă©tait pauvre en protĂ©ine (Ë 25 g/l) dans 136 cas (80%) et riche en protĂ©ine (Ë 25 g/l) dans34 cas (20%).La moyenne des Globules Blancs dans le liquide dâascite Ă©tait de 76,94 Ă©lĂ©ments blancs/mm3 avec des extrĂȘmes de 39 et 678/mm3. Le portage du VHB (virus de lâhĂ©patite B) Ă©tait plus frĂ©quent dans 67 cas (39, 40%).Le foie remaniĂ© Ă©tait plus frĂ©quent dans 108 cas (63,5%). Les Ă©tiologies de lâascite les plus frĂ©quentes Ă©taient la cirrhose dĂ©compensĂ©e dans 138 cas (81,17%), Les sujets de sexe masculin Ă©taient plus exposĂ©s Ă la cirrhose dĂ©compensĂ©e sur le mode ascitique.la carcinose pĂ©ritonĂ©ale dans 15 cas (8,8%) et la tuberculose pĂ©ritonĂ©ale dans 12 cas (7,1%). La cause plus frĂ©quente de la carcinose pĂ©ritonĂ©ale Ă©tait le Carcinome HĂ©patocellulaire dans 13 cas (7,65%). Les principaux facteurs de risque Ă©taient le Virus de lâHĂ©patite B retrouvĂ© dans 55 cas (32,5%) et la consommation dâalcool dans 130 cas (76,5%). Conclusion : les ascites sont dâĂ©tiologies cirrhotique associĂ©es au virus de lâhĂ©patite B et les hommes sont plus concernĂ©e, une politique de vaccination universelle contre le VHB est nĂ©cessaire et prometteuse.
Introduction : Ascites is a very common clinical sign in hospitalization in the hepatogastroenterology and internal medicine department. The etiologies are numerous. Objective : to contribute to better management of ascites in Bangui. Patients and methods: we carried out a descriptive cross-sectional study over 30 months in the hepatogastroenterology department of the CHUASC (Centre Hospitalo-universitaire de l'AmitiĂ© Sino-Centrafricaine de Bangui). Patients of both sexes hospitalized for ascites in whom the diagnosis etiology was known. Results: During the study period, 1210 patients were hospitalized, 204 of whom presented with ascites (16.85%), of whom 170 (14.9%) met our inclusion criteria. Ascites was low in protein (Ë 25 g/l) in 136 cases (80%) and high in protein (Ë 25 g/l) in 34 cases (20%). ascites was 76.94 white cells/mm3 with extremes of 39 and 678/mm3. HBV (hepatitis B virus) carriage was more common in 67 cases (39.40%). Liver remodeling was more common in 108 cases (63.5%). The most revealed etiologies of ascites were decompensated cirrhosis in 138 cases (81.17%), Male subjects were more exposed to decompensated cirrhosis in the ascites mode. %) and peritoneal tuberculosis in 12 cases (7.1%). The most common cause of peritoneal carcinomatosis was Hepatocellular Carcinoma in 13 cases (7.65%). The main risk factors were the Hepatitis B virus found in 55 cases (32.5%) and alcohol consumption in 130 cases (76.5%) Conclusion : ascites are of cirrhotic etiology associated with hepatitis B virus and men are more concerned, a vaccination policy against HBV is necessary and promising
Aspects ĂpidĂ©miologiques Cliniques des Ascites au CHUSC de Bangui
Introduction : lâAscite est un symptĂŽme majeur frĂ©quent dans beaucoup de pathologies digestives. Elle est la complication majeure de cirrhose dĂ©compensĂ©e. Objectif : Contribuer Ă une meilleure prise en charge de lâascite Ă Bangui. Patients et mĂ©thodes : Il sâagit dâune Ă©tude transversale descriptive dâune durĂ©e de 30 mois menĂ©e dans le service dâHĂ©pato gastroentĂ©rologie du CHUASC de Bangui. Nous avions inclus dans lâĂ©tude les patients de deux sexes hospitalisĂ©s pour ascite chez lesquels le diagnostic Ă©tiologique Ă©tait connu. RĂ©sultats : Pendant la pĂ©riode dâĂ©tude, 1210 patients Ă©taient hospitalisĂ©s dont 204 prĂ©sentaient une ascite (16,85%), parmi lesquels 170 (14,9%) avaient rĂ©pondu Ă nos critĂšres dâinclusion. On comptait 100 hommes (58,8%) et 70 femmes (41,2%). La sex-ratio Ă©tait de 1,42. LâĂąge moyen des patients Ă©tait de 46 ans. Les motifs dâhospitalisation les plus frĂ©quents Ă©taient le ballonnement abdominal dans 155 cas (91,2%), lâOMI dans 87 cas (51,2%), la douleur abdominale dans 84 cas (49, 4%). Lâamaigrissement Ă©tait retrouvĂ© dans 134 cas (78,8%) et la fiĂšvre dans 10 cas (5,9%). Lâascite Ă©tait de moyenne abondance dans 89 cas (52,35%). Le foie Ă©tait dâallure cirrhotique Ă lâexamen physique dans 127 cas (74,7%). Conclusion : lâascite est signe frĂ©quent en hospitalisation souvent associĂ©s aux ballonnement abdominal, ĆdĂšme des membres infĂ©rieurs, la douleur abdominale lâamaigrissement et la fiĂšvre. Les hommes Ă©taient les plus atteints, il concerne en majoritĂ© les jeunes. Dans les deux sexes.
Introduction: Ascites is a common major symptom in many digestive pathologies. It is the major complication of decompensated cirrhosis. Objective: To contribute to better management of ascites in Bangui. Patients and methods: This is a descriptive cross-sectional study lasting 30 months conducted in the Hepato-Gastroenterology department of the CHUASC in Bangui. We included in the study patients of both sexes hospitalized for ascites in whom the etiological diagnosis was known. Results: During the study period, 1210 patients were hospitalized, 204 of whom presented with ascites (16.85%), of whom 170 (14.9%) met our inclusion criteria. There were 100 men (58.8%) and 70 women (41.2%). The sex ratio was 1.42. The average age of the patients was 46 years old. The most common reasons for hospitalization were abdominal bloating in 155 cases (91.2%), OMI in 87 cases (51.2%), abdominal pain in 84 cases (49.4%). Weight loss was found in 134 cases (78.8%) and fever in 10 cases (5.9%). Ascites was of medium abundance in 89 cases (52.35%). The liver was cirrhotic on physical examination in 127 cases (74.7%). Conclusion: Ascites is a frequent sign in hospitalization often associated with abdominal bloating, edema of the lower limbs, abdominal pain, weight loss and fever. Men were the most affected, it mainly concerns young people. In both sexes
Aspects ĂpidĂ©miologiques Cliniques des Ascites au CHUSC de Bangui
Introduction : lâAscite est un symptĂŽme majeur frĂ©quent dans beaucoup de pathologies digestives. Elle est la complication majeure de cirrhose dĂ©compensĂ©e. Objectif : Contribuer Ă une meilleure prise en charge de lâascite Ă Bangui. Patients et mĂ©thodes : Il sâagit dâune Ă©tude transversale descriptive dâune durĂ©e de 30 mois menĂ©e dans le service dâHĂ©pato gastroentĂ©rologie du CHUASC de Bangui. Nous avions inclus dans lâĂ©tude les patients de deux sexes hospitalisĂ©s pour ascite chez lesquels le diagnostic Ă©tiologique Ă©tait connu. RĂ©sultats : Pendant la pĂ©riode dâĂ©tude, 1210 patients Ă©taient hospitalisĂ©s dont 204 prĂ©sentaient une ascite (16,85%), parmi lesquels 170 (14,9%) avaient rĂ©pondu Ă nos critĂšres dâinclusion. On comptait 100 hommes (58,8%) et 70 femmes (41,2%). La sex-ratio Ă©tait de 1,42. LâĂąge moyen des patients Ă©tait de 46 ans. Les motifs dâhospitalisation les plus frĂ©quents Ă©taient le ballonnement abdominal dans 155 cas (91,2%), lâOMI dans 87 cas (51,2%), la douleur abdominale dans 84 cas (49, 4%). Lâamaigrissement Ă©tait retrouvĂ© dans 134 cas (78,8%) et la fiĂšvre dans 10 cas (5,9%). Lâascite Ă©tait de moyenne abondance dans 89 cas (52,35%). Le foie Ă©tait dâallure cirrhotique Ă lâexamen physique dans 127 cas (74,7%). Conclusion : lâascite est signe frĂ©quent en hospitalisation souvent associĂ©s aux ballonnement abdominal, ĆdĂšme des membres infĂ©rieurs, la douleur abdominale lâamaigrissement et la fiĂšvre. Les hommes Ă©taient les plus atteints, il concerne en majoritĂ© les jeunes. Dans les deux sexes.
Introduction: Ascites is a common major symptom in many digestive pathologies. It is the major complication of decompensated cirrhosis. Objective: To contribute to better management of ascites in Bangui. Patients and methods: This is a descriptive cross-sectional study lasting 30 months conducted in the Hepato-Gastroenterology department of the CHUASC in Bangui. We included in the study patients of both sexes hospitalized for ascites in whom the etiological diagnosis was known. Results: During the study period, 1210 patients were hospitalized, 204 of whom presented with ascites (16.85%), of whom 170 (14.9%) met our inclusion criteria. There were 100 men (58.8%) and 70 women (41.2%). The sex ratio was 1.42. The average age of the patients was 46 years old. The most common reasons for hospitalization were abdominal bloating in 155 cases (91.2%), OMI in 87 cases (51.2%), abdominal pain in 84 cases (49.4%). Weight loss was found in 134 cases (78.8%) and fever in 10 cases (5.9%). Ascites was of medium abundance in 89 cases (52.35%). The liver was cirrhotic on physical examination in 127 cases (74.7%). Conclusion: Ascites is a frequent sign in hospitalization often associated with abdominal bloating, edema of the lower limbs, abdominal pain, weight loss and fever. Men were the most affected, it mainly concerns young people. In both sexes
Global variation in the long-term outcomes of ypT0 rectal cancers
Background Colorectal cancer mortality presents world-wide variation. In rectal cancers presenting a complete/nearly-complete tumor response (ypT0/ypTis) following neoadjuvant treatment, the features correlated to nodal metastases and relapses still need to be defined. Methods An international cohort study enrolling ypT0/ypTis rectal cancers surgically treated from 2012 to 2017 was conducted. A propensity matching was used to balance nodal-positive and nodal-negative patients and statistical analyses were performed to investigate survivals, using a bootstrap model for internal validation. The features correlated with nodal metastasis were studied. Countries with participating centers were ranked using the World Bank (WBI), Human Development (HDI) and Global Gender Gap (GGG) indexes to compare survivals. Results 680 ypT0/ypTis from 52 European, Australian, Indian and American Institutions were analyzed. Mean follow-up was of 30.4 months. 96.5% were treated with total mesorectal excision, 7.2% were nodal-positive and 8.8% relapsed. Distal cancers (HR 0.71 95%CI: 0.56-0.91) and nodal metastasis and nodal metastasis (HR 3.85 95%CI:1.12â13.19) correlated with worse DFS, whereas a younger age was of borderline significance (HR 0.95 95%CI:0.91â0.99). The bootstrap analysis validated the model on 5000 repetitions. A short-course radiotherapy (OR 0.18 95%CI:0.09â0.37) correlated with the occurrence of nodal metastasis. Those countries classified in the low/medium-WBI, medium-HDI and lower-GGG ranks documented worse DFS curves (respectively p < 0.0001, p < 0.0001 and p 0.0002). However, the clinical stages were similar and patients from medium-HDI countries received more adjuvant chemotherapy than the others (p < 0.0001). Conclusion Sub-groups at risk for relapses and nodal metastasis were identified. A global variation exists also when benchmarking a rectal cancer complete regression
Furin Prodomain ppFurin Enhances Ca2+ Entry Through Orai and TRPC6 Channelsâ Activation in Breast Cancer Cells
The intracellular calcium concentration ([Ca2+]i) modulation plays a key role in the regulation of cellular growth and survival in normal cells and failure of [Ca2+]i homeostasis is involved in tumor initiation and progression. Here we showed that inhibition of Furin by its naturally occurring inhibitor the prodomain ppFurin in the MDA-MB-231 breast cancer cells resulted in enhanced store-operated calcium entry (SOCE) and reduced the cell malignant phenotype. Expression of ppFurin in a stable manner in MDA-MB-231 and the melanoma MDA-MB-435 cell lines inhibits Furin activity as assessed by in vitro digestion assays. Accordingly, cell transfection experiments revealed that the ppFurin-expressing cells are unable to adequately process the proprotein convertase (PC) substrates vascular endothelial growth factor C (proVEGF-C) and insulin-like growth factor-1 receptor (proIGF-1R). Compared to MDA-MB-435 cells, expression of ppFurin in MDA-MB-231 and BT20 cells significantly enhanced SOCE and induced constitutive Ca2+ entry. The enhanced SOCE is impaired by inhibition of Orai channels while the constitutive Ca2+ entry is attenuated by silencing or inhibition of TRPC6 or inhibition of Orai channels. Analysis of TRPC6 activation revealed its upregulated tyrosine phosphorylation in ppFurin-expressing MDA-MB-231 cells. In addition, while ppFurin had no effect on MDA-MB-435 cell viability, in MDA-MB-231 cells ppFurin expression reduced their viability and ability to migrate and enhanced their sensitization to the apoptosis inducer hydrogen peroxide and similar results were observed in BT20 cells. These findings suggest that Furin inhibition by ppFurin may be a useful strategy to interfere with Ca2+ mobilization, leading to breast cancer cellsâ malignant phenotype repression and reduction of their resistance to treatments.This research was funded by SIRIC-Brio, La Ligue Contre le Cancer and Region Nouvelle Aquitaine to A.M.K. and by PID2019-104084GB-C21 and PID2019-104084GB-C22/AEI/10.13039/501100011033, MICINN (Grant BFU2016-74932-C2) and Junta de Extremadura-Fondo Europeo de Desarrollo Regional (FEDER; Grants IB16046 and GR18061) to J.A.R. and T.S. J.J.L. is supported by a contract from Junta de Extremadura (TA18011). C.C. is supported by a contract from Junta de ExtremaduraâFEDER
Pregnane Ă Receptor (PXR) expression in colorectal cancer cells restricts irinotecan chemosensitivity through enhanced SN-38 glucuronidation
<p>Abstract</p> <p>Background</p> <p>Clinical efficacy of chemotherapy in colorectal cancer is subjected to broad inter-individual variations leading to the inability to predict outcome and toxicity. The topoisomerase I inhibitor irinotecan (CPT-11) is worldwide approved for the treatment of metastatic colorectal cancer and undergoes extensive peripheral and tumoral metabolism. PXR is a xenoreceptor activated by many drugs and environmental compounds regulating the expression of drug metabolism and transport genes in detoxification organs such as liver and gastrointestinal tract. Considering the metabolic pathway of irinotecan and the tissue distribution of Pregnane Ă Receptor (PXR), we hypothesized that PXR could play a key role in colon cancer cell response to irinotecan.</p> <p>Results</p> <p>PXR mRNA expression was quantified by RT-quantitative PCR in a panel of 14 colon tumor samples and their matched normal tissues. PXR expression was modulated in human colorectal cancer cells LS174T, SW480 and SW620 by transfection and siRNA strategies. Cellular response to irinotecan and its active metabolic SN38 was assessed by cell viability assays, HPLC metabolic profiles and mRNA quantification of PXR target genes. We showed that PXR was strongly expressed in colon tumor samples and displayed a great variability of expression. Expression of hPXR in human colorectal cancer cells led to a marked chemoresistance to the active metabolite SN38 correlated with PXR expression level. Metabolic profiles of SN38 showed a strong enhancement of SN38 glucuronidation to the inactive SN38G metabolite in PXR-expressing cells, correlated with an increase of UDPglucuronosyl transferases UGT1A1, UGT1A9 and UGT1A10 mRNAs. Inhibition of PXR expression by lentivirus-mediated shRNA, led to SN38 chemoresistance reversion concomitantly to a decrease of UGT1A1 expression and SN38 glucuronidation. Similarly, PXR mRNA expression levels correlated to UGT1A subfamily expression in human colon tumor biopsies.</p> <p>Conclusion</p> <p>Our results demonstrate that tumoral metabolism of SN38 is affected by PXR and point to potential therapeutic significance of PXR quantification in the prediction of irinotecan response. Furthermore, our observations are pharmacologically relevant since many patients suffering from cancer diseases are often exposed to co-medications, food additives or herbal supplements able to activate PXR. A substantial part of the variability observed among patients might be caused by such interactions</p
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