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Li LY, Li BW, Mekaroonkamol P, Chen HM, Shen SS, Luo H, Dacha S, Xue Y, Cristofaro S, Keilin S, Willingham F, Cai Q. Mucosectomy device-assisted endoscopic resection of gastric subepithelial lesions. J Dig Dis 2020; 21:215-221. [PMID: 32129564 DOI: 10.1111/1751-2980.12856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/24/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Some gastrointestinal subepithelial tumors (SETs) have malignant potential and complete resection may be required. However, endoscopic submucosal dissection (ESD) can be a tedious procedure and requires a long and extensive training to master. Devices for endoscopic full-thickness resection (EFTR) are limited and are not widely available. We report here a simpler endoscopic method to resect small SETs using a commercially available endoscopic mucosal resection (EMR) kit and enucleation technique. METHODS All patients with SET who underwent device-assisted resection at our tertiary care hospital from April 2015 to November 2016 were enrolled in this retrospective study. All procedures were performed by a single expert endoscopist with an advanced endoscopy trainee. A mucosectomy and a limited dissection under mucosa were performed to preserve the mucosa before a device-assisted enucleation of the tumor to facilitate endoscopic closure of the defect closure in all cases. RESULTS A total of 12 patients aged 38-70 y, of whom six were males, were included. Most of the tumors originated from the muscularis propria and were located at the proximal gastric body. The mean procedural duration was 53 minutes (range 23-91 min). The average size of the lesions was 13 mm (range 9-21 mm). The mean duration of hospitalization was 1.3 days. Bleeding and intentional perforation were all successfully managed during the procedure and did not result in any clinically significant adverse event. CONCLUSION A device-assisted EFTR using a commercially available EMR kit is a safe and feasible method for the endoscopic resection of small gastric extrovert SETs.
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Affiliation(s)
- Lian Yong Li
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA.,Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bai Wen Li
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA.,Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Parit Mekaroonkamol
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
| | - Hui Min Chen
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA.,Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shan Shan Shen
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA.,Department of Gastroenterology, Drum Tower Hospital affiliated to the Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Hui Luo
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA.,Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Sunil Dacha
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
| | - Yue Xue
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Sarah Cristofaro
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
| | - Steven Keilin
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
| | - Field Willingham
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
| | - Qiang Cai
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
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Gao Y, Lou G, Zhang GM, Sun XW, Ma YY, Yang YM, Liu G. CHFR Promoter Hypermethylation and Reduced CHFR mRNA Expression in Ovarian Cancer. Int J Biol Markers 2018; 24:83-9. [DOI: 10.1177/172460080902400204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Ovarian cancer is one of the most common cancers and can be treated with microtubule-targeting drugs. Checkpoint with forkhead and ring finger domains (CHFR) is a protein implicated in cancer sensitivity to microtubule-targeting drugs. Whereas CHFR downregulation, often with CHFR promoter hypermethylation, has been identified in a large number of tumor types, it has not been in ovarian cancer. We therefore searched for CHFR downregulation in primary ovarian tumors. Methods Fresh ovarian cancer tissues from 53 patients (test) and normal ovarian tissues from 21 patients (control) were tested for CHFR promoter hypermethylation and CHFR mRNA levels. Results The CHFR promoter was hypermethylated in 20.75% (11/53) of the ovarian cancers and none (0/21) of the normal controls. The normal controls had a mean mRNA level of 1.89 relative fluorescence units (RFU) with a range of 0.04–24.78 RFU. The cancer tissues had a mean mRNA level of 0.77 RFU with a range of 0.00–68.75 RFU. The median value of the cancer group was significantly lower than that of the control group (p=0.0067). Those cancer samples that had hypermethylated CHFR promoters also had low (n=3) or undetectable (n=8) CHFR mRNA levels. Conclusions In contrast to previous reports, we found that alterations in CHFR mRNA and CHFR methylation can be frequently found in ovarian cancers. CHFR hypermethylation was strongly associated with the loss of CHFR mRNA expression. CHFR downregulation in ovarian tumors may be clinically relevant as a staging biomarker, as an indicator of sensitivity to microtubule-targeting drugs, and as a future drug target.
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Affiliation(s)
- Ying Gao
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
| | - Ge Lou
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
| | - Guang-Mei Zhang
- Department of Gynecology, First Clinical College of Harbin Medical University, Harbin, Heilongjiang - China
| | - Xi-Wen Sun
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
| | - Yu-Yan Ma
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
| | - Yan-Mei Yang
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
| | - Ge Liu
- Department of Gynecology, Tumor Hospital of Harbin Medical University, Harbin
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