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Sweed D, Elhamed SMA, Aiad HAS, Ehsan NA, Hemida AS, Dawoud MM. STIM1/SOX2 proteins are co-expressed in the tumor and microenvironmental stromal cells of pancreatic ductal adenocarcinoma and ampullary carcinoma. World J Surg Oncol 2024; 22:84. [PMID: 38532463 DOI: 10.1186/s12957-024-03356-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AAC) are lethal malignancies with modest benefits from surgery. SOX2 and STIM1 have been linked to anticancer activity in several human malignancies. This study included 94 tumor cases: 48 primary PDAC, 25 metastatic PDAC, and 21 primary AAC with corresponding non-tumor tissue. All cases were immunohistochemically stained for STIM1 and SOX2 and results were correlated with clinicopathologic data, patient survival, and BCL2 immunostaining results. Results revealed that STIM1 and SOX2 epithelial/stromal expressions were significantly higher in PDAC and AAC in comparison to the control groups. STIM1 and SOX2 expressions were positively correlated in the primary and metastatic PDAC (P = 0.016 and, P = 0.001, respectively). However, their expressions were not significantly associated with BCL2 expression. SOX2 epithelial/stromal expressions were positively correlated with the large tumor size in the primary AAC group (P = 0.052, P = 0.044, respectively). STIM1 stromal and SOX2 epithelial over-expressions had a bad prognostic impact on the overall survival of AAC (P = 0.002 and P = 0.001, respectively). Therefore, STIM1 and SOX2 co-expression in tumor cells and intra-tumoral stroma could contribute to the development of PDAC and AAC. STIM1/SOX2 expression is linked to a bad prognosis in AAC.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Koom, Egypt
| | | | - Hayam Abdel Samie Aiad
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Al Koom, 32511, Egypt
| | - Nermine Ahmed Ehsan
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Koom, Egypt
| | - Aiat Shaban Hemida
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Al Koom, 32511, Egypt
| | - Marwa Mohammed Dawoud
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin Al Koom, 32511, Egypt.
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Sweed D, Mohamady M, Gouda MA, Fayed Y, Saied SA, Elhamed SMA. Does the expression of granzyme B participate in inflammation, fibrosis, and fertility of hydatid cysts? Parasitol Res 2023; 123:22. [PMID: 38072840 PMCID: PMC10710967 DOI: 10.1007/s00436-023-08056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/28/2023] [Indexed: 12/18/2023]
Abstract
Echinococcus granulosus (sensu lato), a cestode that is endemic in Egypt, causes cystic echinococcosis (CE), a significant but neglected zoonotic disease that is prevalent throughout the world. Infected hydatid cysts are classified as fertile or non-fertile based on the presence of protoscoleces; nevertheless, the mechanism of non-fertile CE cysts remains unknown. The study aimed to assess whether granzyme B (GrB) expression and CD4 + /CD8 + could be related to the induction of non-fertile CE cysts. A total of fifty-eight individuals diagnosed with visceral hydatid cysts were selected, and they were further divided according to cyst fertility into fertile and non-fertile. Immunohistochemistry for CD4, CD8, and GrB was done. According to the results, hydatid cysts are common in adults and have no gender preference. The same clinical and laboratory data were shared by patients with fertile and non-fertile cysts (p = 0.186). GrB expression was not impacted by the fibrous deposition inside the hydatid cyst wall (p = 0.85); however, GrB was significantly correlated with the inflammatory density (p = 0.005). GrB expression was also found to be significantly higher in non-fertile cysts (p = 0.04). GrB expression is positively correlated with CD4 and CD8 expression. In conclusion, the expression of GrB in hydatid cysts may exacerbate the inflammatory response and impede cyst fertility while not affecting the fibrous deposition in the cyst wall.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt.
| | - Mohamed Mohamady
- Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Marwa A Gouda
- Clinical and Molecular Parasitology Department, National Liver Institute, Shebin Elkom, Menoufia, Egypt
| | - Yahya Fayed
- Hepatopancreatobiliary Surgery Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Sara A Saied
- Clinical Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Sara M Abd Elhamed
- Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt
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Sweed D, Gammal SSE, Kilany S, Abdelsattar S, Elhamed SMA. The expression of VEGF and cyclin D1/EGFR in common primary liver carcinomas in Egypt: an immunohistochemical study. Ecancermedicalscience 2023; 17:1641. [PMID: 38414954 PMCID: PMC10898887 DOI: 10.3332/ecancer.2023.1641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Indexed: 02/29/2024] Open
Abstract
Background The most common types of primary malignant liver tumours are hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). Treatment options for patients who are inoperable/advanced, or recurring are challenging. Cyclin D1, epidermal growth factor (EGFR) and vascular endothelial growth factor (VEGR) are common carcinogenic proteins that have potential therapeutic targets in various cancers. They have been implicated in the development of HCC and CCA. In this study, we aimed to evaluate the oncogenic function expression of cyclin D1, EGFR and VEGF in HCC and CCA of Egyptian patients. This could help to validate their therapeutic potential. Material and methods Tumour cases were selected from 82 cases of primary liver carcinomas, with 58 cases being from HCC and 24 cases from CCA compared to 51 non-tumour adjacent liver cases and 18 from normal liver tissue. The immunohistochemical study of cyclin D1, EGFR and VEGR was conducted. Results Cyclin D1, EGFR and VEGF are overexpressed in HCC and CCA as compared to the control group (p < 0.001). Cyclin D1 was related to well-differentiated grade and early pathologic stage in HCC (p = 0.016 and p = 0.042, respectively). The well-differentiated grade showed significantly higher VEGF levels (p = 0.04). In the CCA group, however, EGFR was strongly related to high tumour size (p = 0.047). EGFR and VEGF were overexpressed in HCC raised in the non-cirrhotic liver compared to those developed in post-hepatitic liver cirrhosis (p = 0.003 and p = 0.014). Conclusion Cyclin D1, EGFR and VEGF shared significant overexpression in HCC and CCA. EGFR and VEGF may play an oncogenic function in the development of HCC in non-cirrhotic liver. Furthermore, cyclin D1 and VEGF may play a good prognostic function in HCC, but EGFR may play a bad prognostic role in CCA.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Shebin Elkom, Menofia University, Shebin Elkom 32511, Menoufia, Egypt
- https://orcid.org/0000-0001-6483-5056
| | - Shaymaa Sabry El Gammal
- Pathology Department, National Liver Institute, Shebin Elkom, Menofia University, Shebin Elkom 32511, Menoufia, Egypt
| | - Shimaa Kilany
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin Elkom 32511, Menoufia, Egypt
| | - Shimaa Abdelsattar
- Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shebin Elkom 32511, Menoufia, Egypt
| | - Sara Mohamed Abd Elhamed
- Pathology Department, National Liver Institute, Shebin Elkom, Menofia University, Shebin Elkom 32511, Menoufia, Egypt
- https://orcid.org/0000-0003-0526-2627
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Sweed D, Holah NS, Karman E, Asaad N, Mahmoud S. Farnesoid X receptor in chronic liver diseases: an immunohistochemical study. J Immunoassay Immunochem 2023; 44:381-395. [PMID: 37665366 DOI: 10.1080/15321819.2023.2242920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Chronic hepatitis C virus (HCV) related liver diseases are still an ongoing cause of hepatic failure despite the effective role of direct-acting anti-viral agents. Farnesoid X receptor (FXR) agonists have a potential therapeutic effect on the management of chronic liver diseases (CLD). However, data regarding FXR protein expression in human CLDs are limited and conflicting. We aimed to assess the immunohistochemical expression of FXR in HCV-related chronic hepatitis and cirrhosis in comparison with metabolic-associated fatty liver disease (MAFLD) and normal liver tissue. The expression of FXR was low both in hepatocytes and bile ducts of HCV-related chronic hepatitis and cirrhosis (p = .001, respectively). In addition, a significantly low expression of FXR was observed in HCV-related hepatitis and cirrhosis groups compared to MAFLD in hepatocytes (p < .001, for both) and bile ducts (p = .004 and p = .018). FXR expression in HCV-related cirrhosis was significantly associated with compensated liver function (p = .032) and low inflammatory activity (p = .022). FXR expression decreases in HCV-related CLDs. There was some evidence that FXR expression could protect against post-hepatitis cirrhosis.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menofia University, Shebin Elkom, Egypt
| | - Nanis Shawky Holah
- Pathology Department, Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Esraa Karman
- Pathology Department, National Liver Institute, Menofia University, Shebin Elkom, Egypt
| | - Nancy Asaad
- Pathology Department, Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Shereen Mahmoud
- Pathology Department, Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
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Eshiaty SA, Abdelsattar S, Sweed D, Abdel-Aziz SA, Elfert A, Elsaid H. The value of blood and urine metabolomics in differential diagnosis of cholestasis in infants. Egypt Liver Journal 2023. [DOI: 10.1186/s43066-023-00244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract
Background
Early detection of biliary atresia (BA) is a great challenge providing the main useful way to improve its clinical consequence. Promising metabolomics provides an effective method for determining innovative biomarkers and biochemical ways for improving early diagnosis. This study aimed to determine the benefit of serum and urinary potential bile acid metabolites in the differentiation of BA from non-biliary atresia (non-BA) cases using tandem mass spectrometry (MS/MS). Fourteen bile acids metabolites were measured quantitively by MS/MS in serum and urine samples from 102 cholestatic infants and 102 control infants, in addition to the assay of the total serum bile acid enzymatically.
Results
After the diagnostic clinical and laboratory workflow, cholestatic infants were divided into BA (37 infants) and non-BA (65 infants) subgroups. Remarkably on analysis of serum individual bile acid concentrations, there were significant differences between cholestatic BA and non-BA regarding serum (glycocenodeoxycholic acid (GCDCA), taurochenodeoxycholic acid (TCDCA), taurocholic acid (TCA), and GCDCA/chenodeoxycholic acid (CDCA) ratio) (p < 0.001, for all), while there was no significant difference between the two groups regarding serum level of (cholic acid (CA), glycocholic (GCA), or TCDCA/CDCA ratio). There were no significant differences in either the urinary individual bile acids or urinary primary bile acids (conjugated or unconjugated) between BA and non-BA. Further principal component analysis (PCA) analysis was done and receiver operating characteristic (ROC) analysis was performed using score plots of the positive factors in the first two principal components PC1 (CA, GCA, GCDCA, TCA, TCDCA) and PC2 (CA, CDCA, lithocholic (LCA), ursodeoxycholic acid (UDCA)) for establishing the differences between the two diseased groups and revealed that the area under the curve (AUC) for PC1 was (0.770) higher than AUC for PC2 (0.583) indicating that the positive components of PC1 may be potential biomarkers for differentiation between the two cholestatic groups.
Conclusions
Metabolomics of serum bile acid levels using tandem mass spectrometry might change the paradigm differentiating BA from non-BA saving patients from unnecessary invasive procedures.
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Abdelsattar S, Sweed D, Kamel HFM, Kasemy ZA, Gameel AM, Elzohry H, Ameen O, Elgizawy EI, Sallam A, Mosbeh A, Abdallah MS, Khalil FO, Al-Amodi HS, El-Hefnway SM. The Potential Utility of Circulating Oncofetal H19 Derived miR-675 Expression versus Tissue lncRNA-H19 Expression in Diagnosis and Prognosis of HCC in Egyptian Patients. Biomolecules 2022; 13:biom13010003. [PMID: 36671388 PMCID: PMC9856163 DOI: 10.3390/biom13010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Interestingly, lncRNA-H19 acts independently in HCC and influences miR-675 expressions. We aimed to assess the potential utility of tissue lncRNA-H19 versus miR-675 expressions as a non-invasive biomarker for HCC diagnosis and prognosis in Egyptian patients. Ninety-one HCC patients and 91 controls included in this study were investigated for expression of lncRNA-H19 and miR675 using RT-qPCR. Our results showed that the expression of lncRNA-H19 and microRNA-675 were higher in patients than in controls (p < 0.001 for both). Additionally, lncRNA-H19 expression was higher in tumorous than in non-tumorous tissue (p < 0.001). Linear regression revealed that miR-675 expression was a significantly higher positive predictor than lncRNA-H19 for tumor size, pathologic grade, and AFP level; similarly, for cyclin D1 and VEGF protein expression. By using the ROC curve, the sensitivity of miR-675 was higher than lncRNA-H19 for discriminating HCC from controls (95-89%, respectively) and the sensitivity of lncRNA-H19 was higher in tumorous than in non-tumorous tissues (76%). The high expressions of both were associated with low OS (p < 0.001, 0.001, respectively). Oncofetal H19-derived miR-675 expression could be considered a potential noninvasive diagnostic and prognostic biomarker, outstanding the performance of the expression of tissue lncRNA-H19 for HCC.
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Affiliation(s)
- Shimaa Abdelsattar
- Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menofia University, Shebin El-Kom 32511, Egypt
- Correspondence:
| | - Dina Sweed
- Pathology Department, National Liver Institute, Menofia University, Shebin El-Kom 32511, Egypt
| | - Hala F. M. Kamel
- Department of Biochemistry, Faculty of Medicine, Umm Al Qura University, Makka 21955, Saudi Arabia
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Zeinab A. Kasemy
- Public Health and Community Medicine Department, Faculty of Medicine, Menofia University, Shebin El-Kom 32511, Egypt
| | - Abdallah M. Gameel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Hassan Elzohry
- Hepatology and Gastroenterology Department, National Liver Institute, Menofia University, Shebin El-Kom 32511, Egypt
| | - Omnia Ameen
- Physiology Department, Faculty of Medicine, Menofia University, Shebin El-Kom 32511, Egypt
| | - Eman Ibrahim Elgizawy
- Physiology Department, Faculty of Medicine, Menofia University, Shebin El-Kom 32511, Egypt
| | - Ahmed Sallam
- Department of Hepatobiliary and Pancreatic Surgery, National Liver Institute, Menofia University, Shebin El-Kom 32511, Egypt
| | - Asmaa Mosbeh
- Pathology Department, National Liver Institute, Menofia University, Shebin El-Kom 32511, Egypt
| | - Mahmoud S. Abdallah
- Clinical Pharmacy Department, Faculty of Pharmacy, University of Sadat City (USC), Sadat City 32897, Egypt
| | - Fatma O. Khalil
- Clinical and Molecular Microbiology and Immunology Department, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt
| | - Hiba S. Al-Amodi
- Department of Biochemistry, Faculty of Medicine, Umm Al Qura University, Makka 21955, Saudi Arabia
| | - Sally M. El-Hefnway
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Menofia University, Shebin El-Kom 32511, Egypt
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Sweed E, Sweed D, Galal N, Abd-Elhafiz HI. Dapagliflozin Protection against Myocardial Ischemia by Modulating Sodium-glucose Transporter 2 Inhibitor, Silent Information Regulator 1, and Fatty Acid Synthase Expressions. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND: The emerging role of sodium-glucose transporter 2 (SGLT2) inhibitors drugs as potential therapeutic agents in myocardial ischemic (MI) injury treatment has raised the concern for possible mechanisms of action.
AIM: The current experimental study aimed to investigate the possible protective effects of dapagliflozin (DAPA) a SGLT2i, on isoproterenol (ISO)-induced MI in rats.
MATERIALS AND METHODS: Thirty Wistar rats were divided randomly and equally into three groups. Group 1 (control group): Received 1.0 mL of normal saline through an orogastric tube for 14 days. Group 2 (ISO group): Received 1.0 mL of normal saline orally through an orogastric tube for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was freshly dissolved in normal saline and injected subcutaneously once daily. Group 3 (ISO + DAPA-treated group): Received DAPA 1.0 mg/kg/day orally for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was introduced like that described in Group 2.
RESULTS: DAPA protects MI development by reversal of blood pressure changes, electrocardiographic alterations, stabilization of cardiac enzymes, inflammation restoration, oxidative stress, and lipid profile. SGLT2 was overexpressed in the ISO-induced MI, which declined in the ISO + DAPA group. Moreover, DAPA induced silent information regulator 1 (SIRT1)/fatty acid synthase (FASN) overexpression in ISO-induced MI. DAPA could have a potential protective role against acute MI.
CONCLUSION: DAPA protects against acute MI by modulating SIRT1 and FASN expression in cardiac muscles, suppressing oxidative stress, and downregulating inflammatory mediators.
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Sweed D, Sweed E, Moaz I, Mosbeh A, Fayed Y, Elhamed SMA, Sweed E, Macshut M, Abdelsattar S, Kilany S, Saied SA, Badr R, Abdallah MS, Ehsan N. The clinicopathological and prognostic factors of hepatocellular carcinoma: a 10-year tertiary center experience in Egypt. World J Surg Oncol 2022; 20:298. [PMID: 36117166 PMCID: PMC9484175 DOI: 10.1186/s12957-022-02764-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/06/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of several preventive and therapeutic modalities. HCC has heterogeneous and wide morpho-molecular patterns, resulting in unique clinical and prognostic criteria. Therefore, we aimed to study the clinical and pathological criteria of HCC to update the morpho-molecular classifications and provide a guide to the diagnosis of this disease. METHODS Five hundred thirty pathologically analyzed HCC cases were included in this study. The clinical and survival data of these cases were collected. RESULTS Hepatitis C virus is still the dominant cause of HCC in Egypt. Post-direct-acting antiviral agent HCC showed an aggressive course compared to interferon-related HCC. Old age, male gender, elevated alpha-fetoprotein level, tumor size, and background liver were important prognostic parameters. Special HCC variants have characteristic clinical, laboratory, radiological, prognostic, and survival data. Tumor-infiltrating lymphocytes rather than neutrophil-rich HCC have an excellent prognosis. CONCLUSIONS HCC is a heterogenous tumor with diverse clinical, pathological, and prognostic parameters. Incorporating the clinicopathological profile per specific subtype is essential in the treatment decision of patients with HCC. TRIAL REGISTRATION This was a retrospective study that included 530 HCC cases eligible for analysis. The cases were obtained from the archives of the Pathology Department, during the period between January 2010 and December 2019. Clinical and survival data were collected from the patients' medical records after approval by the institutional review board (IRB No. 246/2021) of Liver National Institute, Menoufia University. The research followed the guidelines outlined in the Declaration of Helsinki and registered on ClinicalTrials.gov (NCT05047146).
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Affiliation(s)
- Dina Sweed
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Enas Sweed
- grid.411660.40000 0004 0621 2741Radiology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Inas Moaz
- grid.411775.10000 0004 0621 4712Epidemiology, and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Asmaa Mosbeh
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Yahya Fayed
- grid.411775.10000 0004 0621 4712Hepatopancreatobiliary Surgery Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Sara Mohamed Abd Elhamed
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Eman Sweed
- grid.411775.10000 0004 0621 4712Clinical Pharmacology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Mahmoud Macshut
- grid.411775.10000 0004 0621 4712Hepatopancreatobiliary Surgery Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Shimaa Abdelsattar
- grid.411775.10000 0004 0621 4712Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Shimaa Kilany
- grid.411775.10000 0004 0621 4712Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Sara A. Saied
- grid.411775.10000 0004 0621 4712Clinical Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Reda Badr
- grid.411775.10000 0004 0621 4712Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
| | - Mahmoud S. Abdallah
- grid.449877.10000 0004 4652 351XClinical Pharmacy, Faculty of Pharmacy, University of Sadat City, Sadat City, Menoufia Egypt
| | - Nermine Ehsan
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia Egypt
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Omar TA, Sweed E, Sweed D, Eledel RH, Abou-Elela DH, Hikal G. Mesenchymal Stem Cells for the Treatment of Acetic Acid-Induced Ulcerative Colitis in Rats. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Ulcerative colitis (UC) is an autoimmune inflammatory bowel disease, characterized by chronic and relapsing inflammation of the intestinal mucosa. Clinical treatments fail to reduce inflammation and induce side effects in nearly 30% of patients. Mesenchymal stem cells (MSCs) are immunomodulatory agents that can encourage tissue repair and regeneration.
Aim: To investigate the ability of MSCs to differentiate into enterocytes under the mediation of activin a, fibroblastic growth factor 2, and epidermal growth factors and to study the effect of administering MSCs to rats with acetic acid (AA)-induced UC.
Methods: MSCs isolated from the umbilical cord were induced to differentiate into enterocytes. The induced cells were morphologically evaluated by flow cytometry and immunocytochemistry. Forty rats were divided into four groups: control, AA-induced UC, differentiated, and undifferentiated MSC treated groups. The acute UC in rats was induced by 3% AA transrectal administration. Body weight changes, disease activity index (DAI), and histopathological and immunohistochemical CD105 and CD34 staining were recorded. IL-17, IL-10, and TGF- β levels were measured as well.
Results: In Both differentiated and undifferentiated MSCs, induced MSCs improved the DAI score and significantly recovered the pathological changes. The favorable effect of MSCs was significantly linked to CD105 overexpression and CD34 low expression. IL-10 and TGF-β levels increased while IL-17 levels decreased.
Conclusion: Both differentiated and undifferentiated MSCs showed anti-inflammatory and immunomodulatory effects in our study. Based on our results, MSCs could become potentially useful for regenerative medicine and the clinical treatment of UC.
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Sweed D, Taha M, Abd Elhamed S, Shams El Dein Mohamed A. The Prognostic Role of CD73/A2AR Expression and Tumor Immune Response in Periampullary Carcinoma Subtypes. Asian Pac J Cancer Prev 2022; 23:1239-1246. [PMID: 35485681 PMCID: PMC9375596 DOI: 10.31557/apjcp.2022.23.4.1239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/23/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Periampullary adenocarcinoma (PAAC) is a rare, lethal heterogeneous group of malignancy that differs in their molecular phenotypes. Ecto-5'-nucleotidase (CD73)/adenosine A2A Receptor (A2AR) pathway has shown an emerging role in cancer therapy through modulating the immune response. Therefore, this study aimed to explore the functional role of CD73 and A2AR in pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC). MATERIAL AND METHODS An immunohistochemical study for CD73 and A2AR carried on 48 PDAC cases, 21 AC cases and 34 adjacent non-tumor tissues that were taken from the farthest point of normal pancreatic tissue away from the tumor. RESULTS CD73 was overexpressed in the PDAC (p < 0.001), and AC (p = 0.004) groups compared to their non-tumor tissues. However, A2AR was overexpressed in the PDAC group (p = 0.003) but not in the AC group (p = 0.359) compared to non-tumor tissue. In the PDAC group, CD73 overexpression was significantly associated with longer overall survival (p = 0.018). In contrary, A2AR overexpression was significantly associated with high grade (p = 0.001) and late- stage (p = 0.01). Both markers had no prognostic impact on AC. In the meantime, tumor immune response showed a negative prognostic role in PDAC and AC. The prognostic role of tumor immune response in the PDAC group was strongly modulated by CD73 and A2AR expression. CONCLUSIONS PDAC and AC shared CD73 Overexpression while A2AR was overexpressed in PDAC only. In PDAC, CD73 and A2AR showed an opposed prognostic effect but both had no prognostic impact on AC. In addition, tumor immune response showed a controversial impact on the prognosis of PDAC and AC.
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Affiliation(s)
- Dina Sweed
- National Liver Institute, Menoufia University, Egypt.
| | - Mohammad Taha
- National Liver Institute, Menoufia University, Egypt.
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Sweed D, Abd-Elbary A, Sweed E, Mosbeh A, Moaz I, Yassein T, Elmashad S. Expression of cyclo-oxygenase-2 and yap/taz in hepatocellular carcinoma in untreated and treated hepatitis C virus patients. POL J PATHOL 2022; 73:88-98. [DOI: 10.5114/pjp.2022.118700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
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12
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Sweed D, Sultan MM, Mosbeh A, Fayed YA, Abdelsameea E, Ehsan NA, Abdel-Rahman MH, Waked I. Lymphoepithelioma-like Hepatocellular Carcinoma: a Case Report and Review of Literature. J Gastrointest Cancer 2021; 54:275-281. [PMID: 34813031 DOI: 10.1007/s12029-021-00757-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 01/07/2023]
Abstract
We report a case of hepatic lymphoepithelioma-like carcinoma-hepatocellular carcinoma subtype (LEL-HCC) in a 41-year-old man with chronic hepatitis C virus (HCV) infection. The patient presented with abdominal pain and further assessment revealed a hypoechoic mass on ultrasonography. Serum alpha-fetoprotein (AFP) was 13·6 ng/dl. The patient was diagnosed as hepatocellular carcinoma based on the established triphasic computed tomography (TCT) diagnostic criteria and he underwent a surgical resection of the mass. Microscopic examination showed sheets and cords of malignant epithelial cells intermixed with heavy lymphoid infiltrate, with more than 100 tumor-infiltrating lymphocytes (TILs) per 10 high-power-field (HPF). Based on immunohistochemical studies, the malignant cells were positive for Hep Par 1 and glypican 3, focally positive for cytokeratin 7 (CK7), and negative for cytokeratin 20 (CK20). TILs were diffusely positive for cluster of differentiation 3 CD3 with an approximately equal CD4/CD8 ratio. The patient was recurrence free at 25 months after surgery, as evident by CT and serum alpha-fetoprotein level. LEL-HCC is a rare variant of HCC with a relatively better prognosis. Exploring the potential for immune modulator-based therapy in this subset of tumors is highly recommended.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Mervat M Sultan
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Asmaa Mosbeh
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt.
| | - Yahya A Fayed
- Hepatopancreatobiliary Surgery Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Nermine A Ehsan
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Mohamed H Abdel-Rahman
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Imam Waked
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
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13
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Sweed D, Abdelsameea E, Khalifa EA, Abdallah H, Moaz H, Moaz I, Abdelsattar S, Abdel-Rahman N, Mosbeh A, Elmahdy HA, Sweed E. SARS-CoV-2-associated gastrointestinal and liver diseases: what is known and what is needed to explore. Egypt Liver J 2021; 11:64. [PMID: 34777871 PMCID: PMC8325538 DOI: 10.1186/s43066-021-00123-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described in China as an unexplained pneumonia transmitted by respiratory droplets. Gastrointestinal (GI) and liver injury associated with SARS-CoV-2 infection were reported as an early or sole disease manifestation, mainly outside China. The exact mechanism and incidence of GI and liver involvement are not well elucidated. MAIN BODY We conducted a PubMed search for all articles written in the English language about SARS-CoV-2 affecting the GI and liver. Following data extraction, 590 articles were selected. In addition to respiratory droplets, SARS-CoV-2 may reach the GI system through the fecal-oral route, saliva, and swallowing of nasopharyngeal fluids, while breastmilk and blood transmission were not implicated. Moreover, GI infection may act as a septic focus for viral persistence and transmission to the liver, appendix, and brain. In addition to the direct viral cytopathic effect, the mechanism of injury is multifactorial and is related to genetic and demographic variations. The most frequently reported GI symptoms are diarrhea, nausea, vomiting, abdominal pain, and bleeding. However, liver infection is generally discovered during laboratory testing or a post-mortem. Radiological imaging is the gold standard in diagnosing COVID-19 patients and contributes to understanding the mechanism of extra-thoracic involvement. Medications should be prescribed with caution, especially in chronic GI and liver patients. CONCLUSION GI manifestations are common in COVID-19 patients. Special care should be paid for high-risk patients, older males, and those with background liver disease.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menofia University, Shibin El Kom, 32511 Egypt
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menofia University, Shibin El Kom, Egypt
| | - Esraa A. Khalifa
- Radiology Department, Faculty of Medicine, Menofia University, Shibin El Kom, Egypt
| | - Heba Abdallah
- Clinical Pathology Department, National Liver Institute, Menofia University, Shibin El Kom, Egypt
| | - Heba Moaz
- Microbiology Department, Faculty of Medicine, Menofia University, Shibin El Kom, Egypt
| | - Inas Moaz
- Epidemiology and Preventive Medicine Department, Menofia University, Shibin El Kom, Egypt
| | - Shimaa Abdelsattar
- Clinical Biochemistry, and Molecular Diagnostics Department, National Liver Institute, Menofia University, Shibin El Kom, Egypt
| | | | - Asmaa Mosbeh
- Pathology Department, National Liver Institute, Menofia University, Shibin El Kom, 32511 Egypt
| | - Hussein A. Elmahdy
- Biochemistry Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Eman Sweed
- Clinical Pharmacology Department, Faculty of Medicine, Menofia University, Shibin El Kom, Egypt
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14
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Abstract
Abstract
Background
The rapidly developing era of direct-acting antiviral regimens (DAAs) for more than one hepatitis C virus (HCV) genotype had certainly alleviated HCV burden all over the world. Liver fibrosis is the major dramatic complication of HCV infection, and its progression leads to cirrhosis, liver failure, and hepatocellular carcinoma. The impact of DAAs on liver fibrosis had been debatably evaluated with undetermined resolution.
Main body
The aim of this review is to accurately revise the effects of DAA regimens on liver fibrosis which can either be regression, progression, or non-significant association. Liver fibrosis regression is a genuine fact assured by many retrospective and prospective clinical studies. Evaluation could be concluded early post-therapy reflecting the dynamic nature of the process.
Conclusions
The ideal application of DAA regimens in treating HCV has to be accomplished with efficient non-invasive markers in differentiating proper fibrosis evaluation from necroinflammation consequences. Liver biopsy is the gold standard that visualizes the dynamic of fibrosis regression.
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Sweed D, Kilany S, Taha M, Sweed E, Abdelsattar S, Mosbeh A. Fibroblast Growth Factor 19 is an Independent Prognostic Parameter for Hepatocellular Carcinoma Recurrence. International Journal of Cancer and Biomedical Research 2021. [DOI: 10.21608/jcbr.2021.73946.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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16
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Sweed D, El Shanshory MR, Elaskary EM, Hassan HA, Sweed E, Sweed E, Abdelsattar S, Abdelgawad A, Mosbeh A, Abdallah H, El-Mashad S, Ehsan N. Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report. Egypt Liver J 2021; 11:69. [PMID: 34777872 PMCID: PMC8381346 DOI: 10.1186/s43066-021-00140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. CASE PRESENTATION A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. CONCLUSIONS AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.
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Affiliation(s)
- Dina Sweed
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
| | | | - Eman Mohammed Elaskary
- grid.412258.80000 0000 9477 7793Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hassnaa Atef Hassan
- grid.412258.80000 0000 9477 7793Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Enas Sweed
- grid.411660.40000 0004 0621 2741Radiology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Eman Sweed
- grid.411775.10000 0004 0621 4712Clinical Pharmacology Department, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Shimaa Abdelsattar
- grid.411775.10000 0004 0621 4712Clinical Pathology Department, National Liver Institute, Shibin el Kom, Egypt
| | - Ahmed Abdelgawad
- grid.411775.10000 0004 0621 4712Clinical Biochemistry, and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
| | - Asmaa Mosbeh
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
| | - Heba Abdallah
- grid.411775.10000 0004 0621 4712Clinical Biochemistry, and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
| | - Shereen El-Mashad
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
| | - Nermine Ehsan
- grid.411775.10000 0004 0621 4712Pathology Department, National Liver Institute, Menoufia University, Shibin el Kom, Egypt
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Zakaria H, Sallam AN, Ayoub II, Gad EH, Taha M, Roshdy MR, Sweed D, Gaballa NK, Yassein T. Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study. Ann Med Surg (Lond) 2020. [PMID: 32874564 DOI: 10.1016/j.amsu.2020.07.059.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. Patients and methods This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. Result There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084-0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020-0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046-0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. Conclusion It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC.
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Key Words
- AC, (adenocarcinoma)
- CA, 19-9(Carbohydrate antigen 19-9)
- DM, (diabetes mellitus)
- HBV, (hepatitis B virus)
- HCV, (hepatitis C virus)
- HTN, (hypertension)
- ICU, (intensive care unit)
- IHD, (ischemic heart disease)
- LNs, (lymph nodes)
- PAAC, (periampullary adenocarcinoma)
- PD, (Pancreaticoduodenectomy)
- PDAC, (Pancreatic duct adenocarcinoma)
- PG, (pancreatico-gastrostomy)
- PJ, (pancreatico-jejunostomy)
- PPPD, (pylorus preserving pancreaticoduodenectomy)
- Pancreaticoduodenectomy
- Periampullary adenocarcinoma
- Perineural invasion
- SD, (standard deviation)
- Survival
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Affiliation(s)
- Hazem Zakaria
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Ahmed N Sallam
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Islam I Ayoub
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Emad H Gad
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Mohammad Taha
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Michael R Roshdy
- Department of General Surgery, Faculty of Medicine, Minia University, Egypt
| | - Dina Sweed
- Department of Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Nahla K Gaballa
- Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Egypt
| | - Taha Yassein
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
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18
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Zakaria H, Sallam AN, Ayoub II, Gad EH, Taha M, Roshdy MR, Sweed D, Gaballa NK, Yassein T. Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study. Ann Med Surg (Lond) 2020; 57:321-327. [PMID: 32874564 PMCID: PMC7452109 DOI: 10.1016/j.amsu.2020.07.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. Patients and methods This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. Result There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084–0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020–0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046–0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. Conclusion It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC. Periampullary adenocarcinoma (PAAC) is highly aggressive tumor. It has late diagnosis with poor prognosis. Pancreaticoduodenectomy (PD) is still the only curative treatment option. PD surgery is associated with high morbidity and mortality. It is important to determine which patients who can receive benefit from surgery.
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Key Words
- AC, (adenocarcinoma)
- CA, 19-9(Carbohydrate antigen 19-9)
- DM, (diabetes mellitus)
- HBV, (hepatitis B virus)
- HCV, (hepatitis C virus)
- HTN, (hypertension)
- ICU, (intensive care unit)
- IHD, (ischemic heart disease)
- LNs, (lymph nodes)
- PAAC, (periampullary adenocarcinoma)
- PD, (Pancreaticoduodenectomy)
- PDAC, (Pancreatic duct adenocarcinoma)
- PG, (pancreatico-gastrostomy)
- PJ, (pancreatico-jejunostomy)
- PPPD, (pylorus preserving pancreaticoduodenectomy)
- Pancreaticoduodenectomy
- Periampullary adenocarcinoma
- Perineural invasion
- SD, (standard deviation)
- Survival
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Affiliation(s)
- Hazem Zakaria
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Ahmed N Sallam
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Islam I Ayoub
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Emad H Gad
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Mohammad Taha
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Michael R Roshdy
- Department of General Surgery, Faculty of Medicine, Minia University, Egypt
| | - Dina Sweed
- Department of Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Nahla K Gaballa
- Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Egypt
| | - Taha Yassein
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
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