Purpose Biliary stents combined with percutaneous or endoscopic ultrasound-guided iodine-125 seed implantation into primary tumor have been confirmed to relieve malignant obstructive jaundice (MOJ), and prolong patient’s stent patency. The aim of the study was to evaluate meaningful clinical application indications and better guide the application of this technology. Material and methods Patients with MOJ, who have received bile duct stenting combined with iodine-125 ( 125 I) seed implantation from October, 2010 to April, 2022, were retrospectively analyzed. Univariate and multivariate analyses were adopted to indicate factors of stent patency in MOJ and influencing factors of jaundice reduction at one week after surgery. Results A total of 90 patients were enrolled into the study, including 52 males (57.8%) and 38 females (42.2%), with a mean age of 68.66 ±12.53 years. The median stent patency was 8 months. No serious adverse events occurred during follow-up. Multivariate analysis showed that Child-Pugh score (HR = 2.221, 95% CI: 1.081-4.562), biliary infection (HR = 1.901, 95% CI: 1.084-3.335), and pre-operative jaundice duration (HR = 1.977, 95% CI: 1.106-3.533) were the independent risk factors for stent patency. Child-Pugh B/C (OR = 4.647, 95% CI: 1.080-19.982) and bile duct infection (OR = 3.583, 95% CI: 1.095-11.725) were the independent risk factors for jaundice reduction at one week after surgery. Conclusions MOJ patients treated with biliary stents combined with 125 I seed implantation, and patients with better pre-operative liver function and no biliary tract infection, present not only longer biliary stent patency, but also better early jaundice reduction.

Objective: The main purpose was to investigate expression of CDH11 in pancreatic tissues and analyze its relations with clinical characteristics of patients with pancreatic cancer (PC). Methods: Expression of CDH11 in cancerous tissues and cancer adjacent tissues were detected by immunohistochemistry staining, and their associations with clinical characteristics were analyzed. The text mining methods were used to assist the study of the effect of CDH11 on prognosis. Results: A total of 79 patients with PC were enrolled in the study, including 51 (64.6%) men and 28 (35.4%) women with a median age of 62 (41 -84). The CDH11 expression in cancerous tissues was higher than that in adjacent tissues and the expression of CDH11 in both tissues was positively correlated (P < 0.001). CDH11 of stage II was significantly higher than that of stage I (P < 0.001), while the CDH11 expression in stages III & IV was not different from that in stage I and II (stage I vs III & IV, P > 0.999; stage II vs III & IV, P = 0.308). A higher level of CDH11 expression correlated with worse overall survival (OS) time (P = 0.015). Conclusion: CDH11 may be involved in the development of early PC and lead to poor prognosis and could be a new target molecule for early diagnosis and treatment of PC.

Purpose The objectives of the present study were to evaluate the feasibility, safety, and efficacy of endoscopic ultrasound (EUS)-guided iodine-125 ( 125 I) seed implantation in ampullary carcinoma (AC). Material and methods From January 2011 to June 2020, 13 patients were selected for this retrospective study. Thirteen tumors (27.46 ±12.07 mm) were treated with EUS-guided 125 I seed implantation in 29 sessions. We evaluated the therapeutic efficacy, adverse effects, and overall survival (OS) time. Results Complete response (CR) was observed in one tumor in 6 months. Partial response (PR) was detected in two target tumors in 3 months, seven in 6 months, seven in 9 months, and six in 12 months. Good periods of survival were observed. The median OS was 35 months, 95% confidence interval (95% CI) was 8.97 to 61.03 months. The 1-, 2-, and 5-year OS rates were 100%, 67.5%, and 11.3%, respectively. There were no procedure-related deaths or serious adverse events. Transient abdominal pain (5 cases, 17.2%), abdominal distension and loss of appetite (3 cases, 10.3%), and seed migration (1 case, 3.4%) were observed, respectively. Conclusions In selected patients with inoperable AC, EUS-guided 125 I seed implantation is feasible and safe with favorable local control efficacy and OS.

Background The purpose of this study was to explore the feasibility, safety and efficacy of iodine-125 seed implantation in the treatment of dysphagia of advanced esophageal cancer. Methods We retrospectively analyzed patients with advanced esophageal cancer who underwent EUS-guided iodine-125 seed implantation or conventional chemoradiotherapy in our hospital. The propensity score match was used to reduce the baseline differences. Results A total of 127 patients were enrolled, 17 patients received EUS-guided iodine 125 seed implantation (Group A), 31 patients received radiotherapy (Group B), 38 patients received chemotherapy (Group C) and 41 patients received chemotherapy combined with radiotherapy (Group D). At half month postoperatively, the dysphagia remission rate in Group A (100%) was better than that in Groups B (39.3%), C (20%), D (15.8%), respectively, in the original cohort ( P < 0.01); At 1 month postoperatively, the dysphagia remission rate in Group A (86.7%) was better than that in Group B (57.1%) ( P > 0.05), Group C (25.7%) ( P < 0.05) and Group D (34.2%) ( P < 0.05), respectively, in the original cohort. There was no statistically significant difference in median overall survival (OS) between Group A (16 months) and Group B (37 months) ( P = 0.149), and between Group A (16months) and Group C (16 months) ( P = 0.918) in the original cohort. The mean OS of Group D (54 months) was better than that of Group A (20 months) in the original cohort ( P = 0.031). The incidences of grade ≥2 myelosuppression in Groups B, C, and D were 12.9%, 28.9%, and 43.9%, respectively; the incidence of grade ≥2 gastrointestinal adverse events in Groups B, C, and D were 12.9%, 15.8%, 12.2%, respectively. No serious adverse events were found in Group A. The radiation dose around the patient was reduced to a safe range after the distance from the implantation site was more than 1 m (4.2 ± 2.6 μSv/h) or with lead clothing (0.1 ± 0.07 μSv/h). Conclusions Compared with conventional radiotherapy or chemotherapy alone, iodine-125 seed implantation might improve dysphagia more quickly and safely, further clinical data is needed to verify whether it could effectively prolong the OS of patients.