Kai Huang

Fudan University, Shanghai, Shanghai Shi, China

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Publications (12)18.98 Total impact

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    ABSTRACT: Prognostic factors and optimal management of desmoid tumors have been discussed for decades. The authors present the results of a large series of patients with desmoid tumors treated at a single institution to investigate the prognostic factors influencing event-free survival (EFS) and suitable treatments for these rare tumors. Two hundred fourteen patients with desmoid tumors admitted to the surgical department were included, of whom 20 were recommended for a policy of watchful waiting. The following clinical parameters were studied: admission status, age, sex, tumor site, tumor size, margin status, and therapeutic strategy. Univariate and multivariate analysis were performed for EFS. Forty-two patients had local recurrence. One patient died of intra-abdominal disease. The 5-year and 10-year EFS rates were 78.8% and 77.9%, respectively. In univariate analysis, admission status, tumor site, tumor size, and group (R0 vs R1 and R0 vs R2) had significant impacts on EFS. EFS discrepancy was not significant between R1 and R2 or biopsy groups. In multivariate analysis, tumor size and admission status had independent value. The median delay to progression for patients undergoing watchful waiting was comparable with that for the surgical group. This study demonstrates that tumor size and a history of recurrence are independent predictors of EFS. Surgery is warranted if it can be R0 and function sparing. Nonsurgical modalities or a policy of watchful waiting may be a better choice for unresectable disease.
    No preview · Article · Oct 2013 · American journal of surgery
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    ABSTRACT: Adjuvant therapy is not usually recommended in AJCC T2N0M0 gastric cancer, yet sometimes is indicated for high-risk patients. The purpose of this study is to stratify the risk of pathological T2N0 gastric cancer after gastrectomy based on clinicopathological factors so as to predict prognosis and guide treatment. We analyzed our documented clinical database of 233 patients with T2N0M0 gastric cancer who underwent radical resection between 2000 and 2007. No adjuvant chemotherapy was applied. For the entire study group, the overall 5-year survival rate was 88.5%. Multivariate analysis indicated there were three tumor characteristics which were independent prognostic factors: lymphatic and/or blood vessel invasion (p = 0.025), tumor diameter (p = 0.004), and perineural invasion (p = 0.009). Three risk groups were created based on weighted variables with overall 5-year survival of 97.7%, 83%, and 50.3% as low-risk, intermediate-risk, and high-risk groups, respectively (p < 0.001). Patients with T2N0 gastric cancer have a favorable prognosis after radical resection. A prognostic risk model of patients with pT2N0 gastric cancer undergoing radical resection is constructed based on lymphatic and/or blood vessel invasion, tumor diameter, and perineural invasion. The prognostic risk model identifies a small subgroup of patients with an increased risk of death, suggesting adjuvant therapy may be considered for these patients.
    No preview · Article · Sep 2011 · Journal of Gastrointestinal Surgery
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    ABSTRACT: To compare the effect on survival of anatomic resection (AR) versus nonanatomic resection (NAR) in patients with hepatocellular carcinoma (HCC) from all published comparative studies in the literature. Databases, including Pubmed, Embase, the Cochrane Library, Ovid, and Web of Science, were searched to identify studies comparing AR with NAR for HCC. In this meta-analysis, primary end points were the overall survival and disease-free survival; the secondary end point was local recurrence rate. The meta-analysis was performed by use of RevMan 4.2. Nine comparative studies comprising 1,503 patients (833 AR and 670 NAR) were identified. In the combined results, disease-free survival was significantly higher in the AR group than in the NAR group (OR 1.78, 95% CI 1.22-2.59, P = 0.003; heterogeneity P = 0.08). Overall survival (OR 1.31, 95% CI 0.92-1.85, P = 0.13; heterogeneity P = 0.04) did not suggest any significant difference between AR and NAR. No statistically significant difference was found for local recurrence rate between the two resection methods (OR 0.55, 95% CI 0.25-1.23, P = 0.15; heterogeneity P = 0.010). Anatomic resection is associated with better disease-free survival than nonanatomic resection. Because heterogeneity was detected, caution is needed in interpretation of the results. Better designed, adequately powered studies are required to address this issue.
    No preview · Article · Nov 2010 · Digestive Diseases and Sciences
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    ABSTRACT: Most gastrointestinal stromal tumor (GIST) patients respond to KIT inhibition therapy of imatinib, but eventually become resistant with a median time to progression of 2 years. The mechanism of acquired resistance to imatinib and oncogenic KIT signal transduction in GISTs has not been well defined. We sought to investigate the spectrum of molecular and genomic changes in imatinib-resistant GIST patients. KIT and PDGFRA mutations were evaluated in 48 samples obtained from 32 GIST patients who underwent surgery after imatinib treatment. KIT downstream signaling profiles were also investigated in eight specimens of five patients who were clinically responsive or resistant to imatinib therapy. Biochemical inhibition of KIT, mitogen-activated protein kinase (MAPK), mammalian target of rapamycin (MTOR), AKT, proliferating cell nuclear antigen (PCNA) and BCL-2 were determined by western blotting for protein activation. In all 32 GIST patients, activating mutations in the KIT gene were seen in 26 (81.3%) patients, PDGFRA gene mutations were seen in 2 (6.2%) patients and no primary mutations were found in 4 (12.5%) patients. Secondary KIT mutations were identified in 11/14 (78.6%) imatinib-acquired-resistance patients, with nine patients in KIT gene exon17, and the other two in exon 13. The expressions of p-KIT, p-AKT, PCNA and BCL-2 were higher in the samples of imatinib-resistant GISTs than those of imatinib-responsive ones. P-KIT, p-AKT expressions were higher in imatinib acquired-resistance GISTs with secondary KIT mutations than imatinib-responsive ones with primary mutation. Total KIT, MAPK, p-MAPK, p-MTOR expressions were comparable in all varied GISTs. Novel additional mutations of KIT gene exon 13 or exon 17 indicate the likely mechanism of secondary resistance to imatinib. The PI3-K/AKT pathway might be more relevant than MEK/MAPK for therapeutic targeting in imatinib-resistant GIST patients with secondary mutation.
    No preview · Article · Jul 2010 · Journal of Cancer Research and Clinical Oncology
  • Kai Huang · Hong Fu · Ying-Qiang Shi · Ye Zhou · Chun-Yan Du
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    ABSTRACT: Previous reports even large studies discussing the prognosis of desmoids have included tumors from intra- and extra-abdominal sites as well as incomplete resection. The purpose of this study was to explore prognostic factors associated with the recurrence free survival (RFS) rate in surgically treated extra-abdominal and abdominal wall desmoids. A total of 198 consecutive desmoid patients were treated with surgery over a 20-year period at a single institution. Of these, 151 patients with extra-abdominal and abdominal wall tumors were retrospectively reviewed. One hundred thirteen patients were referred for the primary tumor and the other 38 for recurrent disease initially treated elsewhere. All patients underwent a macroscopically complete resection. The median follow-up interval was 102 months. Thirty-one patients (20.5%) had a local recurrence (LR). No patients died of the disease. The 5- and 10-year RFS was 79.7% and 78.5%, respectively. Admission status, gender, tumor size, margin status, location, and number, were predictors of LR in univariate analysis. Tumor size and margin status were independent prognostic factors in multivariate analysis. Positive margins were predictive of recurrence of primary disease, and also showed a trend for recurrent disease, which was not statistically significant. The selective use of adjuvant radiation did not show significant benefit over local control. Regardless of primary or recurrent disease, microscopically negative margins should always be the goal for extra-abdominal desmoids surgery, if no cosmetic defects or function demolition is encountered. Extra-abdominal desmoids deserve more attention and should be treated more aggressively, especially when leaving positive margins.
    No preview · Article · Dec 2009 · Journal of Surgical Oncology
  • Dean Ta · Kai Huang · Weiqi Wang
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    ABSTRACT: Ultrasonic backscatter offers the advantage of directly analyzing some common fracture sites other than the calcaneus. Spectral centroid shift (SCS), an indicator of ultrasonic attenuation in the bone, is a potential parameter obtained from ultrasonic backscattered signals to represent the bone status. In this paper, twenty-six bovine tibia bones in vitro were scanned by a 10 MHz transducer and the ultrasonic backscattered signals were processed to obtain SCS at corresponding scan spots. Correlations were studied between mean/standard deviation (SD) of SCS values within a ROI of bones and bone structural parameters obtained from a ¿-CT. Results demonstrated that SCS has mediate and significant correlations with all the parameters obtained from ¿-CT (Tb.Th, r = -0.699, p < 0.01; Tb.Sp, r = 0.477, p < 0.05; BV/TV, r= -0.675, p < 0.01; BS/BV, r = 0.663, p < 0.01; BD, r = 0.663, p < 0.01). The SD of SCS was also significantly (p < 0.01) correlation with bone structural parameters. The high relationships between the ultrasonic parameter SCS and bone structural parameters hold promise for later implementing SCS to assess bone quality.
    No preview · Conference Paper · Sep 2009
  • Baiding Yang · Dean Ta · Kai Huang · Weiqi Wang
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    ABSTRACT: In this paper, a high resolution transducer was used to conduct ultrasonic backscatter parametric images based on the measurements of uncompensated backscatter coefficient (BC) and apparent integrated backscatter (AIB), which can provide information related to cancellous bone microstructure. BC&AIB images from 26 bovine cancellous bone samples in vitro were constructed to analyze their abilities of characterizing cancellous bone status. For each of 26 bone samples, mean value and standard deviation (SD) of BC&AIB values within a region of interest (ROI) were calculated and then compared with bone microstructural parameters obtained from mu-CT 3D reconstruction. Results demonstrated that BC and AIB have mediate, but significant correlations with trabecular spacing (Tb.Sp). It was also found that spatial variation of BC or AIB values was significantly related with bone microstructural parameters.
    No preview · Conference Paper · Jan 2009
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    ABSTRACT: The ultrasonic scattering mechanism in cancellous bone is investigated theoretically and a model describing the frequency dependence of ultrasonic scattering from cancellous bone is presented. The ultrasonic backscatter coefficient (BSC) of bovine tibiae, human calcanei in vitro and in vivo, were measured and discussed. The data of BSC were also fitted by polynomial. The results demonstrate that BSC is a nonlinear function of frequency and increases with frequency. A good agreement was obtained between BSC values from theory and experiment. Also, the high correlation coefficient between BSC and bone mineral density was obtained, r=0.85+/-0.07 (mean+/-SD) (n=15, p<0.001). Based on the values of BSC, the status of cancellous bone and the degree of osteoporotic fracture risk may be assessed.
    No preview · Article · Jan 2009 · The Journal of the Acoustical Society of America
  • Kai Huang · Dean Ta · Weiqi Wang · Lawrence H. Le
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    ABSTRACT: Ultrasonic backscatter signals provide useful information relevant to bone tissue characterization. Trabecular bone microstructures have been considered as quasi-periodic tissues with a collection of regular and diffuse scatterers. This paper investigates the potential of a novel technique using a simplified inverse filter tracking (SIFT) algorithm to estimate mean trabecular bone spacing (MTBS) from ultrasonic backscatter signals. In contrast to other frequency-based methods, the SIFT algorithm is a time-based method and utilizes the amplitude and phase information of backscatter echoes, thus retaining the advantages of both the autocorrelation and the cepstral analysis techniques. The SIFT algorithm was applied to backscatter signals from simulations, phantoms, and bovine trabeculae in vitro. The estimated MTBS results were compared with those of the autoregressive (AR) cepstrum and quadratic transformation (QT) . The SIFT estimates are better than the AR cepstrum estimates and are comparable with the QT values. The study demonstrates that the SIFT algorithm has the potential to be a reliable and robust method for the estimation of MTBS in the presence of a small signal-to-noise ratio, a large spacing variation between regular scatterers, and a large scattering strength ratio of diffuse scatterers to regular ones.
    No preview · Article · Aug 2008 · IEEE Transactions on Ultrasonics Ferroelectrics and Frequency Control
  • Kai Huang · Dean Ta · Weiqi Wang · Lawrence H. Le

    No preview · Conference Paper · Jan 2007
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    ABSTRACT: The hollow cylinder model filled with viscous-liquid is performed to simulate tibial bone shape in this paper. Short time Fourier transform (STFT) was applied to identify and analyze guided wave modes of a series of ultrasonic signals acquired at various transmitter-receiver positions for a fixed transmitter. Experimental results were compared with theoretical simulation. The high correlation values for group velocity were obtained between results of experiment and theory for L(0,2) (r=0.89, p<10(-5)), and L(0,3) (r=0.87, p<10(-5)). The experimental group velocities correlated strongly with cortical thickness (cortTh) for L(0,2) (r(2)=0.79, p<10(-5)) and L(0,3) (r(2)=0.74, p<10(-5)) at 0.5 MHz center frequency. The results showed that the STFT is an effective method to identify the propagating modes and derive dispersion information. The experimental results were in good agreement with theoretical predictions. This study suggests that the guided wave L(0,2) mode is a promising mode to assess change in cortical thickness.
    No preview · Article · Dec 2006 · Ultrasonics
  • De-An Ta · Kai Huang · Wei-Qi Wang · Yuan-Yuan Wang
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    ABSTRACT: The scattering mechanism of ultrasound in cancellous bone is investigated theoretically. The relationship of backscatter coefficient (BSC) in cancellous bone with frequency is analyzed in theoretical and experimental. The results of theory and experiment for cancellous bone of bovine tibiae, human calcaneus in vitro and in vivo showed that BSC is a non-linear function of frequency, increasing with frequency. In general, all curve of BSC can be divided into three sections with different slope. The slopes of the first and third section have a large value, and the slope of second section is flat. A good agreement was obtained in the averaged BSC of experiment and cellular model. Those results suggest that the backscatter signal and BSC have a particularly important action in assessment of cancellous bone status and diagnosis of osteoporosis.
    No preview · Article · Feb 2005 · Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference