Objective To introduce the current study on 18F-fluorodexyglucose positron emission tomography (18F-FDG PET) scanning in diagnosis and treatment of carcinoma of large intestine. Methods The literatures about 18F-FDG PET scanning in diagnosis and treatment of carcinoma of large intestine in recent years were reviewed. Results 18F-FDG PET scanning is superior to CT and MRI in identificating carcinoma of large intestine recurrence, metastasis in the early stage after operation and staging carcinoma of large intestine. Conclusion 18F-FDG PET scanning may be one of the accessory examinations in carcinoma of large intestine and may be helpful for the choice of treatment.
ObjectiveTo summarize the role of epithelial-mesenchymal-transition （EMT） in occurrence and development of gastrointestinal cancer. MethodsDomestic and international publications online involving EMT of gastrointestinal cancer in recent years were collected and reviewed. ResultsEMT was a highly conserved process that has been well characterised in embryogenesis. Studies had shown that the aberrant activation of EMT in adult epithelia could promote tumour metastasis by repressing cell adhesion molecules. E-cadherin， one of the epithelial cell markers, maybe involved in the process of the EMT, especially of the Ecadherin transcriptional repressors， these transcriptional repressors significantly increased in the gastrointestinal cancer. Further more， EMT might involve in the process of gastrointestinal cancer stem cells formation. ConclusionsEMT and it’s regulators play a very important role in gastrointestinal cancer， and may provide a newsight into the gastrointestinal cancer. It also can provide a novel clinical targets to treat the gastrointestinal cancer.
【Abstract】ObjectiveTo study the spiral CT features of gastrointestinal invasion by carcinoma of gallbladder. MethodsEight patients with surgical-pathologically documented gastrointestinal invasion by carcinoma of gallbladder were analyzed retrospectively. All patients underwent plain and contrast-enhanced dual-phase scanning of the abdomen. Oral contrast medium (1.2% Angiografin) was used to fill the gastrointestinal tract before CT scanning. ResultsThere were 2 cases of gastric antrum invasion, 6 duodenal invasion and 3 colonic invasion according to the surgical and pathological findings. Spiral CT correctly diagnosed 2 gastric invasion and 4 duodenal invasion based on several imaging features, like blurring of fat plane, focal wall thickening and luminal narrowing of involved gastrointestinal segments, and mass formation. However CT was unable to diagnose the 3 cases of hepatic flexure of colon invasion. ConclusionCT is valuable for diagnosing upper gastrointestinal tract invasion by carcinoma of gallbladder, yet the diagnosis of hepatic flexure of colon invasion is still difficult.
ObjectiveTo summarize recent research advancement on radically surgical therapy of carcinoma of the body and tail of pancreas． MethodsRelevant literatures about radically surgical therapy of carcinoma of the body and tail of pancreas were collected and reviewed． ResultsRecent experimental researches indicated that distal pancreatectomy was the common used surgical way to treat carcinoma of the body and tail of pancreas. Besides， spleenpreserving distal pancreatectomy, distal pancreatectomy with en bloc celiac axis resection, and laparoscopic distal pancreatectomy were also the choices to the treatment of carcinoma of the body and tail of pancreas. ConclusionThe surgical way to treat carcinoma of the body and tail of pancreas has advanced for these years, but furthermore development requires more great efforts.
【Abstract】ObjectiveTo summarize the study on the feasibility of celiac axis ligation. Methods Literatures about celiac axis ligation were reviewed retrospectively. ResultsCeliac axis branches included common hepatic artery， splenic artery， left gastric artery which had many variation and collateral flow between celiac and mesenteric vessels by gastroduodenal artery and pancreaticoduodenal artery. Celiac axis could be possibly ligated without obvious complications in patients who had celiac axis injuries, celiac artery aneurysms, upper gastrointestinal haemorrhage, excision of carcinoma around the celiac axis and portal hypertension. However, gallbladder necrosis or perforation, focal infarction of the liver even higher mortality had also been reported. ConclusionCeliac axis ligation should not be performed routinely, but it is surgically possible and may be a life saving approach in certain circumstances.
Objective To determine the safety and efficacy of surgical biliary bypass on the elderly patients with unresectable pancreatic head cancer. Methods The clinical data of 55 cases with unresectable pancreatic head cancer treated with palliation methods from July 2002 to June 2009 in our hospital were retrospectively analyzed. The patients were divided into three groups according to different age and therapeutic program: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (group A), 19 patients under 65 years of age were treated by surgical biliary bypass (group B) and 17 patients with the age of 65 years or older received percutaneous transhepatic biliary drainage (group C). Then the therapeutic results were compared.Results With respect to the postoperative level of serum bilirubin, the incidence of early complications, postoperative hospitalization and mean survival time, no statistically significant difference was found between group A and B (Pgt;0.05). There was one case of recurrent jaundice and one case of gastric output obstruction in group B, while no one suffered postoperative complication in group A, and the difference was statistically significant (Plt;0.01). Compared with group A, the postoperative level of serum bilirubin, the number of patient readmitted, the rate of recurrent jaundice and gastric output obstruction were higher in group C (Plt;0.05 or Plt;0.01). The mean postoperative hospitalization and overall survival time were significantly shorter in group C than group A (Plt;0.05 or Plt;0.01, respectively). Conclusion Surgical palliation does not increase the morbidity rate, but it does improve the quality of life in elderly patients with unresectable pancreatic head cancer.
ObjectiveTo compare the efficacy between laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in treatment of carcinoma of head of pancreas. MethodsClinical data of 60 patients with locally advanced carcinoma of head of pancreas who underwent pancreaticoduodenectomy in our hospital from October 2004 to October 2009 were collected, of which 26 patients were in LPD group and 34 patients were in OPD group. ResultsOperative time and hospitalization expense of patients in LPD group were both longer or more than those of OPD group (P<0.05), but blood loss, time of starting activity, time of aeration, time of pulling out the drainage tube, time of pulling out the stomach tube, time of absolute resting on bed, and hospitalization time in LPD group were all shorter or lower than those of OPD group (P<0.05). There were 25 patients suffered with postoperative complications, including 10 patients in LPD group and 15 patients in OPD group, and there was no significant difference between the 2 groups in total incidence of postoperative complication (P>0.05). But in the specific postoperative complication, the incidences of pancreatic fistula and biliary fistula of LPD group were higher than those of OPD group (P<0.05), but incidences of incision infection, pulmonary infection, and systemic infection were all lower than those of OPD group (P<0.05). All patients were followed up for 1-60 months with the median time of 21.5 months. During the follow-up period, in LPD group, 24 patients suffered with recurrence, 20 patients suffered with tumor metastasis, and 24 patients died; in LPD group, 31 patients suffered with recurrence, 25 patients suffered with tumor metastasis, and 31 patients died. There were no significant difference between the 2 groups in the recurrence rate, metastasis rate, mortality, and survival situation (P>0.05). ConclusionsFor carcinoma of head of pancreas, postoperative recovery and infection complications of LPD are significantly superior than those of OPD. But compared with the OPD, it has no obvious advantage in reducing the pancreatic fistula, biliary fistula, delayed gastric emptying, and other complications, and it also has no obvious advantage in improving the long-term survival situation too.
The pectoralis major myocutaneous flap was used to repair laryngopharyngeal and esophageal defect following radical excision of pharyngeal and inferior laryngeal carcinomas in 3 cases. The results were susscessful. The patients were follwedup for 6 months to 3 years. The deglutition functions were all reestablished, the general nutritional conditions were improved, and no recurrence or distant metastasis was observed. The advantages of this operative procedure were discussed.
Objective To investigate the prognostic value of epithelial-mesenchymal transition （EMT） related proteins （Snail， E-cadherin， and N-cadherin） in gastric cancer and its relationship with tumor initiating cells （TICs） marker （CD133）. Methods The expressions of EMT-related proteins and CD133 protein in the gastric cancer tissues and normal gastric mucosa tissues adjacent to gastric cancer were detected by Western blot method. The relations between the expressions of EMT-related factors proteins and CD133 protein and the clinicopathologic characters were analyzed. The correlations between EMT-related factors and CD133 were analyzed by Spearman. The correlations between EMT-related factors expressions and CD133 expression and survival were analyzed by Kaplan-Meier method and Log-rank test. Results ① The protein expression levels of Snail， N-cadherin， and CD133 in the gastric cancer tissues were significantly higher than those in the normal gastric mucosa tissues adjacent to gastric cancer （Snail：0.599±0.114 versus 0.259±0.108， P=0.020；N-cadherin：0.754±0.154 versus 0.329±0.134， P=0.001；CD133：0.635±0.119 versus 0.485±0.116， P=0.029）， while the protein expression level of E-cadherin was lower than that in the normal gastric mucosa tissues adjacent to gastric cancer （0.378±0.123 versus 0.752±0.156， P=0.003）.② The expression levels of Snail and N-cadherin in the gastric cancer patients with vascular invasion， lymphatic vessel invasion，N3 lymph node metastasis， diameter more than 5 cm， and Ⅲ＋Ⅳ staging were significantly higher than those in the patients without vascular invasion， lymphatic vessel invasion， N0-N2 lymph node metastasis， diameter less than 5 cm， andⅠ＋Ⅱ staging（P＜0.05）， while E-cadherin protein expression was lower than that in the patients without vascular invasion， lymphatic vessel invasion， N0-N2 lymph nodes metastasis， andⅠ＋Ⅱstaging （P＜0.05）. The expression levels of CD133 in the gastric cancer patients with lymphatic vessel invasion， diameter more than 5 cm， and Ⅲ＋Ⅳ staging were significantly higher than those in the patients without lymphatic vessel invasion， diameter less than 5 cm， andⅠ＋Ⅱ staging （P＜0.05）. ③The Snail and N-cadherin protein expressions were significantly positive correlated with CD133 protein expression， respectively （rs=0.278， P=0.048；rs=0.406， P=0.003）， while E-cadherin protein expression was significantly negative correlated with CD133 protein expression （rs=-0.504， P=0.000）.④ The survival time in the patients with lower expressions of Snail， N-cadherin， and CD133 were significantly longer than those in the patients with higher expressions of Snail， N-cadherin， and CD133 （P＜0.05）. The combination of Snail， N-cadherin， E-cadherin， and CD133 could effectively predict survival. Conclusions There is a significant correlation between EMT and gastric cancer TICs， and which are correlated with aggressive clinicopathologic features of gastric cancer. The combination of Snail， E-cadherin， N-cadherin， and CD133 may be effectively predict the prognosis of gastric cancer patients.