Forty-five pancreatoduodenectomies had been performed in our hospital from 1981 to 1994, of which 35 cases were diagnosed as carcinomas of Vater’s ampulla or pancreatic head, and 10 (cases) as benign lesions. Through analysis of misdiagnosed cases, the authors emphasize that it is important to take correct history of jaundiced patients in detail according to the character of the jaundice and associated symptoms before any operation done. Secondly, all clinical materials must be thoroughly collected and special examinations for diagnosis should be chosen scientifically to avoid relying only on one sort of examination result as diagnostic standard. Thirdly, during operation the area of pancreatic head should be explored carefully and any lesions in doubt should be examined pathologically by puncture biopsy and frozen section to avoid misdiagnosis and thus performing pancreatoduodenectomy.
Objective To investigate the role of KiSS-1 gene in the metastatic process of carcinoma of gallbladder and the clinicopathologic significance of KiSS-1 gene expression in carcinoma of gallbladder. Methods Pathological specimens from 59 gallbladder carcinoma tissues (13 hepatic invasion and 13 lymphatic invasion tissues were included), matched with 7 para-tumor and 6 normal gallbladder tissues, were examined for the expression of KiSS-1 gene by tissue microarray technique and immunohistochemistry (EnVision). Results The positive rate of KiSS-1 expression was down-regulated (P＜0.05) in tumor tissues, as compared with normal and para-tumor tissues. In carcinoma of gallbladder, the expression of KiSS-1 had no relationship with the gender, age, tumor size, histological grade or differentiation, and metastasis of lymph node, while was associated with the depth of infiltration, invasion of liver and the clinical stages (Nevin). In Ⅰ+Ⅱ, Ⅲ+Ⅳ and Ⅴ stage, the positive rates of KiSS-1 were 92.3%, 57.1% and 27.8% respectively, with an undeniably clear lowering tendency (P=0.002). Conclusion Down-regulating expression of KiSS-1 is closely associated with the processes of genesis, invasion and metastasis in carcinoma of gallbladder, and may participate in regulating these processes.
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.
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.
OBJECTIVE To introduce a method to repair the vagina following pelvic exenteration for carcinoma of rectum in which the posterior wall of the vagina and cervix of the uterus were often involved. METHODS From 1990 to 1997 segment of the vascularized ileum was used to repair the vagina in 5 cases, and in 2 of which the whole vagina was repaired while in the other 3 cases only the posterior wall of the vagina was repaired. RESULTS All of the patients had successful results after operation repair. CONCLUSION Vascularized graft was an ideal material for the repair of vagina defect following pelvic exenteration for carcinoma of rectum, because this material was easily accessible, and its vascular pedicle was long enough for its transferring to the perineal region and the ileum had good blood supply which made healing easy. The vagina following repair had a thick posterior wall, good elasticity and very little scar tissue surrounded.
ObjectiveTo compare the advantages and drawbacks of harmonic scalpel (HS) versus conventional electro-scalpel (ES) in the surgery for carcinoma of uterine cervix. MethodsA total of 126 patients with stage Ⅰ uterine cervix carcinoma who underwent surgery between January 2011 and November 2015 were randomly and averagely divided into HS group and ES group with 63 patients in each. The operation time, intra-operative bleeding volume, the number of lymph nodes detected and operation cost were compared between the two groups of patients. ResultsAll the patients underwent surgery successfully. There were significant differences between the HS and ES groups in terms of operation time[(202.06±11.67) minutes vs.(223.48±18.01) minutes, P<0.001], intra-operative bleeding[(373.97±27.95) mL vs.(458.16±33.18) mL, P<0.001], operation cost[(4 171.43±276.46) yuan vs.(3 101.54±258.59) yuan, P<0.001]. There was no significant difference between the two groups in terms of the number of lymph nodes detected (10.38±2.43 vs.9.76±2.61, P=0.172). ConclusionThe use of harmonic scalpel can reduce operation time and intra-operative bleeding volume effectively, but it cannot increase the number of lymph nodes detected. Moreover, it significantly increases the operation cost and economic burden for the patients.
Objective To detect the expression of transferrin receptor 1 (TfR1) in laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma, exploring the relationship between the expression of the four cancers and their occurrence and progression. Methods A total of 24 specimens of head-neck carcinoma were collected in surgery from April 2015 to March 2017, including 8 cases of laryngeal carcinoma, 8 cases of thyroid carcinoma, 4 cases of maxillary sinus carcinoma, and 4 cases of parotid carcinoma. Fluorescence quantitative polymerase chain reaction technique for TfR1 mRNA and western blot for TfR1 protein was performed in those tumor tissues and their adjacent normal tissues. Results The relative expression level of TfR1 mRNA in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma was 0.078±0.002, 0.065±0.044, 0.076±0.014, 0.067±0.004, respectively; while the relative expression level of TfR1 mRNA in the adjacent normal tissues of the four cancers was 0.021±0.012, 0.011±0.007, 0.017±0.013, 0.028±0.007, respectively. The relative expression level of TfR1 protein in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma was 0.668±0.206, 0.640±0.066, 0.452±0.095, 0.925±0.221, respectively; while the relative expression level of TfR1 protein in the adjacent normal tissues of the four cancers was 0.359±0.113, 0.424±0.096, 0.280±0.093, 0.519±0.037, respectively. The expression levels of TfR1 mRNA and TfR1 protein in the tumor tissues of the four cancers were all higher than those in their adjacent normal tissues (P<0.05). Conclusions The expression levels of TfR1 mRNA and TfR1 protein in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma and parotid carcinoma are up-regulated. TfR1 may be involved in the occurrence and progression of the four cancers, and it may be responsible for tumor proliferation by providing necessary raw materials for the proliferation of tumor cells.
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 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 assess the feasibility of the treatment of unresectable late pancreatic cancer with laparoscopic choledochojejunostomy and gastric bypass. MethodsFrom June 2000 to December 2003, laparoscopic choledochojejunostomy and gastric bypass were successfully performed in 15 patients with unresectable late pancreatic cancer. Endoscopic nosobiliary drainage (ENBD) was performed before the operation. ResultsAll procedures were completed laparoscopically. Jaundice and hepatic function of the patients were obviously improved after the bypass. Oral nutrition was recovered after operation. The mean operative time was (100±26) min (range 70-200 min); the mean operative blood loss was (60±15) ml (range 30-120 ml); the bowel function recovery was on the 3rd-5th postoperative day; the average hospital stay was (8.1±0.7) days (range 6-13 days). Incision infection ocurred in one patient. No operative complications occurred in other patients. ConclusionTreatment of unresectable late carcinoma of the pancreas with laparoscopic choledochojejunostomy and gastric bypass aided by ENBD is a minimally invasive technique with less postoperative pain，shorter hospital stay, lower procedurerelated morbidity,and better oral nutrition. The life quality of patients with late pancreatic cancer can be obviously improved.