Objective To investigate the feasibility and indication of synchronous resection of colonic carcinoma and its hepatic metastasis. Methods Radical sigmoidectomy and right hemi-hepatectomy plus left lateral segment resection were performed at the same time in a 71-year-old patient with sigmoid carcinoma and multiple hepatic metastasis. Results The operation lasted for 5 hours and 10 minutes with 300ml blood lost during the procedure. The patient recovered smoothly and was discharged 2 weeks after operation. Follow-up showed no reoccurrence up to the day of this presentation(4 months).Conclusion The operation could be performed safely by experienced surgeon in good-equipment hospital.
ObjectiveTo evaluate the prognostic significance of postoperative metastasis in non-small cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the clinical data of 94 patients who underwent curative lobectomy and pathologically diagnosed with NSCLC in our hospital between January 2005 and December 2011. There were 53 males and 41 females with a mean age of 62 (57-76) years. ResultsAmong 94 patients, metastasis occurred during late stage (more than 2 years postoperatively) in 49 (52.12%) patients. Single organ metastasis and multiple organ metastasis were found in 85 (90.43%) patients. The most popular metastatic site was lung (38/94,40.42%), and then bone (27/94,28.72%), and brain (24/94,25.53%). The overall survival (OS) rate of all included patients was 41.5%. The median survival time was 43 months and 29 months for the single metastasis and multiple metastasis groups respectively. There was a statistical difference in OS rate between the single metastasis and multiple metastasis groups (45.9% vs. 0.0%, P<0.001). The median survival time was 50 months and 32 months for early metastatic patients and late metastatic patients respectively. Statistical difference was found in OS rate between the single metastasis and multiple metastasis groups (53.3% vs. 30.6%, Cox P=0.130, Breslow P=0.014). Cox regression showed TNM stage (P=0.003) and single organ metastasis (P<0.001) were significant prognostic factors for NSCLC. ConclusionLung, bone, and brain were the most popular metastatic organs for postoperative NSCLC. The presence of multiple organ metastases can be identified as an independent poor prognostic factor in NSCLC.
Objective To study the relationship between blood metastasis of colorectal cancer and cancer metastasis related factors.MethodsCK20 mRNA in peripheral blood was investigated by reverse transcription polymerase chain reaction (RTPCR) and proteins of CD44v6 and p53 in cancer tissues were examined by immunohistochemical in 50 cases of colorectal neoplasm. ResultsThe results showed that the positive rates of peripheral blood micrometastasis of colorectal cancer were 68%. It escalated along with the rising of the Dukes stage, the rates in Dukes C and D stage were significantly higher than that in Dukes A and B stage. The positive rates of CD44v6,p53 expression in colorectal cancer were 74% and 62% respectively. The positive rates of CD44v6 and p53 in Dukes A and B stage were significantly lower than those in Dukes C and D stage,in peripheral blood and colorectal cancer micrometastasispositive group were significantly higher than that in the micrometastasisnegative group. CK20 mRNA was significantly correlated with expressions of CD44v6 and p53 in cancer tissues. Conclusion The detection of CK20 mRNA in blood before operation and after operation examination of CD44v6 and p53 in cancer tissues are helpful for prediction of blood metastasis of colorectal neoplasm and postoperative treatment.
ObjectiveTo detect the content of stromal cell derived factor-1α(SDF-1α) in peripheral blood of patients with gastric adenocarcinoma (GC) and investigate its clinical significances. MethodsThe contents of SDF-1αin the peripheral blood of 90 patients with GC were detected by enzyme-linked immunosorbent assay. The correlation of SDF-1αcontent with the clinicopathologic parameters and prognosis after operation were analyzed. Results①The content of SDF-1αin the patients with GC[(6950.8±1131.3) ng/L] was significantly higher than that in the normal healthy volunteers[(5023.7±1103.8) ng/l, P=0.036].②The content of SDF-1αin the GC patients with distant metastasis[(8251.6±1042.5) ng/L] was significantly higher than that without distant metastasis[(6785.3±1025.0) ng/L, P < 0.001]. The contents of SDF-1αin the peripheral blood of patients with distant metastasis either in the liver (P=0.002) or in the lung (P=0.030) were significantly higher than those without distant metastasis (liver or lung).③The TNM stage was later (P < 0.001), lymph node metastasis was broader (P=0.018), invasion of tumor was deeper (P < 0.001), vascular invasion (P < 0.001) and lymphatic vessel invasion were present (P < 0.001), the contents of SDF-1αwere higer. Logistic regression analysis revealed that the depth of tumor invasion (OR=14.999, 95% CI 3.568-74.456, P=0.027) and distant metastasis (OR=0.186, 95% CI 0.610-2.014, P=0.026) were correlated with the high SDF-1αcontent.④The survival time of the patients with higher content of SDF-1αwas significantly shorter than that of the lower content of SDF-1α(P < 0.001). Cox proportial hazard regression model analysis demonstrated that TNM stage (RR=2.497, 95% CI 1.987-10.238, P=0.009), vascular invasion (RR=7.501, 95% CI 2.086-16.942, P=0.002), and high content of SDF-1α(RR=18.302, 95% CI 6.895-30.538, P=0.001) in the peripheral blood were the independent risk factors for survival of the patients with GC. ConclusionHigh content of SDF-1αin peripheral blood might suggest the occurrence of lymph node metastasis, hepatic metastasis or lung metastasis and indicate the poorer prognosis of GC.
Objective To summarize the research progress of CO2 pneumoperitoneum impacts on invasiveness of cancer cells. Methods Currently published experimental and clinical researches related to the effect of CO2 pneumoperitoneum on invasiveness of cancer cells were reviewed. Results CO2 pneumoperitoneum may affect the invasiveness of cancer cell through several ways， such as changing the structure and function of mesothelial cell， changing microenvironment of peritoneum， influencing the expression of oncogen， affecting the secretion of cell factor， and changing the adhesion of cancer cell. Conclusions The consequences of these alterations to cancer cell and the microenvironment are not well understood， but they may facilitate tumor invasion and implantation. Further investigations in this area are very urgent.
Objective To determine the efficacy of radioisotopes to control metastasic pain in patients with tumor bone metastases and complications due to bone metastases (hypercalcaemia, bone fracture and spinal cord compression). The effectiveness of radioisotopes in relation to patient survival and adverse effects were also assessed. Methods MEDLINE (1966 to April 2005),EMBASE (1966 to April 2005), The Cochrane Library (Issue 1, 2005) and CBMdisc (1979 to April 2005) were searched for randomized controlled trials (RCTs). Data were extracted by two reviewers using a designed extraction form. The quality of included RCTs was critically assessed. RevMan 4.2 software was used for data analysis. Results Four RCTs were included. The results of meta-analysis showed that small dose of radioisotopes couldn’t control metastatic pain in short term(2 months) with relative risk (RR) 1.13, 95%confidence interval (CI) 0.34 to 3.76, but large dose can significantly control metastatic pain in medium term(6 month) with RR 1.90, 95％CI 1.23 to 2.92; no evidence was available to assess long term(≥12 months) effects. No study provided data on quality of life, mortality, bone metastatic complications (hypercalcaemia, bone fracture) and analgesic use etc. Leukocytopenia and thrombocytopenia were secondary effects associated with the administration of radioisotopes. The incidences of leukocytopenia and thrombocytopenia were significantly greater in patients treated by radioisotopes with RR 8.28, 95％CI 2.24 to 30.67, and RR 3.70, 95％CI 1.59 to 9.04, respectively. Conclusions There is some evidence indicating that large dose of radioisotopes can relieve metastatic bone pain over one to six months, but adverse effects, particularly leukocytopenia and thrombocytopenia, have also been experienced.
【Abstract】Objective To explore the clinical significance of β-catenin expression in pancreatic carcinoma.Methods The immunohistochemical staining was performed to detect the expression of β-catenin in the specimens of 46 patients with pancreatic carcinoma and the results were statistically analyzed.Results The abnormal expression rate on the membrane was 54.3%, the poorer the differentiation, the higher the abnormal expression rate. The levels of the cases in whom metastasis occurred were much higher than those without metastasis. The abnormal cytoplasm expression rate was 21.7%,which had not significant correlation with the clinical indexes, such as staging, tumor size, grading and metastasis. In 23 patients who accepted intervention chemotherapy before operation, the cytoplasm expression rate in those with tumor mass smaller was 0, which was evidently lower than that of those without tumor mass change (33.3%). Moreover, the abnormal membrane and cytoplasm expression rates had remarkable concordance (63.0%).Conclusion The abnormal membrane expression of β-catenin may accelerate metastasis, and the abnormal expression of β-catenin in cytoplasm may result in cell proliferation.
Objective To evaluate the potential of specific mRNA marker keratin 19(K19) to detect micrometastasis by reverse transcriptase polymerase chain reaction (RT-PCR) .Methods One hundred and ninty four regional lymph nodes harvested from 6 cases of benign diseases, 4 cases of breast carcinoma, 5 cases of gastric carcinoma and 12 cases of colorectal carcinoma patients were examined by conventional pathology and amplifying tissue specific K19 mRNA by RT-PCR separately, then the two methods were compared with each other. Results None of the 34 lymph nodes which were pathological metastasis-negative from benign diseases expressed K19 mRNA by RT-PCR, all of the 28 regional lymph nodes which were pathological metastasis-positive from malignant cases showed trains of K19 mRNA by RT-PCR. Of the 132 lymph nodes which were pathological metastasis-negative from malignant cases, 11 lymph nodes were detected with micrometastasis by genetic diagnosis.Conclusion Genetic diagnosis of lymph node micrometastasis is more sensitive than conventional pathology and has diagnostic value and merits further study.
ObjectiveTo introduce the current study of the metastatic mode and operation methods in advanced gallbladder carcinoma. MethodsThe literatures about metastatic mode and operation methods of advanced gallbladder carcinoma in recent 5 years were reviewed.ResultsLymph node and hepatic invasion were the main mode of advanced gallbladder carcinoma. The Japanese Society of Biliary Surgery （JSBS） classification to gallbladder carcinoma was more reasonable than the UICC classification. The survival rate after radical resection was higher than that after cholecytectomy in patients with T2n1-2M0. In the patients that tumor extended adjacent organs but the lymph node metastatic localized within n2, extended radical resection provided a survival advantage. If the patients’ tumor was not resectable or who had lymph node metastasis beyond n3, the benefit of extended radical resection seemed limited.ConclusionIn the carefully selected patients, extended radical resection will improve the prognosis of advanced gallbladder carcinoma.
Objective To introduce the possible effects and significances of angiogenesis and antiangiogenic in the development and treatment of hepatocellular carcinoma (HCC). Methods Recently relevant literatures were reviewed. Results Angiogenesis played a significant role in the development and therapy of HCC, and the development and metastasis of HCC could be effectively suppressed by antiangiogenic therapy. This might provide a new approach for the treatment of HCC. Conclusion Comprehending the molecular mechanism of angiogenesis and applying antiangiogenic therapy will contribute a lot for the prevention and treatment of HCC.