Objective To investigate the roles of NF-κB and EGFR in hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods Ninety cases of liver tissue specimens from hepatectomies performed in the 2nd Affiliated Hospital of Sun Yat-sen University between August 1989 and June 2009 were enrolled in the study. Among them, 33 cases of hepatolithiasis associated with intrahepatic cholangiocarcinoma were considered as observing group, 32 cases of hepatolithiasis as control group, and 25 cases of normal bile duct tissues as normal control group. The SP method of immunohistochemical staining was applied to detect the expressions of NF-κB and EGFR in intrahepatic biliary ducts epithelial cells, and their relations with clinicopathologic factors and the accumulated survival rate of hepatolithiasis associated with intrahepatic cholangiocarcinoma were analyzed. Results Expression rates of NF-κB and EGFR were gradually raised from normal control group, control group to observing group (Plt;0.01). Expression of EGFR in tumor patients was related to histopathologic differentiation grading and the depth of tumor invasion (Plt;0.05), but not to gender, age, or lymph node metastasis (Pgt;0.05)； there were no significant relationships between the expression of NF-κB and factors described above (Pgt;0.05). The survival rate of patients with tumor expressed EGFR was significantly lower than that of patients with tumor non-expressed EGFR (Plt;0.01). Conclusions NF-κB expression is in the early stage during intrahepatic cholangiocarcinoma genesis. NF-κB and EGFR play cooperating roles during hepatolithiasis carcinogenesis process. Over expression of EGFR is related with poor differentiation and prognosis of tumor.
Objective To summarize the diagnosis and surgical treatment experience of pancreatic ductal stones combined with pancreatic cancer. Methods Nine cases of pancreatic ductal stones combined with pancreatic cancer who treated in our hospital from January 2005 to December 2015 were collected to make a retrospective analysis, summarizing the clinical features, imaging diagnosis, and surgical treatment. Results Four of 9 cases received ultrasound combined with CT angiography, and all of them were diagnosed as pancreatic ductal stones combined with pancreatic cancer; 4 cases received magnetic resonance cholangiopancreatography (MRCP)/magnetic resonance angiography (MRA), and 3 cases were considered as pancreatic ductal stones combined with pancreatic cancer; 3 cases received endoscopic retrograde cholangiopancreatography (ERCP), and all of them were diagnosed as pancreatic cancer. All of the 9 cases underwent surgery, including 4 cases of pancreaticoduodenectomy, 3 cases of distal pancreatectomy with splenectomy, 1 case of pancreatolithotomy plus distal pancreaticojejunostomy, and 1 case of laparoscopic exploration with biopsy. No one died after surgery, but gastric stress ulcer bleeding happened in 1 case, and class B pancreatic fistula happened in 1 case. All of the 9 cases were followed-up for 5-36 months, with the median were 13 months. Seven cases died during follow up period, 5 cases survived longer than 1 year, and 2 cases survived longer than 3 years. Conclusions For patients with recurrent pancreatic stones, we should be wary of the possibility of combining pancreatic cancer, CT and MRCP can be used as further examination of this disease, a variety of imaging methods combination can improve the diagnosis. If imaging examination reveals swollen pancreas without surgical contraindications, surgery is necessary, and standard pancreaticoduodenectomy or pancreas body and tail resection is recommended.
【Abstract】ObjectiveTo investigate the efficacy of radiofrequency (RF) ablation comparing with percutaneous ethanol injection (PEI) in the treatment of postoperative recurrent hepatocellular carcinoma. MethodsOne hundred and thirtyseven patients with recurrent hepatocellular carcinoma excluding those with extrahepatic metastasis or Child C liver function were analyzed retrospectively. Of these patients, 74 cases with 86 lesions underwent RF therapy, while the other 63 cases with 75 lesions treated with PEI therapy. In RF group, the average size of lesions was 2.05 cm in diameter including 9 lesions were more than 3 cm in diameter (the maximum size of the lesions was 4 cm in diameter). In PEI group, all lesions were less than 3 cm in diameter, averagely 2.03 cm. Blood routine, liver function, AFP level and Doppler ultrasound were observed before and after therapy 1-year, 2-year, 3-year survival rates were calculated in two groups as well. Results①There was no serious complications in two groups. ②Complete tumor necrosis was 93.0%(80/86) in RF group and 81.3%(61/75) in PEI group. In RF group, complete tumor necrosis rate for lesions less than 3 cm in diameter was 96.1%(74/77), while that was only 66.7%(6/9) for lesions greater than 3 cm in diameter. ③The 1-year, 2-year, 3-year survival rates were 74.3%(55/74), 62.2%(46/74) and 54.8% (17/31) in RF group as well as 68.3%(43/63), 57.1%(36/63) and 45.0%(9/20) in PEI group， respectively. ④The average treatment needed to achieve tumor ablation were 1.3 for RF group, and 2.5 for PEI group，respectively. ConclusionRF is an efficient treatment for recurrent hepatocellular carcinoma.