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.
【Abstract】 Objective To investigate the expression patterns of vascular endothelial growth factor (VEGF) mRNA as markers for isolated tumor cells in the peripheral blood of patients with hepatocellular carcinoma (HCC) following liver transplantation, and to evaluate the correlation between VEGF and the recurrence and metastasis of HCC following liver transplantation. Methods In this prospective study, 97 patients were divided into four groups according to the pathological results: HCC following liver transplantation group (HCC+LT group, n=53), advanced HCC group (n=8), benign liver diseases group (n=26) and healthy volunteers group (n=10), among which the 53 cases in HCC group were collected from April, 2002 to December, 2003. RNA was purified from the peripheral blood of the other 44 control patients and also from the patients in HCC group before, during and after liver transplantation in order to study the expression specificity of VEGF mRNA in HCC patients and its dynamic change during perioperative period. The correlation between VEGF and the tumor recurrence and metastasis was also analyzed by fluorescent quantitative reverse transcriptase and polymerase chain reaction (FQ RT-PCR). Results VEGF mRNA could be used as marker of isolated tumor cells for its high specificity. The positive rate of VEGF mRNA in HCC group and in advanced HCC group were 37.5% and 75.0%, respectively, which were significantly higher than that in benign liver diseases group (11.5%) and healthy volunteers group (10.0%), P＜0.01. The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA might be relevant with the recurrence and metastasis HCC following liver transplantation （P＜0.01）. Conclusion The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA may predict the recurrence and metastasis HCC following liver transplantation.
ObjectiveTo explore effect and mechanism of the carcinoma associated fibroblasts (CAFs) of breast cancer on growth and metastasis of breast cancer induced in nude mice by inoculation of CAFs and breast cancer cells. MethodsBreast cancer cell line of MDA-MB-231 (abbreviated as MDA), CAFs, and normal breast tissue fibroblasts (NFs) of the same breast cancer patient were collected, and mixed with normal saline (NS) or SDF-1 ligand blockers of four nitrogen heterocyclic fourteen alka (AMD3100, abbreviated as AMD) for inoculation of nude mice in vivo. According to the different combination, 36 nude mice were randomly divided into 6 groups:MDA+NS group, NFs+NS group, MDA+NFs+NS group, MDA+NFs+AMD group, MDA+CAFs+AMD group, and MDA+CAFs+NS group. Forty six days after the inoculation and feeding, volume of tumor, metastasis of lymph node, lung or liver were observed. In addition, level of plasma SDF-1 was tested by using ELISA method, and expressions of SDF-1 mRNA and protein in tumor specimens were detected by using real-time PCR and Western blot method respectively. ResultsExcept for NFs+ NS group, implanted tumor could be seen in nude mice of other 5 groups. In MDA+CAFs+NS group, the volume of tumor[(9.092±2.662) cm3], level of plasma SDF-1[(75.25±16.23) ng/L], and expression levels of SDF-1 mRNA (the median level was 14.714) and protein (the median level was 0.673). of tumor tissue were significantly greater or higher than those of the other 5 groups (P < 0.050). In addition, lymph node metastasis were found in 4 mice in MDA+CAFs+NS group, and 2 in MDA+NS group. The tumor metastasis of lung and liver was not found in all nude mice. ConclusionsCAFs can promote growth and lymph node metastasis of breast cancer, whose mechanism is related with SDF-1 secreted by CAFs and SDF-1/CXC chemokine receptor 4 (CXCR4), signal pathway.
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.
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.
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.
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.
Sixteen cases unresectable carcinoma of the head of the pancreas complicated with jaundice were treated by one stage cholecysto-jejunal and gastro-jejunal loop double anastomosis, the same result of jaundice drainage and prevention of bile reflux were obtained when compared with simple cholecysto-jejunal loop anastomosis, on the other hand, the obstructive symptoms resulting from postoperative cancerous comppression of duodenum and pylorus were avoided as well. The operation is simple with less physiologic disturbance and the patient can lead better postoperative live.
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.