ObjectiveTo detect the expression of somatostatin receptor Ⅱ(SSTR2) mRNA in the specimens of colorectal cancer patients and discuss the relationship between the expression and characteristics of the tumor.MethodsAll tissue samples of 36 cases, including normal colonic mucosa (10 cm beyond the tumor), mucosa adjacent to the tumor (within 2 cm of the tumor), tumor, and mesenteric lymph node, were collected immediately after surgical resection. The SSTR2 mRNA were detected by RT-PCR in 135 samples of the 36 cases. The SSTR2 mRNA expression rate in different samples was compared.ResultsThe SSTR2 mRNA expression rate of normal colonic mucosa, mucosa adjacent to tumor, tumor, mesenteric node without metastasis, and mesenteric node with metastasis was 67.6%(23/34), 75.0%(24/32),91.4%(32/35),93.8%(15/16) and 81.8%(9/11) respectively. Expression rate of tumor significantly increased compared with normal colonic mucosa (χ2=6.37, P＜0.05). The expression rate of the tumor in different groups, such as patients of different sex, serum CEA level, tumor size, location, histological grade and pathological stage, showed no difference (P＞0.05）.ConclusionThe expression rate of SSTR2 mRNA of colorectal adenocarcinoma increases. The expression rate does not correlate with the histological grade and pathological stage of the tumor.
Objective To investigate the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer. Methods Literatures on the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer were reviewed and analyzed. The agreement between computed tomography (CT), endoscopic ultrasound (EUS), magnetic resonance imaging (MRI) and positron emission tomography (PET) and the results of histopathology and survival was analyzed.Results CT and EUS were the method of efficacy evaluation commonly used at present, but the evaluation indexes and criteria were controversial, and the criteria for solid tumors seemed to be not feasible for gastric cancer. Diffusionweighted imaging (DWI) method needed more investigation, while PET held advantage in early selection of patients without response accurately.Conclusion There is no uniform standard for clinical efficacy evaluation yet, so an integration of diverse imaging methods may be the best choice to improve the accuracy of neoadjuvant chemotherapy in patients with gastric cancer.
Objective To explore the causes and treatment of rebleeding after operation on portal hypertension patients. Methods The clinical data of 41 rebleeding cases underwent the operational between January 2000 and December 2009 in Peking Union Medical College Hospital were retrospectively analyzed. Results All 13 cases who got rebleeding after shunt operation received lienectomy, but for those who got rebleeding after lienectomy, 23 patients received Phemister or modified Phemister or expanded lienectomy and 5 patients received shunt operation. Surgical related complications occurred in 7 cases (17.1%) at 2 weeks after operation, including abdominal bleeding (3 cases), gastrointestinal bleeding (2 cases), and intractable ascites (2 cases). After the follow-up of 3-60 months (mean 39 months), all patients were still alive. During the follow-up, 3 cases of recurrent esophageal varices were observed and one of them got rebleeding.Conclusion The majority of rebleeding after lienectomy tend to be ascribed to the wrong operations chose, while bad operation skill often contribute to the rebleeding after shunt operation, suggesting ideal therapeutic effect for rebleeding can benefit from appropriate operation choose.
Objective To review the research progress in relationship between hereditary diffuse gastric cancer (HDGC) and CDH1 gene. Methods Literatures on HDGC which were published in recent years were collected and analyzed. Results Aberrant CDH1 gene is significantly correlated with HDGC: mutations of CDH1 exons play the most important role in pathogenesis of HDGC. Screening CDH1 gene mutation is useful for diagnosis of HDGC as well as the treatments. Alterations of CDH1 other than exon mutation, such as intron mutation, gene promoter methylation and single nucleotide polymorphism may result in downregulation of the gene expression. Further study should be done to confirm the roles of these alterations. Conclusions Alterations of CDH1 gene are significantly associated with the pathogenesis of HDGC. Detecting alterations of CDH1 gene are important for diagnosis and management of HDGC as well as to get insights of the pathogenesis of the disease.
Objective To analyze and summarize clinical characteristics, diagnostic method, choice of treatment, and prognosis of metastatic lung cancer to thyroid gland. Method The clinical materials of the 15 patients presenting with secondary thyroid cancer were analyzed retrospectively. Results There were 10 females and 5 males in the 15 patients, with the female to male ratio of 2 : 1. The age ranged from 36 to 79 years old with an average 59 years old. The diagnoses of 12 cases were made by the surgery or the fine needle aspiration biopsy (FNAB), 3 cases by the clinic. The interval from the diagnosis of the primary tumor to the thyroid metastasis varied from 0 month to 21 months with an average 4 months. Three patients received the thyroidectomy, 5 patients received the chemotherapy or chemoradiotherapy, and 7 patients gave up the treatment. The average survival time was 10 months. Conclusions Metastatic lung cancer to thyroid gland is rare, and FNAB is a useful tool for diagnosis. Thyroidectomy may not be recommended because of poor prognosis.
【Abstract】ObjectiveTo investigate the inhibitory effects of somatostatin analogue (SSTA) on the colonic carcinoma cell growth in vitro and in vivo and its possible mechanism. MethodsThe somatostatin receptor type Ⅱ (SSTR2) mRNA of colonic carcinoma cell line HCT116 was detected by using RTPCR and hybridization in situ. The effects of octreotide (Oct) or NC-8-12 (specific agonist of SSTR2 ) on the proliferation of HCT116 was measured with MTT after HCT116 stimulated by insulin or epidermal growth factor (EGF) and incubated with Oct or NC-8-12 simultaneously for 24 hours. The expression of cyclin D1 was detected with flow cytometry. The HCT116 were implanted in nude mice subcutaneously and treated with Oct or NC-8-12. The tumor volume and tumor weight were measured according to schedule. Results①SSTR2 mRNA was detected in HCT116 and the tumor implanted in nude mice; ②Insulin and EGF increased the proliferation of HCT116 significantly, and this proliferation could be inhibited by Oct and NC-8-12 partially; ③Insulin increased the Cyclin D1 expression of HCT116, its level decreased slightly when treated with Oct or NC-8-12 but not significantly (Pgt;0.05); ④The weight and volume of implanted tumor in nude mice treated with Oct or NC-8-12 showed no significant difference compared with the control group (Pgt;0.05). ConclusionBoth Oct and NC-8-12 could inhibit the proliferation of colonic carcinoma cell line HCT116 in vitro, which indicated that SSTR2 may mediated the inhibition. Oct and NC-8-12 have no effect on the growth of implanted HCT116 in nude mice in this experiment.
Objective To investigate the anatomical character and variation of non-recurrent laryngeal nerve （NRLN）， and to explore measurement to identify and prevent injury of this nerve during thyroidectomy. Methods Clinical data of 2 211 patients who underwent thyroidectomy from Jan. 2007 to Jun. 2012 in Peking Union Medical College Hospital were analyzed retrospectively， and 114 patients with NRLN of related literature reviews were analyzed too. Results There were 3 479 recurrent laryngeal nerve （2 211 cases） which were exposed during thyroid operation in Peking Union Medical College Hospital， of which 11 cases were confirmed to be right NRLN （0.32%， 11/3 479）. Of the 11 cases， 3 cases were typeⅠ， 7 cases were typeⅡA， and 1 case was typeⅡB， one case was also found to have a recurrent branch. None of them injured during operation. One hundred and fourteen cases of NRLN （0.14%-4%） were found in literature reviews. Of the 114 cases， 109 cases were confirmed to be right NRLN， of which 4 cases were typeⅠ （3.7%， 4/109）， 75 cases were typeⅡA （68.8%， 75/109）， 9 cases were typeⅡB （8.3%， 9/109）， 21 cases were unclear （19.3%， 21/109）， 3 cases were also found to have a recurrent branch （2.8%，3/109）. Five cases were confirmed to be left NRLN， of which 2 cases were typeⅡA， 3 cases were unclear， 1 case was also found to have a recurrent branch. Of all the 104 cases reported by treatises and case reports， 16 cases injured during operation， of which 1 case was typeⅠ， 9 cases were typeⅡA， 6 cases were unclear. Conclusions NRLN， which is a rare anomaly， usually happens on the right， and very vulnerable during thyroid surgery. The most usually injured type is typeⅡA. Fully acknowledgment of the NRLN and its variant types is very helpful to avoid damage during thyroid surgery.
Objective To study the incidence，clinicopathological characteristics,diagnosis，treatment， and prognosis of synchronous or metachronous primary cancers in patients with gastric cancer． Methods The clinical data of 103 gastric cancer patients with synchronous or metachronous primary cancers from January 1983 to December 2010 were collected and reviewed．Results The incidence of synchronous or metachronous primary cancer in addition to gastric cancer was 2.26％（103/4 552）.The age of these patients was （63.98±11.93） years （30～84 years） when gastric cancer was diagnosed.There were 29 cases of synchronous primary cancer and 74 cases of metachronous primary cancer,in which there were 46 pre-metachronous cancer patients and 28 post-metachronous cancer patients.All the patients had 113 primary tumors of other organs.Colorectal cancer was the most common type of primary cancer in other organs （27.43%, 31/113）,followed by lung cancer （15.04%, 17/113）.The time interval between gastric cancer and metachronous primary cancer was （87.95±92.98） months （7～506 months）,and 65.49% （74/113） of other primary tumors were diagnosed within 5 years before or after gastric cancer. The overall 5-year survival rate was 48.43%. The 5-year survival rate of post-metachronous group （69.52%） was significantly better than synchronous cancer group （36.40%, P=0.009） or pre-metachronous group （42.31%, P=0.023）.In 33 patients who had definite cause of death, 20 patients died of gastric cancer.Conclusions Primary cancer of other organs should be considered in treatment of gastric cancer.Gastric cancer may be the most important factor impacting the prognosis of these patients.
Objective To explore the effect of multi-disciplinary treatment of the Graves’ disease (GD) with huge-size thyroid during perioperative period. Methods Retrospectively analyzed the clinical data of 8 GD patients with huge-size thyroid who got treatment in Pekin Union Medical College Hospital during Jan. 2006 to Dec. 2016. All patients underwent comprehensive preparation before operation and underwent total thyroidectomy. To explore the changes of thyroid function and culture after anti-thyroid drug (ATD)/iodine preparation/arterial embolization before operation, and to summarize situation of the bleeding loss intraoperation, neck-drainage, thyroid function, and relapses after operation. Results All cases got a satisfactory operation result after standard ATD, iodine preparation (Lugol’s solution 10–15 drops for 3–4 weeks, combined with ATDs for 2–3 weeks ), and main arterial embolization of thyroid in 24 h preoperation. They got shorter operative time (2.5–4.5 h), less bleeding intraoperation (4 cases≤100 mL), less neck-drainage, and almost normal retention time. No severe or permanent complications, for example thyroid storm, abnormal voice, and hypoparathyroid occurred. They were followed as outpatients for 18–133 months, and were found a perfect long-term effect without complication and relapse. Conclusions Perioperative period management is very important to those GD patients with huge-sized thyroid, and multi-disciplinary treatment can decrease theintraoperation bleeding, as well as occurrence of thyroid storm effectively. In addition, operated subtly during surgery can protect the recurrent laryngeal nerve and parathyroid effectively.
We reported a 26-year-old male who was diagnosed with apical hypertrophic cardiomyopathy with left ventricular aneurysm. The location of the hypertrophic myocardium and the extent of resection were accurately assessed preoperatively using 3D modeling and printing technology. Myectomy was performed via transapical approach, and the intraoperative exploration was consistent with the description of the preoperative 3D modeling. The patient underwent the surgery successfully without any complications during the hospitalization, and the cardiopulmonary bypass time was 117 min, the aortic cross-clamping time was 57 min, and the hospital stay time was 7 d. The postoperative echocardiography demonstrated left ventricular cavity flow patency. This case provides a reference for the management of patients with apical hypertrophic cardiomyopathy.