【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.
ObjectiveTo investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in human pancreatic adenocarcinoma and their correlation with clinicobiological behavior.MethodsThe expression of COX-2 and VEGF in 51 cases of human pancreatic ductal adenocarcinoma were detected with immunohistochemistry of Envision.ResultsExpression of COX-2 and VEGF in pancreatic ductal adenocarcinoma were 74.5% and 68.6%, respectively; no expression of COX-2 and VEGF in adjacent normal tissue was detected. Both COX-2 and VEGF expression in clinical stage Ⅲ-Ⅳ were much higher than those in clinical stage Ⅰ-Ⅱ, and also higher in positive group of lymph node metastasis than in negative group as well (Plt;0.05). None of them had relation with histological grades, age, sex, tumor size and location. The expression of COX-2 was closely correlated with VEGF (r=0.411, Plt;0.01).ConclusionCOX-2 and VEGF may play a pivotal role in tumorigenesis and tumor progression in pancreatic cancer, they may provide new targets for therapy of pancreatic cancer.
ObjectiveTo study the expression of HOX A9 mRNA and its clinicopathological significance in the benign and malignant lesions of pancreas. MethodsIn situ hybridization for HOX A9 mRNA was used on routine paraffinembedded sections. ResultsThe positive rate and scoring mean of HOX A9 mRNA expression was significanfly lower in pancreatic carcinoma (49%, 3.3±2.1) than that in chronic pancreatitis (95%, 5.4±0.8) and pericancerous tissues (80%, 4.6±1.2), the negative case of HOX A9 mRNA in chronic pancreatitis and pericancerous tissues showed middle or severelyatypical hyperplasis of the ductal epitheli. The positive rate and scoring mean of HOX A9 mRNA expression was significantly higher in the cases of welldifferentiation (63%, 4.0±2.2) or without metastasis (64%, 4.1±2.2) than that in the ones of poorlydifferentiation (32%, 2.6±2.3) or with metastasis (32%, 2.7±2.2). ConclusionThe expression of HOX A9 mRNA might be related the carcinogenesis, progress, biological behaviors, and prognosis of pancreatic carcinoma. The assay of HOX A9 mRNA expression in the benign lesions of pancreas might have important clinical values in the prevention and earlystage finding of the pancreatic carcinoma.
Objective To study the expression and clinic significance of nm23 gene (product of uncleoside ciphosphate kinase) in the pancreatic adenocarcinoma tissues. MethodsSP immunohistochemical method was used to examine the expression of nm23/NDPK in 40 pancreatic adenocarcinoma and 14 normal pancreas tissues.ResultsTwentysix of 40(65%) pancreatic adenocarcinoma showed b immunoreactivity for NDP kinase, whereas 4 of 14 (28.5%) normal pancreatic tissues showed weak immunoreactivity. Significant difference was found between the two groups (P＜0.05). The nm23/NDPK expression levels in pancreatic adenocarcinoma of lower differentiation was higher than those in pancreatic adenocarcinoma of higher differentiation (10/11，90.9%; 2/8, 25%; P＜0.05). Positive staining was associated with higher incidence of lymph node metastasis (10/14, 71.4%) than negative staining (6/19,31.5%, P＜0.05). These results suggested that nm23/NDPK expression was positively associated with lymph node metastasis and aggressiveness. They also suggested that nm23/NDPK expression had negative correlation with the extent of histologic differentiation. Conclusion nm23/NDPK can serve as a marker for malignant potentiality and indicate the prognosis of pancreatic adenocarcinoma.
ObjectiveTo study the clinicopathologic features, diagnosis and treatment of papillary cystic and solid tumor of the pancreas (PCSTP).MethodsOne case with PCSTP in our hospital and a review of 60 others from the literatures of the People’s Republic of China, a total of 61 cases were analyzed retrospectively.ResultsThe patients (57 women, 4 men) were of mean age 24.6 (range 9~59) years. The main manifestations included abdominal mass (n=52), pain (n=22) and discomfort (n=10). They were distributed in the head (n=29), neck and body (n=2), body (n=1), body and tail (n=5), tail (n=16) and capsule (n=2) of the pancreas. The other 6 cases occurred outside the pancreas. All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination, 7 of which were malignant (11.5%). The total 1, 3, 5year survival rate was 100%, 96.1% and 86.5% respectively.ConclusionIt is difficult to correctly diagnose the PCSTP before operation because PCSTP is often lack of typical clinical manifestations. The correct diagnosis should depend on histopathologic examination.Complete removal of the PCSTP is the most perfect treatment. PCSTP has a good prognosis.
Objective To investigate the application value of the binding pancreaticogastrostomy in pancreatico-duodenectomy. Methods The clinical data of 13 patients that performed pancreaticoduodenectomy with binding pancr-eaticogastrostomy from Jan. 2010 to Mar. 2013 in our hospital were retrospectively analyzed. The incidence of postoper-ative complications were counted. Results There was 1 patient with pancreatic stump bleeding after operation， and then recovered after conservative treatment. There was no patient with pancreatic fistula， bile fistula， delayed gastric empt-ying， and other complications after operation in whole group. Peritoneal fluid and amylase level in peritoneal fluid were gradually reduced or degraded after operation. The gastrointestinal function was recovered better. All patients were compl-etely cured. Conclusion The binding pancreaticogastrostomy in pancreaticoduodenectomy has its own unique advantage.It could be reduce the incidence of pancreatic fistula in postoperative patients by using binding pancreaticogastrostomy reasonably.
Objective To investigate the clinicopathologic features and effect of surgical treatment of pancreatic neuroendocrine carcinoma（PNEC）. Methods Clinical data of 31 patients with PNEC treated from Jan. 2008 to Mar. 2012 in our hospital were analyzed，and the expressions of protein CgA，Syn，CD56，CK，VEGF，and Ki-67 were detected by immunohistochemical method. The differences of survival rate and time between radical excision group and palliative surgery group were analyzed by log-rank test. Results Of the 31 patients，22 patients received radical resection and 9 patients received palliative surgery. The positive expression rate of protein CgA，Syn，CD56，CK，and VEGF was 64.52%（20/31），100%（31/31），77.42%（24/31），90.32%（28/31），90.32%（28/31），respectively. According to the percentage of Ki-67 positive cells， 14（45.16%） patients expressed less than 3%，7（22.58%） patients expressed between 3% and 20%， and 10（32.26%）patients expressed more than 20%. The survival rate and time of radical resection group were significantly higher and longer than palliative surgery group（P＜0.001）. Conclusions PNEC is a high potential malignancy and demonstrates aggressive biological behavior. Radical resection can improve the prognosis of patients with PNEC.
Objective To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas. Methods Demographic data, clinical manifestations, diagnostic exams, surgical procedures, pathological diagnosis, postoperative complications, and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively. Results There were 8 （28%） serous cystic tumors （SCN）, 12 （41%） mucinous cystic tumors （MCN）, 3 （10%） intraductal papillary mucinous tumors （IPMN）, and 6 （21%） solid pseudopapillary tumors （SPT）. Eight cases of SCN, 7 cases of MCN, 1 case of IPMN, and 5 cases of SPT were all benign. The ages of the patients were from 15 to 78 years〔average, （49±17）years〕and all tumors were more common in female （76%, 22/29）. Twenty-three cases of 29 patients were performed operations, 22 cases were underwent surgical resection, and 1 case was performed exploration and biopsy. There was no surgery-related death. The rest 6 cases were not performed operation. Twenty-one cases followed-up for 6 months to 8 years 〔average, （2.7±2.3） years〕, 8 cases didn’t followed-up. Sixteen cases with surgical resection had no recurrence during follow-up period, 1 case performed exploration and biopsy died in 1 year after operation, and 4 cases of SCN without surgery didn’t deteriorate. Conclusions The most common cystic neoplasms of pancreas are mucinous and serous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 42% of mucinous cysts are malignant. Misdiagnosis may delay appropriate treatment and increase mortality. The resection rate of pancreatic cystic tumor is high, and the prognosis is good after radical resection.
ObjectiveTo investigate the possible mechanism of cucurmosin on apoptosis in human pancreatic cancer cell line SW1990 in vitro. MethodsThe inhibition of cucurmosin on SW1990 cell was detected by MTT assay, the apoptosis was observed by transmission electron microscope, the apoptosis rate was analyzed by flow cytometry, and the protein level of caspase3 was determined by Western blot. ResultsAfter exposure to cucurmosin at 1.25, 2.50, 5.00, 10.00, 20.00, 40.00, and 80.00 μg/ml for 24, 48, and 72 h, the proliferation of SW1990 cell was inhibited in a time-and dose-dependent manner (Plt;0.05). At 72 h after 40.00 μg/ml cucurmosin treatment, the typical apoptosis changes and apoptotic bodies were observed by transmission electron microscope. After exposure to cucurmosin at 0, 2.50, 10.00, and 40.00 μg/ml for 72 h, the apoptosis rate increased gradually as (0.30±0.11)%, (18.93±1.06)%, (28.00±2.07)%, and (49.93±3.25)%, respectively (Plt;0.05). The expression of caspase-3 protein was elevated gradually (Plt;0.05). ConclusionCucurmosin may induce the apoptosis of pancreatic cancer cell through up-regulating the expression of caspase-3.
Objective To reveal the significance of D2-40/CK19 dual immunohistochemistry for micrometastasis of peripancreatic neural plexus in patients with pancreatic cancer. Methods Between January 2006 and January 2007, 44 patients with pancreatic duct adenocarcinoma underwent extended radical resection. Conventional hematoxylin/eosin staining and double immunohistochemical staining using CK19 and D2-40 were used to determine peripancreatic neural invasion and lymphatic vessel invasion (LVI) in peripancreatic neural plexus tissues. Results D2-40 immunohistochemistry showed brown-yellow tube-like lymph vessels. The lymph vessel of peripancreatic nerve plexus followed vascular and perineurium, and the lymph vessel adjacent to peripheral nerve fascicles owned tube-like structure. CK19 immunohistochemistry showed cytoplasm of pancreatic cancer cell was red. The LVI was observed in lymphatic capillaries. Peripancreatic neural plexus invasion was found in 30 cases (68.2%), tumor cell invading presented in lymph vessels of peripancreatic neural plexus in 21 patients (47.7%) with pancreatic cancer. The peripancreatic neural plexus invasion was associated with LVI (P=0.003). The plexus of pancreatic capitalis and celiac plexus were respectively confirmed to be the spot with the highest lymphatic vessel density and the maximal incidence of neural plexus invasion simultaneously. Conclusions Patients with pancreatic cancer should be given the opportunity of radical operation combining related peripancreatic neural plexus as far as possible. The dual immunohistochemical staining with anti-CK19 and anti-D2-40 monoclonal antibodies should be a new method in research of perineural invasion of pancreatic cancer, exhibiting both the pancreatic cancer cells and lymph vessels clearly and distinctly.