Objective To study the effects of estrogen and progesterone and their receptors on the development of gallstone (GS) and primary gallbladder carcinoma (PGC), and probe to the relationship between the biological characteristic of PGC and female hormone and their receptors. Methods The study of PGC related to female hormone was reviewed by history document and experimental study in resently. Results The female hormone influenced human body extensively: they acted on not only the target organs, but also the nontarget organs with their receptors. The action was brought about by their receptors expression. The action intensity was dependent on not only the serum level of female hormone but also their corresponding receptors distributing in organs. The carcinogenic mechanism of estrogen was more clear with the discovery of estrogen-regulating-proteins. Conclusion The estrogen play an important role in the onset and development of GS and PGC. Estrogen and progestrone can inhance the patients′ susceptibility to the cholesterol gallstone and become a high risk factor in causing PGC through inducing their corresponding receptors expression in the gallbladder. Evaluating the effects of estrogen-estrogen receptor-estrogen-regulating-protein on biological characteristic of PGC is significant in guiding clinical endocrine treatment.
ObjectiveTo discuss the relationship between angiogenesis and the clinical pathological characteristics, prognosis in primary gallbladder carcinoma (PGC ). MethodsThe specimens of 42 patients with PGC who underwent operation during 1993 and 1996 were collected. The immunohistochemical staining was performed in these specimens through SABC manner. Angiogenesis was represented by intratumor microvessel count (MVC ) and expression of vascular endothelial growth factor (VEGF ).ResultsIn all the patients, the average MVC was 70.4±20.7, and the VEGF positive expression rate was 69.0%. The mean MVC was 57.9±15.4 in the tumor of histograde Ⅰ and Ⅱ, and was 88.8±11.5 in another group of grade Ⅲ and Ⅳ respectively. The mean MVC was 45.0±17.0 in the cases of Nevin stage Ⅰ, Ⅱ and Ⅲ, and was 77.2±16.0 in the other cases of Nevin stage Ⅳ and Ⅴ. There were significant differences between two groups. VEGF expression positive rate was correlated with grade and stage, in the patients with poordifferentiated grade and late stage the MVC was significant higher. The expression of VEGF was markedly correlated with MVC. The 3year survival rate was significant lower in the group of high MVC or VEGF positive expression. Conclusion Manifold VEGF secretion in PGC may increase the MVC value, and accelerate the tumor advance and metastasis. Angiogenesis may be considered as an effective predictor to the prognosis of the primary gallbladder carcinoma.
【Abstract】ObjectiveTo evaluate the advances in minimally invasive surgery treatment for hepatolithiasis. MethodsLiteratures about the advances in minimally invasive surgery treatment for hepatolithiasis were collected and reviewed. ResultsHepatectomy and bile duct exploration using laparoscopy can get better effect. Fibrocholedochoscopy play an important role in the course of operation and after operation for hepatolithiasis. ConclusionThe individualization treatment program should be used for hepatolithiasis. Association application of multipathway minimally invasive operation, such as laparoscopy, fibrocholedochoscopy and so on, can increase the cure rate of hepatolithiasis.
【Abstract】ObjectiveTo study the relationship between the bacterial spectrum difference of gallbladder mucosa and choledochus bile and clinical prognosis of gallstone pancreatitis. MethodsA synchronic bacterial culture and drug sensitivity test were carried out on 48 patients with gallstone pancreatitis. ResultsThe cases of positive gallbladder mucosa and choledochus bile were 13 (27.1%) and 31 (64.6%) respectively. The cases of double positivity were 12 (25.0%). The cultural strains of gallbladder mucosa and choledochus bile were significantly different. Some strains were only found in choledochus bile，whereas in gallbladder mucosa L-form bacteria predominated.ConclusionThe most common causative strain of gallstone pancreatitis is Bacterium coli. The drug-resistant strain emerges maybe due to bacterium immigration and delitescence in gallbladder mucosa. L-form bacteria should be considered when using antibiotics, because L-form bacteria have close relationship with the prognosis of gallstone pancreatitis.
Objective To investigate the expressions of hypoxia-inducible factor-1α (HIF-1α) and caudal homeobox gene 2 (CDX2) in colorectal adenocarcinoma, and the relationships between them and the clinicopathologic factor of colorectal adenocarcinoma. Methods The expressions of HIF-1α and CDX2 were detected by immunohistochemistry in 62 specimens of colorectal adenocarcinoma and 20 specimens of normal colorectal mucosa tissue. The correlation between the expressions of HIF-1α and CDX2 was analyzed by Spearman rank correlation analysis. Results The positive rates of HIF-1α expression in normal colorectal mucosa tissue and colorectal adenocarcinoma were 5.0% （1/20） and 62.9% （39/62）, CDX2 were 95.0% （19/20） and 69.4% （43/62）, the differences of positive rate between different tissues were significant （Plt;0.05）. In colorectal adenocarcinoma, the expression of HIF-1α or CDX2 was related to tumor differentiation, lymph node metastasis, and Dukes staging (Plt;0.05). There was a negative correlation between HIF-1α and CDX2 expressions in colorectal adenocarcinoma （r=－0.293 2，Plt;0.05）. Conclusions The up-regulation of HIF-1α and down-regulation of CDX2 may be involved in the genesis of colorectal adenocarcinoma， and there is a negative correlation between the two kinds of protein. HIF-1α may participate in modulation of CDX2 expression and lead to accelerate the progression of colorectal carcinoma.
【Abstract】ObjectiveTo study the diagnosis and the treatment of gastrointestinal stromal tumor (GIST). Methods In this retrospective study, tissue slices, including immunohistochemical examinations, of 48 patients with GIST from January 1999 to December 2004 were collected. All of their clinical symptoms, pathologic characters, and surgical treatment and other information were also analyzed. ResultsTwenty-seven males and 21 females with a mean age of 68 were included in this report. All patients received tumor resections. Tumors were located in the stomach in the 29 cases (60.4%), and 11 cases (22.9%) were in the small intestine. The main clinical manifestations were alimentary tract hemorrhage (52.1%) and abdominal mass (35.4%). Immunohistochemical examination showed the positive rate of CD117 was 83.3%(40/48), and CD34 was 77.1%(37/48). Conclusion GIST mostly occurs at stomach and small intestine in aged people with clinical manifestations of alimentary tract hemorrhage and abdominal mass. The diameter of the mass is an important clinical index to distinguish malignant and benign tumors. The diagnosis of GIST depends on the combination of pathological and immunohistochemistry examinations. Complete regional resection of the tumor may be the most effective treatment.