Objective To investigate the effect of CO2 pneumoperitoneum on the tumor cell port site implantation in laparoscopic surgery. Methods Male SpraqueDawley rats were intraperitoneally injected with gastric cancer cells (cell line SGC-7901). Continuous CO2 pneumo of 15 mm Hg or 30 mm Hg were established for 5 mins, 60 mins, 120 mins and 180 mins with the injection of different concentrations of tumor cells (104/ml, 106/ml respectively). Several samples of peritoneal washing served as positive control. All collecting dishes were incubated at 37℃ with 5% CO2 concentration for one week and then examined for the presence of tumor cell under microscope. Results After one week of incubation, some of the dishes with continuous flow of CO2 gas (5 L/min) at pneumo 30 mm Hg for 60 mins or longer demonstrated tumor growth, and all peritoneal washing samples showed tumor growth, while other dishes showed negative. Conclusion The research suggests that gastric cancer cells can cause port site implantation and the concentration of tumor cells, pneumoperitoneum pressure and duration may affect the occurrence of port site implantation. It may help to find a suitable way to prevent the port site implantation in operations.
Objective To study the relationship between metalloproteinases (MMPs) and breast cancer. Methods The literature in recent years on the relationship between the expression of MMPs and breast cancer was reviewed. Results The balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs) is keeping normally kept in human body. Many of the studies showed that the expression of MMPs is increased in breast cancer. Conclusion The growth, invasion and metastasis of breast cancer is closely related with the increased expression of MMPs. This suggests that MMPs is a valuable prognostic marker and TIMPs would be a novel drug against cancer.
ObjectiveTo explore the value of a radiomics model based on ultrasound imaging in predicting the HER-2 status of breast cancer prior to surgery.MethodsA total of 230 patients with invasive breast cancer were retrospectively analyzed, all the patients underwent preoperative breast ultrasound examination. According to the order of examination time, the patients were categorized into training group (n=115) and validation group (n=115). Image J software was used to manually delineate the lesion area in the ultrasound image along the tumor boundary. Pyradiomics was used to extract 1 820 features from each lesion area, and three statistical methods were used to screen features. A logistic regression model was used to construct ultrasound imaging radiomics model. The receive operating characteristic curve (ROC), calibration curve and decision curve were used to evaluate the performance and value of ultrasound imaging radiomics model in predicting HER-2 status.ResultsNine key image features were identified to construct ultrasound imaging radiomics model. The area of under the ROC curve of the model in the training group and the validation group were 0.82 (95%CI 0.74 to 0.90) and 0.81 (95%CI 0.72 to 0.89), respectively. The calibration curve showed that the model had a good calibration in both the training and validation groups.ConclusionsUltrasound-based imaging radiomics model is of significant value in predicting the HER-2 status of breast cancer prior to surgery.
ObjectiveTo summarize the progress in mutant gene sequences of different types of hereditary colorectal cancer.MethodThe relevant literatures about genetic mutations in hereditary colorectal cancer at home and abroad were reviewed.ResultsHereditary colorectal cancer coule be divided into two categories according to whether it was related to the germline mutations of known oncogenes. Among the known germline mutant genes, the gene of adenomatous polyposis coli (APC), MUTYH, thymidine glycol DNA glycosylase 1 (NTHL1), polymerase (DNA) epsilon, catalytic subunit (POLE), and polymerase (DNA) delta 1, catalytic subunit (POLD1) were closely related to adenomatous polyposis syndromes, mismatch repair (MMR)-related genes were related to Lynch syndrome, serine/threonine kinase 11 (STK-11) gene was related to Peutz-Jeghers syndrome, mutant genes of SMAD4 and bone morphogenetic protein receptor type 1A (BMPR1A) were found in JPS individuals, and Cowden syndrome was caused by phosphatase and tensin homology deleted on chromosome ten (PTEN) gene mutation. For colorectal cancer patients with unknown germline mutations but significant genetic characteristics (such as hyperplastic polyposis), relevant genes had also been gradually searched out, which needed further evidence.ConclusionsColorectal cancer is a malignant tumor with genetic characteristics. Compared with sporadic colorectal cancer, the time of hereditary colorectal cancer from adenoma to cancer is shorter, and the occurrence of heterogeneous tumor is also increased, but the survival rate after active intervention is higher than the sporadic one. To study the mutant gene sequences of hereditary colorectal cancer is the improvement and development of the diseases control in modern medicine.
ObjectiveTo further understand function of circular RNA (circRNA) and explore its relationship with occurrence and development of gastric cancer and its value in diagnosis and prognosis of gastric cancer.MethodThe published literatures on the circRNA function and its relationship with gastric cancer were reviewed and summarized.ResultsThe closed loop structure of circRNA made it was enzymatically stable. At present, it was clear that the circRNA acted as a microRNA (miRNA) sponge and regulated the gene transcription by binding with the corresponding sites, even could be as a translation template to participate in the protein translation. Further the circRNA could act on the target gene regulated by the miRNA through the miRNA sponge. The biosignal pathway involved in the development of gastric cancer regulated by the growth of gastric cancer cells. The circRNA was differentially expressed in the gastric cancer tissue and its adjacent tissue as well as in the serums of patient and healthy human, which had the close relationships with the clinical features (pathological staging, lymph node metastasis, distant metastasis, CEA, CA19-9, etc.) and the poor prognosis and shorter postoperative survival time of patients with gastric cancer.ConclusionsDue to structural characteristics of circRNA closed loop, it has an enzyme stability and can play a variety of biological functions based on miRNA sponge. Differential expression of circRNA in gastric cancer is expected to play an important role in diagnosis and prognosis evaluation of gastric cancer.
Objectives To evaluate the effect of preoperative body mass index (BMI) on the perioperative and long-term results in esophageal squamous cell cancer patients. Method We retrospectively analyzed the clinical data of 503 patients with esophageal cancer between January 2001 and December 2009. There were 268 males and 235 females with the median age of 57 years ranging from 32-88 years. The associations between preoperative BMI and clinic patholo-gical characteristics were assessed by using the χ2 or Fisher's exact test. Survival analysis was performed by Kaplan-Meier curves with log-rank tests. ResultsThe 1-year, 3-year, 5-year, and 10-year overall survival rate for the entire cohort of patients was 64.0%, 49.0%, 43.0%, and 41.0% respectively. The occurance rates of weight loss, lymph node metastases, and poorly differentiated tumorigenesis represented statistically higher in patients with BMI≤18.5 kg/m2 than those in the patients with BMI>18.5 kg/m2 (P=0.026, P=0.006, P=0.048). For the cohort, the Kaplan-Meier survival analysis showed a significant trend toward a decreased survival in esophageal cancer patients with underweight (P=0.001). No statistical difference in overall complication, anastomotic leakage, and pulmonary complication rate was detected among the different BMI classes(P=0.162, P=0.590, P=0.376). Univariate and multivariate analysis showed that the drinking status, pathological stage, and underweight were the independent prognostic factors. ConclusionsAfter esophagectomy, BMI is not associated with the incidence of postoperative complications in patients. Patients with underweight are usually diagnosed with advanced stage, therefore tend to have poorer survivals than those with normal or over-weight.
Objective To evaluate the effect of neoadjuvant chemotherapy on the expression of CXCR4 in breast cancer and its clinical significance.Methods The clinical data of 59 patients with breast cancer of stage Ⅱ and stage Ⅲ underwent neoadjuvant chemotherapy with paclitaxel plus epirubicin for 3 cycles between April 2005 and March 2009 were retrospectively analyzed. The expression of CXCR4 in the breast cancer tissues before and after neo-adjuvant chemotherapy was examined by immunohistochemistry and its relationship with clinicopathologic factors was analyzed.Results The CXCR4 positive expression was observed in 56 patients with breast cancer (94.9%), but not in corresponding nontumor normal tissues. The expression level of CXCR4 was correlated to lymph nodes metastasis (P=0.019) and breast cancer stage (P=0.040), but it was not correlated to age of patients, tumor size, grade, hormone receptor (ER and PR)， and HER2 status. The expression level of CXCR4 was significantly decreased after neoadjuvant chemotherapy. Decline extent of CXCR4 expression after chemotherapy and CXCR4 expression level were not correlated to the effect of neoadjuvant chemotherapy, while the effect of chemotherapy in patients expressed CXCR4 in cluster distribution was better than that in scattering distribution (P=0.015). Conclusion The decline extent of CXCR4 expression level after paclitaxel combined with epirubicin neoadjuvant chemotherapy is not correlated to the efficacy, but its expressing distribution may be considered as an index to the effect of neoadjuvant chemotherapy.
Objective To evaluate the accuracy of preoperative 64 multidetector spiral computed tomography (MDCT) in the diagnosis of stage Ⅳ gastric cancer. Methods The data of patients with stage Ⅳ gastric cancer between July 2007 and April 2008 were collected. Twenty-nine patients underwent preoperative 64 MDCT were retrospectively analyzed. All computed tomography scans were prospectly analyzed by 2 abdominal radiologists separately. Pathological tumor stage was based on TNM stage according to the revised Japanese Classification of Gastric Carcinoma from the Japanese Gastric Cancer Association. All CT results were compared with clinical, surgical and histopathologic results. Results The 65.2% (15/23), 47.8% (11/23) and 70.8% (17/24) of the stage Ⅳ patients were accurately predicted of T, N and M stage, respectively. Moreover, 58.6% (17/29) of the stage Ⅳ patients were accurately predicted of TNM stage. But 6/9 cases with peritoneal metastases were not detected by preoperative 64 MDCT. Conclusion The 64 MDCT is a promising technique for detection and preoperative staging of stage Ⅳ gastric cancer. It was difficult to detect peritoneal metastases, but it may not increase the rate of exploratory laparotomy.
In order to rise the efficiency of combined therapy and evaluate the value and status of cryosurgery in advancedstage liver cancer, liquid nitrogen was employed in treating 90 patients with hepatic carcinoma in our department from Nov. 1994 to Dec. 1997. The results revealed that cryotherapy could induce unrecoverable coagulation necrosis of the tumors. The levels of serum AFP decreased after cryosurgery and one patient has been surviving for three years. The authors believe that cryosurgery is an effective method for unresectable lesions of hepatic carcinoma and has a probability in decreasing its postoperative recurrent rate.
Radioimmunoassay was performed to measure carcinoembryonic antigen (CEA) levels in gastric juice before and after operation in 51 gastric cancer patients (group Ⅰ)， 33 patients with gastric benign lesion (group Ⅱ) and 8 patients with malignant lesion in digestive system other than gastric cancer (group Ⅲ). The results showed that preoperative CEA levels of in group Ⅰ were the highest among three groups (Ｐ＜0.01), but no statistic difference was noted in group Ⅱ and group Ⅲ. In group Ⅰ and group Ⅱ, postoperative CEA levels were higer than the preoperative levels. The authors believe that preoperative CEA measurement of gstric juice is an accessory method in diagnosing gastric cancer, nevertheless, there is no diagnostic significence of postoperative measurement in patient undergone partial gastrectomy.