Clinicopathological significance of the expression of carbonic anhydrase II in human pancreatic invasive ductal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathological significance of the expression of carbonic anhydrase (CA)II protein and mRNA in primary invasive ductal cancer (IDC) of human pancreas.</p><p><b>METHODS</b>The expression of CAII protein in 33 paired paraffin embedded IDC specimens of the pancreas and paired adjacent non-cancerous pancreatic tissues was detected by immunohistochemistry. Western blot and reverse transcription polymerase chain reaction (RT-PCR) were used to examine the expression of CAII protein and mRNA level in 12 paired fresh IDC specimens of the pancreas and adjuvant non-cancerous pancreatic tissues. The relationship between the protein expression and clinicopathological features was analyzed.</p><p><b>RESULTS</b>Overexpression of CAII protein was shown in 11 cases of pancreatic IDC tissues (33.3%, 11/33), which was much lower than that in paired non-cancerous pancreatic tissues (72.7%, t = 6.275, P = 0.000). The expression of CAII protein had no correlation with tumor position (χ² = 0.992, P = 0.319), differentiation (χ² = 0.866, P = 0.352), TNM stage (χ² = 1.210, P = 0.271) and Lymph node metastasis (χ² = 0.798, P = 0.372), but had bordering statistic sig with the prognosis of the patients (χ² = 3.233, P = 0.072). The median survival time in the patients with high expression of CAII protein was 540 days, while that in the patients with low expression was 320 days. The expression of CAII protein and mRNA was lower in IDC than that in paired non-cancerous pancreatic tissues detected by Western blot and RT-PCR respectively (t = 3.399, P = 0.006; t = 2.281, P = 0.043).</p><p><b>CONCLUSION</b>CAII is down regulated in pancreatic IDC and might be relative with the prognosis.</p>

Analysis of pancreatic leaking-related risk factors after pancreaticoduodenectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To analysis the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).</p><p><b>METHODS</b>A retrospective clinical study had been done in 97 patients who underwent PD between June 2001 and June 2006. The two groups were first compared by the univariate analysis;logistic regression was then used to determine the effect of multiple factors on pancreatic fistula. A P-value of less than 0.05 was considered to be statistically significant.</p><p><b>RESULTS</b>Of the 97 patients, 13 patients were identified as having pancreatic fistula. Factors significantly increasing the risk of pancreatic fistula by univariate analysis included preoperative serum total bilirubin (P = 0.038), operative time (P = 0.003) and whether or not Braun anastomosis (P = 0.034), and prophylactic use of somatostatin (P = 0.003) after operation. A multivariate logistic regression analysis revealed the factors most highly associated with pancreatic fistula to be preoperative serum total bilirubin (OR = 11.687, P = 0.021) and postoperative prophylactic use of somatostatin (OR = 0.056, P = 0.020).</p><p><b>CONCLUSIONS</b>Preoperative serum total bilirubin more than 170 mmol/L was a risk factor of pancreatic fistula after PD, and postoperative prophylactic use of somatostatin was a protect factor of pancreatic fistula after PD.</p>

Surgical treatment of asymptomatic primary hyperparathyroidism / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and management of asymptomatic primary hyperparathyroidism (PHPT).</p><p><b>METHODS</b>Clinical data of 46 cases of primary hyperparathyroidism from January 1990 to December 2006 were retrospectively analyzed. There were 5 cases of asymptomatic PHPT. Three out of the 5 cases obtained the diagnosis by routine health examination and 1 case was misdiagnosed as thyroid tumor before surgery, but was conformed as parathyroid adenoma by intraoperative biopsy. Remaining 1 case was diagnosed because of weakness. The serum calcium and the parathyroid hormone (PTH) levels were elevated in 4 cases, while only 1 being normal range. Unilateral neck exploration was performed in all 5 cases.</p><p><b>RESULTS</b>There were no operational death, recurrent nerve injury or other complications. All patients had the same pathological diagnosis as parathyroid adenomas. Three cases showed gentle circumoral paresthesia after surgery with normal serum level of calcium, but the symptoms were relieved with oral use of calcium gluconate. Only 1 patient had tetany with the lowest level of serum calcemia at 1.96 mmol/L in 24 h postoperatively. The signs and symptoms were all relieved by intravenous use of calcium gluconate for 3 d after surgery. Remaining 1 case has normal level of serum calcemia after surgery. Time range of following-up for 4 cases was from 2 months to 2 years. The level of serum calcemia was normal for them. One lost following-up.</p><p><b>CONCLUSIONS</b>Asymptomatic primary hyperparathyroidism could be diagnosed according to co-elevated serum calcemia and PTH without typical symptoms. Unilateral neck exploration was the best choice for the patients with accurate imaging localization. Conservative management including adequate hydration, dietary calcium intake and pharmacological approaches could be used for the patients who were unfit for surgery.</p>

Epidermal growth factor-mediated NF-kappaB activation promotes uPA expression and invasiveness in pancreatic cancer cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To determine the effect of EGF on the invasiveness of pancreatic cancer cells and its related regulatory mechanism.</p><p><b>METHODS</b>The effects of EGF on the proliferation, adhesion and invasion of pancreatic cancer cells were detected by WST-1 proliferation assay, adhesion assay and invasive assay. The expression of uPA was assayed by Western blot and RT-PCR. The activity of NF-kappaB was examined by EMSA.</p><p><b>RESULTS</b>EGF significantly increased the invasiveness of pancreatic cancer cells but did not affect cell proliferation or adhesion. Increased invasiveness was associated with the induction of uPA at both mRNA and protein levels. Furthermore, EGF stimulated the NF-kappaB binding activity, and pretreatment of cells with a NF-kappaB inhibitor, pyrrolidine dithiocarbamate, markedly attenuated EGF-induced NF-kappaB activation. Subsequently, the EGF-induced uPA expression and invasiveness were also inhibited by NF-kappaB inhibitor.</p><p><b>CONCLUSION</b>Our findings indicated that NF-kappaB-mediated up-regulation of uPA expression is responsible for EGF-induced invasiveness in pancreatic cancer cells, and implicate that such anti-NF-kappaB therapy with NF-kappaB inhibitors may contribute to the reduction of invasiveness of pancreatic cancer.</p>

Comparison of pBcl-2 and pBax expression in primary invasive ductal pancreatic cancer between Chinese and Japanese patients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To clarify the clinicopathologic significance of the expression of the Bcl-2 protein (pBcl-2) and the Bax protein (pBax), and their clinical implications in Chinese and Japanese patients with human invasive ductal carcinomas (IDCs) of the pancreas.</p><p><b>METHODS</b>The study included 59 Chinese and 65 Japanese patients with IDCs of the pancreas. pBcl-2 and pBax expression were immuno-stained with streptavidin-biotin (SAB) method.</p><p><b>RESULTS</b>pBcl-2 (+) was seen in 35.6% of Chinese and in 23.1% of Japanese patients. pBax (+) was seen in 49.2% of Chinese and 64.7% of Japanese patients. A comparison between them showed that there were significant differences in the male patients, in the patients with the moderately differentiated cancer, and in the elderly patients (chi squared = 4.447, P = 0.035; chi squared = 4.114, P = 0.043; chi squared = 6.657, P = 0.010 respective). In both Chinese and Japanese patients, those with pBcl-2 positive expression had a significantly higher survival rate than those with negative one (chi squared = 9.99, P = 0.0016; chi squared = 7.63, P = 0.0058). The group with pBax positive expression had a significantly higher survival rate in Japanese patients (chi squared = 9.37, P = 0.0022). Japanese patients whose tumors exhibited pBcl-2 and pBax positive immunostaining survived significantly longer than Chinese patients did (chi squared = 4.48, P = 0.0342; chi squared = 5.23, P = 0.023).</p><p><b>CONCLUSIONS</b>The expressions of both pBcl-2 and pBax are high found in Chinese and Japanese patients. The pBcl-2 positive expression implies a better prognosis in both Chinese and Japanese patients with IDCs of the pancreas. The effect of pBax expression on prognosis is different between Chinese and Japanese patients.</p>

Expressions of p53 and Gadd45a proteins in human pancreatic cancer and their clinicopathological significance / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the expressions of p53 and Gadd45a proteins and their clinicopathological significance in human pancreatic cancer.</p><p><b>METHODS</b>The expression of p53 and Gadd45a proteins was detected with immunohistochemistry in a series of 59 pancreatic cancers. Their relationships with the clinicopathological parameters including gender, tumor site, TNM stage, histological differentiation, and the prognosis of pancreatic cancer patients were analyzed.</p><p><b>RESULTS</b>The positive expression rate of p53 protein was 67.8% (40/59) and that of Gadd45a protein was 42.4% (25/59). The positive expression rate of p53 protein is significantly higher in patients < 65 years than in patients > or = 65 years (chi squared = 4.711, P = 0.030). Gadd45a expression was not correlated to the age of the patients. No significant difference was found between the expression of p53 proteins and histological differentiation and TNM stage of the tumors. Gadd45a expression was correlated with histological differentiation of pancreatic cancer (chi squared = 10.052, P = 0.007), but not with TNM stage of the tumors. No significant differences in the prognosis were found between the groups with and without p53 expression (chi squared = 0.09, P = 0.764) and the groups with and without Gadd45a expression (chi squared = 0.14, P = 0.704).</p><p><b>CONCLUSIONS</b>Both p53 and Gadd45a are highly expressed in human pancreatic cancer and may be associated with biological features of pancreatic cancer. Their expression alone or co-expression may be not helpful to evaluate the prognosis of patients with pancreatic cancer.</p>

Role of Epidermal Growth Factor in Invasion and Metastasis of Pancreatic Cancer Cells / 中国普外基础与临床杂志

Objective Overexpressions of epidermal growth factor(EGF)and EGF receptor have been associ- ated with progression and invasive phenotype of pancreatic cancer.However,the underlying molecular mechanism by which EGF worked in pancreatic cancer cells has not been completely understood.In this study,effect of EGF on the invasion and metastasis of pancreatic cancer cells and its regulatory mechanism were investigated.Methods The effects of EGF on the proliferation,adhesion and invasion of pancreatic cancer cells were detected by WST-1 prolif- eration assay,adhesion assay and invasive assay,respectively.The activity and expression of MMP-2 and MMP-9 were examined by zymography,Western blot and RT-PCR,respectively.The activity of NF-?B was examined by EMSA.Results EGF could significantly promote the invasiveness of pancreatic cancer cells but did not affect cell proliferation or adhesion.The expressions of NF-?B and MMP-9 were significantly increased by EGF,but EGF did not affect the activity and expression of MMP-2.Furthermore,EGF stimulated the NF-?B binding activity.Pre- treatment with NF-?B inhibitors,pyrrolidine dithiocarbamate(PDTC),could significantly inhibit the activity of NF-?B induced by EGF.Meanwhile,the EGF-induced expression and activity of MMP-9,as well as cell invasiveness were also inhibited by NF-?B inhibitor.Conclusion EGF could increase the expression and promote the invasiveness of MMP-9 via the activation of NF-?B in pancreatic cancer cells,which implies that NF-?B inhibitant,such as PDTC,may diminish the invasiveness of pancreatic cancer cells.