ABSTRACT
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been gradually developing and has replaced the percutaneous transhepatic bile duct drainagebecause of its safety and effectiveness, and it has become an effective alternative plan after endoscopic retrograde cholangiopancreatography treatment failure in patients with benign and malignant biliary obstruction. In clinical operation, the surgeons can choose the appropriate surgical method according to the patient's own condition and anatomical characteristics. This paper summarized the clinical application and research progress of EUS-BD technology by collecting relevant literatures published in recent years.
ABSTRACT
Objective To investigate the expressions of ATPase family AAA domain-containing protein 2 (ATAD2) and β-catenin,and to analyze their correlations with clinicopathological features and prognostic significance in patients with hepatocellular carcinoma (HCC).Methods The HCC tissues of 40 patients were tested by real-time PCR to study the expressions of ATAD2 and β-catenin.Real-time PCR and Western blot were performed to detect the proteins and mRNA levels of ATAD2,APC,β-catenin and wnt signaling pathway downstream.The HCC tissues of 80 patients and 20 peritumoral tissues were tested by immunohistochemistry (IHC).The cumulative survival-rate was analyzed by the Kaplan-Meier method,and univariate and multivariate were analyzed by the Cox proportional hazards model.Results ISH:The positive rates of ATAD2 and β-catenin were 65.0％ and 55.0％,respectively.These rates were significantly higher than those in the peritumoral tissues (30.0％ and 25.0％,respectively).The ATAD2 expression was related to tumor size (P ＜ 0.05),metastasis (P ＜ 0.05),serum AFP level (P ＜ 0.05) and TNM stag ing (P ＜ 0.05).The β-catenin expression was only significantly related to metastasis (P ＜ 0.05).Correlation analysis showed that the ATAD2 expression was positively related to the β-catenin expression (Pearson =0.578,P ＜ 0.01,R2 =0.3607,Spearman =0.495).This positive relationship was also found in the remaining 4 cell lines except the SK-hep1.Depleting ATAD2 up-regulated APC and down-regulated β-catenin protein and mRNA expression.Univariate and multivariate analyses showed that ATAD2 and β-catenin expressions,tumor size,metastasis,serum AFP,and TNM staging were poor prognostic factors for HCC,and ATAD2 and β-catenin expressions,metastasis,serum.AFP were independent prognostic factors.Patients whose ATAD2 and β-catenin were both positive had worse survival than those with only one positive expression or both negative expressions (P ＜ 0.05).Depleting ATAD2 down-regulated survivin,cyclinD1,c-myc,MMP7,Vimentin in wnt signaling pathway and EMT related proteins.Conclusions ATAD2 and β-catenin expressions were positively related in patients with HCC.Abnormal expressions between ATAD2 and β-catenin might participate in the wnt signaling pathway.
ABSTRACT
Objective To investigate the feasibility of laparoscopic endoscopic cooperative dissection without mucosa injury for patients with small gastric stromal tumor. Methods Fifteen patients with small gastric stromal tumor underwent laparoscopy and endoscopy combination therapy from January 2015 to October 2016. The gastric serous layer was cut open after submucosal injection, and then tumor was removed without mucosa injury under laparoscope. The clinical data were retrospectively analyzed. Results All of the 15 patients successfully completed the operation,and no one conversed to open surgery because of intraoperative complications. The operation time was 53.4±15.8 min, and the intraoperative blood loss was 15.2±3.5 mL. The gastric tube was pulled out on the day of operation.The mean time of recovering liquid diet after operation was 1.6±0.5 days, and the length of postoperative hospital stay was 3.3 ± 0.6 days. All the specimen had complete pseudocapsule,and their pathology results were all gastric stromal tumors,including 12 cases of very low risk degree, 2 low risk degree, and 1 middle risk degree. Conclusion Laparoscopic endoscopic cooperative dissection for small gastric stromal tumor has satisfactory short-term outcomes and shows a quick postoperative recovery,which meets the idea of minimally invasive surgery and rapid recovery. It is a new choice of treatment for patients with small gastric stromal tumor.
ABSTRACT
Objective To investigate the correlation and clinicopathological features of ATAD2 and E-cadherin expression in human hepatocellular carcinoma (HCC),and role of ATAD2 in HCC cells invasion and metastases.Methods The expressions of ATAD2 and E-cadherin in 90 HCC specimens and 16 specimens collected from peritumoral tissue were detected by immunohistochemistry (IHC) test.The correlations between ATAD2 and E-cadherin expression and clinicopathological features were analyzed.The lentiviral vector of sh-ATAD2 RNA was used to interfere with ATAD2 expression.Western blot was performed to evaluate the changes of E-cadherin and Vimentin expression in HCC cells after ATAD2 expression interference.The role of ATAD2 in HCC cells invasion and metastasis was assessed by Transwell analysis.Results ATAD2 protein expression was obviously upregulated in HCC tissue compared to peritumoral tissue (56.7％ vs.31.3％,P ＜ 0.05).Meanwhile,E-cadherin expression was significantly downregulated in HCC tissue (43.3％ vs.68.7％,P ＜0.05).ATAD2 and E-cadherin expressions were both correlated with HCC metastasis (P ＜ 0.05).Correlation analysis demonstrated that the ATAD2 expression was negatively correlated with E-cadherin (r =-0.263,P ＜ 0.05).After interfering ATAD2 expression,cell migration and invasion of HCCLM3 cells were suppressed (migration,42.5 ± 2.6 vs.78.1 ± 3.8,P ＜ 0.05;invasion,33.0 ± 4.7 vs.72.7 ± 5.6,P ＜ 0.05).Meanwhile,the E-cadherin expression was remarkably upregulated (P ＜ 0.05).However,the Vimentin expression downregulated (P ＜ 0.05).Conclusions ATAD2 expression was upregulated in HCC,and silencing ATAD2 could upregulate E-cadherin expression and downregulate Vimentin expression,and inhibit the invasion and metastasis of HCC cells.Modulating E-cadherin expression may be the potential mechanism of ATAD2 in HCC invasion and metastasis.