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Objective@#Short-course neoadjuvant radiotherapy (SCRT) combined with delayed surgery seems to be safer than SCRT in combination with immediate surgery. However, the clinical efficacy between SCRT and long-course neoadjuvant radiotherapy (LCRT) combined with delayed surgery has not been compared. Therefore, this meta-analysis was performed to compare the safety and efficacy between SCRT and LCRT followed by delayed surgery in patients with locally advanced rectal cancer.@*Methods@#Relevant literatures were searched using relevant databases. Baseline characteristics and treatment results of patients were extracted. The included studies were subject to bias risk assessment. Evidence assessment and data analysis were conducted.@*Results@#A total of 7 studies with 4967 patients were included. Meta-analysis results illustrated no statistical significance between two groups in terms of sphincter preservation rate, R0 resection rate, postoperative complications, local recurrence rate (LRR), distant metastasis, recurrence-free survival (RFS), overall survival (OS), length of hospital stay and acute radiotherapy toxicity (all P>0.05). Compared with SCRT with delayed surgery, LCRT with delayed surgery was associated with a significant increase in the tumor downstaging rate (RR=0.84, 95%CI=0.76-0.93, P<0.05) and a considerable increase in pathologically complete remission rate (RR=0.46, 95%CI=0.34-0.61, P<0.05).@*Conclusions@#SCRT with delayed surgery is as effective as LCRT with delayed surgery in terms of sphincter preservation rate, R0 resection rate, postoperative complications, LRR, RFS, OS, grade Ⅲ-Ⅳ acute toxicity and length of hospital stay. However, LCRT in combination with delayed surgery enhances the tumor downstaging rate and pathologically complete remission rate.
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Objective To investigate the expression of FZD7 (frizzled homolog protein7,FZD7) and IL-6 (interleukin-6,IL-6) in primary hepatocellular carcinoma(HCC) and the impact on the prognosis.Methods Immunohistochemistry(IHC) was used to detect the expression level of FZD7 and IL-6 in 68 HCC tissues,30 para-carcinoma tissues and 10 healthy controls from patients with hepatic hemangioma.Patients were followed-up for survival analysis.Results The expression ratio of FZD7 in HCC tissue,paracarcinoma tissue and healthy controls were 72％,53％ and 0 (P ＜ 0.001),the ratio of IL-6 expression was respectively 69％,57％ and 0 (P ＜0.001).The expressions of FZD7 were positively correlated with that of AFP level (x2 =7.059,P =0.035),pathology classification (x2 =4.732,P =0.043),and the infection of HBs (x2 =3.508,P =0.032).The overall survival (65 ％ vs.84％,x2 =5.525,P ＜ 0.05) and the disease free survival (33％ vs.75％,x2 =5.991,P ＜0.05) of HCC patients with co-positive was significantly lower than that with co-negative expression of FZD7 and IL-6.Conclusion FZD7 and IL-6 play a critical role in development and progression of HCC.
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Objective To study the expression of hypoxia-inducible factors-1 α and pyruvate kinase type M2 in Hp infected gastric carcinoma and their clinical significances.Methods The expression levels of hypoxia-inducible factors-1α and pyruvate kinase type M2 in 85 cases of gastric carcinoma tissues were detected by using RT-PCR and immunohistochemical method.The Virulence level of CagA gene were detected in Hp infected gastric tissue.Results As the degree of tumor differentiation,invasion depth and clinical stage of tumor increased,the positive expression rate of HIF-1 α and PKM2 increased,and the expression level of the two was in positive correlation.The positive expression rate of HIF-1α (73％)was related to lymph node metastasis (x2 =4.204,P =0.041).The positive expression rate of PKM2 (85 ％)was related to tumor diameter.The positive expression rate of HIF-1α and PKM2 (75％ and 85％,respectively)significantly increased in Hp infected gastric carcinoma tissue (x2 =6.486,P =0.010;x2 =7.341,P =0.009,respectively) and related to CagA + type.Conclusion HIF-1α and PKM2 may be closely correlated to development and metastasis of gastric carcinoma with Hp infection.
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Objective To evaluate positive p-mTOR expression and its significance in gastric cancer.Methods Original studies published for the correlation between p-mTOR and clinicopathological parameters as well as prognostic significance were enrolled from Cohrane Library,Pubmed,EMbase database and CBM,CNKI.Analyses were performed by software REVMAN 5.0.Age,gender,TNM stage,lymph node metastasis,type were analyzed using pooled odds ratio (OR) with 95％ confidence interval (CI),and OS were analyzed using pooled hazard ratio (HR) with 95％ CI.Results Seven studies including 2 477 gastric cancer patients were enrolled in the meta analysis.p-mTOR expression was positive in 1 089 of the cases.p-mTOR positive expression was correlated with age,OR =0.74,95％ CI:0.62-0.89,dcpth of invasion OR =0.76,95％ CI:0.60-0.97,lymph node metastasis,OR =1.95,95％ CI:1.59-2.39,TNM stage,OR =0.57,95％ CI:0.38-0.84,type,OR =0.64,95％ CI:0.50-0.83,and OS,HR =1.86,95％ CI:1.60-2.16.Gastric cancer patients with p-mTOR positive expression tend to be younger,had a higher risk of lymphatic invasion,later TNM stage and poor prognosis.Its positive expression had no relation with the gender.Conclusion p-mTOR positive expression is a significant predictor for advanced TNM stage,more lymph node metastasis,intestinal type and poorer OS.
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<p><b>OBJECTIVE</b>To explore the effect of body mass index (BMI) on postoperative short-term prognosis and survival rate of gastric cancer patients.</p><p><b>METHODS</b>Clinical and follow-up date of 153 gastric cancer cases undergoing radical operation in our hospital from January to June 2010 were retrospectively analyzed. According to BMI, patients were divided into low group (BMI<18.5, 23 cases), normal group (18.5≤BMI<25.0, 95 cases) and high group (BMI≥25.0, 35 cases). Clinicopathological features and outcomes were compared the among three groups.</p><p><b>RESULTS</b>Among three groups, the differences in operation time, intraoperative blood loss, number of lymph node retrieved, postoperative hospital stay, lymph node metastasis rate, tumor staging and postoperative complication morbidity were not statistically significant (all P>0.05). Preoperative hemoglobin in the low group was significantly lower as compared to normal and high groups [(106.1±13.8) g/L vs. 113.5±5.2) g/L and (123.5±8.7) g/L, F=3.265, P=0.041], and so was the preoperative albumin [(38.7±2.5) g/L vs. (41.3±0.8) g/L and (43.5±1.4) g/L, F=8.516, P=0.000]. The ratio of gastric cardiac cancer in the low group was significantly lower as compared to the normal and high groups[34.8%(8/23) vs. 68.4%(65/95) and 62.9%(22/35), χ(2)=8.913, P=0.012]. Five-year survival rate of the low, normal and high groups were 43.5%, 50.5% and 65.7% respectively(P=0.189). Subgroup analysis showed that the 5-year survival rate of patients with gastric cardiac cancer in the low group was significantly lower as compared to those in the high group (25.0% vs. 84.6%, P=0.004).</p><p><b>CONCLUSIONS</b>BMI dose not generally play a role in short-term outcomes and long-term survival of the gastric cancer patients. Nutritional improvement and body weight maintenance may be beneficial to low BMI patients, especially those with gastric cardiac cancer.</p>
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Humans , Blood Loss, Surgical , Body Mass Index , Gastrectomy , Length of Stay , Lymph Nodes , Lymphatic Metastasis , Neoplasm Staging , Operative Time , Postoperative Complications , Postoperative Period , Retrospective Studies , Stomach Neoplasms , General Surgery , Survival Rate , Treatment OutcomeABSTRACT
Objective Todetecttheexpressionofvascularendothelialgrowthfactor(VEGF)andmigrationinhibitoryfactor (MIF) in colorectal cancer .Methods The immunohistochemical staining (SP method) was used to measure the expression of VEGF and MIF in 80 samples of colorectal cancer and 80 samples of normal colorectal tissues at 5 cm apart from the tumor edge . The relationship between VEGF and MIF with the clinical pathologic characteristics of colorectal cancer was anlyzed .Results The positive rates of VEGF and MIF in the colorectal cancer tissues were 77 .50% and 82 .50% respectively ,but which in the normal colorectal tissues were 22 .50% and 27 .50% respectively ,the positive rate of VEGF and MIF expression in the colorectal cancer tis‐sues were higher than that in the normal colorectal tissue with statistical difference (P<0 .05) .The expression of VEGF and MIF had correlation with the tumor infiltration depth ,lymph node metastasis ,and clinical stage ,but no correlation with gender ,age and histodifferentiation .Conclusion VEGF and MIF are highly expressed in the colorectal cancer tissues .
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Objective To study the expression of clusterin (CLU) and P-glycoprotein (P-gp) in hepatic cell carcinoma (HCC) and its relationship.Methods The expression of CLU gene in the tissue of H CC (41 cases),cirrhosis(10 cases) and normal liver (10 cases) and the expression of P-gp in the tissue of HCC were detected by immunohistochemical method.Results The positive expression rate of CLU was 82.93％(34/41) in HCC,and negative or weak positive were detected in cirrhosis and normal liver tissue.The positive expression rate of CLU was significantly correlated with Edmondson's histological grade (P ＜ 0.05),but had no correlation with patients' age,sex and cirrhosis (P ＞ 0.05).The positive expression rate of P-gp in HCC was 70.73％(29/41).There was significant correlation between the expression of CLU and P-gp (P ＜ 0.05).Conclusions The over expression of CLU is significantly associated with clinical multidrug resistance in HCC.It should be a potential target for treatment of HCC.
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Objective To evaluate the causation and management of complications caused by enteral nutrition (EN)after stomach cancer surgery.Methods The clinical data of 195 gastric cancer patients which used EN after surgery were analyzed retrospectively from September 2002 to April 2008 in our hospital.Results Among the 195 patients,29(14.87%)developed abdominal distention,17(8.71%)diarrhoea,Six(3.07%)metabolic complica tions,three anastomotie leakage,1 patient with colon perforation.Conclusion These complications caused by EN after stomach cancer surgery associated with the stress of surgery,the speed and concentration of nutrition infusion, patients'metabolic conditions and other related factors.
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Clinical trials have demonstrated that arsenic trioxide was effective in the treatment of acute promyelocytic leukemia. Based on this fact, more and more studies have been carried out to study its role in the treatment of human hepatocarcinoma cell. This article reviews arsenic trioxide in trial studies and clinical use of hepatoma carcinoma cell.
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Objective To evaluate the diagnosis and surgical management for pancreatic duct stones (PDS). Methods The clinical data of 19 PDS patients admitted to our hospital from Jan. 1985 to Sep. 2003 were analyzed retrospectively. Results Epigastric pain was the first symptom in all patients,and chronic pancreatitis was associated, pancreatic carcinoma coexisted in 6 cases. Fifteen cases were found to have PDS or pancreatic duct dilation by B-type ultrasonography. Twelve patients underwent pancreatolithotomy plus side to side Roux-en-Y pancreaticojejunostomy. Pancreatoduodenectomy was performed on four patients ,caudal pancreatectomy and pancreatolithotomy on three patients. Six pancreatic carcinoma patients died during follow-up of 9～26 months. Abdominal pain was relieved completely in 11 cases and partially in 1,stones and pain recurred in one patient. Conclusions B-type ultrasonography、CT and endoscopic retrograde cholangiopancreatography(ERCP) are most useful diagnostic methods;Surgical procedures should be selected according to the following factors: (1) location of the pancreatic duct stones. (2) stenosis of the main pancreatic duct.(3) pancreatic duct stones associated with or without pancreatic carcinoma.
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Objective To investigate MDR1mRNA quantitative expression in patients with hepatocellular carcinoma( HCC) and its relation to pathologic features, chemotherapy sensitivity, metastasis and prognosis. Methods Total RNA extracted from 47 cases of HCC and 12 normal liver tissue were subjected to analysis of MDR1mRNA expression by fluoregenic probe quantitative RT-PCR(FQ-RT-PCR). Result The level of MDR1mRNA expression was 1.4?10 3～3.6?10 6copies/?g RNA .The positive rates observed in 72% of the tumor tissue was significantiy higher than in 51% of the adjacent liver tissue and in 42% of the normal liver tissue (P