Application endoscopic mucosal resection to therapy early gastrointestinal cancer and precancerous lesion / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value of endoscopic mucosal resection (EMR) on early gastrointestinal cancer and precancerous lesion.</p><p><b>METHODS</b>The EMR data of 42 lesions from 28 patients, collected from Apr. 2001 to Dec. 2005, were retrospectively analyzed. All the lesions were confirmed histologically before and after operation.</p><p><b>RESULTS</b>Forty-two lesions were removed by the EMR from 28 patients. Lesion types observed under endoscopy were as follows: type I 9 lesions (type Isp 2 lesions, type Is 7 lesions), type II 33 lesions (type IIa 23 lesions, type IIa + IIc 4 lesions, type IIb 6 lesions). Thirty-eight EMRs were performed by using snare resection techniques and 4 EMRs by using suction cap-assisted techniques. The size of lesions changed from 0.6 cm x 0.6 cm to 3.0 cm x 3.5 cm. Complete resections were achieved in 36 of 40, among them, 2 lesions were divided into 2 pieces and 1 lesion was divided into 3 pieces. Post-EMR histopathologic evaluation revealed the following</p><p><b>RESULTS</b>carcinoma in 4 lesions, high-grade dysplasia (HGD) in 11 lesions, middle-grade dysplasia (MGD) in 17 lesions, adenoma in 6 lesions, non-adenoma in 2 lesions. The pathology match rate between local biopsy and EMR was 60.0%. The detection rates of cancer, HGD and MGD by EMR were higher than that by routine biopsy. No serious complications were seen in this study.</p><p><b>CONCLUSION</b>Endoscopic mucosal resection has significant impact on the endoscopic intervention treatment of early cancer and precancerous lesion in digestive tract.</p>

Relationship between cyclooxygenase- 2 expression and angiogenesis in patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate COX-2 expression in patients with gastric cancer and its relationship with angiogenesis and clinicopathologic features of gastric cancer.</p><p><b>METHODS</b>COX-2 expression and CD34-stained microvessel density (MVD) were detected by immunohistochemical methods in specimens from 96 patients with gastric cancer. The correlations among COX-2 expression, MVD and clinicopathologic features were analyzed.</p><p><b>RESULTS</b>The COX-2 positive rate and MVD in gastric cancer were significantly higher than those in the normal gastric mucosa (80.2% vs. 13.3%; 32.5+/- 8.3 vs. 13.1+/- 2.4, all P< 0.01). The COX-2 positive rate and MVD in the patients with stage III and IV were significantly higher (91.4% and 34.9+/- 8.7 respectively, P< 0.01), than that in the patients with stage I and II. The COX-2 positive rate and MVD in the cases with lymph node metastasis were 87.9% and (35.0+/- 8.5) respectively, higher than those in the cases without lymph node metastasis (P< 0.05). The Spearman rank correlation test showed a significant correlation between COX-2 expression and tumor MVD (r=0.311, P< 0.01).</p><p><b>CONCLUSIONS</b>COX-2 plays an important role in gastric cancer angiogenesis. COX-2 and angiogenesis induced by COX-2 contribute to tumor invasion and lymph node metastasis.</p>

Expression of glutathione S-transferase-pi and DNA topoisomerase II alpha and their implications in colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of GST-pi and Topo II-alpha, and their relationships with clinicopathological parameters in colorectal carcinoma.</p><p><b>METHODS</b>The expression of GST-pi and Topo II-alpha were detected by avidin-biotin-peroxide complex (ABC) method in tumor specimens, matched paratumor tissues from 60 cases with colorectal carcinoma and normal colonic tissues from 15 cases.</p><p><b>RESULTS</b>The expression rates of GST-pi and Topo II-alpha were 90.0% and 86.7% respectively in tumor tissues, significantly higher than those in matched paratumor tissues and normal tissues (P< 0.01). The expressions of GST-pi and Topo II-alpha were associated with cellular differentiation, Dukes stage and lymph node metastasis (all P< 0.01), but not with tumor size and histological type (all P > 0.05). The expression level of GST-pi was significantly higher in poorly differentiated tumors than that in well differentiated tumors. The expression level of Topo II-alpha in well-differentiated tumors were stronger than that in poorly differentiated tumors.</p><p><b>CONCLUSIONS</b>The detection of GST-pi and Topo II-alpha expressions may be helpful to judge the malignant behavior, metastasis and prognosis in human colorectal carcinoma.</p>