Prognostic factors of small non-functional pancreatic neuroendocrine tumors / 中华消化杂志

Objective To investigate the clinical features and prognostic factors of small (maximum diameter≤ 2.0 cm) non-functional pancreatic neuroendocrine tumors (NF-PNET).Methods From January 2002 to April 2017,the clinical data of 18 patients with small NF-PNET were retrospectively analyzed.The prognosis and clinical pathological features were investigated.According to the prognosis,the patients were divided into death group (four cases) and disease-free survival group (14 cases).Fisher's exact test and Mann-Whitney rank inspection were performed for statistical analysis.Results All 18 patients (nine males,nine females) aged 23 to 80 years old,median age 52.5 years old received radical resection.The median follow-up time was 54 months.Four patients died during the follow-up.There was no statistically significant difference in median age (61.0 years,32.0 to 80.0 years vs 49.0 years,23.0 to 72.0 years) and median tumor maximum diameters (1.9 cm,0.8 to 2.0 cm vs 1.5 cm,0.8 to 2.0 cm) between the death group and disease-free survival group (Z=-1.223 and-0.752,P=0.233 and 0.505).Compared with that of disease-free survival group,tumor differentiation degree of the death group was lower (poor/high differentiation,2/2 vs 0/14),and the difference was statistically significant (Fisher's exact test,P=0.039).However,there was no significant difference in histological grades (G1/G2/G3,1/1/2 vs 9/5/0;Fisher's exact test,P=0.057).The distribution of tumor in death group and disease-free survival group was similar.The proportion of patients with tumor at pancreatic head was 2/4 and 6/14 of the death group and disease free survival group,respectively.The surgical methods of the death group included pancreaticoduodenectomy (two cases),distal pancreatectomy (one case),and total pancreatectomy (one case),and there was no statistically significant difference in rates of surgical methods between the two groups (Fisher's exact test,P=0.260).Conclusion Age,tumor maximum diameter,degree of differentiation,histological grade and surgical methods may be correlated with poor prognosis of small NF PNET.

A Research on Relationship of TCM Constitution and Syndrome Elements in Hyperhomocysteinemia Patients / 中国中医药信息杂志

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.

Identification of microRNA-217 targeted gene ANLN in pancreatic cancer PANC1 cells / 中华胰腺病杂志

Objective To identify the miR-217 targeted gene ANLN by experiment.Methods Bioinformatic algorithms were used to predict the potential targets of miR-217.Then,ANLN binding with miR217 and mutant ANLN (mutANLN) sequence were designed and synthesized,and their amplified fragments were inserted into plasmid psiCHECK-2,and recombinant plasmid psiCHECK-2-ANLN and psiCHECK-2-mutANLN were reconstructed.The two recombinant plasmids were co-transfected into pancreatic cancer cell line PANC1 with miR-217,miR-217 inhibitor,NC,NC inhibitor by liposome,respectively.Dual luciferase reporter system was used to determine the luciferase activity,and Western blot was used to measure the expression of ANLN protein.Results The luciferase activities of psiCHECK-2-ANLN,psiCHECK-2-ANLN +miR-217,psiCHECK-2ANLN + miR-217 inhibitor,psiCHECK-2ANLN + NC,psiCHECK-2-ANLN + NC inhibitor were 2.221 ± 0.188,0.769 ± 0.061,3.764 ± 0.371,2.265 ± 0.201,2.242 ± 0.018,and the difference among these groups was statistically significant (F =77.405,P ＜0.001),but the difference among psiCHECK-2ANLN group,psiCHECK-2-ANLN + NC group and psiCHECK-2-ANLN + NC inhibitor group was not statistically significant.However,luciferase activities of psiCHECK-2-ANLN + miR-217 group were significantly decreased when compared with other 3 groups,and luciferase activity of psiCHECK-2-ANLN +miR-217 inhibitor group were significantly increased when compared with other 4 groups (all P ＜0.001).Luciferase activities of groups transfected with psiCHECK-2-mutANLN was not significantly different (P =0.053).The expression of ANLN protein in PANC1 with psiCHECK-2-ANLN + miR-217 co-transfection was significantly down-regulated when compared with that with psiCHECK-2-ANLN transfection alone.Conclusions ANLN is one of the direct target genes of miR-217 in PANC1 cells.

Application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail.</p><p><b>METHODS</b>Six cases of cystic carcinoma in the pancreatic body and tail treated between Nov, 2009 and Mar, 2011 were retrospectively analyzed. The original image data of 64-slice spiral CT were collected and using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted to obtain the 3-dimensional reconstruction images with customized image manipulation software. The specific surgical approach (the trocar position) and surgical procedure were planned based on the reconstructed mode.</p><p><b>RESULTS</b>The reconstructed 3-dimensional model clearly displayed cystic carcinoma in the pancreatic body and tail and the adjacent organs, showing distinct relationship between the cystoma and the splenic artery and vein. All the patients successfully underwent laparoscopic resection of the pancreatic body and tail without perioperative death. The spleen was preserved in 5 cases and removed in 1 case due to mucinous cystadenocarcinoma. The overall rate of pancreatic fistulae was 33.3% without incidences of postoperative hemorrhage. The average hospital stay of the patients was 12 days.</p><p><b>CONCLUSION</b>Three-dimensional reconstruction based on pancreatic CT data provides valuable assistance for laparoscopic resection of cystic carcinoma in the pancreatic body and tail.</p>

Expression of miR-216a in pancreatic cancer and its clinical significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical significance of miRNA-216a expression in pancreatic cancer.</p><p><b>METHODS</b>Fourteen patients with pancreatic cancer undergoing pancreaticoduodenectomy and 6 patients with benign pancreas lesions were examined for miR-216a expressions in the tumor or lesion tissues using Agilent Human miRNA Microarray (V12.0). The relationship between miR-216a expressions and the clinicopathological features of the patients was analyzed.</p><p><b>RESULTS</b>The expression of miRNA-216a was significantly lower in pancreatic cancer than in benign pancreas lesions (P=0.000). The expression of miRNA-216a was significantly correlated with the T stage of the tumor (P=0.002), but not with the patients' age, gender, smoking status, tumor stage, lymph node metastases, distant metastasis, tumor differentiation, nerve invasion, vessel invasion or serum CA19-9 level (P>0.05).</p><p><b>CONCLUSIONS</b>The down-regulated expression of miR-216a in pancreatic cancer suggests the involvement of miR-216a in the tumorigenesis and development of pancreatic cancer. miR-216a may potentially serve as a novel tumor marker and also a prognostic factor for pancreatic cancer.</p>

The value of 18-fluorodeoxyglucose positron emission tomography in prognosis of patients with pancreatic cancer / 中华普通外科杂志

Objective To evaluate the value of 18F-FDG PET in predicting the prognosis of pancreatic cancer. Methods Fifty-four cases of pancreatic cancer were divided into two groups. Taking standard uptake value(SUV) at 4 as the cut off point, patients (22 cases) with that not more than four were classified into group A, and those (32 cases) with SUV greater than four were into group B. The prognosis of patients by SUV was analyzed statistically. Results There was a statistically significant difference in survival between the two groups ( P =0. 01 ). The 1-,3-year survival rate was 68. 18% 、34. 91% in group A in those the SUV≤4, and 33.61% 、11.95% in group B( SUV ＞4), respectively. Cox proportional hazard model showed that tumor staging and SUV were the significantly independent prognostic factors in patients with pancreatic cancer. Conclusions 18F-FDG PET is of value in predicting the prognosis of patients with pancreatic cancer.

The diagnosis and treatment of cystic pancreatic tumors / 中华普通外科杂志

Objective To explore the diagnosis and treatment of cystic pancreatic tumors. Methods The clinical data of 21 cases with cystic pancreatic tumors were retrospectively analyzed. Results This group enrolled 21 cases including serous cystic neoplasm of the pancreas (SCN, 11 cases), mucinous cystic neoplasm of the pancreas (MCN, 6 cases), intraductal papillary mucinous neoplasms (IPMN,2 cases), solid posudopapillary tumor of the pancreas (SPTP,2 cases). Seven cases had certain symptoms or typical signs, while others were asymptomatic and tumors were found by regular physical examinations. All of the cases were diagnosed by CT scans, and the value of serum tumor markers was within normal range. Twenty patients underwent pancreatic tumor resections and there was no perioperative death. Pancreaticoduodenectomy was performed in 8 cases, and distal pancreatectomy was performed in 6 cases including 1 patient undergoing laparoscopic distal pancreatectomy. Middle segment resection was performed in 4 cases, and tumor enucleation was performed in 2 cases. These 20 patients were followed up for 11 to 96 months, and there was no tumor recurrence or metastasis. One patient with mucinous cystic carcinoma underwent palliative operation and survived 4 months after surgery. Conclusions Preoperative imaging was not able to confirm the definite tumor pathological category. Laparotomy should be performed in a patient with cystic pancreatic tumor. The selection of surgical approach should be individualized, and the laparoscopic operation is an alternative.