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ObjectiveTo investigate the effect of Gegen Qinliantang （GGQLT）-medicated serum on free fatty acid （FFA）-induced nonalcoholic steatohepatitis （NASH） in vitro model of human hepatoma cells HepG2. MethodNASH model of HepG2 cells was established in vitro， and the cells were intervened with different volume fractions of GGQLT-medicated serum and resveratrol. Intracellular lipid deposition in each group was detected by oil red O staining， the level of reactive oxygen species （ROS） in each group were detected by flow cytometry， the levels of glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， triglyceride （TG） and malondialdehyde （MDA） in each group were detected by kits. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to measure the mRNA expression levels of nuclear transcription factor （NF）E2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， quinone oxidoreductase 1 （NQO1）， Kelch-like epichlorohydrin-associated protein-1 （Keap1）， NF-κB， thioredoxin interacting protein （TXNIP）， interleukin-1β （IL-1β） in HepG2 cells of each group. The protein expression of Nrf2， TXNIP in cells of each group was detected by Western blot. ResultFFA induced large accumulation of intracellular lipids. Compared with the normal group， the activities of GSH-Px and SOD were significantly decreased （P<0.01） and the contents of TG， ROS and MDA were significantly increased （P<0.05， P<0.01） in the model group. Compared with the model group， all GGQLT groups and resveratrol group could elevate intracellular SOD activity to different degrees （P<0.05， P<0.01） and significantly reduce the levels of intracellular ROS and MDA （P<0.05， P<0.01）， GGQLD high- and medium-dose groups and resveratrol group significantly elevated GSH-Px activity （P<0.01）， GGQLD medium- and low-dose groups and resveratrol group significantly decreased TG content （P<0.05， P<0.01）. Compared with the model group， GGQLT high- and medium-dose groups and resveratrol group could significantly upregulate the mRNA expression levels of Nrf2， HO-1 and NQO1 （P<0.01）， all GGQLT groups and resveratrol group could significantly downregulate the TXNIP protein expression level， as well as significantly downregulate the mRNA expression levels of Keap1， NF-κB （P<0.05， P<0.01）. Nrf2-siRNA transfection of cells revealed that Nrf2 expression was significantly downregulated （P<0.01） in the Nrf2-siRNA group of cells by comparing with NC-siRNA group at the corresponding dose of drugs， and the inhibitory effects of GGQLT and resveratrol on TXNIP， IL-1β were attenuated. ConclusionFFA induces the production of ROS and inflammatory factors in HepG2 cells， and GGQLT can improve the anti-inflammatory and antioxidant capacities of cells， and its mechanism may be related to the regulation of Nrf2/TXNIP signaling pathway， so as to improve NASH.
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<p><b>BACKGROUND</b>Prophylactic para-aortic nodal dissection (PAND) has no proven benefits for potentially curable advanced gastric cancer. However, the value of therapeutic PAND for involved para-aortic nodes (PANs) in patients with locally advanced gastric cancers has not been determined yet.</p><p><b>METHODS</b>Between 1998 and 2010, 157 gastric cancer patients with 1-3 involved PANs underwent extended D2 (D2+) lymphadenectomy plus PAND (PAND group, n = 69) or extended D2 lymphadenectomy alone (non-PAND group, n = 88). The clinicopathologic features and prognostic data were compared between the two groups. A propensity score-adjusted analysis was used for a balanced comparison.</p><p><b>RESULTS</b>The rate of PAN metastasis was 40.6% (28/69) in the PAND group. The 5-year survival rate was significantly higher in the PAND group than in the non-PAND group (43.7% vs. 31.8%, P = 0.044). Compared to the non-PAND group, the death hazard ratios in the PAND group were 0.45 (95% CI 0.274-0.739; P = 0.002) and 0.536 (95% CI 0.328-0.861; P = 0.0097) by multivariate analysis without and with propensity score adjustment respectively. Recurrence rate at 5 years was 39.1% in the PAND group and 43.2% in the non-PAND group (P = 0.628).</p><p><b>CONCLUSION</b>Extended D2 lymphadenectomy plus PAND is associated with superior outcomes for advanced gastric cancer patients with 1-3 involved PANs.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Lymph Node Excision , Prophylactic Surgical Procedures , Methods , Stomach Neoplasms , General Surgery , Treatment OutcomeABSTRACT
Cancer metastasis is multi-step process that requires cancer cells to jump through many hoops.The low-molecule-weight beparin (LMWH) has been reported effective for the treatment of metastasis to some extent, the mechanisms are proposed as anticoagulation, inhibition of heparanase, selectins, adhesion, angiogenesis mediated by the tumor cells, and the effects on cell cycle and apoptosis.
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Objective To investigate the clinical pathologic characters of colorectal cancer with simultaneous hepatic metastasis and the prognosis. Methods From Aug. 1994 to Dec. 2006, 2019 cases of colorectal carcinoma were admitted, among them there were 166 patients of colorectal cancer with synchronous liver metastases receiving surgical therapy. Results were analyzed retrospectively using the software of SPSS. Results These 166 patients with synchronous liver metastases from colorectal cancer accounted for 8.1% of all 2019 patients of colorectal cancer admitted. Multivariate analysis demonstrated that CEA level before surgery、depth of invasion、 pathological type and Ducks' stage were the key risk factors predicting simultaneous liver metastasis from colorectal cancer. The survival rates at 1, 3 and 5 years were 69%, 21%, and 9% respectively. There was significant difference among the different liver metastasis group of H1, H2 and H3(X2=23.35, P<0.01). The survival rates of patients undergoing radical resection was higher than those undergoing palliative resection (PR)and by-pass operation or feeding neostomy(BP/ FN)(X2= 21.18,P<0.01). PR improved short-term prognosis but did not improve long-term survival compared with BP/FN group(P=0.13). Conclusion Colorectal cancer with synchronous liver metastases has poor clinic pathological characters. Different degree of liver metastasis result in different prognosis.Radical resection leads to a better prognosis. Palliative resection can improve short-term prognosis and life quality but can't improve long-term survival.
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Objective To investigate the clinicopathological difference and prognosis of colorectal adenocarcinomas including mutinous, Signet-ring cell, papillary and tubular carcinomas. Methods Two thousand and eighty-nine patients with colorectal cancer underwent colorectal operation between August 1994 and April 2007. The clinicopathological characteristics of mucinous adenocarcinoma (n=144), signet-ring cell carcinoma (n=25), papillary and tubular carcinomas (n= 1837) were compared expect of other types of cancer (n = 83). The single factor and Logistic regression methods were used to analyze the clinicopathological parameters that influence the prognosis of colorectal cancer such as age, location of the tumor, staging, peritoneum and pathological typing. The survival rates of patients with above three types of adenocareinomas were analyzed. Results The mean age of onset was lowest in patients with mutinous adenocarcinomas [(54. 20 ± 16.25) years] compared with that in patients with signet-ring cell cancer [(40.43 ± 12.88)years] or papillary and tubular carcinomas [(58. 73 ±13.62)]. There were significant differences in gender, size and location of the tumor, TNM staging, peritoneal metastasis, lymph node involvement and adjacent organ invasion among three groups (all P values <0.05). The single factor and Logistic regression analysis revealed that both mucinous adenocarcinoma and signet-ring cell carcinoma were risk factors ot prognosis. The patients with mucinous adenocarcinoma or signet-ring cell tumor were poor in long-term overall survival in comparison with patients with papillary and tubular carcinoma (P<0. 001). Conclusions The colorectal mucinous and signet-ring cell adenocarcinomas are risk factors for prognosis of colorectal cancer, which imply the poor outcome.
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Objective To explore clinical features,prognosis and study related cancer types in patients with familial gastric carcinoma. Methods Nine families of ICG-HGC and 3 families of suspected-ICG-HGC according with International Collaborative Group on Hereditary Gastric Cancer standard were collected and their pedigree trees were drawn.Clincial features and prognosis of ICG-HGC and suspected-ICG-HGC families were analyzed.and the related cancer types of ICG-HGC and suspected-ICG-HGC kindreds were investigated. Resuits The morbidity of ICG-HGC and suspected-ICG-HGC was 0.99%;The age of patients among the propositi of 12 kindreds were 29～65 years old with the mean age of 56 years old.Among 11 kindreds,there were 45 cases of cancers including 2 cases of multiple cancers.There were 30 foci of gastric cancer,most of which were located in lower and middle third of the stomach,with pathologic type of adenocarcinoma in poor to moderate differentiation.There were totally 15 extrastomach tumors including 7 colorectal cancers.Four cases of 11 kindreds had survived for 3 years including 1 case surviving for more than 10 years. Conclusion The familial gastric cancers in southern China have special characteristics such as poorly pathologic differentiation,advanced cancer stage,early age of onset,distal end of the stomach in location and high incidence of related tumors in colorectum.
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Objective To study the effect of operative modalities on the prognosis of gastric carcinoma patients suffering from various types of intra-abdominal metastasis. Methods In this study, 150 cases of gastric cancer with abdominal metastasis screened from data base, were divided by the location into peritoneal dissemination group (n=106), hepatic metastasis group (n=19) and both peritoneal dissemination and hepatic metastasis group (n=25). The surgical interventions include total resection, palliative resection and no resection. The clinicopathological parameters and prognosis were analyzed. Results The total tumor resection rate in peritoneal dissemination group (48.1%) and hepatic metastasis group (63.2%) was significantly higher than that in both peritoneal and hepatic metastasis group (20.0%), with the mean survival time (months) being 31.1, 12.8, 9.7 respectively (P<0.05). In peritoneal group, the mean survival (months) for tumor total resection, palliative and no resection subgroup was 46.3,1.7,4.8 respectively (P<0.05), whereas in hepatic metastasis group, the mean survival (months) was 17.2,4.0,5.4 respectively (P<0.05), in both peritoneal and hepatic metastasis group, the mean survival (months) was 11.2,8.9,5.0 respectively (P>0.05). Lymph nodes resection significantly prolonged survival in peritoneal dissemination group. Conclusions The prognosis of gastric cancer with peritoneal dissemination is better than with hepatic metastasis. Tumor total resection and lymph node dissection significantly improve the survival of patients suffering from peritoneal or hepatic dissemination.
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Objective To summarize the clinicopathologic characters and the route of lymphatic metastasis of cancers at the gastroesophageal junction. Methods Clinicopathologic data of 86 cancer patients treated from October 2000 to December 2004 were analyzed retrospectively. Results There were 66 males and 20 females, the mean age was 60 years. Most patients were of Bormann typeⅢadenocarcinoma. The incidence of high differentiated adenocarcinoma in TypeⅠcancer was higher than that in other two types (P = 0. 002, P = 0. 004) , while the incidence of poor differentiated carcinoma in typeⅢcancer was higher than other two types(P = 0. 005 ,P = 0. 015). Metastatic rate of lymph nodes in group 1 and group 2(34. 9% ) .group 3 and group 4(36. 0% ), group 7 through to group 9(27. 9% ), group 10 and 11 (15. 1% ) was higher than in other groups, while that in group 5 and 6(11. 6% ) , and group 12(5. 8% ) was lower compared with other lymph nodes (P
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Objective To analyze clinicopathological features of synchronous colorectal carcinoma. Methods Data of colorectal cancer patients admitted to our hospital from June 1994 to December 2003 were analyzed retrospectively. Patients were divided into multiple synchronous colorectal carcinoma group ( MCG) and single colorectal cancer group ( SCG). Clinicopathological features and prognosis were compared between the two groups. SPSS 10. 0 was used for data analysis. Results Of all colorectal cancer(CRC) patients,3. 2 % (39/1225) had multiple synchronous CRCs and 939 patients had sporadic single CRC. In MCG, two patients had hereditary nonpolyposis colorectal cancer ( HNPCC) syndrome. No significant differences were found between MCG and SCG with regard to demographic features, Dukes stage and differentiation of index CRC. More patients in MCG had metachronous CRC (x2 = 4. 545, P= 0.033) and colorectal polyps ( x2 = 12. 013, P = 0.001) compared with SCG. Forty-six percent of multiple synchronous CRCs located in right colon in MCG, which was higher than that in SCG ( x2 = 25. 757 ,P = 0. 0001). Malignancy in adenoma was the frequent event accompanying cancer in MCG. Five-year survival rate in MCG was 57% compared with 64% in SCG ( x2 =0.084, P = 0.772 ). Conclusion Patients with right colon cancer seem easily to have multiple synchronous CRCs and malignancy in adenoma is most frequently accompanying the cancer. For patients with multiple synchronous CRCs, the prognosis is equivalent to that of patients with SCG.
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Objective To evaluate J-pouch coloanal anastomosis after low anterior resection for the middle and low rectal carcinoma. Methods From January 1998 to July 2002, 120 patients undergoing low anterior radical resection for the middle or low rectal carcinomas were divided into groups of coloanal anastomosis and that of 5 cm colonic J-pouch-anal anastomosis. WT5”HZResults These two groups were well matched for gender, age and histologic stage. There were no significant differences in operative time, hospital stay, complications, postoperative recurrence rate and postoperative survival time between the two groups as founded by an average follow-up of 18 months. The mean distance from the inferior edge of the tumor to the dentate line was (3 6?1 5) cm in the J-pouch group, significantly less than that in coloanal anastomosis group of (5 2?1 9) cm, ( P =0 000). Defecation frequency, urgency and incontinence were significantly improved at 3 months and 12 months after operation in the J-pouch group ( P 0 05). Conclusion J-pouch coloanal anastomosis after low anterior resection for the middle and low rectal carcinoma significantly improves the short-term bowel function after operation.
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Objective To investigate the lymph node metastases in gastric carcinoma and its clinical significance Methods The clinicopathological data of 608 patients with gastric carcinoma were analyzed retrospectively The total metastatic rate was calculated Binary logistic regression analysis was used to analyze the influence index of ten clinicopathological factors on the No 7～9 lymph node metastases Results The metastases rate (44 4%) of No 3 group lymph node was the highest seconded by No 15 group (43 2%) The overall lymph node metastases in No 7～9 group was 37 5% The depth of tumor invasion and the lymph node metastases in No 1～6 group were significantly correlated with lymph node metastases in the No 7～9 group ( P