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Chylothorax is one of the complications of surgery and lymphatic diseases. The incidence rate of chylothorax has been increasing in recent years. X-ray-guided interventional therapy is a new method for treating chylothorax, and its curative effect is no less than the traditional surgical treatment. Based on discussing the aetiology and diagnosis of chylothorax, this paper briefly summarizes the application progress of X-ray-guided interventional therapy for chylothorax to provide further reference and a basis for clinical practice.
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Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.
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Objective@#To study the correlation between pancreatic duct stent placement and postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy.@*Methods@#We performed a retrospective review on 298 patients who underwent pancreaticoduodenectomy from Jan 2011 to Dec 2016. Patients were divided into none stent group, external stent group and internal stent group according to the placement and drainage of the pancreatic duct stent.@*Results@#There were 60 cases in none stent group, 103 cases in external stent group and 135 cases in internal stent group. Altogether there were 52 cases suffering from biochemical pancreatic fistula, 52 cases of grade B fistula and 9 cases of grade C pancreatic fistula. There were three factors with statistical significance: 1, the operative method (χ2=20.947, P=0.000), 2, the diameter of main pancreatic duct (χ2=8.662, P=0.013), and 3, the intraoperative blood loss (χ2=14.03, P=0.001). There were no statistical significance difference between no stenting group and external/ internal stent group in the incidence of pancreatic fistula (P>0.05). The difference between internal stent group and external stent group was of statistical significance (χ2=9.948, P=0.019). The incidence of clinically relevant pancreatic fistula in external stent group was lower than the internal stent group (14.5% vs. 26.6%)(χ2=9.777, P=0.002).@*Conclusions@#The pancreatic duct stenting is not a risk factor for pancreatic fistula. The external drainage of pancreatic juice is associated with a lower incidence of pancreatic fistula compared to the internal drainage.
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Objective To study the correlation between pancreatic duct stent placement and postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy.Methods We performed a retrospective review on 298 patients who underwent pancreaticoduodenectomy from Jan 2011 to Dec 2016.Patients were divided into none stent group,external stent group and internal stent group according to the placement and drainage of the pancreatic duct stent.Results There were 60 cases in none stent group,103 cases in external stent group and 135 cases in internal stent group.Altogether there were 52 cases suffering from biochemical pancreatic fistula,52 cases of grade B fistula and 9 cases of grade C pancreatic fistula.There were three factors with statistical significance:1,the operative method (x2 =20.947,P =0.000),2,the diameter of main pancreatic duct (x2 =8.662,P =0.013),and 3,the intraoperative blood loss (x2 =14.03,P =0.001).There were no statistical significance difference between no stenting group and external/ internal stent group in the incidence of pancreatic fistula (P ＞ 0.05).The difference between internal stent group and external stent group was of statistical significance (x2 =9.948,P =0.019).The incidence of clinically relevant pancreatic fistula in external stent group was lower than the internal stent group (14.5％ vs.26.6％)(x2 =9.777,P =0.002).Conclusions The pancreatic duct stenting is not a risk factor for pancreatic fistula.The external drainage of pancreatic juice is associated with a lower incidence of pancreatic fistula compared to the internal drainage.
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Objective@#To explore the reasons and clinical treatment process of postoperative internal hernia in cases of gastric cancer, and improve the diagnosis and treatment level postoperative acute abdomen pain of gastric cancer patients.@*Methods@#A retrospective analysis was carried out to study the data of clinical diagnosis and treatment in 7 patients, who were performed an emergency operation within the First Affiliated Hospital of Soochow University from January, 2013 to August, 2016 caused by postoperative internal hernias of gastric cancer.@*Results@#Among the 7 postoperative gastric cancer patients, 2 cases had taken surgery of radical full gastric resection, 3 cases had taken surgery of radical distal gastric resection, and 2 cases had taken surgery of radical proximal gastric resection. All the 7 cases were confirmed to be incarcerated intestinal obstruction caused by internal hernia during emergency operation. Only 1 case was diagnosed to be internal hernia before surgery, while 3 cases were diagnosed as volvulus, 2 cases were diagnosed as perforation and 1 case was diagnosed as gastrolplegia. The small intestinal obstruction of all cases was caused by incarcerated intestinal. All the patients recovered well, and no complications occurred.@*Conclusions@#Internal hernias of the postoperative gastric cancer patients, which is often characterized by small intestinal obstruction symptoms, is difficult to diagnose before operation. Emergency operation in time for the postoperative gastric cancer patients with continuous acute abdominal pain may help to reduce the severe complications and improve patient′s prognosis.
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Objective To explore sensitive indicators for the initiation,development,and metastasis of gastric cancer and to provide objective evidence for the early diagnosis,treatment,and progression monitoring of gastric cancer.Methods A total of 108 patients with gastric cancer were enrolled in this study.The expression of interleukin receptor 1 (CXCR1)in samples from gastric cancer and adjacent tissues was detected by immunohistochemistry and patient clinical data were collected for correlation analysis.Logistic regression analysis of the 5-year survival rate of patients was conducted.Results The positive CXCR1 expression rate in gastric neoplasm tissues was significantly higher than that in adjacent tissues.Nevertheless,CXCR1 was correlated with tumor differentiation (P =0.017),TNM staging (P =0.006),and the existence of lymphatic metastasis (P =0.035).The overall survival rate (P =0.043) and recurrence-free survival rate (P=0.029) of patients with positive CXCR1 were lower than those of patients with negative CXCR1.Conclusions CXCR1 expression levels increase in gastric neoplasm tissues and are associated with tumor differentiation,TNM staging,and lymphatic metastasis.Positive CXCR1 is correlated with poor prognosis and has the potential to serve as one of clinical prognostic indicators.
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Objective To discuss the effect of main organ-preserving pancreatectomy operations on the postoperative complications and the long-term quality of life.Methods The clinical data of 320 patients undergoing pancreatic surgery from January 2013 to December 2016 in the First Affiliated Hospital of Soochow University were retrospectively analyzed and all the patients were divided into traditional pancreatectomy surgery group and organ-preserving pancreatectomy surgery group.The traditional pancreatectomy surgery group included pancreaticoduodenectomy (PD),distal pancreatectomy (DP),and laparoscopic distal pancreatectomy (LDP);and the organ-preserving pancreatectomy surgery group included pylorus-preserving pancreaticoduodenectomy (PPPD),spleen-preserving distal pancreatectomy (SPDP),enucleation pancreatectomy (EP),and middle-preserving pancreatectomy (MSP).Face to face clinic visit or telephone follow-up was scheduled every three months until May 31,2017.The operation time,intraoperative hemorrhage,intraoperative blood transfusion,postoperative complications (hemorrhage,pancreatic fistula,biliary fistula,abdominal infection,delayed gastric emptying),postoperative hospitalization stay,secondary surgery and the survival status within 30 days after surgery,the pancreatic endocrine function,exocrine function and the long-term quality of life were recorded.Results The operation time,intraoperative hemorrhage and intraoperative blood transfusion were not statistically different between PD and PPPD groups,DP and SPDP groups,LDP and LSPDP groups,DP and MSP groups,and DP and EP groups,respectively (all P values ＞0.05).Compared with MSP group,the hospitalization time in DP group was shorter [(18.61 ±12.46)d vs (26.88 ± 15.22)d],the occurrence rate of postoperative pancreatic fistula (24.07％ vs 56.25％),bleeding (3.70％ vs 25.00％),abdominal infection (1.85％ vs 18.75％),delayed gastric emptying (5.56％ vs 31.25％),secondary surgery (0 vs 25.00％),and glycemic control rate were decreased (27.78％ vs 0),and all the differences were statistically significant (all P values ＜ 0.05).After discharge,the incidence of chronic diarrhea in the PD group was higher than that in the PPPD group (17.31％ vs 2.08％).The fatigue in the DP group was higher than that in the SPDP,MSP and EP groups,and fatigue,social function,overall health score of the LDP group were lower than those in LSPDP group;emotional function in the DP group was better than that in MSP group,and all the differences were statistically significant (all P values ＜ 0.05).Conclusions The organ-preserving pancreatectomy can reduce the trauma of the operation,postoperative complications and postoperative pancreatic endocrine and exocrine dysfunction,and improve the long-term quality of life.
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Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P ＜ 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P ＜ 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P ＜ 0.01).Celluar apoptosis rates in experimental group (9.4％ ± 1.1％) elevated in contrast with NC group (6.4％ ± 0.8％) and CON group (6.5％ ± 1.0％) (both P ＜ 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P ＜ 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P＜0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.
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Objective To construct the stably over-expressing hB7-H3 gene human pancreatic cancer cell line PANC1,and provide tools for further investigating the function of hB7-H3.Methods hB7-H3 gene fragment was inserted into lentiviral plasmid GV287 carrying GFP to construct recombinant hB7-H3-GV287 plasmid vector.293T cells were transfected,and the GFP expression was evaluated under fluorescence microscopy.Western Blot wasused to detect the expression of hB7-H3 protein.Lentiviral vectors were packaged and the titer was determined.The recombinant hB7-H3 expressed lentivirus was used to infect PANC1 cell.Flow cytometry was applied to detecte the percentage of GFP and hB7-H3 positive cells.Real-time PCR and Western Blot was used to verify the mRNA and protein expression of hB7-H3.Self-cyclizing GV287 plasmid served as negative control (NC).Results PCR amplified fragment of recombinant plasmid was around 1 368 bp,and no amplified production of NC plasmid was observed.The DNA sequencing of recombinant plasmid was completely consistent with the designed fragment,indicating that hB7 H3-GV287 plasmid was successfully constructed.293T cells transfected with recombinant plasmid expressed hB7-H3 protein,while those cells transfected with NC plasmid did not express hB7-H3 protein.The virus titer of lentiviral packaged recombinant hB7-H3 plasmid was 2 × 108 TU/ml.The percentage of hB7-H3 positive cells,hB7-H3 mRNA and protein expression in PANC1 cells infected with cells infected with hB7-H3 lentivirus was 94.3％,5.09 ± 0.24 and 2.85 ± 0.27,respectively,which was obviously higher than 18.5％,1.28 ± 0.53 and 0.44 ± 0.69 in cells infected with NC lentivirus,and the differences were statistically significant (P value ＜0.01).Conclusions A human pancreatic cancer cell line PANC1 stably over-expressing hB7-H3 was successfully constructed.
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Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.
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Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P ＜ 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P ＜ 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P ＜ 0.01).Celluar apoptosis rates in experimental group (9.4％ ± 1.1％) elevated in contrast with NC group (6.4％ ± 0.8％) and CON group (6.5％ ± 1.0％) (both P ＜ 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P ＜ 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P＜0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.
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Objective To investigate the influence of Let-7f regulation on MMP-11 in migration and in-vasion of pancreatic cancer. Methods RT-qPCR was performed to assay the expression of Let7 and MMP-11 ex-pression in pancreatic cancer cells and normal pancreatic cells. Let-7f mimic and inhibitor were transfected to PANC-1 and Bx-PC3, respectively. The influence of Let-7f expression on migration and invasion of pancreatic cancer cells was analyzed by transwell. The influence of Let-7f intervention on MMP-11 expression was observed by RT-qPCR. Results Let-7f expression decreased in PANC-1 and Bx-PC3, compared to HPDE6c7, while MMP-11 expression up-regulated in PANC-1 and Bx-PC3 , compared to HPDE6c7 cells. Let-7f overexpression in-hibited the expression of MMP-11. Up-regulated Let-7f could significantly inhibit migration and invasion of PANC-1 and Bx-PC3 and Let-7f inhibitor enhanced MMP-11 expression. However , down-expression of Let-7f could not significantly promote migration and invasion abilities of PANC-1 and Bx-PC3cells. Conclusions Let-7f may affect migration and invasion by regulating MMP-11 expression in pancreatic cancer , suggesting that Let-7f might be a potential target for gene therapy in human pancreatic cancer.
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Compared with distal gastrectomy, pylorus-preserving gastrectomy is less invasive which can decrease incidence of dumping syndrome, diarrhea and body weight lost, cholecystitis and gallstone, reflux gastritis and esophagitis and remnant gastric cancer. Based on new Japanese Gastric Cancer Treatment Guideline and new progression in the world, we give a review mainly basic characteristics, indications, operation details and short- and long-time outcomes after pylorus-preserving gastrectomy.
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Humans , Gastrectomy , Methods , Gastric Stump , Pathology , Gastroenterostomy , Organ Sparing Treatments , Pylorus , General Surgery , Stomach Neoplasms , General SurgeryABSTRACT
Objective CD4 +IL-17 +cells are a group of newly discovered effector CD4 +T cells, which may play a key role in the pathogenesis of cancer.This study aims to investigate the expres-sion of CD4 +IL-17 +cells in pancreatic cancer and its correlation with the clinicopathological characteristics and prognosis of the dis-ease as well as the clinical significance of the cells in the microenvironment of pancreatic cancer. Methods We collected tumor tis-sue and tumor-adjacent normal tissue samples from 51 pancreatic cancer patients.We determined the expressions of CD34 and vascular endothelial growth factor ( VEGF) and measured the proportion of IL-17 +cells in the cancer tissue using immunohistochemistry and the fluorescence activated cell sorter, respectively, followed by analysis of their correlation with tumor angiogenesis, clinicopathological pa-rameters, and survival time of the patients. Results The percentage of CD4 +IL-17 +cells in tumor tissue was positively correlated with microvessel density (r =0.534, P0.05).Fifty (98.0%) of the patients were successfully followed up for 2-67 months, which revealed a median survival time of 16.6 ±4.8 months, significantly longer in those with a higher expression of intratumoral IL-17 +cells (P<0.05).Univariate analysis showed an association of the survival rate with the tumor size, TNM stage, lymph node metastasis, and level of intratumoral IL-17 +cells, while multivariate analysis showed the TNM stage to be an independent prognostic factor for the survival of the pancreatic cancer patients. Conclusion The expression of CD4 +IL-17 +cells in the tumor tissue is positively correlated with tumor angiogenesis, while that of IL-17 +cells with the clinicopathological parameters and survival time of the patients and therefore may serve as an important immune indicator for the prognosis of pancreatic cancer.
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Objective To investigate the clinical value of emergent perspective stent implantation for leftside obstructive colonic cancer.Methods The clinical data of 26 patients with obstructive colonic cancer who received emergent perspective stent implantation at the Affiliated Xuzhou Hospital of Southeast University from October 2011 to February 2014 were retrospectively analyzed.A soft and a hard guidewire and a catheter were applied in the operation.The guidewires were put through the hole of the intestinal tumor,and then the metal stent and the conveyor were guided by the guidewires and were pulled through the hole of the intestinal tumor,finally the stent was released and the conveyor was adjusted to ensure that the stent was at the right position.Patients were followed-up through outpatient examination till 4 weeks after tumor resection.Results Of the 26 patients,9 were with rectal cancer,10 with sigmoid colonic cancer,6 with descending colonic cancer,1 with splenic flexure cancer.The median length of stenosis was 4.6 cm (range,2.0-8.0 cm).The surgery of the 26 patients was successful.The mean operation time was 35.2 minutes (range,15.2-72.0 minutes),and the mean time of stent implantation was 5.6 minutes (range,2.6-26.9 minutes).Patients had watery or loose stool for 4-8 times after stent implantation.Ten hours after the operation,all the patients were given liquid diet.The remission rate of clinical symptoms was 100.0％ (26/26).No colonic perforation was detected during the operation.Two patients were complicated with slight bleeding,and was alleviated by medication.Twenty-six patients received stage Ⅰ tumor resection procedure within 7-10 days after the symptoms of intestinal obstruction were remised.The success rate of surgery was 100.0％ (26/26).No infection and other drainage were detected after tumor resection through follow-up.Conclusion Emergent perspective stent implantation for left-side obstructive colonic cancer is safe and effective.
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AIM:To observe the expression and tissue localization of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta 1 ( TGF-β1 ) in the rat acute cerebral ischemia model.METHODS:Male Wistar rats were used to establish acute cerebral ischemia model by a suturing method.The rats were divided into normal control group, sham group and ischemia 6 h, 12 h, 1 d, 2 d, 6 d and 14 d groups.The rat cerebral cortex and hippocampus of the brain were collected at different time points.The mRNA and protein levels of MMP-9 and TGF-β1 in the brain tissues were detec-ted by real-time PCR and in situ histochemistry staining, respectively.The levels of MMP-9 and TGF-β1 in the plasma were also measured by ELISA.RESULTS:The results of real-time PCR showed that the mRNA levels of MMP-9 began to in-crease 6 h after acute ischemia and reached to a peak 2 d after acute ischemia.Similarly, the mRNA level of TGF-β1 began to rise 12 h after acute ischemia and reached to the highest level 6 d after acute ischemia.Compared with the sham rats, the mRNA levels of MMP-9 and TGF-β1 in the rat brains that collected at ischemic time of 12 h, 1 d, 2 d, 6 d and 14 d were significantly increased.Moreover, results of in situ histochemical staining showed that the expression of MMP-9 was detected at cerebral cortex and hippocampus 1 d after acute cerebral ischemia.Further studies showed that MMP-9 dyeing of the rat cerebral cortex was most obvious 2 d after the acute cerebral ischemia.Similarly, the rat cortex and hippocampus began to express TGF-β1 2 d after acute ischemia and TGF-β1 staining at rat cerebral cortex was most obvious 6 d after the acute cerebral ischemia.In addition, ELISA showed that the increase in MMP-9 and TGF-β1 was detected in the plasma 12 h after ischemia.Compared with the sham rats, the level of these 2 factors significantly upregulated since 1 d after ischemia. CONCLUSION:The brain tissue itself contributes to the upregulation of MMP-9 and TGF-β1 post acute cerebral ischemia, which shed light on the related research in the field.
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Objective:To explore and study the clinical values of CT and MRI in the diagnosis of spinal trauma. Methods: One hundred patients with spinal trauma in our hospital were selected as the study objects and randomly divided them into 2 groups, 50 cases in each group. The control group was diagnosed by CT, the experimental group was diagnosed by MRI. Results: The efficacy of CT(control group) on fracture line and fracture flat shift was better than experimental group, but in the aspect of spinal cord injury, ligamentous injury and soft tissue injury, experimental group(MRI) was more sensitive than control group(x2=4.0, P<0.05), differences between 2 groups were statistically significant. Conclusion:Every coin has 2 sides, so as to applying CT and MRI in the diagnosis of spinal trauma, but the accuracy to overall spinal trauma of experimental group is higher. Furthermore, it can avoid misdiagnosing with spinal trauma that applying combined CT and MRI, it is worthy of being widely recommended in clinic.
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Objective To investigate the expression and clinical significance of Rho GDP dissociation inhibitor 2 (Rho-GDI2) in pancreatic cancer.Methods Immunohistochemistry and RT-PCR were used to evaluate the expression of Rho-GDI2 in 60 pairs of pancreatic cancer tissues and adjacent pancreatic tissues,and its correlation with clinicopathological parameter of pancreatic cancer was also analyzed.Results The expressions of Rho-GDI2 mRNA were 0.661 ± 0.021 and 0.199 ± 0.023 in pancreatic cancer tissues and adjacent pancreatic tissues,and the positive rate of Rho-GDI2 protein expression were 73.3％ (44/60) and 41.7％ (25/60),the positive rate of Rho-GDI2 expression in pancreatic cancer tissues was higher than that of adjacent normal tissues,and the difference between the two groups was statistically significant (P ＜ 0.01).The expression of Rho-GDI2 was strongly correlated with tumor size,differentiation,staging,lymph node metastasis,vascular invasion (P＜0.05),but it was not associated with gender,age,tumor location (P ＞0.05).Conclusions Rho-GDI2 expression is up-regulated in pancreatic cancer,and is strongly correlated with the malignant biological behavior of pancreatic cancer.
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Objective To study the expression of reversion-inducing-cysteine-rich protein with Kazal motifs (RECK) in human pancreatic carcinoma tissues and pancreatic carcinoma cell lines; the effects of recombinant lentiviruses carrying RECK gene(LV-RECK) therapy on human pancreatic carcinoma xenograft in nude mice; and to find out the relationship between the expression of RECK and the prognosis of pancreatic carcinoma.Methods Immunohistochemical method was used to detect the expression of RECK in the resected specimens of pancreatic carcinoma and their corresponding normal pancreatic tissues in 42 patients.Western blotting was used to examine the expression of RECK in human pancreatic carcinoma cell lines (PANC-1,MIAPaCa-2,AsPC-1).Statistical analyses were performed to determine the relationship between RECK expression and the clinicopathological characteristics and prognosis in pancreatic carcinoma.Subcutaneous xenograft tumor models of human pancreatic carcinoma were established in nude mice.These nude mice were then divided into the experimental group,the negative control group and the blank control group randomly.The three groups of nude mice were intratumorally injected with LV-RECK,LV-EGFP and normal saline (NS) respectively.The antitumor effect was studied.Immunohistochemical method was used to detect the expression of RECK and microvessel density (MVD).Terminal deoxynucleotidyl transferase mediated dUTP-DIG nick end labeling (TUNEL) was used to detect the apoptosis of tumor cells.Survival analysis was performed.Results All three pancreatic carcinoma cell lines did not express RECK.The overall positive rate of RECK expression was 45.2 ％ (19/42) in pancreatic carcinoma,and 88.1 ％ (37/42) in normal pancreatic tissue.The expression level of RECK was significantly lower in the tumor tissues than in the normal tissues (P＜0.01).The expression of RECK was significantly associated with TNM stage,lymph node metastasis and local infiltration of pancreatic carcinoma (P＜0.05).Kaplan-Meier survival analysis revealed that the survival time was significantly longer in the RECK positive patient group than in the RECK negative patient group.Univariate Cox regression analysis revealed that RECK expression,TNM stage,lymph node metastasis and local infiltration were significantly related with prognosis for pancreatic carcinoma (P＜0.05).Multivariate Cox regression analysis revealed that only RECK expression remained as an independent significant factor in predicting the prognosis of pancreatic carcinoma (P ＜ 0.001).When compared with the negative control and the blank control groups,the volume of subcutaneous xenograft tumor in the experimental group was significantly decreased (P＜0.05).RECK protein in the experimental group was re-expressed.MVD of the experimental group was significantly less than those of the control groups (P＜0.05).Apoptotic index (AI)of the experimental group was significantly higher than those of the control groups (P＜0.05).The survival time of nude mice in the experimental group was significantly longer than those in the control groups (P＜0.05).Conclusions RECK expression was closely related to invasion,metastasis and prognosis of pancreatic carcinoma and it was an independent prognostic marker.RECK gene over-expression inhibited neovascularization of pancreatic carcinoma,induced apoptosis of tumor cells,inhibited the growth of tumor xenograft and improved the prognosis of tumor-bearing mice.These results suggest a possible new treatment for pancreatic carcinoma.