ABSTRACT
Objective:To investigate the correlation between morphology of esophageal and gastric mucosal and Helicobacter pylori ( HP) infection under white light gastroscope. Methods:A retrospective analysis was performed on data of 1 339 patients who underwent 13C-urea breath test and white light gastroscopy at the same time in the Southwest Hospital of Army Medical University from September 2018 to August 2019. Chi-square test or Fisher exact probability method was used to analyze the difference on detection rates of 22 indexes of gastroscopic mucosal manifestation between the HP infection group ( n=422) and the non-infection group ( n=917). Then the indexes with difference were further analyzed by binary logistic regression. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve and the sensitivity, specificity, positive predictive value and negative predictive value of prediction of HP infection was calculated. Results:The diffuse redness, spotted redness, mucosal swelling, enlarged folds, sticky mucus, digestive tract ulcer, nodularity, hyperplastic polyp, xanthoma, atrophy, intestinal metaplasia, and depressive erosion were more common in patients with HP infection (all P<0.05). Binary logistic regression analysis showed that diffuse redness ( P<0.001, OR=75.974, 95% CI: 32.551-177.327), spotted redness ( P=0.002, OR=3.360, 95% CI: 1.536-7.349), mucosal swelling ( P<0.001, OR=3.150, 95% CI: 1.654-5.996) were independent risk factors for HP infection. ROC curve analysis showed that the area under ROC curve of diffuse redness, spotted redness, mucosal swelling, enlarged folds, sticky mucus, peptic ulcer, and depressive erosion predicting HP infection were all greater than 0.5 ( P<0.05), among which, the area under curve of diffuse redness, spotted redness and mucosal swelling predicting HP infection were greater than 0.7. The sensitivities corresponding to the three indicators were 0.735, 0.512, and 0.445, the specificities were 0.992, 0.983, and 0.971, the positive predictive values were 0.978, 0.931, and 0.874, and the negative predictive values were 0.890, 0.814, and 0.792, respectively. Conclusion:Morphological manifestations of esophageal and gastric mucosa, especially diffuse redness, spotted redness, and mucosal swelling, are excellent indicators for HP infection under white light gastroscopy.
ABSTRACT
Objective:To explore the correlationship of clinicopathological factors and lymph node metastasis (LNM) in early gastric cancer (EGC).Methods:Data of 164 patients diagnosed as EGC by endoscopic biopsy who underwent D2 radical gastrectomy at the First Affiliated Hospital of Army Military Medical University from January 2012 to December 2018 were retrospectively studied. The correlation between the clinicopathological factors and the presence of LNM was analyzed with univariate analysis and multivariate logistic regression.Results:Of the 164 patients, 34 cases had LNM. Univariate analysis showed that tumor size, depth of invasion, histopathologic type and vessel involvement were markedly associated with a higher rate of LNM (all P<0.05). Logistic regression multivariate analysis showed that tumor maximal diameter >2 cm ( OR=3.2, 95% CI: 2.305-4.187), invasion of submucosa ( OR=2.5, 95% CI: 2.091-3.859), poor histological differentiation ( OR=1.7, 95% CI: 1.029-2.933), and vessel involvement ( OR=2.1, 95% CI: 1.817-3.176) were significantly associated with a higher rate of LNM ( P<0.05). The highest frequency of LNM at upper EGC was 66.7% in Group No.1, and 33.3% in Group No.3. The highest frequency of LNM at middle EGC was 75.0% in Group No.3, and 25.0% in Group No.4, and the highest frequency of LNM at lower EGC was 33.3% in Group No.6, 25.9% in Group No. 3, 25.9% in Group No.4, and 14.8% in Group No.7. No metastasis was seen at the first stop of early cancer within mucosa which was well-differentiated and diameter ≤2 cm. Conclusion:Tumor maximal diameter>2 cm, invasion of submucosa, poor histological differentiation, and vessel involvement are risk factors of LNM in EGC. Distribution of LNM is clearly related to the location of cancer. And LNM in EGC shows a proximal-to-distal metastatic pattern.
ABSTRACT
Objective To compare the advantage and disadvantage of peroral endoscopic myotomy (POEM)and pneumatic dilation(PD)for the treatment of achalasia of cardia(AC). Methods Patients with confirmed AC undergoing endoscopic therapy in Southwest Hospital, Third Military Medical University between January 2011 and September 2014 were divided into POEM treatment group(n=56)and PD treatment group(n = 30), according to the decision of the patients and their families. Postoperative improvement of clinical symptoms, changes in the maximum esophageal diameter, complications, hospital stay,and inpatient expenses were compared between the two groups. Results No significant differences were observed in general preoperative data between the two groups,including gender,age,body mass index (BMI),maximum esophageal diameter, Eckardt score and disease duration(all P>0.05). The Eckardt score showed a significant decrease in 1, 6, and 12 months after operation compared to the pre?operation score in both groups(P<0.05). No matter 1 month or 6 months after operation, the Eckardt score had no significant difference between the two groups(P>0.05). Six months after operation, the response rate between the two groups was no significantly different[93%(52/56)VS 80%(24/30), χ2=0.115, P=0.076],but the maximum esophageal diameter of the POEM group was smaller than that of the PD group (25.39±7.12 mm VS 32.12±9.99 mm,t=3.612,P=0.001). Twelve months after operation,the Eckardt score of the POEM group was lower than that of the PD group(0.44±0.85 score VS 1.26±1.74 score,t=2.940,P= 0.004), and the response rate was higher in the POEM group[93%(52/56)VS 80%(24/30),χ2=0.115, P=0.076]. The incidence of pneumatic complications was 32%(18/56)in the POEM group,but none occurred in the PD group(χ2=12.195,P=0.000). The hospital stay of the POEM group and the PD group was 12.33±4.13 days and 6.50±2.28 days, respectively(W=616, P=0.000). The inpatient expense of the POEM group and the PD group was 8 013.283± 4 322.695 yuan, and 1 571.018±1 590.193 yuan,respectively(W=505,P=0.000).Conclusion Both POEM and PD showed good short?term efficacy for AC.POEM is more effective,and its treatment outcome lasts longer,whereas PD has more widely indications because it is easier to operate with less complications,shorter hospital stay,and lower costs.Trail registration Chinese clinical trial registry,ChiCTR?OOC?15005889.
ABSTRACT
Objective To explore the diagnosis value of narrow-band imaging magnifying endoscopy (NBI-ME) in the early esophageal cancer and precancerous lesions while estimating the quality,depth and treatment strategy.Methods One hundred and eleven cases of patients with suspected early esophageal cancer and precancerous lesions,who underwent ESD treatment,were selected as the study subjects.To estimate the diagnosis value of NBI-ME in the quality,depth and treatment strategy with pathological histology as gold standard.Results While estimating quality,there was no low grade intraepithelial neoplasia(LGIN) cases with NBI-ME.A total of 33 cases were diagnosed as high grade intraepithelial neoplasia(HGIN),including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,and the other 78 cases were diagnosed as early esophageal cancer,including 5 cases of LGIN,22 cases of HGIN,and 51 cases of early esophageal cancer.Compared with the pathology results,the quality consistency of NBI-ME is general:K=0.498.While estimating depth,there was no LGIN cases with NBI-ME.A total of 33 cases were diagnosed as HGIN,including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,67 cases were diagnosed as intramucosal carcinoma,including 5 cases of LGIN,22 cases of HGIN,30 cases of intramucosal carcinoma,and 10 cases of submucosal carcinoma after ESD treatment,and 11 cases were diagnosed as submucosal carcinoma.Compared with the pathology results,the depth consistency of NBI-ME is general:K=0.469.Most of the patients shoud be treated by ESD except 8 cases of LGIN.Conclusion The study shows general diagnosis value of NBI-ME in estimating quality,depth and treatment strategy of early esophageal cancer and precancerous lesions.
ABSTRACT
Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS), and explore the efficacy of endoscopic treatment in patients with esophageal submucosal tumor. Methods Sixty-eight patients with esophageal submucosal tumor were selected, and the tumor was derived from the muscularis mucosa and submucosa according to the common endoscope and endoscopic ultrasonography detection. Endoscopic mucosal resection (EMR) was applied to remove submucosal tumor with diameter less than 1.0 cm, endoscopic piecemeal mucosal resection (EPMR) or endoscopic submucosal dissection (ESD) was applied to remove submucosal tumor with diameter 1.1 - 1.5 cm, and ESD was applied to remove submucosal tumor bigger than 1.5 cm. Samples were examined by pathology after treatment. Results Tumors in all the patients were completely removed, and the tumor diameter was 0.6-2.3 cm. Forty-one cases were treated with EMR, 9 cases were treated with EPMR and 18 cases were treated with ESD. Four patients had intra-operative bleeding that was stopped by electrocoagulation hemostasis. No perforation occurred in all cases. Postoperative pathology revealed 43 cases had leiomyoma, 23 cases had interstitialoma, and 2 cases had lipoma. Patients were reviewed by gastroscope 3 months after operation. The white scars formed in all patients, and there was no residue or recurrence. Conclusions Different origin layers and property of esophageal submucosal tumor can be diagnosed accurately by EUS, and endoscopic therapy (EMR, EPMR and ESD) is an effective treatment for submucosal tumor from muscularis mucosa and submucosa. Endoscopic therapy is safe and effective. It provides sufficient pathological information.
ABSTRACT
Objective Colorectal polyp is a precancerous lesion of colorectal cancer .Aim of the study was to explore the risk fac-tors of colorectal polyp malignant transformation .Methods The related information of 75 084 colonoscopies performed from 2003 to 2012 in Southwest Hospital in Chongqing were collected and the relationship between polyp malignant transformation and the pa-tient age ,sex ,polyp location ,size or histological types was analyzed .Results From 2003 to 2012 ,polyps were diagnosed in 14 806 cases of the total 75 084 patients with a 19 .72% detection rate .There were significant difference of the left-side and right-side pol-yp detection rate in different age groups ,and the frequency of polyps distributed in the whole colorectum increased with the increase of age .The rates of epithelial neoplasia and malignant transformation increased with age .At the same time ,malignant transforma-tion rate was significant higher in polyps located in left-side than that in right-side (P<0 .0167) ,in adenoma than that in inflamma-tory hyperplastic polyp (P<0 .01) .The larger diameter and the more villus ,the higher rate of malignant transformation .Conclusion Patient age ,polyp size ,location and histological type could be considered as the significant predictors of colorectal polyp malignant transformation .It may be useful to treat the polyp with endoscopy in patient with age more than 45 and adenoma whose diameter was not less than 1 cm ,located in left-side for prevention of colorectal cancer .
ABSTRACT
Objective To investigate the correlation between gastric polyps and helicobacter pylori (Hp) infection .Methods 150 patients with gastric polyps(experimental group) and 150 patients with chronic gastritis(control group) from October 2011 to No-vember 2012 in Shapingba people′s hospital of Chongqing were enrolled in this study .The polyps biopsy in patients with gastric polyps and the mucosa in gastric antrum big and small bends ,and the anterior and posterior walls(about 2-5 cm from the pylorus) from both groups were detected for the pathological type ,inflammation degree and stained(modified Giemsa staining) for detection of the existence of Hp .Results In 150 patients with gastric polyps ,58% (87/150) of the cases were infected by Hp mainly in medi-um and low degree ,in which 39 .3% (59/150) of the infection located at polyps and 42% (63/150) of the infection occurred out of polyps .Pathological analysis for this group further demonstrated that the types of hyperplastic polyps ,fundic gland polyps ,inflam-matory polyp and adenomatous polyps accounted for 68 .0% (102 cases) ,20 .7% (31 cases) ,9 .3% (14 cases) and 2 .0% (3 cases) of total 150 gastric polyps cases ,of which 63 .7% (65/102) ,38 .7% (12/31) ,57 .1% (8/14) and 66 .7% (2/3) cases were infected by Hp ,respectively .Pathological analysis also indicated that ,among total 150 gastric polyps cases ,single polyps and multiple polyps types accounted for 62 .0% (93 cases) and 38 .0% (57 cases) .The polyps commonly existed at gastric fundus in which the incidence rate of the hyperplastic polyps type and the fundic gland polyps type were 94 .1% (96/102) and 87 .1% (27/31) ,respectively .The infection rate in hyperplastic polyps was markedly higher than that in fundic gland polyps (P<0 .05) ,and the infection of hyperplas-tic polyps was mainly medium and high degrees .In addition ,the inflammatory response in the hyperplastic polyps was higher ,ac-companied by the intestinal metaplasia and atrophy of gastric mucosa ,as compared with non-hyperplastic polyps .In the total 150 control cases ,52 .0% (78/150) patients were infected by Hp with mainly medium and high degree .Results indicated that there is no relationship between polyps occurring and Hp infection .Conclusion Compared to the chronic gastritis ,there is no positive associa-tion between gastric polyps and Hp infection .There is no remarkable difference for Hp infection rate and degree between the polyps and the non-polyps sites in the stomach .The infection rate and infection degree of hyperplastic polyps is significantly higher than that of fundic polyps .However ,the underlying mechanisms for the development of hyperplastic polyps have to be elucidated in the future .
ABSTRACT
Objective To analyze and investigate endoscopic and pathological characteristics in the diagnosis of early esophageal carcinoma. Methods The clinical data of 62 patients with early esophageal carcinoma who had been admitted to Southwest Hospital from January 2003 to December 2007 were retrospectively analyzed. Results Of all patients, 8 had upper esophageal carcinoma, 42 had middle esophageal carcinoma and 12 had lower esophageal carcinoma. The tumor growth patterns included surface diffusion growth (n = 30), bidirectional growth (n = 11), intracavitary growth (n = 9), intra-esophageal wall growth (n = 7) and mixed growth (n = 5). The diameter of lesions ranged from 1.0 cm to 2.9 cm in majority. Surgical resection was done in 38 patients, endoscopic mucosal resection in 23 patients and endoscopic submucosal dissection in 1 patient. Postoperative pathological examination showed that 13 patients had in situ carcinoma, 22 had intramucosal carcinoma and 27 had submucosal carcinoma. The lymph node metastatic rate of intramucosal carcinoma and submucosal carcinoma were 5% (1/22) and 15% (4/27), respectively. The numbers of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma carcinoma and spindle carcinoma were 57, 2, 1, 1, 1, respectively. ConelusionsEarly esophageal carcinoma tends to appear in the middle part of esophagus, and with surface diffusion growth type. Most of the early esophageal carcinoma are squamous cell carcinoma. Endoscopy combined with lugol's iodine and methyleneblue staining is effective in detecting early esophageal carcinoma.
ABSTRACT
Objective To investigate the endoscopic and ultrasonic endoscopic features of colorectal carcinoid and the indications of endoscopic treatment. Methods The clinical data of 22 patients with colorectal carcinoid who had been admitted to our hospital from 2002 to 2007 were collected. The endoscopic and ultrasonic endoscopic features and the relationship between the features and invasion depth of colorectal carcinoid were analyzed. Results Under the endoscope, early carcinoid presented submucosa tumor with 1.5cm in diameter, and yellow or white smooth surface; advanced carcinoid presented submucosa tumor with 0.8-3.0cm in diameter, and yellow or white little nodus or ulcerative surface. The ultrasonic endoscopic feature of the colorectal carcinoid was orbicular-ovate low level echo tumor with punctiform slightly high-level echo and an unsharpness edge. Sixteen mucosal layer-cancers and submucosal layer-cancers were removed by endoscopic mucosal resection, and 10 of them were additional treated by argon plasma coagulation. After a follow-up period of 4-36 months, no recurrence was observed. Conclusions Endoscopy and endoscopic ultrasonography are effective methods to diagnose colorectal carcinoid and its invasion depth. Endoscopic treatment is a simple, safe and effective means to treat the early colorectal carcinoid tumors.
ABSTRACT
Objective To assess the potential diagnostic value of the potential of flexible image col-or enhancement system(FICE)with magnifying endoscopy for superficial esophageal lesions by observing the intrapapillary capillary loops(IPCL)in esophageal mucosa. Methods IPCL in patients with esophageal diseases were studied with Fujinon EG-590ZW FICE endoscopy. The relationship between changes of IPCL in 31 cases of superficial esophageal lesions and pathological findings was studied. Results The vascular patterns of IPCL were analyzed and classified as follows: Type Ⅰ,often seen in normal esophagus,were e- venly distributed with regular forms. TypeⅡ,protracted,often occured in esophagitis. Type Ⅲ showed two or three of such four changes as,dilatation,wave-like inflection,irregular caliber and deformity,which was mainly seen in dysplasia. While Type Ⅳshowed all the four changes mentioned above and frequently ap- peared in esophageal cancer. Of the 17 cases of esophagitis,fifteen cases were TypeⅡIPCL and the others Type Ⅲ. Of the 10 cases of dysplasia,eight were Type Ⅲ IPCL and two high-grade dysplasia showed Type Ⅳ IPCL. One sml early esophageal cancer showed Type Ⅲ IPCL and all three advanced esophageal cancer showed TypeⅣ IPCL. Conclusion The esophageal microvessels can be clearly seen by FICE with magnif- ying endoscopy,and the differentiation of superficial esophageal lesions can be fairly performed with the ob- servation of IPCL,it gives an important practical siginificance in diagnosing tumorous lesions.
ABSTRACT
Objective To investigate the effect of silence of human protection of telomeres 1 (hPOT1), which was induced by RNA interference, on expression of telomeric repeat factor 1 (TRF1), telomeric repeat factor 2 (TRF2) and Tankyrase 1 in human gastric cancer cell BGC823. Methods The ex-pression of TRF1 ,TRF2 and Tankyrasel at mRNA level were determined by semi-quantitative RT-PCR. Re-sults Significant increase in expression of TRFI, marked decrease of TRF2 and Tankyrase1 at mRNA level were observed in cells of hPOT1 siRNA. Conclusion The significant increase in expression of TRF1 and the marked decease in TRF2 and Tnakyrasel at mRNA level after the inhibited expression of hPOT1 in human gastric cancer cell BGC823 indicate that hPOTI is highly correlated with the expressions of other three te-lomere-specific binding proteins.
ABSTRACT
Objective To develop a novel endoscopic classification system to determine the invasion depth of early esophageal cancer.Methods The esophageal lesion was endoscopicaUy stained with Lugol's iodine first,then methylene blue.According to the growth pattern,height and cup depth under endoscope,the lesions were classified into 5 types,including surface diffusion growth,intra-lumen growth,intra-wall growth,bi-direction growth and mix growth types.The lesions were then removed by endoscopic mucosa reection or surgery,the precise invasion depth of the lesion was determined pathologically and the results were compared with the endoscopy classification.Results The data of 44 cases of esophageal mucosal cancer and 34 cases of esophageal sub-mueosal cancer were included.With the criteria of mucosal cancer as surface diffusion growth,intra-lumen growth <5mm,bi-direetion growth <2mm and intra-wall growth <0.5 mm,the diagnostic specificity was 89.1%(41/46) and sensitivity was 93.2%(41/44).With the criteria of submucosal cancer as intra-lumen growth≥5 mm,hi-direction growth≥2mm,intra-wall growth≥0.5 mm and mix growth type,the diagnostic specificity was 90.6%(29/32) and sensitivity was 85.3%(29/34).The overall diagnostic accuracy in differentiating esophageal mucosal cancer from esophageal submueosal cancer by endoscopic classification was 89.7%(70/78).Conclusion This endoscopic classification system is effective in differentiating esophageal mucosal cancer from submucosal ones.
ABSTRACT
BACKGROUND: Microsatellite instability (MSI), an important gene change type, plays animportant role in the occurrence of tumor. Mismatch repair gene induces its occurrence. Although the effect of mismatch repair gene hMLH1 mutation in the hereditary nonpolyposis colorectal cancers (HNPCC) has been reported, its effect on the sporadic colorectal carcinoma lacks in-depth study.OBJECTIVE: To investigate the effect of mismatch repair gene hMLH1 mutation on colorectal carcinogenesis, and its correlation with MSI.DESIGN: Single-sample experiment.SETTING: Department of Gastroenterology, Southwest Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Seventy-six cases of sporadic colorectal carcinoma and corresponding normal tissues were obtained from surgically resected specimens of coloreetal carcinoma in Southwest Hospital between January 2001and December 2003. No patients had family history of tumor, or had received radiotherapy and chemotherapy. Patients were informed of the experiment.METHODS: Mutation of hMLH1 was detected by two-dimensional electrophoresis and DNA sequencing; MSI was analyzed by PCR-based methods.MAIN OUTCOME MEASURES: ① Detection rate of hMLH1 mutation of colorectal carcinoma and MSI. ② The relationship of MSI and hMLH1 mutation.RESULTS: Seventy-six cases of sporadic colorectal carcinoma were studied for hMLH1 mutation and MSI. hMLH1 mutation was detected in 8 (10.5%) cases of colorectal carcinomas while MSI was detected in 20 (26.3%) cases of colorectal carcinomas. Frequency of hMLH1 mutation and MSI was significantly higher in right colorectal cancer than in left colorec tal cancer (6/26 vs 2/50, x2=4.739, P=0.029; 11/26 vs 9/50,x2=5.212,P=0.022). No association was observed between hMLH1 mutation or MSI and tumor size, differentiation, histological type, depth of invasion, metastasis or clinical pathological stages. ② MSI was divided into high-frequency group (≥ 2 loci, n=10) and low-frequency group (1 locus, n-10), and MSI negative group (n=56). 8 hMLH1 mutations were all detected in high frequency MSI group, but no mutation was found in low frequency MSI or MSI negative groups.CONCLUSION: hMLH1 mutation and MSI occur in cancer of the right large intestine and hMLH1 mutation is involved in carcinogenesis of some sporadic colorectal cancer with high-frequency MSI.
ABSTRACT
Objective To compare the real time diagnosis and treatment values of magnifying endoscopy and electronic colonoscopy Methods A total of 105 colorectal polyps for colonoscopic examination were included in this study A magnifying videoscope with zoom ranges from ?1 to ?100 magnification and a common electronic endoscopy combined with indigocarmine dye were employed to observe the pit patterns of colorectal polyps Pit patterns were analyzed according to Kudo's modified classification as follows: ①type Ⅰ: round pit; ②type Ⅱ: asteroid pit; ③type Ⅲs: tubular or round pit, which is smaller than a normal pit (type Ⅰ); ④type ⅢL: tubular or round pit, which is larger than a normal pit (type Ⅰ); ⑤type Ⅳ: dendritic or gyrus like pit; ⑥type Ⅴ: irregular or amorphous pit; and ⑦ mixed type Results Magnifying colonoscopy revealed that phenotypes of non neoplastic and neoplastic lesions were 78 57% and 21 43% in inflammatory and hyperplastic polyps, 3 33% and 96 67% in neoplastic polyps, and 100% non neoplastic phenotype in juvenile polyps, respectively Pit pattern analysis according to Kudo's modified classification showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 96 67% and 80%, and specificity was 86 57% and 94 73%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 89 52% Pit pattern by common electronic colonoscopy showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 88 3% and 73 3%, and specificity was 81 5% and 82 5%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 82% Conclusion The pit pattern analysis of colorectal lesions by magnifying colonoscopy or electronic endoscopy combined with indigocarmine dye is a useful method for the identification of non neoplastic polyps, adenomas and invasive carcinomas in the large bowel Therefore, it may be possible to determine, at the time of colonoscopy, which lesions should be removed endoscopically and surgically
ABSTRACT
Objective To explore the clinical characteristics of posthepatitic cirrhosis accompanied with peptic ulcer (called as hepatogenic ulcer, HU) and the effect of quadruple therapy in this event Methods A total of 105 cases of PU were subjected in this study, and 126 patients with simple peptic ulcer (PU) served as control Endoscopy was carried out to observe the peptic ulcer, bleeding, and healing after treatment Urease testing was employed to detect Helicobacter pylori (Hp) in gastric mucosa All patients were followed up for 2 years Results Most cases of PU were confirmed to have duodenal ulcer The positive rate of Hp was 72 4% in HU group before treatment Ulcer healing rates of quadruple therapy were 65 7% and 88 5% respectively in HU group and PU group During the follow up, the rates of recurrence and rebleeding were 68 4% and 30 2% in HU group, and 48 9% and 16 6% in PU group,with very significant difference between them ( P
ABSTRACT
Objective To investigate the galectin-3 expression in squamous carcinioma of esophagus and analyze its relationship with clinicopathological characteristics.Methods S-P immunohistochemistry was used to detect the expression of galectin-3 in 80 paraffin-embedded specimens of esophageal carcinoma and 22 specimens of normal tissues adjacent to the benigh lesions of esophagus.RT-PCR was performed to detect galectin-3 mRNA expression in 36 pairs of fresh squamous carcinoma tissues and corresponding adjacent normal mucosa.Results Out of 80 specimens of squamous carcinoma of esophagus,62 specimens had positive expression of galectin-3,with the positive rate of 77.5%(62/80)that was significantly higher than 27.27% in normal esophageal tissues(6/22,P
ABSTRACT
Objective E cadherin catenin complex mediates cell cell adhesion and plays an important role in maintaining normal architecture and function of epithelial tissues. We evaluated the expression patterns of E cadherin, ? catenin, and ? catenin in gastric carcinoma and determine the potential relationship between E cadherin catenin complex and tumor clinicopathological features as well as patient survival. Methods Immunohistochemical staining of E cadherin, ? catenin, and ? catenin in 148 gastric carcinomas was performed. Results The abnormal expression rates of E cadherin, ? catenin and ? catenin in the tissues of gastric carcinomas were 44.6%, 73.6% and 43.2%, respectively. The total abnormal expression rate of E cadherin complex in 148 cases of gastric carcinoma was 91.9%. Reduced expression of E cadherin, ? catenin and ? catenin were significantly correlated with tumor differentiation status ( P
ABSTRACT
Objective To evaluate the diagnostic value of Endoscopic ultrasonography(EUS) and endoscopic therapies in gastrointestinal submucosal tumors under the guidance of EUS.Methods Patients underwent endoscopy for dyspepsia at our unit. Two hundred and thirty eight patients were found to have a presumed submucosal tumor(SMT) and all subjected to Endoscopic ultrasonography(EUS). Endoscopic therapy including endoscopic mucosal resecation(EMR), endoscopic mucosa strip removal(EMSR), snare cauterization,sclerotherapy or surgery operation had been taken according to the different deriving layers of submucosal tumors. The ultimate diagnosis was confirmed by histology.Results Seventy three stromal tumors derived from muscularis mucosa,7 carcinoid in mucosa propiria; 6 cysts, 13 lipomas, 17 etopic pancreases in stomach and 5 varices in gastric fundus derived from submucosa; 95 benign stromal tumors and 21 malignent stromal tumors derived from muscularis propria,1 carcinoid invaded muscularis propria. 61 benign stromal tumors derived from muscularis mucosa , 8 benign stromal tumors derive from muscularis propria, 8 lipomas, 4 cysts, 8 etopic pancreases and 7 carcinoids were resected by endoscopy; 33 benign stromal tumors from muscularis propria, 18 malignent stromal tumors, 2 lipoma and 2 etopic pancrease,1 carcinoid were resected surgically. Submucosal tumors 97.97% diagnosed by EUS were identified by pathology.Conclusion Different layers of gastrointestinal tract with submucosal tumors can be distinguished clearly by EUS, leading to definite diagnosis of submucosal tumors. EUS is important in selecting treatment procedures of submucosal gastrointestinal tumors and should routinely be performed on all presumptive submucosal tumors prior to attempt at removal.
ABSTRACT
Objective To investigate the relationships among clinical features, endoscopic characteristics and pathologic epithelial types of Barrett esophagus. Methods Magnification chromoendoscopy ( MCE) was performed in 2506 patients with gastroesophageal reflux disease ( GERD) and 106 patients with Barrett esophagus in our hospital during Feb,2003 -Feb,2004 were analyzed. The clinical features, endoscopic characteristics, pathologic epithelial types and their relationships were analyzed. Results The symptoms of gastro esophageal reflux disease ( GERD) were the main presentation of Barrett esophagus but 27 (25. 5% ) cases without such presentation. Four types of mueosal patterns, dot pattern, ridge or villous pattern and irregular/distorted pattern. were noted within the columnar mucosa using high magnification endos-copy: There were three epithelial types within the columnar lined esophagus: intestinal metaplasia (IM ) , cardiac and fundie types. Three epithelial types were noted in the methylene blue staining areas; ridged/vil-lous pattern and irregular/distorted pattern, all of them were in epithelial types of intestinal metaplasia. Conclusion Magnification chromoendoscopy helps to identify areas with IM, and having important significance in diagnosis and clinical follow up of Barrett esophagus.
ABSTRACT
Objective To evaluate the therapeutic effects of microwave coagulation and balloon dilatation on benign esophageal stenosis. Methods The location and degree of esophageal stenosis was diagnosed by endoscopy. Balloon dilatation or microwave coagulation plus balloon dilatation were selected to treat esophageal stenosis according to the severity of esophageal stenosis. Results 87 cases of esophageal stenosis were caused by esophageal anastomosis after esophagectomy (n=37), radiotherapy(n=25), chemical damage(n=22) and unclear causes(n=3) respectively. 66 cases of esophagostenosis were treated by balloon dilatation and 21 cases were treated by microwave coagulation plus balloon dilatation. 78 cases of esophageal stenosis were significantly improved, 8 cases were improved, and 1 case happened esophageal perforation. Conclusion Endoscopic therapies including balloon dilatation or microwave coagulation plus balloon dilatation were efficacious to esophageal stenosis caused by various causes.