ABSTRACT
Objective To investigate the involvement of VEGFR-3 signaling pathway in lymphatic metastasis of thyroid cancer. Methods The expression of VEGFR-3 mRNA in thyroid carcinoma and normal thyroid tissue was detected by RT-PCR. The expression of VEGFR-3 mRNA and the lymphatic vessel density (LVD) in thyroid carcinoma and normal thyroid tissue was measured by immunohistochemical staining. Results All thyroid cancer samples expressed VEGFR-3 and the expression rate of VEGFR-3 in thyroid carcinoma was significantly higher than that in the normal thyroid group ( P ＜ 0. 05 ). LVD in thyroid cancer was significantly higher than that in normal control. LVD with lymph nodes metastasis ( N + ) was significantly higher than that without lymph node metastasis (NO) (P ＜ 0. 05). Conclusions There is upregulatin of VEGFR-3 expression in thyroid carcinoma. The higher the expression of VEGFR-3, the severer of lymph node metastasis. VEGFR-3 receptor-mediated signal transduction pathway might be an important factor of thyroid cancer lymph node metastasis.
ABSTRACT
Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.