ABSTRACT
Objective:To study the impact of patients with intrahepatic cholangiocellular carcinoma (ICC) who underwent surgical resection with or without lymph node dissection (LND), negative or positive lymph node metastasis detected by LND, different extents of LND, and prognostic factors on long-term prognosis of these patients.Methods:The clinical data of 162 patients who were admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2014 to October 2019 and underwent surgical resection with postoperative histopathological results confirming ICC were retrospectively analyzed. According to the degree of LND, these patients were divided into three groups: the undissected group ( n=68), N0 dissected group (prophylactic dissection) ( n=41) and N1 dissected group (positive dissection, n=53). Of 94 patients who underwent LND, 23 patients underwernt the first station LND (the routine dissection group, n=23), and 71 patients underwent extended LND (the extended dissection group, n=71). The Kaplan-Meier method was used to construct survival curves. Cox regression analysis was used to detect independent factors affecting survival and long-term prognosis of patients. Results:In this study, there were 87 males and 75 females, with a median age of 60 years.The median survival time of these 162 ICC patients was 10 months. The cumulative survival rates at 1-, 3- and 5-year after surgery were 37.6%, 16.5% and 7.9%, respectively. The 1-, 3- and 5-year cumulative survival rates of the N0 dissection group were 52.1%, 31.7% and 25.4%, respectively, which were significantly better than those of the undissected group (34.2%, 12.7%, 3.4%), and the N1 dissection group (30.3%, 11.4%, 0) ( P<0.05). There were no significant differences in postoperative survival between the extended dissection group and the routine dissection group ( P>0.05). Preoperative CA19-9 >50 U/ml ( RR=1.425, 95% CI: 0.962-2.112), maximum tumor diameter > 5 cm ( RR=0.672, 95% CI: 0.456-0.989), without LND ( RR=1.715, 95% CI: 1.140-2.580), positive margin ( RR=0.591, 95% CI: 0.390-0.897), and without postoperative adjuvant therapy ( RR=0.663, 95% CI: 0.504-0.872) were independent risk factors affecting postoperative survival ( P<0.05). Conclusions:LND in ICC patients improved long-term survival outcomes. However, extended LND did not improve prognosis of these patients. The preoperative CA19-9 level, maximum tumor diameter, lymph node dissection, surgical margin status, and postoperative adjuvant therapy were independent risk factors affecting long-term prognosis of these patients.
ABSTRACT
Objective:To investigate the application value of a new internal cold circula-tion bipolar radio frequency device in open hepatectomy.Methods:The retrospective cohort study was conducted. The clinical data of 85 patients with hepatocellular carcinoma who underwent open hepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from February 2017 to January 2020 were collected. There were 48 males and 37 females, aged from 32 to 74 years, with a median age of 52 years. Of 85 patients, 45 cases undergoing hepatectomy assisted by the new internal cold circulation bipolar radio frequency device were allocated into new internal cold circulation bipolar radio frequency device group, and 40 cases undergoing hepatectomy assisted by Habib-4X bipolar radio frequency device were allocated into Habib-4X group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient, inpatient reexamination and telephone interview to detect the postoperative complications and death of patient within postoperative 30 days up to May 2020. Measurement data with normal distribution were represented as Mean± SD, and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M(range), and nonparametric Mann-Whitney U test was used for comparison between groups. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Repeated measurement data were anlyzed by the repeated ANOVA. Results:(1) Intraoperative situations: the time of crosscutting process for liver parenchyma, average area transection speed, coagulation tissue width, cases with needle bleeding rate and electrode needle charring were (55±16)minutes, (4.8±1.2)cm 2/minute, (1.4±0.2)cm, 6, 10 for the new internal cold circulation bipolar radio frequency device group, versus (64±15)minutes, (3.6±1.0)cm 2/minute, (1.8±0.2)cm, 14, 25 for the Habib-4X group, respectively, showing significant differences in the above indicators between the two groups ( t=2.665, 4.973, 9.204, χ2=5.525, 14.184, P<0.05). (2) Postoperative situations: for the new internal cold circulation bipolar radio frequency device group, the total bilirubin (TBil) was (20±12)μmol/L, (25±12)μmol/L, (20±14)μmol/L at postoperative 1, 3, 7 days, the prothrombin time (PT) was (15.4±2.2)seconds, (14.2±2.1)seconds, (12.7±0.8)seconds, the alanine aminotransferase (ALT) was (288±248)IU/L, (132±61)IU/L, (67±32)IU/L, the aspartate aminotransferase (AST) was (279±114)IU/L, (50±22)IU/L, (30±13)IU/L. For the Habib-4X group, the TBil was 1(22±15)μmol/L, (23±10)μmol/L, (19±8)μmol/L at postoperative 1, 3, 7 days, PT was (15.8±2.8)seconds, (14.3±2.0)seconds, (13.6±1.3)seconds, the ALT was (369±269)IU/L, (133±99)IU/L, (54±30)IU/L, the AST was (345±125)IU/L, (60±36)IU/L, (32±11)IU/L. There were significant differences in the time effect of PT, ALT, AST between the two groups ( F=18.364, 23.020, 93.786, P<0.05). There was no significant difference in the time effect, between-group effect, interaction effect of TBil or between-group effect, interaction effect of PT, ALT, AST between the two groups ( F=2.421, 1.424, 0.522, 1.593, 0.312, 0.121, 0.267, 1.027, 0.600, P>0.05). (3) Follow-up: 85 patients were followed up for 4 to 39 months, with a median follow-up time of 16 months. There were 5 patients in the new internal cooling circulation bipolar radiofrequency device group and 8 patients in the Habib-4X group with complications, respectively, showing no significant difference in overall complications between the two groups ( χ2=1.292, P>0.05). The number of deaths in the new internal cooling circulation bipolar radio frequency device group and Habib-4X group was 0 and 1, respectively, showing no significant difference between the two groups ( P>0.05). Conclusion:The new internal cold-circulating bipolar radio frequency device for open hepatectomy is safe and effective, which cuts the liver parenchyma faster, has lower carbonization rate at the tip of electrode needle, and has more accurate coagulation range.
ABSTRACT
Objective:To evaluate prognostic significance of metastated lymph nodes (LN) in patients with intrahepatic cholangio carcinoma (ICC) after radical resection.Methods:Data were reviewed on 90 patients at Department of Hepatobiliary and Pancreatic Surgery in our hospital from Feb 2013 to Oct 2019, 37 cases had no LN metastasis (N0 group), 21 cases were in N1 group (positive LN<3) and 32 cases in N2 group (positive LN≥3),and Kaplan-Meier method was used to construct survival curve. Univariate and multivariate COX regression analysis was used to screen independent risk factors.Results:In N0 group the 1-and 3-year survival rates were 57.7% and 35.2%, respectively. In N1 group the 1-and 3-year survival rates were 46.7% and 17.5%, respectively in N2 group. the 1-and 3-year survival rates were 19.6% and 0, respectively. There was statistical significance in overall survival rate among the three groups ( χ2=15.272, P<0.05). Multivariate analysis showed that resection margin ( P=0.009) and the number of positive LN ( P=0.002) were independent risk factors affecting the prognosis of patients. Conclusion:Resection margin and the number of metastasing LN were closely related to postoperative prognosis of ICC patients.
ABSTRACT
Objective@#To investigate the correlations between the systemic immune inflammatory index (SII) and prognosis of patients with gallbladder cancer.@*Methods@#From April 2005 to January 2019, patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Zhengzhou University were followed up and their SII values were analyzed. The receiver operating characteristic curve (ROC) was used to determine the best clinical boundary value of SII. According to the boundary value, patients were divided into two groups: low SII and high SII. Survival curves were drawn by Kaplan-Meier method. The overall survival time of the two groups was analyzed, and univariate analysis of postoperative survival was performed using log-rank test. Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis.@*Results@#A total of 312 patients were included, including 120 males and 192 females, aged 30.0 to 86.0 (61.5±9.9) years. The best clinical cut off value of preoperative SII was determined by ROC curve to be 510.42. A total of 312 patients with gallbladder cancer were divided into low SII group (SII≤510.42) and high SII group (SII>510.42). Kaplan-Meier survival curve was used to analyze the 1, 3 and 5-year survival rates of gallbladder cancer patients in low SII group and high SII group after operation. The survival rates were 65.7%, 39.6% and 30.2%, and 27.9%, 12.0% and 9.6% respectively. The median survival time was 25 months (95% CI: 16.9-33.1) and 9 months (95% CI: 8.1-9.9), respectively. The survival rate of gallbladder cancer patients in low SII group was better. There were significant differences of the overall survival rate between the two groups (P<0.05). Univariate analysis showed that SII>510.42 (HR=0.086, 95% CI: 0.032-0.289) was a risk factor for overall survival of gallbladder cancer patients. Cox multivariate analysis confirmed that preoperative SII (HR=2.649, 95% CI: 1.981-3.543) was an independent risk factor for overall survival of gallbladder cancer patients.@*Conclusions@#SII can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer. The higher the preoperative SII, the worse the prognosis of patients with gallbladder cancer.
ABSTRACT
Objective To investigate the correlations between the systemic immune inflammatory index(SⅡ)and prognosis of patients with gallbladder cancer.Methods From April 2005 to January 2019,patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancre-atic Surgery,Affiliated Tumor Hospital of Zhengzhou University were followed up and their SⅡ values were analyzed.The receiver operating characteristic curve(ROC)was used to determine the best clinical bounda-ry value of SⅡ.According to the boundary value,patients were divided into two groups:low SⅡ and high SⅡ.Survival curves were drawn by Kaplan-Meier method.The overall survival time of the two groups was analyzed,and univariate analysis of postoperative survival was performed using log-rank test.Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis.Results A total of 3 12 patients were included,including 120 males and 192 females,aged 30.0 to 86.0(61.5±9.9)years.The best clinical cut off value of preoperative S11 was determined by ROC curve to be 510.42.A total of 312 patients with gallbladder cancer were divided into low SⅡ group(SⅡ≤510.42)and high SⅡ group(SⅡ＞510.42).Kaplan-Meier survival curve was used to analyze the 1,3 and 5-year survival rates of gallbladder cancer patients in low SⅡ group and high SⅡ group after operation.The survival rates were 65.7％.39.6％and 30.2％,and 27.9％,12.O％and 9.6％respectively.The median survival time was 25 months(95％CI:16.9-33.1)and 9 months(95％CI:8.1-9.9),respectively.The survival rate of gallbladder cancer patients in low SⅡ group was better.There were significant differences of the overall survival rate between the two groups(P＜0.05).Univariate analysis showed that SⅡ＞510.42(HR=0.086,95％C/:0.032-0.289)was a risk factor for overall survival of gallbladder cancer patients.Cox multivariate analysis confirmed that preoperative SⅡ(HR=2.649,95％CI:1.981-3.543)was an independent risk factor for overall survival of gallbladder cancer patients.Conclusions SⅡ can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer.The higher the preoperative SⅡ,the worse the prognosis of patients with gallbladder cancer.
ABSTRACT
Objective To investigate the effect of growth differentiation factor 15 ( GDF15 ) downregulation on cell proliferation of human glioblastoma U 87MG cells.Methods Human glioblastoma U87MG cells with stable GDF15 downregulation was used as shGDF 15 group.U87MG cells with scramble knockdown was used as scramble group . Protein expression levels of GDF 15 were determined by Western blot analysis .Growth curve and BrdU incorporation assays were used to observe cell proliferation .Protein expression levels of ERK 1/2 and p-ERK1/2 were determined by western blot analysis .CCK-8 assays were used to observe cell proliferation .Results Compared with scramble cells, GDF15 downregulation significantly promoted cell proliferation ( P<0.05 ) , increased DNA synthesis in S phage ( P<0.01 ) , enhanced activity of ERK pathway and cell tolerance to VM-26 ( P<0.05 ) .Moreover , ERK pathway inhibitor rescued the increased cell proliferation with GDF15 downregulation.Conclusions GDF15decrease DNA synthesis in S phage and cell proliferation of human glioblastoma U 87MG cells through inhibiting ERK pathway .GDF15 is a potential target of chemotherapy sensitivity in glioblastoma clinical treatment .
ABSTRACT
Objective: to determine the frequency of duodenal ulcer [DU], as well as other clinical characteristics occurring after endoscopic variceal ligation [EVL] of the esophagus
Study Design: descriptive study
Place and Duration of Study: the First Affiliated Hospital of Fujian Medical University, Fuzhou, China, from April 2012 to April 2013
Methodology: a total of 47 patients with esophageal varices [EVr] who had also undergone EVL and gastroscopic follow-up within 3 months of the procedure was retrospectively analyzed. The status of Helicobacter pylori [Hp] infection, Child-Pugh classification, and the grades of portal hypertensive gastropathy [PHG] were collected. Sixty EVr patients without EVL treatment, but with clinical data available, served as the control group
Results: the frequency of DU in the EVL group [29.8%, 14/47] was higher than the control group [6.7%, 4/60] [p=0.02]. Hp infection rate in EVL group was 19.15% [9/47], while in control group was 21.67% [13/60] [p=0.813]. Hp positive rate [12.5%, 1/8] in patients exhibited new DUs after EVL was comparable to the patients without DU in the EVL group [12.1%, 4/33] [p=1.00]. Patients with DU after EVL received 18.79 +/- 8.48 of ligating bands, while in those who did not exhibit DUs received 13.85 +/- 6.47 [z = -2.042, p = 0.041]. Logistic regression analysis showed that the occurrence of DU was not associated with age, gender, Child-Pugh classification, or the grade of PHG [p > 0.05]
Conclusion: esophageal EVL is associated with a higher frequency of developing DU, which is related to a larger number of applied bands but is not correlated with Hp infection status or other variables
ABSTRACT
Objective To explore the bone marrow stromal cells,anti-late antigen-4 (VLA-4) antibody (aVLA-4),cytarabine (Ara-C) on the proliferation and apoptosis of leukemia HL-60 cells.Methods The experiment was divided into five groups:HL-60 cells were cultured alone (control group),HL-60 cells and stromal cells group (stromal cells group),HL-60 cells + stromal cells + aVLA-4 (antibody group),HL-60 cells + stromal cells + Ara-C group (drug group),HL-60 cells + stromal cells + aVLA-4 + Ara-C group (antibody +drug group).Cell proliferation or inhibition rate was detected by CCK-8 method,the HL-60 cells apoptosis was detected by flow cytometry.The expression of anti-apoptotic gene bcl-2 in HL-60 cells was determined by Western blot.Results After 24 h and 48 h,treatment,the number of the stromal cells group HL-60 cells were higher than that of the control group with significant difference cultured [(7.2±0.3)×1O5/ml vs (5.3±0.4)×105/ml,(8.4±0.2)×105/ml vs (6.8±0.3)×105/m1,P ＜ 0.001],while the HL-60 cell proliferation inhibition rate [(24.3±2.1) ％,(37.0±2.6) ％,(65.6±3.8) ％] and apoptosis rate [(5.7±0.6) ％,(8.0±0.5) ％,(10.4±0.9) ％,(16.5±0.7) ％] of antibody group,drug group,antibody + drug group were higher than the control group with a difference of statistically significant (P ＜ 0.05),and the increase of antibody + drug group was most obvious.With the decreasing of the bcl-2 protein expression,which was most the decrease of antibody + drug group was most obvious.Conclusion Bone marrow stromal cells can stimulate the proliferation of leukemia cells,aVLA-4 interference the interaction between stromal cells and leukemia cells can enhance the chemosensitivity of leukemia cells to Ara-C.
ABSTRACT
<p><b>BACKGROUND</b>A high mortality rate of pancreatic cancer becomes a bottleneck for further treatment with long-term efficacy. It is urgent to find a new mean to predict the early onset of pancreatic cancer accurately. The authors hypothesized that genetic variants of cationic trypsinogen (PRSS1) gene could affect trypsin expression/function and result in abnormal activation of protease activated receptor-2 (PAR-2), then lead to pancreatic cancer. The aim of this study was to elaborate some novel mutations of PRSS1 gene in the patients with pancreatic cancer.</p><p><b>METHODS</b>Totally 156 patients with pancreatic cancer and 220 unrelated individuals as controls were enrolled in this study. The mutations of PRSS1 gene were analyzed by direct sequencing. K-ras Mutation Detection Kit was used to find the general k-ras gene disorder in the pancreatic cancer tissue. Then the clinical data were collected and analyzed simultaneously.</p><p><b>RESULTS</b>There were two patients who carried novel mutations which was IVS 3 + 157 G > C of PRSS1 gene in peripheral blood specimens and pancreatic cancer tissue. What's more, it was surprising to find a novel complicated mutation of exon 3 in PRSS1 gene (c.409 A > G and c.416 C > T) in another young patient. The complicated mutation made No. 135 and No. 137 amino acid transfer from Thr to Ala and Thr to Met respectively. No any mutation was found in the normal controls while no mutations of k-ras gene were detected in the three patients.</p><p><b>CONCLUSION</b>Mutations of PRSS1 gene may be an important factor of pancreatic cancer.</p>
Subject(s)
Adult , Female , Humans , Male , Asian People , Mutation , Pancreatic Neoplasms , Genetics , Trypsin , GeneticsABSTRACT
<p><b>BACKGROUND</b>Mutations in the cationic trypsinogen gene (PRSS1) have been detected in patients with hereditary pancreatitis (HP). This study investigated the prevalence of the R122H (c.365 G > A), A121T (c.361 G > A) and D162D (c.488 C > T) mutations or polymorphisms in the common, non-hereditary forms of chronic pancreatitis and in an HP family.</p><p><b>METHODS</b>DNA was prepared from blood samples of 54 patients with chronic pancreatitis (35 alcoholic, 17 idiopathic and 2 hereditary) and 120 normal controls. The PRSS1 genes were amplified by polymerase chain reaction (PCR) and their products were analyzed by sequencing and related clinical data were also collected.</p><p><b>RESULTS</b>A new polymorphism (c.488 C > T) of PRSS1 was found in 25 patients with chronic pancreatitis (including one affected member of the HP family) and six members of the normal controls. The C/T genotype was significantly increased in chronic pancreatitis (OR: 16.379, 95% CI: 5.7522 - 52.3663), the frequency of c.488 C > T change was in according with the Hardy-Weinberg equilibrium, but it doesn't affect the clinical phenotype. The commonly reported change of R122H (c.365 G > A) was not detected in any of the study subjects. c.361 G > A was found in 2 affected members and one unaffected carrier in an HP family. One of the affected members of an HP family had c.361 G > A mutation and polymorphism (c.488 C > T) in the PRSS1 gene at the same time. The patient's clinical values (C3, C4, CA19-9 and HbA1c) were higher than those of the other patients with chronic pancreatitis. The two patients with HP developed diabetes mellitus and their father died with pancreatic cancer.</p><p><b>CONCLUSION</b>A new polymorphism (c.488 C > T) in the PRSS1 gene is associated with chronic pancreatitis, but it did not affect the clinical phenotype while the A121T (c.361 G > A) mutation in the gene shows a significant correlation in the patients with HP.</p>
Subject(s)
Female , Humans , Male , Mutation , Pancreatitis , Genetics , Pancreatitis, Chronic , Genetics , Polymorphism, Genetic , Trypsin , Trypsinogen , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To characterize the profile of chromosomal imbalances of esophageal squamous cell carcinoma (SCC) in Linzhou, the high prevalence area of Henan province.</p><p><b>METHODS</b>Comparative genomic hybridization (CGH) was used to examine 52 cases of primary SCC of esophagus.</p><p><b>RESULTS</b>Gains in part or in whole of chromosome 3q, 8q, 5p, 1q, 6q, 18p, 20q and losses of 3p, 1p, 9q, 19p, 4p, 8p were detected frequently in SCC (> 20%). Gain of 3q, 5p, 1q, 11q13-14 and loss of 4pq, 13q were all significantly correlated with pathologic staging (P < 0.05). Gains of 8q, loss of 4p were linked to nodal metastasis (P < 0.05). Gains of 2p and loss of 4pq, 11q14-qter were associated with distant organ metastasis (P < 0.05).</p><p><b>CONCLUSION</b>These observations suggest that 3q, 8q, 5p, 1q, 6q, 18p, and 20q may contain SCC-related oncogenes; 3p, 1p, 9q, 19p, 4p and 8p may contain SCC-related tumor suppressor genes. It is likely that gain of 3q, 5p, 1q, 11q13-14 and loss of 4pq, 13q are the genetic aberrations critical for the development of esophageal carcinoma, whereas gains of 8q, 2p and loss of 4pq, 11q14-qter are considered later events associated with tumor progression and are thought to confer metastatic potential to esophageal carcinoma. Furthermore, nodal and distant organ metastases involve different genes.</p>
Subject(s)
Humans , Carcinoma, Squamous Cell , Genetics , Chromosome Aberrations , Chromosome Deletion , Chromosomes, Human, Pair 3 , Chromosomes, Human, Pair 4 , Chromosomes, Human, Pair 8 , Esophageal Neoplasms , Genetics , Gene Amplification , Lymphatic Metastasis , Neoplasm Metastasis , Genetics , Neoplasm Staging , Nucleic Acid HybridizationABSTRACT
<p><b>OBJECTIVE</b>To characterize the profiles of chromosome imbalance in esophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma (GCA) from the high incidence area in Henan.</p><p><b>METHODS</b>Chromosomal aberrations of 37 samples of SCC and 30 GCA were analyzed by comparative genomic hybridization comparative genomic hybridization (CGH).</p><p><b>RESULTS</b>It was found that the most frequently detected gains were on chromosome arm 8q (78%), and followed by 3q, 5p, 6q and 7p. The most frequent loss was found on 3p (57%), and followed by 8p, 9q and 11q in SCC. For GCA, the most frequent gain was found on chromosome arm 20q (43%), and followed by 6q, 8q and 6p. The most frequent loss was on the chromosome 17p (57%), and followed by 19p, 1p and 4p.</p><p><b>CONCLUSION</b>The present findings demonstrate that gains of 8q, 3q and 5p, and losses of 3p, 8p, and 9q are characteristic profile of chromosome imbalance in SCC, and the gains of 20q, 6q and losses of 17p, 19p and 1p are characteristic profile of chromosome imbalance in GCA, which provide important theoretic information for identifying and cloning novel SCC/GCA-related genes.</p>