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Objectives To investigate the relationship between the expression of hENT1 protein in pancreatic cancer and the efficacy,adverse reactions and prognosis of gemcitabine.Methods The tissues of 83 patients with pancreatic cancer diagnosed in Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital and Jiaxing City Hospital of Traditional Chinese Medicine from June 2013 to January 2016 were collected by endoscopic fine needle aspiration biopsy.The expression of hENT1 protein was detected by immunohistochemistry,which was divided into hENT1 low expression group and high expression group.According to the curative effect of chemotherapy,it was divided into gemcitabine effective group and drug resistance group.The clinicopathological parameters,adverse reaction rate,median survival,and progressionfree survival (PFS) were compared between the two groups.Results Of the 83 pancreatic cancer tissues,37 (44.6％) had high expression of hENT1 and 46 (55.4％) had low expression.There were no significant correlations of the efficacy of gemcitabine chemotherapy with gender,age,clinical symptoms,primary tumor location,tumor size,TNM staging,CA19-9 level,CEA level,presence or absence of liver metastasis,but gemcitabine resistance rate in high expression group was significantly higher than the low expression group (78.1％ vs 50.0％),and the difference was statistically significant (P =0.010).Both groups were able to tolerate adverse reactions of gemcitabine chemotherapy and no chemotherapy-related death was observed,but the incidence of leucopenia and thrombocytopenia in hENT1 low expression group was significantly higher than those in bENT1 protein high expression group (63.0％ vs 21.6％,47.8％ vs 16.2％),the differences was statistically significant (all P ＜ 0.05).The median survival and 1-year PFS of hENT1 protein low expression group were significantly lower than those of high expression group (11 months vs 15 months,19.4％ vs 50％),and the differences were statistically significant (P ＜0.05).Conclusions Decreased hENT1 protein expression in pancreatic cancer tissue could reduce the efficacy of gemcitabine chemotherapy,increasing the incidence of leucopenia and thrombocytopenia.
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Objective To establish a novel method using a nano microfluidic chip to detect circulating tumor cells (CTCs) in peripheral blood in gallbladder carcinoma,and to study the relationship between CTCs with clinicopathology and prognosis in these patients.Methods The peripheral blood samples of 51 patients with gallbladder carcinoma were collected from June 2014 to January 2017.The CTCs from peripheral blood samples were detected by a novel nano microfluidic chip.This study aimed to study the correlation between CTCs with the clinical and pathological features.The significance of CTCs on prognosis in patients with gallbladder carcinoma was also analyzed.Results The positive rate of CTCs in the peripheral blood of gallbladder carcinoma patients was 43.1％ (22/51).There were significant correlations between CTCs with liver metastasis (P ＜ 0.05) and Nevin staging (P ＜ 0.05).The 1-and 2-year overall survival (OS) in patients with CTCs were 70.7％ and 35.3％,and the 1-and 2-year OS in patients without CTCs were 92.0％ and 56.1％.There was a significant difference in the 2-year OS (P ＜ 0.05) but no significant difference in the 1-year OS between the 2 groups of patients (P ＞ 0.05).Conclusions Peripheral blood CTCs in patients with gallbladder carcinoma were efficaciously detected by a novel nano microfluidic chip.Peripheral blood CTCs was closely related to the Nevin staging and liver metastasis.CTCs could serve as a potential prognostic indicator in patients with gallbladder carcinoma.
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Objective To detect circulating tumor cells (CTCs) in the peripheral blood of patients with pancreatic cancer using a new nano microfluidic chip and to explore the relationship between CTCs and clinicopathological feature,postoperative recurrence and prognosis of pancreatic cancer.Methods The peripheral blood samples of 53 patients with pancreatic cancer who underwent curative resection in the second affiliated hospital of Jiaxing college of medicine were collected from January 2015 to January 2017.The CTCs from peripheral blood were detected by novel nano microfluidic chip.The cut-off value for CTCs-positive and negative groups was 1 CTC.The relationship between CTCs positive and postoperative recurrence and prognosis of pancreatic cancer were evaluated.Results The number of CTCs for 23 pancreatic cancer of 53 patients ranged from 5 to 196 per ml,and the mean number was 78.5 ± 44.7 per ml;the rate of CTCs-positive patients was 43.4％ (23/53).There were significant correlation between CTCs with vascular invasion (P =0.001),but but CTCs was not correlated with the gender,age,the presence of clinical symptoms,tumor size,pathological type,lymph metastasis and TNM stage.31 patients had tumor recurrence,and the rate of tumor recurrence was 58.5％.Among them,there were 13 cases with tumor local recurrence,10 cases with tumor distant metastasis (including liver,lung,kidney,etc.) and 8 cases with both tumor local recurrence and distant metastasis.The median recurrence free survival time of all patients was 14.0 months (13.0-17.0) and the median overall survival time was 19.0 months (15.5-24.0).The cumulative one-year and two-year recurrence free survival rate were 66.9％,12.2％ for patients with CTCs-positive and 88.3％,42.2％ for CTCs-negative patients,and the differences were statistically significant (both P ＜ 0.05).The cumulative one-year and two-year overall survival rate were 85.4％,33.6％ for patients with CTCs-positive and 96.3％,62.2％ for CTCs-negative.There was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate (P =0.028).Conclusions Peripheral blood CTCs of pancreatic cancer can be effectively detected by a novel nano microfluidic chip.There were significant correlation between CTCs with vascular invasion and survival time after surgery.CTCs may be a potential prognostic indicator of the postoperative recurrence and prognosis of pancreatic cancer.
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Objective To investigate the application of damage control surgery (DCS) concept in treatment of pancreas trauma. Methods The clinical data of 22 cases of pancreas trauma from January 2009 to June 2016 were analyzed retrospectively, including degree of injury, therapies and effect. Results Following DCS concept, 3 cases were given conservative treatment, and 19 cases were treated by operation, including debridement, hemostasis, suture, simple drainage and preserved pancreas function;21 cases were cured and 1 died;pancrestic fistula occurred in 11 cases, abdominal infection occurred in 6 cases and injured pancreatitis occurred in 1 cases by conservative treatment;false cyst occurred in 1 cases 6 weeks after operation. All patients were followed up for 12-36 months, with an average of (25.1 ± 1.7) months, and No significant impact was seen on the lives or work of 21 patients after surgery. Conclusions Pancreas trauma needs early-stage diagnosis and active treatment. Rational application of dcs concept can reduce the mortality and improve the outcome effectively.
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Objective To investigate the application of damage control surgery (DCS) concept in treatment of pancreas trauma. Methods The clinical data of 22 cases of pancreas trauma from January 2009 to June 2016 were analyzed retrospectively, including degree of injury, therapies and effect. Results Following DCS concept, 3 cases were given conservative treatment, and 19 cases were treated by operation, including debridement, hemostasis, suture, simple drainage and preserved pancreas function;21 cases were cured and 1 died;pancrestic fistula occurred in 11 cases, abdominal infection occurred in 6 cases and injured pancreatitis occurred in 1 cases by conservative treatment;false cyst occurred in 1 cases 6 weeks after operation. All patients were followed up for 12-36 months, with an average of (25.1 ± 1.7) months, and No significant impact was seen on the lives or work of 21 patients after surgery. Conclusions Pancreas trauma needs early-stage diagnosis and active treatment. Rational application of dcs concept can reduce the mortality and improve the outcome effectively.
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Objective To investigate the feasibility, efficacy, safety and economy of secondary splenic pedicle trisection method in removing schistosoma cirrhosis caused the splenic function. Methods Thirty patients receiving spleen secondary structure amputation between July 2014 and September 2016 were analyzed. Results Laparoscopic splenectomy with secondary splenic pedicle transaction was successfully performed in 28 patients, whereas two Endo-GIAs were used in 2 patients. The average of operation time was (80 ± 20) min, and operative blood loss was (320 ± 10) ml. The drainage of the splenic fossa was removed (3- 4) days after operation.Postoperative hospital stay was (10.8 ± 1.2) days after operaions. No massive hemorrhage, pancreatic leakage, secondary infection, serious complications such as abscess under diaphragm and recent complication such as infection of incision occurred postoperatively. Platelet of all patients recovered in 4 days postoperatively, and patients with platelet>400 × 109/L was given oral aspirin enteric-coated metformin hydrochloride. All patients were followed up for 6 months postoperatively, and no intestinal obstruction, portal vein thrombosis and other long-term complications occurred in all patients. Conclusions The amputation of secondary structures of the spleen in laparoscopic splenectomy to remove schistosoma cirrhosis caused the splenic function is safe. It could shorten the length of hospital stay and reduce the medical cost. It is a valuable method for clinical promotion.
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Objective To detect the sequence of SLC29A1 gene rs1288 single nucleotide polymorphism (SNP) in advanced pancreatic cancer patients,and to explore its correlation with gemcitabine toxicity and prognosis.Methods Peripheral blood samples were collected and DNA was extracted.The segment containing SLC29A1 gene SNP (rs1288) was amplified by PCR,and then DNA sequencing was conducted to identify SLC29A1 gene SNP (rs1288).According to the sequencing results,the patients were divided into SLC29A1 gene rs1288 T→A mutation type group and wild type group.Clinical data,toxicity of gemcitabine chemotherapy,progression free survival (PFS) and overall survival (OS) between two groups were compared.Results A total of 83 pancreatic cancer patients were enrolled.Sequencing results showed that SLC29 A1 gene 1288 T→A mutation type was present in 52 patients and wide type was observed in 31 patients,so mutation rate was 62.7％.All the patients in both two groups could tolerate the gemcitabine toxicity,and no chemotherapy related death occurred.There were no statistical differences on the gender,age,CA19-9,tumor site,size and TNM stage between the two groups.There were statistically higher iucidences of leukopenia and thrombocytopenia in the SLC29A1 gene rs1288 T →A mutation type group compared to the wild type group (55.8％ vs 32.3％,P＜0.05;40.4％ vs 19.4％,both P＜0.05).Median OS and PFS in mutation type group were shorter than those in wide type group (11 months vs 14 months,P ＜ 0.05;9 months vs 12 months,P ＜ 0.05).Conclusions Advanced pancreatic cancer patients with the SLC29A1 gene rs1288 T→A mutation type had a higher incidence of adverse reaction in gemcitabine chemotherapy and a worse therapeutic effect,and thus detecting the mutation of SLC29A1 gene rs1288 point mutation may serve as a marker for evaluating the toxicity and prognosis of gemcitabine chemotherapy in patients with pancreatic cancer.