ABSTRACT
Objective To evaluate magnetic resonance cholangiopancreatography (MRCP) in identifying Mirizzi syndrome and surgical modality Methods According to MRCP identification open laparotomy was adopted for those 7 case with gallbladder enlargemeng incarcerated stones close to the hilum and long segment obstruction of the common bile duct.Other 16 type Ⅰ Mirizzi syndrome cases without these characteristics underwent LC.Results Among 23 patients in MRCP group 22 cases were successfully operated on based on preoperatively planned surgical procedures.Only one was converted to open surgery because of the variation of gallbladder artery.While in 23 cases without undergoing preoperative MRCP examination,7 out of 12 cases assigned to LC were converted to open cholecystectomy (OC),11cases were done by OC.The Preoperative accurate diagnosis rate was 82.6％ (19/23) in MRCP patients with type Mirizzi Ⅰ syndrome.The success rate of preassigned surgical approach was 95.7％ (22 / 23).While in non-MRCP group,the conversion rate was 58.3％ (7/12),the average length of stay were significantly prolonged.Conclusions Preoperative MRCP examination helps accurately establish the diagrosis of type Ⅰ Mirizzi syndrome,precisely plan appropriate surgical approaches.
ABSTRACT
Objective To investigate the expression of E-cadherin(E-cad)and the relationship with the Lauren classification,the degree of histological differentiation,the clinical stage,the depth of invasion,lymph node metastasis and distant metastasis of gastric cancer. Methods 80 cases architecture of gastric cancer and normal tissue were collected.The expression level of E-cad in 80 cases of gastric carcinomas and their metastatic lymph node tissues were examined by immunohistochemical assays.Results The expression rate of E-cad in 80 cases of gastric carcinomas Was 55.00%.The expression level of E-cad was positively correlated with the Lauren classification,the degree of histological differentiation,the clinical stage,the depth of invasion,lymph node metastasis and distant metastasis(P＜0.05),but Was not correlated to patients sex,age and tumor size.The expression rates of E-cad in metastatic gastric carcinoma of primary lesions and lymph nodes metastasis were 35.48%and 32.26%. respectively. Furthermore, E-cad expression in metastatic gastric carcinoma was significandy correlated with primary lesions and lymph node memstasis(r=0.4978,P＜0.05).Conclusion The expression level of E-cad in gastric carcinoma Was closely correlated with the degree of tumor differentiation,infiltration and transferring.
ABSTRACT
Objective To investigate the gene variation and the dependability and to evaluate the possible tumor suppressor genes on chromosome 9 in the development and progression of EC. Methods LOH was detected in normal esophageal mucosa, high-grade squamous dysplasia and esophageal squamous cell carcinoma by microdissection, polymerase chain reaction, denaturing polyacrylamide gel eleetrophoresis and silver nitrate staining technology. The changes of LOH at six microsatellite markers and the relationship between LOH rate were analyzed. Results In the informative cases, total frequency of LOH was 17.2 % in high-grade squamous dysplasia and 24.9 % in esophageal squamous cell carcinoma. In high grade squamous dysplasia and squamous cell carcinoma, LOH was detected at marker D9S162 (20.8 %, 36.7 %), D9S171 (33.3 %, 36 %), D9S753(34.8 %, 46.2 %), D9S1748(4.2 %, 13.8 %), D9S242(14.3 %, 21.2 %), D9S43(0, 0). The frequency of LOH showed significant difference among the six microsatellite markers (X2=17.26, P< 0.005; X2=22.66,P<0.005). Conclusion The progression from normal squamous epithelium to high-grade Squamous dysplasia and subsequently to squamous cell carcinoma of the esophagus is associated with accumulation of chromosomal change. The situs of D9S171, D9S162, D9S242, D9S753 exist higher LOH and all exceed 20 %. Possible tumor suppressor genes at or near D9S171, D9S162, D9S242, D9S753 may be related to the progression of esophageal squamous cell carcinoma.