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Background and purpose: Recent studies have shown that, the new gene PRR11 had abnormal expression in lung cancer, stomach cancer, speculated that it might be correlated with tumor progression. This study aimed to detect the expression of PRR11 protein in human pancreatic carcinoma, and to analyze the relationship between PRR11 protein level and the clinical pathological parameters of pancreatic carcinoma. Methods: Immunohistochemistry (SP) method was used to detect the expression of PRR11 protein in 32 cases of human pancreatic cancer tissues, 20 cases of paracancerous tissues and 6 cases of normal pancreatic tissue. Chi Square test was used to analyze the relationship between the expression levels of PRR11 protein and the clinical pathological parameters (age, gender, the size of tumor, the location of tumor, differentiation, lymph node metastasis and TNM stage). Results:The positive expression rates of PRR11 protein in pancreatic cancers, paracancerous tissues and normal pancreatic tissues were 78.1%(25/32), 5.0%(1/20) and 0.0%(0/6), respectively. The expression level of PRR11 in pancreatic cancer tissues was significantly higher than those in paracan-cerous tissues or normal tissues. The positive expression rate of PRR11 protein in pancreatic carcinoma was significantly associated with cell differentiation degree and TNM stage (P0.05). Survival analysis demonstrated that the survival rate in the patients with PRR11 protein positive expression was significantly lower than the patients with negative expression (P<0.05). Conclusion:PRR11 protein can be a possible prognostic indicator of pancreatic cancer.
ABSTRACT
Objective To investigate the efficacy of duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis combined with type Ⅰ and Ⅲ pancreatic duct stones.Methods The clinical data of 55 patients with chronic pancreatitis and type Ⅰ and Ⅲ pancreatic duct stones who were admitted to the People's Hospital of Hunan Province from June 2008 to June 2013 were prospectively analyzed.All the patients were randomly divided into the pancreatoduodenectomy (PD) group (27 patients) and the DPPHR group (28 patients).There were 18 patients with chronic pancreatitis and type Ⅰ pancreatic duct stones and 9 patients with chronic pancreatitis and type Ⅲ pancreatic duct stones in the PD group.There were 16 patients with chronic pancreatitis and type Ⅰ pancreatic duct stones and 12 patients with chronic pancreatitis and type Ⅲ pancreatic duct stones in the DPPHR group.Patients in the PD group received PD + Child anastomosis + end-toside pancreato jejunal anastomosis + pancreatic stent placement + end-to-side cholangiojejunostomy.Patients in the DPPHR group received free of duodenum + pancreatic duct incision + resection of pancreas at 1 cm ahead of the pancreatic duct + extraction of the pancreatic duct stones + pancreaticoduodenal Roux-en-Y anastomosis.Patients were followed up via out-patient examination till December 2013.The measurement data were analyzed using the t test or Mann-Whitney U test,and the count data were analyzed using the chi-square test.Results During the operation,2 patients in the PD group were converted to the DPPHR group and 1 patient in the DPPHR group was converted to the PD group.No patient died during the perioperative period,and the symptoms including abdominal pain and diarrhea were alleviated at postoperative week 2.The operation time,blood loss,duration of postoperative hospital stay,total expenses and incidence of complications were (7.5 ± 1.6) hours,(460 ± 88) mL,(18.0 ± 3.5) days,(7.8 ± 2.1) × 104 yuan,19.2％ (5/26) in the PD group,and (4.0 ± 1.0) hours,(120 ± 36) mL,(9.5 ± 2.9) days,(3.9 ± 1.2) × 104 yuan,3.4％ (1/29) in the DPPHR group,there were no significant differences in the operation time,blood loss,duration of hospital stay,total expenses and incidence of complications between the 2 groups (t =9.358,11.365,6.325,8.647,x2 =3.976,P ＜ 0.05).Fifty-three patients were followed up,with the median time of 33 months (range,6 months to 5 years).No patient died during the follow-up.Twenty-four patients in the PD group were followed up,2 patients had slight abdominal pain,1 patient had severe abdominal pain due to pancreatic duct stenosis,and the symptom was alleviated after resection of partial pancreas ; the condition of 12 patients was improved among the 19 patients with diabetes.Twenty-nine patients in the DPPHR group were followed up,2 patients had slight pain; the condition of 16 patients were improved among the 22 patients with diabetes.Conclusion DPPHR is an ideal surgical procedure for patients with chronic pancreatitis and type Ⅰ and Ⅲ pancreatic duct stones.