Prediction of colon neoplasms by rectal aberrant crypt foci / 中华消化内镜杂志

Objective To evaluate the relationship between endoscopic rectal aberrant crypt foci (ACF) and colon neoplasm, including lesions with high risk of aggressive progression (adenoma with diameter ≥ 1cm, villus adenoma, tubular-villus adenoma, adenoma of high grade dysplasia, or cancer). Methods The rectum of 212 patients who underwent colonoscopy was stained by 0. 4% indigo armine, and the patient was classified into different grade according to the number of rectal ACF, namely Grade 0 as no ACF, Grade Ⅰ as 1-4, Grade Ⅱ as 5-9 and Grade Ⅲ as more than 10. The correlation between rectal ACF grade and colon lesions was analyzed. Results Of 212 patients, 72 were classified as Grade 0, 48 as Grade Ⅰ , 41 as Grade Ⅱ, and 51 as Grade Ⅲ. The detection rate of colon neoplasm and lesions with high risk of aggressive progression in patients with rectal ACF were significantly higher than that in patients without rectal ACF (OR at 95% CI was 22. 352 (6. 716 -74. 395) and 7. 982 ( 1. 838-34. 672), respcetively). Conclusion Rectal ACF may predict the detection of colon lesions, including those with high risk of aggressive progression.

Replacing CTL epitope of recombinant HBsAg by SOEing PCR / 第三军医大学学报

Objective To replace the endogenous CTL epitope LLD in HBsAg with EYILSLEEL of glypican(GPC3)in order to prepare a GPC3-HBsAg multiple peptides vaccine for HBV infection.Methods The HBsAg/GPC3 DNA was amplified by gene splicing by overlap extension(SOEing)PCR from pcHBsAg plasmid and then inserted into pBSSK+ vector to construct a pBSSK/GPC3 vector.The vector was then identified by PCR,double digesting and sequencing.The fragment encoding GPC3 CTL epitope EYILSLEEL was obtained by double digesting the plasmid pBSSK/GPC3 and then inserted into pcDNA3.1+ vector.Results Sequencing and restrict endonulease digestion indicated that eukaryotic expression vector pcDNA-HBsAg/GPC3 was constructed successfully.Conclusion The endogenous CTL epitope LLD of HBsAg is replaced by the EYILSLEEL,and an eukaryotic expression vector pcDNA-HBsAg/GPC3 is constructed.

Diagnosis and treatment of laterally spreading tumor (LST) through endoscopy / 解放军医学杂志

Objective The laterally spreading tumor (LST) of the large intestine have received a great deal of study in Japan, but no report of such cases was found in China. We here of report 46 cases of LST (47 lesions, because one of the patients was found to have two lesions) diagnosed in our hospital in last two years. The morphological features under endoscopy, pit pattern, pathology and treatment under endoscopy were studied. Methods The 47 lesions of LST were found in a total of 5 735 patients who underwent colonoscopic examination in the last two years (from 01-12-2000 to 30-11-2002). The site, size and morphological features of LST were recorded, and the pit pattern was classified with magnification. 42 patients (totally 42 lesions) received colonoscopic surgery, and the rest refused to accept endoscopic therapy, therefore only a biopsy was done for pathological study. In those patients who accepted colonoscopic surgery, 14 patients were treated by mucosal resection (EMR) after injection of saline solution, 24 were treated by piecemeal mucosal resection (EPMR) after injection of saline solution, in 3 patients the lesion was removed by high frequency loop resection, and Cap-EMR was performed using distal hyaline hat attachment fitted to the end of endoscope. The resected or biopsy specimens were studied pathologically. Results 47 lesions of LST were found in a total of 5863 patients who underwent colonoscopic examination. The distrihution of LST lesions were as follows. 22 lesions were situated in the rectum, 10 lesions in the sigmoid colon, 7 lesions in the descending colon, 4 lesions in the transverse colon, 2 lesions in the ascending colon, and 2 lesions were located in the cecum. Macroscopic type: 25 lesions were homogeneous granular type, 12 lesions were mixed nodular granular type, 8 lesions were flat elevated type, and 2 lesions were pseudo-depressed type. The pit pattern as revealed under magnifying endoscopy indicated that 2 lesions were of type II pit, 8 lesion of type II+III L pit, 9 lesions of type III L pit, and 28 lesions of type IV. The pathological diagnosis revealed that 28 lesions were villous adenomas in which 7 lesions showed early malignant degeneration (6 intramucosal cancer and 1 submucosal cancer). 11 lesions were tubular adenomas, in which 1 was intramucosal cancer, 2 lesions were hyperplastic polyp, and 6 lesions were mixed hyperplastic polyps (serrated adenomas). Conclusion The LST manifest some special features, and their incidence may be higher in China than in Japan. EMR or EPMR may be considered as a good method for treatment for LST.

The importance of magnifying endoscopy and stereomicroscopy in the diagnoss of colon tumors / 解放军医学杂志

Objective To investigate the relationship between early colonic cancer and the pit patterns of abnormal colonic mucosa. Methods We examined the pit patterns of 124 polypi in 139 patients by magnifying colonoscopy and stereomicroscopy, and compared the relations between the pit patterns and pathological diagnosis of polypi. Results 5 cases of LST(laterally spreading tumor)and 9 cases of advanced cancer were found out of 124 polypi in 139 patients. 1 among these 5 cases of LST showed Ⅲ L pit pattern, and 4 showed Ⅳ pit pattern with both magnifying colonoscopy and stereomicroscopy. Magnifying colonoscopy showed high coincidence rate with stereomicroscopy. Conclusion Pit patterns are found to be very important in disguishing tumorous lesions from non-tumorous lesions, and to discover early colonic cancer. Ⅴ pit pattern indicates that the polyp is carcinomatous.

Immune Response Induced by Dendritic Cells Pulsed with Tumor Extracts in vivo Inhibit Growth of Implanted Tumor and Reject Challenge of Tumor Cells in Nudes / 中国肿瘤生物治疗杂志

To study if the immune response in vivo induced by dendritic cells (DC) pulsed with tumor extract can inhibit the growth of implanted tumor and reject the challenge of tumor cells in nudes, we isolated and purified DC from hepato-cellcular cancer(HCC) patient with combination of granulocyte /macrophage colony stimulating factor and interleukin 4; extracted tumor-associated antigen from human hepatocellcular cancer cell line HepG2 tumor cells; initiated the T lymphocyte with DC pulsed by the TAA to product cytotoxic T lymphocyte (CTL); implanted the CTL to inhibit the growth of implanted tumor in nudes and protected the nudes against the further challenge of HepG2 tumor cells, and further found that the CTL induced by DC pulsed with TAA from HepG2 tumor cells can inhibit the growth of implanted tumor in nudes and protect the nudes against the further challenge of HepG2 tumor cells. The results suggest, as a new concept anti-tumor vaccine, DC pulsed by TAA may play an important role in therapy and prevent against tumor.