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Objective To study the operational techniques and feasibility of superior rectal artery preserving laparoscopic resection of sigmoid colon carcinoma.Methods From Jan 2015 to Nov 2016,85 patients with sigmoid colon carcinoma were divided into artery preserving group (27 cases) and traditional surgical group (58 cases).Results The mean operation time was (283 ± 51) min,the mean lymph node dissection was (15 ± 8) and the mean blood loss was (62 ± 17) ml in the artery preserving group.The mean operation time was (179 ±e63) min,the mean lymph node dissection was (15 ±7) and the mean blood loss was (67 ± 17) ml in the traditional surgery group.The number of resected lymph nodes and blood loss had no statistical significance between these two groups (t =0.058,P ＞0.05).Longer operating time were observed in the retained vascular group as compared to the traditional surgical group (t =7.530,P ＜ 0.05).There was no anastomotic fistula in the retained vascular group,however,two anastomotic fistula cases occurred in the traditional surgical group (x2 =0.043,P ＞ 0.05).Conclusions Preservation of superior rectal artery was safe and feasible for laparoscopic resection of sigmoid colon carcinoma.
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Objective To compare the esophageal acid and alkaline exposure characteristics of patients with cardia carcinoma after proximal gastrectomy or total gastrectomy.Method A total of 77 patients of cardia carcinoma who underwent radical resection from Sep 2007 to Sep 2011 in our hospital were retrospectively reviewed.24 hour esophageal pH monitoring were performed in all patients.Result Patients were divided into three groups:group TG had total gastrectomy (n =25),group PP had proximal gastrectomy with pyloroplasty (n =33),group NP had proximal gastrectomy (n =19).It revealed that indicators of acid reflux including the overall time length of acid episodes,＞ 5 min times of acid episodes,duration of longest acid episodes,time length of pH ＜ 4.00 and the DeMeester Scores in group NP were significantly higher than in group PP(U =32,P ＜ 0.01 ; U =35,P ＜ 0.01 ; U =23,P ＜ 0.01 ; U =39,P ＜0.01 ;U =49,P ＜0.01 respectively).Only alkline reflux was observed in group TG.The total times of alkaline episodes in PP group was significantly lower than in group TG(U =52,P ＜0.01) and group NP (U =182,P ＜0.01).＞5 min times of alkaline episodes in group TG was larger than in group PP,and that in group PP was larger than in group NP(P ＜0.01).Duration of longest alkaline episodes and total period of pH ＞7.00 in group PP was significantly higher than in group TG(U =125,P ＜ 0.01 ; U =143.5,P ＜ 0.01),and that in group TG was higher than in group NP(U =23.5,P ＜ 0.01 ; U =14,P ＜ 0.01).Conclusions Alkaline reflux deserves more attention in evaluating esophageal reflux in patients with cardia carcinoma after resection.Pyloroplasty is not helpful to relieving esophageal acid episodes while causing severe alkaline reflux.
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<p><b>OBJECTIVE</b>To investigate the predictive value of serum CA125 in peritoneal metastasis, and to examine the association of CA125 with the prognosis.</p><p><b>METHODS</b>Clinical data of 1285 gastric cancer patients admitted to the Qilu Hospital from March 2003 to September 2008 were retrospectively reviewed. The sensitivity, specificity and accuracy of serum CA125 for peritoneal metastasis were analyzed. Clinicopathological characteristics and survival were compared between patients with normal serum CA125 level(≤35 μg/L) and patients with elevated serum CA125 level(>35 μg/L).</p><p><b>RESULTS</b>The specificity, sensitivity and accuracy of serum CA125 for peritoneal metastasis were 96.0%, 13.8% and 81.2%, respectively. A significantly higher incidence of peritoneal metastasis was observed in the patients with elevated serum CA125 level as compared to those with normal serum CA125 level(43.2% vs. 16.5%). CA125 was an independent predictor of peritoneal metastasis(RR=3.475, 95% CI:2.124-5.685). The 5-year overall survival rate in patients with elevated serum CA125 level was 13.5%, which was significantly lower than that of patients with normal serum CA125 level (49.8%, P<0.01). CA125 was an independent prognostic factor of gastric cancers(HR=2.049, 95%CI:1.355-2.873).</p><p><b>CONCLUSION</b>Serum CA125 is useful in predicting peritoneal metastasis and prognosis of gastric cancer, which should be used as a routine examination of gastric cancer patients.</p>
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Humans , CA-125 Antigen , Blood , Neoplasm Staging , Peritoneal Neoplasms , Blood , Prognosis , Retrospective Studies , Stomach Neoplasms , Blood , Pathology , Survival RateABSTRACT
Objective To investigate the clinicopathological characteristics and prognosis of serumb alpha-fetoprotein(AFP)-producing gastric cancer.Methods A total of 1396 cases of gastric cancer in our hospital from 2002 to 2007 were retrospectively reviewed.The relationship between serum AFP with clinicopathological factors,survival rate,prognosis and liver metastasis were analyzed.Results There were 90 AFP-producing gastric cancer patients accounting for 6.45％ of all the gastric cancer cases during the time period.In those patients there was bigger tumor size,more T3 and T4 invasion (82.2％ vs.69.2％),higher incidence of lymph node metastasis (80.0％ vs.60.2％)and liver metastasis(6.67％ vs.1.68％),and later clinical stage than that in the AFP-negative group.The 1,3,5 year-overall survival (OS) rate in AFP-positive group were 52.2％,31.1％,20％ while those in AFP-negative group were 82.5％,59.9％,48.8％.The 1,3,5 year-disease free survival(DFS) rate in AFP-positive group were 47.8％,24.4％,15.6％ while those in AFP-negative group were 77.5％,54.8％,44.3％.The AFP-positive group had a shorter median time period than the AFP-negative group when liver metastasis happened (5 months vs.11 months).Conclusions Serum AFP-producing gastric cancer was higher malignancy,it was deeper in invasion and later in clinical stage,more patients with lymph nodes and liver metastasis,low survival rate and poorer prognosis.
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Objective To study retrospectively the relation of the number of all dissected and negative lymph nodes (LNs) to the prognosis of patients with stage Ⅲ rectal carcinoma after radical resection.Methods From 2002 to 2007,412 sage Ⅲ rectal carcinoma patients undergoing radical resection were enrolled.Patients were divided into five groups according to the number of dissected LNs as follows:1 to 6 lymph nodes,7 to 12 lymph nodes,13 to 18 lymph nodes,19 to 24 lymph nodes,and more than 24 lymph nodes.The association with the survival was analyzed.The Kaplan-Meier method was used to estimate survival as a function of time,and survival differences were analyzed with the log-rank test.The correlation between all dissected and negative lymph nodes was analyzed.The Cox proportional hazard model were used to investigate the risk factors for stage Ⅲ rectal carcinoma.Results The 1,3 and 5 years survival rates were respectively 79.9％,59.2％ and 43.0％.The 5-year survival rates increased with the increasing number of the examined LNs and the negative LNs,the differences were significant (20.0％、26.5％ 、43.9％ 、54.2％ 、53.5％,P =0.001 ; 10.3％ 、34.8％ 、51.9％ 、56.8％ 、70.8％,P =0.000).There were 7301 LNs dissected among which 5698 were pathology negative.The dissected LNs were correlated positively with negative LNs on the Pearson's correlation test(correlation coefficients r =0.899).The total number of dissected LNs and negative LNs were independent prognostic predictors.Conclusions The total number of dissected lymph node and negative lymph nodes are significantly correlated to prognosis of staged Ⅲ rectal carcinoma patient.On premise of standard procedure,we see all dissected and negative lymph nodes as a prognostic auxiliary index.
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Objectives: To detect the expressions of mTOR and HIF-1?and their relationship with angiogenesis in gastric carcinomas. Methods: The expressions of mTOR and HIF-1?in gastric carcinomas tissues(n=70)and normal tissues(n=45)were measured by immunohistochemistry staining.CD34 immunostaining was used to measure the microvascular density(MVD).Results: The rates of the mTOR and HIF-1? positive expression were 51.4% and 67.1% respectively. MVD value of gastric cancer tissues was much higher than that of normal tissues(t=4.358, P
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Objective:To investigate the related factors and clinical significance of peritoneal micrometastasis in patients with gastric carcinoma,providing theoretical basis for resection range。Methods:CK19,CK20 immunohistochemistry were performed on 62 patients' tissues taken from anterior lobe of transverse mesocolon,posterior wall of omental bursa,pancreatic capsule and rectovesical pouch or Douglas pouch during the operations,compared with HE staining and peritoneal lavage cytology(PLC).Results:No metastasis was found by HE staining.Peritoneal micrometastasis were found in 27 cases out of 62 by immunohistochemistry,and its positive rate was 43.55%,obviously higher than PLC(14.52%).The peritoneal micrometastasis of gastric carcinoma had relations with diameter of tumor,depth of infiltration,clinical stage,lymph node metastasis(P0.05).Conclusion:Immunohistochemistric measure of CK 19 and CK20 can be effective to detect the micrometastasis of gastric carcinoma,which is helpful to guide clinical staging and useful to provide evidence for accurate selection of operation and postoperative treatment.Routine detection of peritoneal micrometastasis should be taken in patients of advanced gastric carcinoma,especially with a large size of serosa invasion.Multiple spots sampling is helpful to improve the detection rate.Anterior lobe of transverse mesocolon and pancreatic capsule should be peeled,and radical resection of omental bursa should be considered as routine operation in these patients.
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Objective:To investigate the expression and clinical significance of metastasis suppressor gene Kiss-1 and KAI-1 in colorectal cancer. Methods: In situ hybridization was used to detect and analyze the gene expression of Kiss-1 and KAI-1 in 61 cases of colorectal cancer and 20 cases of normal para cancer tissue. Results: In situ hybridization revealed that the positive expression rates of Kiss-1 and KAI-1 in colorectal cancer were significantly lower than those in normal para cancer tissue (P
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<p><b>OBJECTIVE</b>To investigate the percentage of splenic CD(5)(+) B lymphocytes in chronic idiopathic thrombocytopenic purpura (IT) and the impact of splenic CD(5)(+) and CD(5)(-) B lymphocytes on the production of platelet glycoprotein (GP)-specific autoantibodies.</p><p><b>METHODS</b>Splenic CD(5)(+) B lymphocytes were identified by two-color flow cytometric analysis in eight patients. Four of the eight patients displayed plasma autoantibodies against both GPIIb/IIIa and GPIb/IX, and their splenic B lymphocytes were separated by Ficoll-Hypaque density gradient and sheep erythrocyte, and further purified by magnetic activate cell separation (MACS). Purified CD(5)(+) and CD(5)(-) B lymphocytes were cultured separately with or without staphylococcus aureus cowan I (SAC). GP specific autoantibodies in culture supernatants were measured by modified monoclonal antibody immobilization of platelet antigen assay (MAIPA).</p><p><b>RESULTS</b>The percentage of splenic CD(5)(+) B lymphocytes in ITP patients was slightly higher than that in control with no statistical significance. MACS purified splenic CD(5)(+) and CD(5)(-) B lymphocytes from three out of four ITP patients produced high levels of anti-GPIIb/IIIa and anti-GPIb/IX antibodies. Culture supernatants of CD(5)(+) B lymphocytes from the other patient showed positive reaction only in GPIb/IX MAIPA. Culture supernatant of CD(5)(-)B lymphocytes from the same patient were double positive in both GPIIb/IIIa and GPIb/IX MAIPA.</p><p><b>CONCLUSIONS</b>Both splenic CD(5)(+) and CD(5)(-) B lymphocytes produce platelet GP-specific autoantibodies in chronic ITP with similar antibody spectrum and titer, and may all play a role in the autoimmune pathogenesis of ITP.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Autoantibodies , B-Lymphocytes , Allergy and Immunology , CD5 Antigens , Chronic Disease , Platelet Glycoprotein GPIIb-IIIa Complex , Allergy and Immunology , Platelet Glycoprotein GPIb-IX Complex , Allergy and Immunology , Purpura, Thrombocytopenic, Idiopathic , Allergy and Immunology , Spleen , Cell BiologyABSTRACT
Objectives:To explore the inhibition effect of TK/GCV and CD/5-FC system on liver metastasis of colon carcinoma.Methods:Forty nude mice were divided into 4 groups randomly,which were the control group,TK group,CD group and TK-CD group with 10 nude mice in each group.The mice in the control group were injected SW480 cells in the spleen and NS into the peritoneal cavity.The mice in other groups were all injected SW480/TK-CD cells in the spleen.And GVC,5-Fc,GVC+5F-c were injected into the peritoneal cavity of the mice in the TK group,CD group and TK-CD group respectively.Liver metastasis rate,the number of liver metastasis,the pathological changes of the tumor tissues under the electronic microscope,tumor cell's apoptotic index and life span and other indexes of nude mice in four groups were analyzed.Results:Liver metastasis rate of nude mice in every treatment group was lower than that in control group.Compared with control group,average number of liver metastasis decreased,life span of nude mice was prolonged,and the apoptosis rate of cancer cell in liver metastasis increased.The combined genes in the TK-CD group worked more markedly,and there was mutual effect between TK/GCV and CD/5-Fc.Conclusions:Synergistic effect was acquired combining TK/GCV with CD/5-FC system and it inhibited the formation of liver metastasis of colon carcinoma efficiently.
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Objective : The patients with inguinal hernia were treated with plug mesh hernia repair. Methods:The hernia sacs were isolated and dissected back to the internal ring. The unoperated sacs were allowed to drop back through the internal ring into the abdominal cavity. A cone-shaped mesh hernia plug is inserted tapered end through ring and placed into position just beneath the crura. All our repairs were reinforced a second piece of flat was placed from the pubic tubercle, overlying the direct space. Results : Com-paired with conventional suture surgical techniques, a plug repair uses less disscection and ensures tenssion free hernioplusty. Conclusion : We believe that the two factors are the most important reseasons for greater patients confort, rapit rehabilitation, decreased recurrence and lessened overall complication rates with the mesh hernia plug techniques.
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Objective: To study the immunohistochemical features and the differential diagnosis of mesenteric fibromatosis (MF), solitary fibrous tumors (SFT)and gastrointestinal stromal tumors (GIST). Methods: The expressions of CD117, CD34, ?-catenin, S-100, Desmin, Bcl-2 and Dog-1 of the three tumors were studied by immunohistochemistry method (S-P method). Results: By immunohistochemical staining detection, the expression of ?-catenin in six MF cases were positive, the positive expression rates of CD117 and Dog-1 in GIST cases were 85% and 92% respectively, and the positive expression rates of CD34 and Bcl-2 in SFT were 71% . Conclusion: MF, SFT and GIST can be identified by the combining applying of CD117,CD34 and ?-catenin through the immunohistochemistry method.