Clinical significance of epidermal growth factor receptor and thymidylate synthase expression in primary liver cancer / 中华肝脏病杂志

Objective@#To investigate epidermal growth factor receptor (EGFR) and thymidylate synthase (TS) expression in primary liver cancer, and analyze its clinicopathological features and prognostic significance.@*Methods@#Immunohistochemistry was performed using EnVision method to detect EGFR and TS expression in 41 cases of liver cancer. Correlation coefficient between EGFR and TS was calculated by Spearman method. Fisher's exact probability method or χ2 test was used to analyze the clinicopathological features of EGFR and TS. Kaplan-Meier method was used to calculate the survival rate of patients in conjunction with the log-rank test.COX proportional hazard regression model was used to analyze the prognostic factors of patients. ROC curve was used to analyze the predictive accuracy of EGFR and TS for prognosis.@*Results@#The positive rates of EGFR and TS in liver cancer tissues were 34.15% and 39.02%, respectively. There was a positive correlation between EGFR and TS expressions, and the difference was statistically significant (P < 0.05). EGFR was associated with tumor size and tissue differentiation (P < 0.05) in HCC patients, whereas TS was associated with tissue differentiation (P < 0.05). There was no significant difference in prognostic effect of EGFR on survival rate (P > 0.05). TS prognostic effect on survival rate was statistically significant (P < 0.05). HR of EGFR was 0.210 with 95% CI, 0.052-0.852, P = 0.029; indicating that the risk of death in patients with negative EGFR was 0.210 times higher than that in patients with positive EGFR. HR of TS was 2.496, with 95% CI, 1.325-4.701, P = 0.005, indicating that the risk of death increased by 2.496 times with the same level of EGFR. The area under the EGFR curve was 0.553 and its approximate reference confidence interval was 95% (0.355, 0.751), indicating that EGFR was a risk factor for death and the area under the TS curve was 0.695, and its approximate reference confidence interval was 95% (0.513, 0.878), indicating that TS was a risk factor for death.@*Conclusion@#EGFR and TS were equally expressed in primary liver cancer, and EGFR and TS expressions were positively correlated. EGFR and TS had an effect on the degree of tissue differentiation in patients with liver cancer. EGFR and TS were risk factors for prognosis, and TS may assist EGFR.

THE BLOOD SUPPLY AND NERVE INNERVATION OF THE GRACILIS MUSCLE / 解剖学报

The blood vessels, nerves and the size of the gracilis muscle were studied in 50 adult Chinese cadavers (43 males and 7 females).In average, the length of the gracilis muscles is 325 mm the breadth is 26.18mm the thickness is 6.56mm. The length of its tendon is 112.78 mm.The nutrient arteries of the gracilis muscle may arise from the profund femoral artery, medial circumflex femoral artery, the first perforating artery, femoral artery, popliteal artery, supreme genicular artery or obturator artery. Among them, the profund femoral artery and femoral artery give off constant branches to the gracilis muscle.The dominant nutrient artery of the gracilis muscle arises from the profund femoral artery in 94 cases (94％), from the medial circumflex femoral artery in 5 cases (5％). There is only one case (1％) arising from the first perforating artery.The average length of the dominant nutrient artery is 83.6mm. Its diameter in the origin is 2.24mm. and outside the hilum, 1.44mm. The distance from the vascular hilum to the pubic tubercle is 142.48mm. The surface respresentation of the dominant neuro-vascular hilum is situated at the junction point of the upper and middle thirds of the line joining the pubic tubercle to the adductor tubercle.There are 72.5％ of the dominant nutrient arteries of the gracilis muscle accompanying with two veins and 27.5％, with only one vein.The gracilis muscle is innervated by the anterior branch of the obturator nerve which accompanies the dominant nutrient artery entering the muscle. Its average diameter is 1.78mm.

THE BLOOD SUPPLY AND NERVE INNERVATION OF THE SATORIUS MUSCLE / 解剖学报

The satorius muscle,its blood vessels and nerves have been dissected and examinedin 20 Chinese adult cadavers.It was found,on the average,that the length of thesatorius muscle is 529?8.48mm;the breadth,25.30?0.82mm;and the thickness,10.5?0.66mm.The arteries of the satorius muscle may arise from the surperficial circumflex iliacartery (0.66%?0.46),the femoral artery(58.36%?2.82),the deep femoral artery(3.93?1.11),the lateral circumflex femoral artery and its branches(13.44%?1.95),the supreme genicular artery(20.98%?2.33)and the popliteal artery(2.62%?0.91).There may be 5～13 arterial branches,averaging 7.6,in each satorius muscle,distributing roughly and evenly to the whole muscle,with an interval of about 7cmbetween two adjacent arteries and showing segmental distribution.The upper one third of the satorius muscle is mainly supplied by the branchesof the deep femoral artery and the lateral circumflex femoral artery while theinferior one third,by the branches of the supreme genicular artery.Therefore twoisolated flaps may be planned depending on the arteries mentioned above.The satorius muscle is innervated by the femoral nerve.70% of the cases arewith 1～2 branches of nerves,which,before entering the muscle,may give out 1～7twigs.