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Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.
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Objective@#To investigate the correlation between serum chemokine CXCL13 (CXCL-13), interleukin-1beta (IL-1beta), interleukin-6 (IL-6) levels and liver function damage and hepatitis B virus replication in patients with chronic hepatitis B (CHB).@*Methods@#Eighty patients with CHB who were treated in Jiyuan People′s Hospital of Henan Province from January 2016 to December 2018 were selected as the study subjects. According to the severity of the disease, the patients were divided into mild group (34 cases), moderate group (26 cases) and severe group (20 cases). Eighty healthy people in the same period were selected as control group, and the serum levels of CXCL-13, IL-1β and IL-6 were detected and compared. Spearman correlation analysis was used to analyze the relation between CXCL-13, IL-1β, IL-6 and ALT, AST, HBV-DNA.@*Results@#The levels of ALT, AST, serum CXCL-13, IL-1β and IL-6 in patients with CHB were significantly higher than those in control group (P=0.000 for all comparisons); the levels of ALT, AST, HBV DNA and serum CXCL-13, IL-1β and IL-6 in patients with CHB were significantly higher than those in control group (P=0.000 for all the comparisons). Serum CXCL-13, IL-1β, IL-6 were positively correlated with ALT and AST (P=0.000, P=0.006, P=0.003, P=0.000, P=0.000, P=0.001), CXCL-13 level was positively correlated with HBV DNA (P=0.014), IL-1β and IL-6 were not correlated with HBV DNA. There were positive correlations among CXCL-13, IL-1β and IL-6 (P=0.012, P=0.019, P=0.008).@*Conclusions@#Serum CXCL-13 and IL-1β, IL-6 were closely related to the degree of liver function damage and disease progression in CHB patients. The level of CXCL-13 is positively correlated with the amount of hepatitis B virus. Therefore, close monitoring of serum CXCL-13, IL-1β and IL-6 in CHB patients is of clinical reference value for judging the patient′s condition.
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Objective To investigate the expression of gastric and intestinal phenotypic markers in Siewert typeⅡand Ⅲ early gastroesophageal junction(GEJ) cancer, and to explore its correlation with clinic-pathological features.Methods From April 2010 to July 2015, 53 cases diagnosed as early GEJ cancer were enrolled.The gastric and intestinal phenotypic markers such as mucin5AC(MUC5AC),mucin6(MUC6),mucin2(MUC2),caudal related homeodomain transcription 2(CDX2) and cluster of differentiation 10(CD10) were detected, and then the patients were divided into gastric type, gastrointestinal type, intestinal type and non-classified type according to the results of immunohistochemical staining.Combined with Siewert classification the clinicopathological features were analyzed.Chi square test or Fisher′s exact test was performed for statistical analysis.Results In the cancer tissues of 47 patients with Siewert type Ⅱand Ⅲ early GEJ cancer, the case numbers of positive expression of MUC5AC,MUC6,MUC2, CDX2 and CD10 were 21(44.7%),19(40.4%),31(66.0%),27(57.4%) and 17(36.2%),respectively;the case numbers of gastric type, gastrointestinal type, intestinal type and non-classified type were 11(23.4%),14(29.8%),21(44.7%) and one(2.1%), respectively.The positive expression rates of MUC5AC and MUC6 in Siewert typeⅡwere 55.9%(19/34) and 50.0%(17/34),which were higher than those of Siewert typeⅢ(2/13), and the positive expression rate of MUC2 was 55.9%(19/34), which was lower than that of Siewert typeⅢ(12/13), and the differences were statistically significant (x2=6.240,4.679 and 4.053;all P<0.05).In Siewert typeⅡ, the proportion of intestinal type was 32.4%(11/34), which was lower than that of Siewert typeⅢ(10/13), and the differences were statistically significant (x2=7.142,P=0.010).In patients with Siewert typeⅡand Ⅲ early cancer, males predominated in intestinal type which were mostly well differentiated type with less submucosal carcinoma.The maximum diameter of tumor was less than those of gastric type and gastrointestinal type.In paracancerous mucosal tissues, the incidences of intestinal metaplasia in gastrointestinal type and intestinal type were 11/14 and 81.0%(17/21), which were higher than that of gastric type (3/11);the incidences of atrophy in gastrointestinal type and intestinal type were 12/14 and 85.7%(18/21),which were higher than that of gastric type (4/11),and the differences were statistically significant (Fisher′s exact test,all P<0.05).Conclusions Siewert typeⅡand Ⅲ early GEJ cancer can directly originated not only from gastric mucosa, but also from gastrointestinal and intestinal mucosa.Atrophy and intestinal metaplasia could exist before cancer genesis.
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Objective To explore the inhibitor of growth family member 4 (ING4) and hypoxia inducible factor-1α(HIF-1α)expression in colorectal cancer and the prognostic significance. Methods Immunohistochemistry was used to detect the ING4 and HIF-1α expression in 133 cases of colorectal cancer tissues and 76 cases of normal rectal tissues. Survival analysis was performed on the following data. Results ING4 in colorectal cancer tissues with positive rate (53.4%) was significantly lower than normal rectal tissue (85.5%) and the difference was statistically significant (P < 0.01); HIF-1α in colorectal cancer tissues with positive rate (69.9%) is higher than normal rectal tissue (42.1%), and the difference was statistically significant (P < 0.01); ING4 and HIF-1αexpression was related with tumor differentiation, Dukes stage and lymph node metastasis (P < 0.05); colorectal cancer tissues ING4 and HIF-1α expression was negatively correlated (r = -0.317, P < 0.001); By multivariate analysis, tumor differentiation, Dukes stage, lymph node metastasis, ING4 expression of HIF-1α expression has independent prognostic significance. Conclusion ING4 and HIF-1α may be involved in the occurrence and development of colorectal cancer , and combined detection could help determine the prognosis of colorectal cancer.