Single-center study of different treatment for advanced or unresectable angiosarcoma patients / 中华肿瘤杂志

Objective: To evaluate the efficacy and safety of different medical treatment in advanced or unresectable angiosarcoma. Methods: This study was a single-center retrospective clinical study. Fifty-five advanced or unresectable angiosarcoma patients treated in Sun-Yat Sen University Cancer Center from January 2005 to August 2020 were enrolled. There were 34 patients who received first-line doxorubicin-based chemotherapy (doxorubicin group), 12 patients received first-line doxorubicin or liposome doxorubicin plus paclitaxel or albumin bound paclitaxel chemotherapy (combination therapy group), and 4 patients received first-line paclitaxel-based treatment (paclitaxel group). There were 6 patients who received anti-angiogenesis targeted therapy, another 2 patients received anti-PD-1 antibody plus anti-angiogenesis targeted therapy. Targeted therapy and immunotherapy plus targeted therapy included 5 cases of first-line therapy and 3 cases of second-line therapy. The therapeutic effect was evaluated by RECIST 1.1 standard. The adverse reactions were evaluated by CTCAE4.0 standard. Kaplan-Meier survival analysis was evaluated with Log rank test. Cox proportional hazard model was used to analyze the influencing factors. Results: There were 18 patients achieved partial response (PR) in 34 patients in the doxorubicin group, median progression-free survival (mPFS) was 4.5 months, and median overall survival (mOS) was 15 months. Four patients achieved PR in 12 patients in the combination therapy group, mPFS and mOS were 4 months and 19 months. Two patients achieved PR in 4 patients in the paclitaxel group, mPFS and mOS were 3 months and 9 months. However, only 1 in 6 patients achieved PR for anti-angiogenesis targeted therapy, mPFS and mOS were 3 months and 16 months. Two patients who received anti-PD-1 immunotherapy combined with anti-angiogenesis targeted therapy acquired PR for 17 months and more than 16 months. Median PFS (7.5 months) were longer in those with primary liver, lung and spleen angiosarcoma than in those with other primary site (3.0 months, P=0.028). The mOS (20 months) was longer in females than that in males (12 months, P=0.045). Primary tumor site, sex, age and treatment were not independent prognostic factors for angiosarcoma patients (P>0.05). Grade 3-4 cardiac toxicity was found in 2 patients in the combination therapy group. Conclusions: Doxorubicin-based and paclitaxel-based chemotherapy are the most important treatment for advanced angiosarcoma. Potential efficacy for targeted therapy combined with anti-PD-1 immunotherapy are showed in some patients with long duration of response and moderate adverse event.

Progress in diagnosis and treatment of gastroparesis after colon cancer surgery / 中华胃肠外科杂志

At present, comprehensive treatment dominated by surgical procedures is an important measure for colon cancer to obtain the chance of cure. Surgical intervention, while removing the tumor, carries the risk of postoperative gastroparesis (PG) . Because of the low incidence rate and insignificant early clinical symptoms, early stage PG is often overlooked clinically. However, PG can increase the risk of malnutrition, delay postoperative antitumor treatment, and increase the risk of tumor recurrence and metastasis. This review focuses on the mechanisms, clinical risk factors, preventive measures, and advances in treatment of PG due to colon cancer. Aim to increase the clinician's adequate attention to PG in colon cancer and from a surgical point to reduce the risk of gastroparesis in colon cancer by optimizing the surgical strategy.

Prognostic factors affecting the success of conversion chemotherapy in patients with unresectable liver metastases from initially colorectal cancer / 中华胃肠外科杂志

Objective: To investigate the factors affecting the success of conversion therapy in patients with initially unresectable colorectal cancer liver metastases (CRLM) in order to provide evidence-based medical evidence for formulating individualized treatment strategies for patients. Methods: A retrospective case-control study was used in this study. Clinical data of 232 patients with initially unresectable CRLM receiving first-line systemic treatment in Sun Yat-sen University Cancer Center from January 2013 to January 2020 were collected, including 98 patients of successful conversion and 134 patients of failed conversion as control. Conversion therapy scheme: 38 patients received FOLFOXIRI regimen chemotherapy (irinotecan, oxaliplatin, calcium folinate and fluorouracil), 152 patients received FOLFOX regimen (oxaliplatin, calcium folinate and fluorouracil), 19 patients received FOLRIRI regimen (irinotecan, calcium folinate and fluorouracil), 23 patients received systemic chemotherapy combined with fluorouridine hepatic artery infusion chemotherapy; 168 patients received targeted therapy, including 68 of bevacizumab and 100 of cetuximab. Logistics analysis was used to compare the factors affecting the success of conversion therapy. The Kaplan-Meier method was used to calculate progression-free survival (PFS), and the Log-rank test was used for survival comparison. Results: Among 232 patients, 98 patients had successful conversions and 134 patients had failed conversions with a successful conversion rate of 42.2%, meanwhile 30 patients underwent simple hepatectomy and 68 underwent hepatectomy combined with intraoperative radiofrequency ablation. After first-line chemotherapy, 111 patients (47.8%) were partial remission, 57 patients (24.6%) were stable disease, and 64 patients (27.6%) were progression disease. During the median follow-up of 18.8 (1.0-87.9) months, 148 patients were dead or with tumor progression. The median PFS time of patients with successful conversion was longer than that of patients with failed conversion (31.0 months vs. 9.9 months, P<0.001). Univariate analysis found that the bilobar distribution of liver tumors (P=0.003), elevated baseline carcinoembryonic antigen (CEA) levels (P=0.024), tumor invasion of the portal vein (P=0.001), number of metastatic tumor>8 (P<0.001), non-FOLFOXIRI (P=0.005), and no targeted therapy (P=0.038) were high risk factors for the failed conversion therapy. The results of multivariate logistics analysis indicated that the number of metastatic tumor >8 (OR=2.422, 95%CI: 1.291-4.544, P=0.006), portal vein invasion (OR=2.727, 95%CI: 1.237-4.170, P=0.008) were the independent risk factors for failed conversion therapy, while FOLFOXIRI regimen (OR=0.300, 95%CI: 0.135-0.666, P=0.003) and targeted drugs (OR=0.411, 95%CI: 0.209-0.809, P=0.010) were independent protective factors for successful conversion therapy. Conclusions: The number of metastatic tumor and portal vein invasion are key factors that affect the outcomes of conversion therapy for initially unresectable CRLM. If a patient can tolerate chemotherapy, a combination program of three-drug and targeted therapy is preferred for the active conversion therapy.

Advances and challenges in neoadjuvant treatment for colorectal cancer liver metastasis / 中华胃肠外科杂志

Liver metastasis is the leading cause of death in patients with colorectal cancer. Since surgical resection alone has a high postoperative recurrence rate, neoadjuvant therapy as an important means is widely applied in order to reduce recurrence and improve survival. Progress has been achieved in many aspects of neoadjuvant therapy in colorectal cancer liver metastasis, such as eligible patients selection, optimal regimens and courses of chemotherapy. However, controversies still remain regarding the standards of resectability of lesions and the application of targeted drugs. Individualized treatments could be developed based on multidisciplinary teamwork to achieve the goal of 'resources integration and treatment stratification'.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Change of peripheral blood Th17 cells and its signiifcance in patients with different kinds of chronic rhinosinusitis with nasal polyps / 中国耳鼻咽喉头颈外科

OBJECTIVETo observe the change of peripheral blood Th17 cells in patients with different kinds of CRSwNPs and the relationship between the frequency of Th17 cells and inflammatory cell density in nasal polyps tissue, and to explore the correlation between levels of peripheral blood Th17 cells and prognosis of patients with CRSwNPs.METHODSEighty one patients with CRSwNPs and 20 controls were recruited in this research. Flow cytometer was used to detect the expression of peripheral blood Th17 cells. The number per 10000μm2 of infiltrated inflammatory cells in nasal polyp tissue (including eosinophils, neutrophils, lymphocytes and plasma cells) was counted at a high-power field. The CT scores were evaluated by Lund-Mackay system and the nasal endoscopy scores were graded according to Lund-Mackay methods. RESULTSThe percentages of Th17 cells in patients with E-CRSwNPs and NE-CRSwNPs were 2.10% (3.75%, 1.40%)和1.10% (1.70%, 0.73%). There was significant difference between the two groups (Mann-WhitneyU=358.0,Z=-2.965, P=0.001). Furthermore, a positive association between the percentage of Th17 cells in peripheral blood and the eosinophil density of nasal polyp (r=0.408,P<0.001) was demonstrated. The percentage of Th17 cell in peripheral blood was significantly correlated with the endoscopic score of CRSwNPs at third month after the operation (r=0.458, P<0.001).CONCLUSIONThl7 might be involved in the pathogenesis and prognosisof eosinophilic CRSwNPs.

The recurrent rate of nasal endoscopic microsurgical skills for the treatment of nasal inverted papilloma: a meta-analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the recurrence rate of nasal inverted papilloma treating by endoscopic and non-endoscopic approach.@*METHOD@#A search on Pubmed, Medline, Springer and Elsevier databases was done to collect the reports (2001-2013) concerning different surgery treating nasal inverted papillomas, and meta-analysis was performed with RevMan 5.0 software.@*RESULT@#Twelve papers (2001-2013) concerning the different surgery approach treating nasal inverted papillomas were retrieved. The heterogeneity test indicated that the 12 studies were consistent statistically (Q = 14.64, df = 11, P = 0.20), the data from these 12 studies could be analyzed by fixed effect model. After combination of these data, those of 1012 subjects accepted endoscopic surgical intervention and 359 subjects treating by non-endoscopic surgical intervention were collected. Test of overall effect by fixed effect model showed that the recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group (OR = 0.49, 95% CI was 0.35-0.69, P < 0.01). Funnel plot implied that publication bias was not obvious.@*CONCLUSION@#The recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group.

Surgery with versus without preoperative concurrent chemoradiotherapy for mid/low rectal cancer: an interim analysis of a prospective, randomized trial / 癌症

<p><b>INTRODUCTION</b>Multimodality therapy, including preoperative chemoradiotherapy (CRT) and total mesorectal excision (TME), has effectively reduced local recurrence rates of rectal cancer over the past decade. However, the benefits and risks of the addition of neoadjuvant CRT to surgery need to be evaluated. This study was to compare the efficacy of TME with versus without preoperative concurrent chemoradiotherapy (CCRT) involving XELOX regimen (oxaliplatin plus capecitabine) in Chinese patients with stages II and III mid/low rectal adenocarcinoma.</p><p><b>METHODS</b>We randomly assigned patients to the TME group (TME without preoperative CCRT) or CCRT + TME group (TME with preoperative CCRT). The primary endpoint was disease-free survival (DFS); the secondary endpoints were overall survival (OS), local and distant recurrence, tumor response to CRT, toxicity, sphincter preservation, and surgical complications. An interim analysis of the potential inferiority of DFS in the CCRT + TME group was planned when the first 180 patients had been followed up for at least 6 months.</p><p><b>RESULTS</b>A total of 94 patients in the TME group and 90 patients in the CCRT + TME group were able to be evaluated. The 3-year DFS and OS rates were 86.3 % and 91.5 % in the whole cohort, respectively. The 3-year DFS rates of the TME and CCRT + TME groups were 85.7% and 87.9 % (P = 0.766), respectively, and the 3-year OS rates were 90.7 % and 92.3 % (P = 0.855), respectively. The functional sphincter preservation rates of the TME and CCRT + TME groups were 71.3 % and 70.0 % (P = 0.849), respectively. In the TME group, 16 (17.0 %) patients were proven to have pTNM stage I disease after surgery. In the CCRT + TME group, 32 (35.6 %) patients achieved a pathologic complete response (pCR).</p><p><b>CONCLUSIONS</b>Preliminary results indicated no significant differences in the DFS, OS, or functional sphincter preservation rates between the TME and CCRT + TME groups. However, preoperative CCRT with XELOX yielded a high pCR rate. Newer techniques are needed to improve the staging accuracy, and further investigation is warranted.</p><p><b>CLINICAL TRIAL REGISTRATION NUMBER</b>Chi CTR-TRC-08000122.</p>

New prospective on adjuvant treatment for gastrointestinal stromal tumors / 中华胃肠外科杂志

Gastrointestinal stromal tumor (GIST) represents the most common mesenchymal tumor of the gastrointestinal tract. With decades of development, surgical excision combined with molecular targeted agents is becoming the mode for the GIST treatment. Imatinib mesylate (IM) is the first-line therapy medicine for GIST adjuvant treatment, and it significantly reduces recurrence or metastasis and increases survival. According to the recently results of SSGXVIII/AIO study, imatinib adjuvant therapy should be administered for at least 3 years for the GIST patients with a high estimated risk of recurrence and metastasis after surgery. Nevertheless, the optimal duration of the adjuvant therapy or the follow-up policy remains unclear, and we look forward to standard assessment criteria for individualized treatment.

Study on associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors after complete resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors (GIST) after complete resection.</p><p><b>METHODS</b>Tumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry (IHC). The association of above factors expressions with recurrence, metastasis and prognosis was examined.</p><p><b>RESULTS</b>Log-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection (all P<0.05), and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival (all P<0.05). Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53 (all P<0.05), and the overall survival was only associated with Ki-67 (P<0.05).</p><p><b>CONCLUSION</b>Ki-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.</p>

Expression of molecular markers detected by immunohistochemistry and risk of lymph node metastasis in stage T1 and T2 colorecrectal cancers / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the molecular risk factors of lymph node metastasis in stage T1 and T2 colorectal cancers by tissue microarray and immunohistochemistry techniques.</p><p><b>METHODS</b>Two hundred and three patients with stage T1 and T2 colorectal carcinoma who underwent radical surgery from 1999 to 2010 in our department were included in this study. Their clinicopathological data were retrospectively analyzed. Expression of the following 14 molecular markers were selected and assayed by tissue microarray and immunohistochemistry: VEGFR-3, HER2, CD44v6, CXCR4, TIMP-1, EGFR, IGF-1R, IGF-2, IGFBP-1, ECAD, MMP-9, RKIP, CD133, MSI. Chi-squared test and logistic regression were used to evaluate the variables as potential risk factors for lymph node metastasis.</p><p><b>RESULTS</b>The positive expression rates of biomarkers were as following: VEGFR-3 (44.3%), EGFR (30.5%), HER-2 (28.1%), IGF-1R (63.5%), IGF-2 (44.8%), IGFBP-1 (70.9%), ECAD (45.8%), CD44v6 (51.2%), MMP-9 (44.3%), TIMP-1 (41.4%), RKIP (45.3%), CXCR4 (40.9%), and CD133 (49.8%). The positive rate of MSI expression was 22.2%. Both univariate and multivariate analyses showed that VEGFR-3, HER-2, and TIMP-1 were significant predictors of lymph node metastasis. Univariate analysis showed that CD44v6 and CXCR4 were significant significant predictors of lymph node metastasis.</p><p><b>CONCLUSIONS</b>VEGFR-3, HER2 and TIMP-1 are independent factors for lymph node metastasis in stage T1 and T2 colorectal cancers.</p>

Disputes about surgical treatment of colorectal liver metastasis / 中华胃肠外科杂志

As the most common metastasis in colorectal cancer, liver metastasis is the primary cause of treatment failure. Resection plays a dominant role in multidisciplinary treatment of colorectal liver metastases. However, this surgical field is still filled with disputes and challenges. Literature on liver metastasis of colorectal cancer were reviewed and clinical trials were collected. Different opinions were analyzed according to clinical evidence and personal experience. There are many disputes about surgical treatment of colorectal liver metastases, including incomplete staging system, inconsistent criteria of potential resectability, neoadjuvant chemotherapy for resectable liver metastases, adjuvant chemotherapy regimen after radical resection, and treatment of asymptomatic primary lesion in patients with unresectable liver metastasis.

Compliance and associated factors of postoperative chemotherapy for elderly patients with colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the compliance and associated factors of postoperative chemotherapy for elderly patients with colorectal cancer.</p><p><b>METHODS</b>A total of 386 elderly patients (>70 years old) with stage II(-IIII( colorectal cancer underwent surgery between January 2000 and January 2010. The clinicopathological data were retrospectively reviewed. There were 226 patients received postoperative chemotherapy and 160(41.4%) refused. Logistic regression model was used to analyze factors associated with patients compliance to chemotherapy. Patients were followed up by phone call regarding the reason for refusal.</p><p><b>RESULTS</b>Multivariate analysis showed that gender, body mass index (BMI), body surface area (BSA), age, and complication were independent risk factors associated with chemotherapy compliance(All P<0.05). Follow-up phone questionnaire showed that 63.8%(51/80) of patients with stage II( cancer did not received chemotherapy because of the doctor's uncertainty of chemotherapy benefit. For stage III( patients, fear of chemotherapy (31.2%, 15/48), feeling uncomfortable (18.8%, 9/48), and financial issues(18.8%, 9/48) were the main factors. The desperate feeling was the predominant reason for stage IIII( patients(56.2%, 18/32).</p><p><b>CONCLUSIONS</b>Gender, BSA, age, and postoperative complication are the main factors associated with compliance to postoperative chemotherapy. Doctors' recommendation should be emphasized for stage II( patients. For stage III( patients, treatment recommendation should be enthusiastic.</p>

A multivariate analysis of prognostic determinants for stages II and III colorectal cancer in 141 patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous prognosis analyses of colorectal cancer (CRC) patients with stage II and III disease were done as separate categories. The purpose of this study was to analyze prognostic factors associated with survival in a group of patients who underwent radical resection of stages II and III CRC.</p><p><b>METHODS</b>A retrospective review was performed for 141 consecutive stages II and III patients who had undergone radical resection of colorectal adenocarcinoma between May 2003 and November 2003. Univariate and multivariate analyses were performed to assess the effect of record variables on disease free survival and overall survival.</p><p><b>RESULTS</b>The median follow-up time was 59 months, and the 3- and 5-year survival rates were 76% and 68%, respectively. Four factors were independently associated with a worse disease-free survival: diabetes (hazard ratio (HR) 2.338; 95% confidence interval (CI) 1.011 - 5.407), expression of cyclooxygenase-2 (Cox-2) (HR 0.335; 95%CI 0.126 - 0.888), expression of matrix metalloproteinases 2 (MMP-2) (HR 0.233; 95%CI 0.101 - 0.541), expression of vascular endothelial growth factor (VEGF) (HR 0.295; 95%CI 0.088 - 0.996). Four factors were independently associated with a worse overall survival: lymph nodes metastasis (HR 1.67; 95%CI 1.29 - 2.14), Cox-2 positive (HR 0.056; 95%CI 0.247 - 0.731), MMP-2 positive (HR 0.398; 95%CI 0.190 - 0.836), VEGF (HR 0.364; 95%CI 0.090 - 0.716).</p><p><b>CONCLUSIONS</b>Diabetes, expression of Cox-2, MMP-2 and VEGF were independently associated with a worse disease- free survival. Lymph nodes metastasis, expression of Cox-2, MMP-2 and high level of VEGF predicted a poor overall survival.</p>

Surgical treatment and prognosis of gastrointestinal stromal tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the outcome of surgical treatment for gastrointestinal stromal tumor(GIST) and the associated factors.</p><p><b>METHODS</b>A total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University. The clinical data were retrospectively reviewed and the pathological examination was reviewed. Follow-up was performed.</p><p><b>RESULTS</b>There were 176 males and 101 females. The age ranged from 20 to 81 years old (median,57). Location of the tumor included colorectum (n=28),small bowel(n=76), stomach(n=173). All the patients had en bloc resection, including local excision in 98 patients, organ resection in 64, and extended resection in 115. The 5-year survival rates were 83.5%, 71.9%, and 61.9% in the three different procedures, respectively, and the difference was not statistically significant(P>0.05). Cox model showed that the tumor size, recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients(P<0.05).</p><p><b>CONCLUSIONS</b>Surgery remains the major approach for gastrointestinal GIST. Complete resection is the principal treatment. Extensive resection or extended lymph nodes dissection is not associated with improved survival.</p>

Correlation analysis between loss of heterozygosity at chromosome 18q and prognosis in the stage-II colon cancer patients / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Colorectal cancer is one of the most common malignant cancers in the world. Although the clinicopathologic staging is the golden criterion for the prognosis at present, the optimum prognostic criteria for colorectal cancer should be a combination of the clinicopathologic staging and the molecular markers. However, there are currently no molecular markers available for the prognosis of colorectal cancer. Several tumor-suppressor genes associated with colorectal cancer have been mapped at the 18q21-23 region. In this study we detected the frequency of loss of heterozygosity (LOH) at chromosome 18q and investigated the relationship between LOH and clinicopathologic features and its prognostic value for patients with stage II colon cancer.</p><p><b>METHODS</b>A total of 106 samples of tumor tissues and corresponding normal mucosa from patients with sporadic stage-II colon cancer were included in this study. All the samples were formalin-fixed and paraffin-embedded. DNA was extracted from tumor tissues and LOH of D18S474, D18S55, D18S58, D18S61 and D18S64 at chromosome 18q was analyzed using polymerase chain reaction (PCR), polyacrylamide gel-electrophoresis, and DNA sequencing method. Multivariate analysis for association between LOH and prognosis in colon cancer patients was performed with Cox proportional hazards regression model.</p><p><b>RESULTS</b>The median follow-up time was 68 months. For 106 patients, 5-year survival rate was 83.6%, which was associated with age and gross tumor type (P = 0.011 and 0.034, respectively). Among 102 patients who were eligible for LOH information, the overall frequency of LOH is 49.0% (50/102), and that of LOH at 5 microsatellite loci of D18S474, D18S55, D18S58, D18S61, and D18S64 was 30.2% (26/86), 23.4% (18/77), 28.6% (20/70), 35.0% (28/80), and 20.8%(15/72), respectively. The occurrence of LOH was significantly associated with tumor location and histopathologic grade (P = 0.023, 0.016 and 0.005, respectively). LOH was more frequent on the left-side, poorly-differentiated adenocarcinoma, and nonmucinous colon cancers. The occurrence of 18q-LOH was significantly associated with 5-year overall survival rate and disease free survival rate (P = 0.008 and 0.006, respectively). The occurrence of 18q-LOH at the loci of D18S474 and D18S61 was significantly associated with 5-year overall survival rate (P = 0.010 and 0.005, respectively). The multivariate analysis showed that only the occurrence of 18q-LOH was significantly associated with prognosis (P = 0.021).</p><p><b>CONCLUSIONS</b>There is a high occurrence of LOH at the loci of 18q. The expression of LOH is significantly associated with tumor location and histopathologic grade. The occurrence of 18q-LOH is an independent poor prognostic factor for the patients with stage-II colon cancer.</p>

Surgical treatment for 140 patients with gastric stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To analyze the outcome of the patients with gastric gastrointestinal stromal tumor(GIST) after surgical treatment and identify the associated risk factors.</p><p><b>METHODS</b>Clinical data and the tissue slices including immunohistochemistry staining of 140 patients with gastric GIST from January 1990 to December 2008 were retrospectively reviewed. SPSS 16.0 for Windows software package was used for statistical analysis.</p><p><b>RESULTS</b>The overall survival rates of 1-, 3-, 5-year were 96.8%, 86.7% and 79.3%, respectively. The survival rates of 1-, 3-, 5-year were 98.1%, 90.0% and 85.4% in patients who underwent complete tumor resection. But the survival rates of 1-, 3-, 5-year were 38.1%, 0 and 0 in patients with incomplete tumor resection. The differences were statistically significant (P<0.05). Gender, preoperative metastasis, tumor size,pathology type,karyokinesis, recurrence and metastasis were associated with survival rates in patients with complete tumor resection by univariate analysis. However, only tumor size, karyokinesis, recurrence and metastasis were associated with survival rates by Cox regression multivariable analysis(P<0.05).</p><p><b>CONCLUSION</b>Surgery remains the main treatment for gastric GIST. Local complete resection is the principal treatment.</p>

Efficacy and prognostic analysis on surgical resection of pulmonary metastasis from colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the efficacy and probable prognostic factors of surgical resection of pulmonary metastasis from colorectal cancer.</p><p><b>METHODS</b>Clinical data and outcomes of 35 colorectal patients with pulmonary metastasis undergone pulmonary metastasectomy were analyzed retrospectively.</p><p><b>RESULTS</b>Median follow-up time was 48.0 months. The median overall survival time was 36.0 months. Five-year survival rate was 33.0%. Nineteen patients died of tumor progression. Sixteen patients were survival including survival with tumor (10 cases) and without tumor (6 cases). One patient was still alive without tumor for 164 months. Univariate analysis revealed that disease free interval (DFI) was a prognostic risk factor, while gender, age, primary tumor site, pulmonary metastasis size and location, surgical procedure, pre-surgical CEA level, re-metastasectomy did not show influence on the survival time after pulmonary metastasectomy.</p><p><b>CONCLUSIONS</b>For some selected patients with indication, pulmonary metastasectomy may be a potential curative method. DFI may be associated with the prognosis after pulmonary metastasectomy.</p>

Comparing of different methods on habitat adaptive division of Chinese material medica / 中国中药杂志

<p><b>OBJECTIVE</b>To comparing two kinds habitat adaptive division of Chinese material medica with different models.</p><p><b>METHOD</b>The habitat adaptive divisions of A. lancea according essential oil accumulation with two kinds pattern, model pattern and template pattern were carrid and compared.</p><p><b>RESULT</b>Two habitat adaptive divisions of A. lancea maps according essential oil accumulation were gotten.</p><p><b>CONCLUSION</b>Both model pattern and template pattern were efficient on habitat adaptive division of Chinese material medica, but they shoud bu used with different processesd and based different background [corrected]</p>