ABSTRACT
Objective To analyze the clinicopathological characteristics and the related factors influencing the prognosis of rectal neuroendocrine neoplasms.Methods The clinical and follow-up data of 442 patients with rectal neuroendocrine neoplasms admitted between Sep 1993 and Dec 2015 in 5 hospitals in southern China were analyzed retrospectively.The univariate and multivariate analysis of survival prognosis were analyzed statistically.Results Of the 442 patients,the median age was 50 years and 64.7％ were males.The average tumor size was (1.4 ± 0.7) cm.NENs ＜ 1 cm accounted for 66.1％ cases,1-2 cm accounted for 17.2％ and ＞2 cm accounted for 16.7％ of the tumors.Stage Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 73.5％,8.6％,7.2％,10.6％ of the tumors;G1,G2,G3 accounted for 76.5％,14.7％,8.8％ of the tumors;The median survival time for all 442 patients was 35 months (range,1-224 months).The overall 5-year survival rate was 85％.The 5-year survival rates for patients in stage Ⅰ-Ⅳ were 95％,94％,52％,36％ respectively.The 5-year survival rates for patients with G1-3 were 94％,80％,19％respectively.Univariate analysis showed that G grade,T stage,N stage,M stage,TNM stage,functional,gender,medication,surgical therapy,age,tumor sizes were statistically significant (all P ＜ 0.05).Multivariate analysis revealed that G grade (P =0.001),tumor sizes (P =0.012) and TNM stage (P =0.008) were the independent factors affecting the prognosis.Conclusion Patients with rectal neuroendocrine neoplasms have no specific clinical characteristics.G grade,tumor sizes and TNM stage were the independent factors affecting the prognosis.
ABSTRACT
Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the safety and feasibility of simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis.</p><p><b>METHODS</b>Clinical data of 11 patients undergoing simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis in our hospital from January 2011 to October 2013 were reviewed retrospectively. Feasibility, safety and efficacy of this procedure were investigated.</p><p><b>RESULTS</b>Procedure was completely successful in all the cases without conversion. The mean operation time was (284.6 ± 28.8) min and the mean blood loss was (322.7 ± 75.4) ml. The mean time to intestinal function recovery was (2.9 ± 0.7) d and the mean hospital stay was (12.3 ± 1.9) d. There were no anastomosis leakage, bile leakage, abdominal massive bleeding or infection, and liver failure after operation. During follow-up of 3-35 months, only one patient died of tumor progression.</p><p><b>CONCLUSION</b>Laparoscopic approach for colorectal carcinoma and synchronous liver metastasis is safe and feasible in selected patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Colectomy , Methods , Colorectal Neoplasms , Pathology , General Surgery , Hepatectomy , Laparoscopy , Methods , Liver Neoplasms , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To investigate the expression of multidrug resistance protein such as multidrug resistance-associated protein 1 (MRP1),lung-resistance related protein (LRP), P-glycoprotein (Pgp),glutathione s-transferase (GST-π) and topoismerase Ⅱ (TOPO Ⅱ ) in hepatocellular carcinoma (HCC), which would be supplied for the clinical chemotherapy of HCC. Methods Twenty-six cases of HCC who underwent hepatectomy were enrolled and immunohistochemical (IHC) staining was carried out on all specimens for the detection of expression of MRP1,LRP,Pgp,GST-πand TOPO Ⅱ and the data was analyzed by image analysis system. Results The expression of five multidrug resistance protein in HCC tissue were significantly higher than those in adjacent tissue beyond cancer (P ＜0.05). The significant differences were found in the expression of Pgp,TOPO Ⅱ and GST-π between HCC tissue and distant metastasis (P ＜ 0.05 ). The expression of the five multidrug resistance protein in poorly differentiated HCC tissue was higher than that in well-differentiated tissue,while the significant difference was only found in the expression of TOPO Ⅱ (P ＜ 0.05 ). The significant association was not found between the expressions of five multidrug resistance protein in HCC tissue and the size of tumor,AFP, the portal vein tumor thrombus,hepatic cirrhosis and liver function. Conclusions Five multidrug resistance protein overexpression in various degrees in HCC tissue, which relates to some biological behavior of the cancer. Combined detection is of much benefit to the choice of the drug of chemotherapy and to the prediction of prognosis.
ABSTRACT
ObjectiveTo investigate the effectiveness of combined oxaliplatin regimen as adjuvant chemotherapy for hepatocellular carcinoma and to evaluate the efficacy of using adenosine triphosphate tumor chemosensitivity assay (ATP-TCA) for direction of individual chemotherapy.MethodsThe twenty-six patients with primary hepatocellular carcinoma were operated.Specimens were collected and adenosine triphosphate tumor chemosensitivity assay (ATP-TCA) was applied to evaluate the sensitiveness of chemotherapy agent(Adriamycin, Mitomycin, Mitoxantrone, Oxaliplatin, Irinotecan, 5-FU, Gemzar, Carboplatin, Cisplatin, Docetaxel and Etoposide).Sensitive group (SG) was from from 11 patients who were sensitive to oxaliplatin, and control group was from the other 16 patients who were not sensitive to oxaliplatin.All the twenty-six patients received oxaliplatin combined with 5-FU or capecitabine regimen chemotherapy.The effectiveness (CR,PR,SD,PD,ORR,OS and DFS) of the regimen according to RECIST criteria and WHO criteria for anticancer drugs toxicity and efficacy of ATP-TCA were evaluated.ResultsTwenty-six patients were successfully evaluated.In SG, six patients obtained complete remission(CR), three got partial remission(PR), one got stable disease (SD) and one patient got progression disease (PD).While in control group,four patients obtained CR,two patients got PR, five patients got SD and four got PD.No significant differences were found in overall survival (OS, P = 0.1116) and disease-free survival (DFS, P = 0.2328)between sensitive group and control group.But significant differences were found in overall response rate (ORR) (81.8％ vs 40.0％, P =0.0401) between two groups.Common toxicities were as follows:I to Ⅱdegree of myelosuppression was 53.8％, I to Ⅱ degree of gastrointestinal tract response was 50％, I to Ⅱ degree of liver function damage was 57.7％ and I to Ⅱ degree of neuropathy was 23.1％, respectively.Most of these toxicities were tolerable at grade 1 ～ 2.No significant differences were found in the toxicities between two groups.ConclusionsCombined oxaliplatin regimen might be an effective choice for adjuvant chemotherapy for HCC, which has with tolerable systemic toxicity.Application of ATP-TCA system might further improve the efficacy of this regimen by selecting right candidate.
ABSTRACT
Objective To investigate the feasibility and safety of autologous tumor tissue lysate loading den-dritic cells(DC) for the treatment of hepatocellular carcinoma (HCC). Methods The monocytes-derived DC were induced and antigen loaded with tumor tissue lysate to produce DC vaccine. Vaccination and clinical observation were conducted in 12 HCC patients for 41 times. Results The average output of DC was 1.69×107(1.69×107±9.44×106>) from 90 ml peripheral blood. 63.41% (26/41)patients appeared to develop delayed-type hypersensitivity after intradermal injection. After an average of 9 months follow up, 1 patient out of 4 recurrence and metastasis pa- tients survived for 17 months. The other three patients progressed. Out of 8 patients undergoing immunotherapy post- operatively,6 patients had no signs of recurrence and the others were found to have liver rceurrence and progression. Conclusion DC based immunotherapy is safe and feasible,with no side effects,which can be applied in the immu- notherapy strategy of HCC patients.
ABSTRACT
Objective To observe the effectiveness of dexamethasone combined with azasetron for the prevention of postoperative nausea and vomiting(PONV) in patients after laparoscopic cholecystectomy(LC).Methods A total of 150 ASA(Ⅰ~Ⅱ) patients undergoing an elective LC were randomly divided into three groups with 50 patients in each group: Group D+A was given intravenous dexamethasone 5mg and azasetron 10mg(2ml) at the end of surgery,Group A received intravenous azasetron 10mg(2ml) at the end of surgery,and Group C received normal saline(NS) 2 ml as the control.Episodes of nausea and vomiting were recorded for 24 h following the surgery.Results The incidence of nausea was 4% in the Group D+A(2/50),which was significantly lower than in the Group A(16%,8/50) and the Group C(34%,17/50)(?~2=4.00 and 14.62;P=0.046 and 0.000).The incidence of vomiting was 2% in the Group D+A(1/50),which was significantly lower than in the Group A (14%,(7/50)) and the Group C(32%,16/50)(?~2=4.89 and 15.95;P=0.027 and 0.000).The incidences of nausea and vomiting were significantly lower in the Group A than in the Group C(?~2=4.32 and 4.57;P=0.038 and 0.033).Conclusions Use of a low dose of dexamethasone in combination with azasetron is more effective than azasetron prophylaxis alone for a successful control of PONV after LC.
ABSTRACT
To explore the effects of Quyu Xiaoban Capsule (QXC) on blood lipid level and platelet activity in coronary heart disease (CHD).A randomized single blinded trial was adopted in 62 cases of CHD. Thirty one cases (control group) were treated with routine western medicine and the rest (QXC group) with QXC added. Serum levels of total cholesterols (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL C) and platelet-activating ? granule membrane protein (GMP 140) were detected before and after treatment.After ten weeks of treatment, GMP 140, TC and TG levels were decreased to various degrees in QXC group, the differences being significant as compared with those in control group and those in QXC group before treatment (P0 05).[Conclusion]QXC can decrease the blood lipid level and improve platelet activity and has a certain effect in preventing and treating CHD.
ABSTRACT
AIM: The ?-catenin is a key molecule in the Wnt signal pathway, which plays a critical role in normal development and tumorigenesis. However, the mechanisms of the ?-catenin on the cell growth control are still not completely defined. The aim of this study was to test the hypothesis that the mutant ?-catenin may regulate the hepatocyte proliferation. METHODS: The immortalized murine hepatocyte cell line, AML12, was used for this study. A plasmid that contain mutant ?-catenin S33Y was transfected into the AML12 cells and a stable cell line AML12S33Y was established. The cell growth property of this cell line and the parental cell were compared by flow cytometry analysis and direct cell count. The cells were also tested for the ability to form soft agar colonies, and the ability to form tumors in the severe immune deficient mice (SCID). RESULTS: 1. The mutant ?-catenin containing cell line AML12S33Y has higher proliferating index compared with the parental AML12 cells ( P
ABSTRACT
AIM: To investigate the effect of Chinese herbs, Ganxianfang(GXF), on rat hepatic stellate cells (HSC) proliferation and collagen synthesis. METHODS: Two types of herb serum, portal venous serum and circumferential venous serum, were prepared from rats infused intragastrically with 16,8,4 times adult dose of GXF decoction. HSC isolated from rat liver were processed with the above sera in vitro . Then we mensurated the radioactivity of HSC admixed with [ 3H]proline and [ 3H]thymine to judge the effect on proliferation and collagen synthesis of HSC. RESULTS: Both two types of serum collected 0 5, 1, 2 h after intragastrical infusion inhibited HSC proliferation ( P 0 05). CONCLUSION: Inhibition of HSC proliferation and decrease of collagen synthesis may contribute to the GXF antifibrotic action.
ABSTRACT
AIM: To explore the feasibility of direct separat and selective enlargement of the bone marrow-derived liver stem cells (BDLSC) from bone marrow cells with a culture system containing cholestatic serum in vitro . METHODS: Bone marrow cells of rats were cultured with selective media containing 2%, 5%, 7% and 10% cholestatic rat serum, respectively. The BDLSC were then induced to proliferate with the addition of hepatocyte growth factor (HGF) on the firth day. BDLSC were characterized using immunocytochemistry and RT-PCR for lineage markers, glycogen staining and urea synthetic assay for functions 2 weeks later. RESULTS: Bone marrow cells were unble to form colony in the presence of 2% cholestatic serum and apopotosis appeared gradually in 7% or 10% cholestatic serum. The BDLSC survived in the medium containing 5% cholestatic serum while the other types of cells did not. The survival cells proliferated with a high speed during the second week and then formed hepatocyte-like colony-forming units (H-CFU). Cells in the H-CFU expressed the characteristic proteins of fetal hepatocytes. Furthermore, they had glycogen storage and urea synthesis functions, two of the critical features of hepatocytes. CONCLUSION: The selective micro-environment effectively selected BDLSC from the bone marrow cell, and will be a new way to provide an abundant source of donor hepatocytes for clinical cell therapy.
ABSTRACT
AIM: To investigate the biological characteristics of cytokine-induced killer (CIK) cells in vitro METHODS: The non-adhere peripheral blood monoclear cells from healthy donors were induced into CIK cells in the presence of IFN-?, IL-1?, IL-2 and anti-CD3 antibody. LAK (lymphokine activated killer) cells were prepared as a control. The cellular phenotype were detected by FCM and immunocytochemistry and the cytotoxicity was measured by LDH release assay. RESULTS: After 2 weeks of induction, the proliferation rate of CIK cells reached a peak and the proportion of CD3 + population was above 95%, and then the cells growth entered to plateau phase at week 3. The proportion of CD3 +CD56 + NKT subset cells was 16 5% on day 15 and it had no obvious variety between 2 and 4 weeks. Correspondingly, LAK cells grew slowly and had lower proliferation rate compared with the CIK cells ( P
ABSTRACT
AIM: To investigate the expression of adhesion molecules in hepatocellular carcinoma (HCC), and analyze its clinical significance. METHODS: The expression of adhesion molecules of tumor tissues of 64 cases and adjacent tissues of 12 cases of HCC were detected with RT-PCR. RESULTS: ①The expression rates of E-cadherin, ICAM-1 , CD44, CD 44V , ? 5, ? 1 were 90 62%, 93 75%, 50 00%, 96 88%, 100%, 100%, respectively, and there was a significant difference between CD44 and other adhesion molecules. ②The expression level of E-cadherin, ICAM-1, CD44, CD 44V , ? 5,? 1 in liver cancer tissues were 1 24?0 54, 0 96?0 37, 0 62?0 73, 0 86?0 33, 0 97?0 49, 1 41?0 24, respectively, and there was a significant difference between CD44 and E-cadherin, ? 1. ③The expression level of E-cadherin and CD44 mRNA declined as HCC stage become higher, and there was a statistical difference in the expression level of CD44 mRNA between Ⅰ-Ⅱ stage and Ⅳ stage. The expression level of ICAM-1, ? 5, ? 1 had a trend to rise as HCC stage become higher, and there was a statistical difference in the expression level of ICAM-1 between Ⅰ-Ⅱ stage and Ⅳ stage. ④The expression level of ICAM-1,CD 44V , ? 5, ? 1 had positive correlation with tumor volume, tumor nodules, tumor metastasis, and had negative correlation with tumor encapsulation. E-cadherin and CD44 had negative correlation with tumor volume, tumor nodules, tumor metastasis, and had positive correlation with tumor encapsulation. All showed no significant correlation with the level of AFP , the degree of cirrhosis and the function of liver. CONCLUSION: There was a significant difference in the expression level of adhesion molecule mRNA in HCC, and their expression had Spearman correlation with each other. The expression level of adhesion molecule mRNA is associated with tumor volume, tumor nodules and tumor metastasis. [
ABSTRACT
Objective To observe the effect of somatostatin (SST) on the expression of metalloproteinase-2(MMP-2) and tissue inhibitor matrix metalloproteinase-2(TIMP-2) of implanted tumor in nude mice after partial hepatectomy.Method Nude mice were divided into group A(n=10) implanted by human hepatocellular carcinoma(HCC),group B(n=10, partial hepatectomy) and C(n=10,HCC implantation after liver resection). SST(250 ?g/kg,b.i.d) was given intraperitoneally in group C. Mice were sacrificed on 35th d, tumor was measured, the expression of MVD.MMP-2 and TIMP-2 was detected by immunochemical staining and quantitative image computer-analysis. Results In group B, the weight and volume and expression of MVD.MMP-2 of tumor tissue was markedly incressed than in group A(P
ABSTRACT
AIM: To investigate the immune stimulation capacity of B7-H1 blockade on immature dendritic cells (DCs) in vitro. METHODS: The human monocyte-derived dendritic cells were induced in the presence of cytokine GM-CSF and IL-4. The expression of B7-H1 was detected by FCM. On blockade of B7-H1, the maturation and endocytic activity, T cells stimulatory proliferation capacity, IL-12 production, T cell differentiation effect of DCs were detected by FCM, MTT assay, ELISA and ELISPOT, respectively. RESULTS: The expression of B7-H1 was increased with the induction of DCs. On day 7, the positive expression was 54.12%, and the TNF-? induced mature DCs had the positive expression rate of 83.64%. The blockade of B7-H1 on immature DCs had sharply increased their T cells stimulatory proliferation capacity and IL-12 production, and efficiently induced the development of Th1/Tc1 cells, but had no effect on their maturation and endocytic activity. CONCLUSION: The blockade of B7-H1 on immature DCs increases its immune stimulation activity. It is valuable to investigate the antitumor immune responses of DCs vaccine with B7-H1 blockade.
ABSTRACT
AIM: To investigate the expression of adhes i on molecules in human hepatocellular carcinoma (HCC), and analyze the correlatio n between the expression of adhesion molecules and chemosensitivity. METHODS: The surgical and needle specimens from 64 patients were tested by the ATP-TCA. The expression of adhesion molecules and multi-drug resi stance genes (MDR) of tumor tis sues of 64 cases and adjacent tissues of 12 cases of HCC were detected with RT-P CR. RESULTS: The expression level of E-cadherin, ICAM-1, CD 44, CD 44V, ? 5, ? 1 in liver cancer tissues was 1.24?0.54, 0.96?0.3 7, 0.62?0 .73, 0.86?0.33, 0.97?0.49, 1.41?0.24, respectively. There was a signif icant difference between CD 44 and E-cadherin, ? 1. The expression levels of MD R 1, MRP, GST-?, LRP, TOPO II mRNA in liver cancer tissues were 1.17?0.47, 1 .59?0.33, 1.18?0.48, 1.03?0.48, 1.00?0.31, respectively. The express ion level of adhesion molecule mRNA had positive Spearman correlation with the expression level of MDR mRNA. ICAM-1, ? 5 had positive Spearman correlation w ith MDR 1. E-cadherin and CD 44 had negative Spearman correlation with MDR 1. E-cadherin had negative Spearman correlation with MRP. ICAM-1 had positive Spearman correlation with LRP. E-cadherin and CD 44 had negative Spearman c orrelation with LRP. CONCLUSION: The expression levels of adhesion molecule mRNA ha ve correlation with the effect of chemotherapy and the expression of MDR genes .
ABSTRACT
Objective:To investigate the most effective strategy for mature induction of dendritic cells.Methods:Human monocyte-derived dendritic cells were induced in the presence of cytokines GM-CSF and IL-4. On day 6, the immature DCs were pulsed with each of CD40L, LPS, TNF-? or a cocktail of cytokines(TNF-?, IL-6, IL-1?, PGE2). DCs were harvested after 24 h induction. The surface markers for maturation CD80,CD83,CD86 and HLA-DR were detected by FCM. FITC-Dextra endocytic activity was measured by FCM. IL-12 production was detected by ELISA. The capacity of DCs for T cell activation was detected by MTT assay.Results:CD40L,LPS,TNF-? and the cocktail of cytokines all could induce DCs’ maturation. The most effective scheme for induction of maturation was the cocktail of cytokines, and the expression rate of CD83 was up to 66.91%(P