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Objective To examine the single nucleotide polymorphism(SNP) of apurinic/apyrimidinic endonuclease1 (APE1) in primary small cell carcinoma of esophagus(PSEC) ,then investigate the relationship between these SNPs and the prognosis.Methods Sixty cases first-treated patients with PSEC were recruited, patients with esophageal squamous cell carcinoma (ESCC) and healthy blood donors were recruited as positive and negative controls.APE1 (Asp148Glu) of the patients with PSEC and controls were genotyped by the TaqMan method.Every patient was treated with platinum-based chemotherapy(EP regimen for PSEC and TP regimen for ESCC)and radiotherapy(3D-CRT) ,then every case was followed-up for 2 years.The relationship between these SNPs and the follow-up outcome was analyzed.Results Compared with the ESCC group and control group, APE1 148 pure mutant(Glu/Glu) of PSEC group increased significantly(PSEC group was 40％ (12/30), ESCC group was 13.3％ (4/30) , control group was 10％ (2/20)), the difference was statistically significant (x2 =7.248,P =0.027).According to data of following-up, there was a significant increase in rate of progress (1year:40.0％ (12/30) vs 16.7％ (5/30), x2 =4.022, P =0.045;2 years: 86.7％ (26/30) vs 40.0％ (12/30) ,P =0.004) and a significant decrease in survival (33.3％ (10/30) vs 76.7％ (23/30)) of PSEC compared with ESCC.The SNPs of APE1 Asp148Glu was significantly correlated with frequency of progress, a significant increase was found in rate of progress of the patients with mutant type(Asp/Glu±Glu/Glu) compared with wild genotype(1 year: 50.0％(11/22) ,x2 =3.854,P=0.05;2 years: 81.8％ (19/22) ,x2 =10.519,P =0.001) ,the survival of the patients with mutant genotype was significantly lower than wild type (22.7％ (5/22) ,x2=10.77,P=0.001).Conclusion The most of polymorphisms of APE1(Asp148Glu) are mutation type in PSEC.Pure mutant genotype (APE1 148Glu/Glu) carry significant enhancement of progression.The polymorphisms of APE1 (Asp148Glu) maybe one of those molecular mechanisms of high frequency of progress and poor prognosis in PSEC.
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Objective To study the changes of serum carcinoembryonic antigen (CEA ) ,squamous cell carcinoma related antigen (SCC) and cell keratin protein fragments-19(CYFRA21-1) levels before and after radiotherapy in the patients with esophageal car-cinoma .Methods Serum CEA ,SCC and CYFRA21-1 levels were measured in 80 patients with esophageal carcinoma before and af-ter radiotherapy as well as 30 healthy persons by the double-antibody sandwich ELISA .The detection results were compared .The serum CEA ,SCC and CYFRA21-1 levels were in the survival group and the dead group within 1 year were detected .Results The serum CEA ,SCC and CYFRA21-1 levels in the patients group were significantly higher than those in the control group ,the differ-ence was statistically significant (P< 0 .01) .The serum CEA ,SCC and CYFRA21-1 levels before radiotherapy were significantly higher than those after radiotherapy ,which in the dead group were significantly higher than those in the survival group ,the differ-ence was statistically significant (P<0 .05) .Conclusion Serum CEA ,SCC and CYFRA21-1 levels can provide reference for moni-toring and the curative judgement in the patients with esophageal carcinoma .
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ObjectiveTo describe the modified (narrowed) gastric tube and two methods on the establishmentof enteral feeding pathway in esophagectomy.MethodsFrom July 2003 to April 2006,we made traditional gastric tube for patients underwent esophagectomy to substitute the dissected esophagus while from May 2006 to November 2009,we made modified gastric tube for the same purpose.From July 2003 to November 2009,enteral nutrition tubes for all these patients are placed intraoperatively by two different ways,which made early post-operative nutrition support possible for these patients.ResultsNo perioperative death occurred among the patients.The length of the modified gastric tube ensured the anastomosis by circular stapler at the apex thorax or in the bases of cervical region.No statistical differences were found between the two group in terms of survival rate.The intraoperative establishment of enteral nutrition pathway ensured the early enteral nutrition support after the operation.ConclusionThe utility of the modified gastric tube extends the length of gastric tube to make mechanical anastomose easier and safer; meanwhile,the intraoperative establishment of enteral nutrition pathway ensures the early enteral nutrition support after the operation.
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Objective To compare the probability of anastomotic leak in the Chinese patients with carcinoma of esophagus using anastomat anastomose and manual anastomose in order to provide some refer -ence for patients with carcinoma of esophagus .Methods By meta-analysis, we made a comprehensive a-nalysis of 12 literatures published in China on anastomat anastomose and manual anastomose in preventing anastomotic leak in patients with carcinoma of esophagus .Results The probability of anastomotic leak in patients with carcinoma of esophagus was obvious heighten in using anastomat anastomose compared to that in using manual anastomose,with the combined odds ratio(OR)value being 0.53(95%CI:0.40-0.71) >0,( P <0.01 ).Conclusion To preventing anastomotic leak in patients with carcinoma of esophagus , anastomat anastomose is more predominant than manual anastomose .
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Objective To present the experience of surgical treatment of 12 patients with advanced carcinoma of esophagus involving aorta. Methods Resection of esophageal carcinoma and cervical esophago-gastrostomy or supraaortic esophago-gastrostomy were done in 12 patients. In all 12 patients, the resection of limited aortic adventitia was performed in 2 patients, excision of aorta and simple suture in 2 patients and aortoplasty with Gore-Tex patch in 7 patients, the resected segment was replaced with artificial vessel in 1 patient. Results Complete recovery was achieved in 2 weeks in 12 patients, without severe complications such as aortic fistula. Conclusion Surgical treatment expands the operative indications for patients suffering from esophageal carcinoma involving aorta and improves their life quality.
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Purpose:To study the surgical treatment of the cases with cancer of esophageal and gastroesophageal conjunction by thoracotomy. Methods:Total of 43 patients were selected. Squamous cell carcinoma of esophagus were found in 26 patients,among them 23 received radical resection and 3 failed due to massive invasion of the tumor.The rest were diagnosed as adeno carcinoma of cardia,13 of them undergoing radical resection and 4 failed.Results:The results of the whole group were surgical resection 93.0 %,complication 41.9% and operative mortality 4.7%.Conclusions:The authors conclude that selecting patients with precise indications as well as treating complication correctly was very important for surgical procedures of elderly patients.The pre-operative preparation,nutrition and approach for resection are also important.
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Objective: To review the clinical effect of early enteral nutrition in patients with carcinoma of esophagus after operation.Methods: Nutrient canal was indwelt through Fresubin(TP) was given through the nasal-intestinal tube in 120 cases with carcinoma of esophagus after operation.Results: The complications such as anastomotic leakage,lung infection and incisional infection in the patients receiving early enteral nutrition were much less than those in control group.No death occurred.The time for bowel function recovery was much shorter.Conclusion: Early enteral nutrition can promote the recovery of gastrointestinal function,improve the nutrition,decrease the occurrence of complications and raise the successful rate of operation in operative patients with esophagus carcinoma.
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Argyrophilic nucleolar organizer region proteins were determined in 50 patients with squmous cell carcinoma of esophagus by argyrophilic technique. Pathological sections of the tissue of the resected specimens were examined. The results showed that the AgNOR content was corelated with the lymph node metastasis rale, histologic grading of the CA and the postoperative prognosis. The higher the AgNOR content, the higher lymph node matastasis rate(P
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Protein synthesis and nitrogen equilibrium have been investigated in the early postoperative period in 21 patients with carcinoma of esophagus and cardia after resection. They received 17-L-crystalline amino acid (AAM) and glucose infusion through parenteral route and were compared with a series' of 11 patients taking similar volume and calorie with protein hydrolysate (PRH) and glucose.In AAM series, the plasma protein could be maintained in preoperatiye level but not in PRH series. In AAM series a nitrogen equilibrium was reached while in PRH series was a negative equilibrium. The cellular immunity and serum amino acid spectrum were improved or replaced in both series, but they were better in AAM series. The improvement in nitrogen balance was probably mainly due to an increase in protein synthesis.