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Objective:To compare the diagnostic efficacy of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT and 18F-fluorodeoxyglucose (FDG) PET/CT in TNM staging before radical prostatectomy. Methods:From July 2018 to December 2019, a total of 67 patients ((67.5±6.8) years) with prostate cancer diagnosed pathologically by radical surgery in Renji Hospital, School of Medicine, Shanghai Jiao Tong University were retrospectively enrolled. All patients underwent 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT whole-body scans before surgery. Results of PET/CT were compared with pathological diagnosis after surgery to compare the diagnostic efficiencies of 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT for preoperative TNM staging ( χ2 test). The differences of the maximum standardized uptake value (SUV max) in primary lesions between 2 imaging methods were compared by Mann-Whitney U test. Patients were divided into low-risk, intermediate-risk and high-risk for stratified analysis. Results:Among 67 patients, 9 were with low-risk, 19 were with intermediate-risk, 39 were with high-risk. For T staging, 59 (88.06%, 59/67) patients showed positive results by 68Ga-PSMA-11 PET/CT imaging, with median SUV max of 13.80(7.30, 22.40) for 67 patients; 31(46.27%, 31/67) patients showed positive results in 18F-FDG PET/CT imaging, with median SUV max of 4.00(3.10, 5.60) ( U=62, P<0.05). Stratifed analysis showed that the detection rate of 68Ga-PSMA-11 PET/CT was higher than that of 18F-FDG PET/CT in intermediate-risk patients (17/19 vs 6/19; χ2=4.920, P<0.05). Among 67 patients, 10 were diagnosed as N1 stage based on the pathological results. The sensitivities, specificities, accuracies, positive predictive values and negative predictive values of 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT for detecting positive regional lymph nodes were 6/10, 87.72%(50/57), 83.58%(56/67), 6/13, 92.59%(50/54) and 4/10, 89.47%(51/57), 82.09%(55/67), 4/10, 89.47%(51/57), respectively. 68Ga-PSMA-11 PET/CT detected 15 patients (22.39%, 15/67) with M1 stage, and 18F-FDG PET/CT identified 9 patients (13.43%, 9/67; χ2=35.436, P<0.05). Conclusions:As for T staging, the detection rate of 68Ga-PSMA-11 PET/CT in the intermediate-risk group is better than 18F-FDG PET/CT. In N and M staging, the detection rates of 68Ga-PSMA-11 PET/CT are higher than those of 18F-FDG PET/CT.
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Objective To investigate the clinical effect of thymosin combined with liver gland peptide drugs in the treatment of primary liver cancer.Methods 138 cases of primary hepatocellular carcinoma (HCC) were seleted as the research subjects,and they were divided into observation group (n=69) and control group (n=69) according to the number table method.The control group was treated with simple hepatoprotective drugs,the observation group was treated with thymosin on the basis of the control group.The clinical curative effect of the two groups,quality of life improvements were observed.Results In the observation group,the total effective rate was 81.16%,which in the control group was 43.47%,the difference was statistically significant between the two groups (χ2=8.362,P<0.05).The rate of life quality improvement of the observation group was 60.86%,which of the control group was 23.18%,there was statistically significant difference between the two groups (χ2=9.726,P<0.05).Conclusion The primary HCC patients treaed with thymosin combined with hepatoprotective drugs can effectively improve the patients' life quality,with good clinical curative effect,and it is worth clinical promotion and application.
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Purpose To eva1uate the effects of Annexin A3 on pro1iferation and apoptosis of gastric cancer ce11s. Methods The re-combinant p1asmid pYr-ads-4-Annexin A3 was constructed and ana1yzed by restriction ana1ysis and sequencing and was transfected into MGC803 ce11s. The stab1e transfectants were obtained after screening with G418. Western b1ot ana1ysis was used to examine the expres-sion of Annexin A3 before and after transfection. CCK8 assay,c1one assay and f1ow cytometry were used to study the effects of Annexin A3 on pro1iferation and apoptosis of MGC803 ce11s. Results The recombinant p1asmid pYr-ads-4-Annexin A3 was successfu11y con-structed. Western b1otting resu1ts indicated that the Annexin A3 expression was significant1y higher in ce11s transfected with pYr-ads-4-Annexin A3 compared with ce11s transfected with empty vectors and un-transfected ce11s( P<0. 05 ). CCK8 assay resu1ts showed the number of ce11s transfected with pYr-ads-4-Annexin A3 was significant1y higher than those transfected with empty vectors and un-trans-fected ce11s(P<0. 05). Moreover,the number of c1one in ce11s transfected with pYr-ads-4-Annexin A3 was significant1y higher than the other two groups(P<0. 05). Important1y,high Annexin A3 expression inhibited to apoptosis of MGC803 ce11s(P<0. 05). Con-clusion Annexin A3 expression p1ay important ro1es in tumorigenesis of gastric cancer. Annexin A3 cou1d promote the pro1iferation and inhibited apoptosis of gastric cancer ce11s and it might be a potentia1 target for gastric cancer treatment.
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Purpose To investigate the comparison of miR-106a in fresh and paraffin-embedded tissues and its expression in precan-cerous 1esions of gastric cancer. Methods Human gastric cancer tissues inc1uding 30 coup1es of fresh and 40 coup1es of paraffin-em-bedded samp1es were co11ected,quantitative rea1-time PCR was used to detect the expression of miR-106a in these two samp1es. Anoth-er paraffin-embedded samp1es inc1uding 20 cases of precancerous 1esions and 40 cases of gastric adenocarcinoma were a1so co11ected,in situ hybridization was used to assess the expression of miR-106a in these stages. Results The re1ative expression of miR-106a in fresh tissues was 3. 25 ± 1. 99,in paraffin-embedded tissues was 3. 18 ± 2. 14,indicating that the expression of miR-106a in these two sam-p1es has no statistica1 difference(P>0. 05),corre1ation ana1ysis showed that there was a significant corre1ation of miR-106a expression in these two samp1es(rs =0. 998,P<0. 001). The expression of miR-106a was detected in the stage of precancerous 1esions with the positive rate was 70%. The positive signa1s were 1ocated in dysp1astic epithe1ia1 ce11s and appeared as dark b1ue fine granu1es. The positive rate of miR-106a in gastric cancer tissues was 87. 5% and the frequency and extent increased and enhanced compared with pre-cancerous 1esions. Conclusion miR-106a has significant corre1ation in gastric cancer fresh tissues and paraffin-embedded tissues. Detection of miR-106a with paraffin tissues and its ear1y changes in prema1ignant 1esions can provide va1uab1e information for the ear1y diagnosis of gastric cancer.
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Purpose To exp1ore the expression and c1inica1 significance of epiderma1 growth factor receptor( EGFR)and human epi-derma1 receptor-2(HER-2)in co1orecta1 carcinoma. Methods Immunohistochemistry(IHC)PV-9000 was used to detect the expres-sion of EGFR and HER-2 in 78 cases of co1orecta1 carcinoma. Si1ver in situ hybridization( SISH)was used to detect HER-2 amp1ifica-tion in co1orecta1 carcinoma. Results The positive rates of EGFR in 78 co1orecta1 carcinomas were 69. 23%( 54/78 ). The differ-ences of the expression of EGFR between different depth of invasion group and 1ymph node metastasis group were statistica11y signifi-cant. The differences of the expression of EGFR between different aging group,gender group,tumor size,different histo1ogica1 grading group and Dukes stage were insignificant. The positive rates of HER-2 in 78 cases of co1orecta1 carcinoma were 25. 64%(20/78). The differences of the expression of HER-2 between different depth of invasion group and 1ymph node metastasis group were statistica11y sig-nificant. The differences of the expression of HER-2 between different aging group,gender group,tumor size,histo1ogica1 grading group and Dukes stage were insignificant. The expression of EGFR and HER-2 was positive1y corre1ated. Among the 20 cases of HER-2 protein overexpression,10 cases showed HER-2 gene amp1ification,15 cases showed HER-2 protein overexpression(~)by IHC and 10 cases showed HER-2 gene amp1ification by SISH. The rate of HER-2 gene amp1ification was 66. 67%. 5 cases with 1ow HER-2 protein overexpression( +)and no case showed HER-2 gene amp1ification. Conclusions EGFR and HER-2 are high1y ex-pressed in co1orecta1 carcinoma. EGFR and HER-2 expression is connected to invasion and metastasis process of co1orecta1 carcinoma. The both may be synergy. The corre1ation between HER-2 protein overexpression(~)and HER-2 gene amp1ification is statisti-ca11y significant. Therefore,immunohistochemistry can be regarded as an initia1 screening method for HER-2 gene amp1ification,and then SISH testing shou1d be done as we11 to confirm the resu1t. It is usefu1 for mo1ecu1ar target therapy to detect HER-2 status in co1or-ecta1 carcinoma.
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Purpose To assess the potentia1 of DNA image cytometry and urinary cyto1ogy in screening for urothe1ia1 carcinomas,and to find the idea1 method of ear1y diagnosis of urothe1ia1 cancer. Methods Voided urine specimens from 121 patients with urothe1ia1 carcinoma were random1y co11ected as test group and 95 patients with symptomatic uro1ogic disease but not urothe1ia1 carcinoma as con-tro1 group,a11 of the specimens were ana1yzed by both urinary cyto1ogy and DNA image cytometry. Results Urinary cyto1ogy had a higher sensitivity but 1ower specificity in diagnosis of urothe1ia1 carcinoma than that of DNA cytometry. Urinary cyto1ogy yie1ded an o-vera11 sensitivity of 85. 10%,specificity of 76. 80%. DNA cytometry revea1ed a sensitivity of 81. 80%,specificity of 81. 10%. Among the 121 urothe1ia1 carcinoma,there were 103 b1adder cancers,18 patients with upper urothe1ia1 carcinoma. For different types of urothe1ia1 carcinoma,both of the two methods demonstrated good sensitivity in the high 1eve1 tumor. And DNA cytometry had exce11ent sensitivity in the diagnosis of urothe1ia1 carcinoma in invasive b1adder cancer and upper urinary tract cancer,and both were more than 94%. Conclusions In 1ight of its high1y good sensitivity and specificity in urothe1ia1 carcinoma,especia11y in invasive b1adder cancer and upper urinary tract cancer,DNA cytometry shou1d be used to eva1uate suspect urothe1ia1 ce11s in urinary cyto1ogy specimens. Com-bined with the conventiona1 urinary cyto1ogy,the detection for urothe1ia1 carcinoma wou1d be significant1y improved.
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Purpose To report the c1inicopatho1ogica1 characteristics,diagnosis and differentia1 diagnosis of extranoda1 fo11icu1ar den-dritic ce11 sarcoma( FDCS)of the pharyngea1 region. Methods The c1inica1 features,histopatho1ogica1 changes and immunohisto-chemica1 findings were ana1yzed in three cases of FDCS with review of the re1ated 1iterature. Results Case 1,a 70-year-o1d man pres-ented with the comp1aint of a pain1ess mass in pharyngea1 region accompanied by shortness of breath for the past 2 months. Case 2,a 40-year-o1d woman presented with the comp1aint of pharyngea1 foreign body sensation and b1oody sputum for the past 1 month. Case 3, a 38-year-o1d man presented with the comp1aint of intermittent epistaxis for the past 2 months. 3 cases showed simi1ar morpho1ogies:the neop1astic ce11s were ovoid to spind1e-shaped,with indistinct ce11 borders,dispersed granu1ar chromatin,and scattered sma11 nuc1e-o1i. Notab1y,severa1 nuc1ear inc1usions were identified,and rare binuc1ear and mu1tinuc1eated ce11s were a1so present. There were main1y 3 kinds of growth patterns in the tumors:diffuse sheets,fascic1es,and storiform arrangements admixed with sma11 1ymphocytes, which sometimes gathered into a mass. Immunohistochemica11y,tumor ce11s( 3/3 )were strong1y and diffuse1y positive for fo11icu1ar dendritic ce11 markers CD21,CD23 and CD35. Tumor ce11s(3/3)were a1so diffuse1y positive for fascin and D2-40. Some tumor ce11s (1/3)were diffuse1y positive for CXCL-13. Ki-67 pro1iferation index was estimated at 6%-20%. Conclusions Extranoda1 FDCS of the pharyngea1 region is rare and misdiagnosis is frequent1y made. A comprehensive eva1uation of c1inica1 manifestations,patho1ogic features and immunohistochemica1 findings are essentia1 for definitive diagnosis.
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Purpose To investigate the effects ofβ-1apachone on inhibition of pro1iferation and migration and induction of apoptosis in gastric cancer ce11s in vitro. Methods The ce11 viabi1ity was detected using MTT and co1ony formation assay,the migration abi1ity was determined using scratch assay method,and the apoptosis was examined using f1ow cytometry. Meanwhi1e,the expression of biomarkers of pro1iferation,EMT markers andapoptosiswere detected using Western b1ot ana1ysis. Results β-1apachone cou1d significant1y inhibit the pro1iferation of SGC-7901 and AGS gastric cancer ce11s( P<0. 05),and down-regu1ate the expression 1eve1s of Skp2 and DEK pro-teins. β-1apachonecou1d a1so inhibited the invasion and moti1ity of gastric cancer ce11s via down-regu1ating the expression 1eve1s of MMP-2/9 and Ezrin proteins and up-regu1ating the epithe1ia1 markers. In addition,β-1apachone enhanced the apoptosis of gastric canc-er ce11s,down-regu1ation of BCL-2/Bax ratio and up-regu1ation of activated Caspase-3/8/9. Conclusions β-1apachone can effective1y inhibit the pro1iferation and induce the apoptosis of gastric cancer ce11s,and inhibit the migration of gastric cancer ce11s via MMPs and EMT pathways.
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Purpose To investigate the expression of miR-134 in breast carcinoma and its c1inica1 significance,and to ana1yze the as-sociation between its expression with bio-markers of epithe1ia1-mesenchyma1 transition( EMT). Methods The expression of miR-134 in 97 breast cancer samp1es was detected by in situ hybridization and the expression of E-cadherin,N-cadherin,and vimentin was de-tected by MaxVision two-step method of immunohistochemistry,to ana1yze the re1ationship between their expression and c1inicopatho1og-ica1 characteristics. Results The expression of miR-134 in breast cancer was negative1y associated with higher histo1ogica1 grade, HER-2 overexpression,1ow expression of E-cadherin as we11 as high expression of N-cadherin and vimentin. Both 1ow-expression of E-cadherin and up-expression of N-cadherin and vimentin in breast cancer were positive1y corre1ated with higher histo1ogica1 grade,1ymph node invo1vement and HER-2 overexpression,whi1e negative1y associated with the expression of ER and PR. Conclusion The expres-sion of miR-134 in breast cancer tissue is negative1y re1ated to both the ma1ignant progression and EMT,indicating that it might be a potentia1 bio-marker for breast cancer.
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Purpose To investigate the expression and significance of epiderma1 growth factor receptor( EGFR)mutation-specific anti-bodies in 1ung adenocarcinoma. Methods Immunohistochemica1( IHC)technique was used to detect the expression of EGFR muta-tion-specific antibodies(EGFR-19,EGFR-21)and EGFR tota1 protein antibody(EGFR-P)in 171 cases of 1ung adenocarcinoma with resected specimens,and EGFR gene mutation was a1so performed by amp1ification refractory mutation aystem-PCR( ARMS-PCR). The expression of EGFR-19,EGFR-21 and EGFR-P mutant proteins was compared with EGFR gene mutation and their re1ationship with histo1ogica1 c1assification and c1inica1 characteristics were ana1yzed. Results The expression of EGFR mutant protein was corre1ated with the poor differentiation group inc1uding micropapi11ary and so1id predominant types( P=0. 021 ). EGFR-21 high expression was re1ated to p1eura1 invasion(P=0. 005). The coherence of IHC(with EGFR-19/21 antibodies)and ARMS-PCR was existed(Kappa>0. 4 ). Taking ARMS-PCR as a standard,the sensitivity and specificity of EGFR-19 and EGFR-21 were 65. 0% and 89. 4%, 70. 0% and 97. 6%,respective1y. Conclusions Expression of EGFR mutation-specific antibodies is associated with poor differentia-tion and p1eura1 invasion. It suggests a worse prognosis indicator in 1ung adenocarcinoma. Because of the coherence with ARMS-PCR, using IHC with mutation-specific antibodies to detect the mutant proteins of EGFR-19/21 may act as a pre1iminary screening method of EGFR gene mutation.
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Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.
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Purpose To ana1yze the expression features of 5-F1uorouraci1(5-FU)metabo1ic enzyme thymidy1ate synthetase(TS),thy-midine phosphory1ase( TP),dihydropyrimidine dehydrogenase( DPD)and its re1ationship with c1inicopatho1ogica1 factors and progno-sis in co1orecta1 cancer,in order to further exp1ore its potentia1 significance in guiding co1orecta1 cancer chemotherapy. Methods Es-tab1ishment of a tissue microarray containing 72 patients with co1orecta1 cancer,and 56 norma1 tissue( dista1 cut edge tissue near carci-noma)was used to detect TS,TP,and DPD by immunohistochemistry,and to ana1yze its re1ationship with c1inicopatho1ogica1 factors and prognosis of co1orecta1 cancer through statistica1 method. Results The expression of TS in co1orecta1 cancer was 1ower than that in norma1 tissue(P=0. 876),which was associated with TNM(P=0. 043)and positive1y corre1ated with patients’overa11 surviva1(P=0. 027),the expression of TP in co1orecta1 cancer was higher than that in norma1 tissue(P=0. 315)that was associated with 1ymph node metastasis(P=0. 009)and negative1y corre1ated with the prognosis of patients(P=0. 040),DPD expression in co1orecta1 canc-er was higher than that in norma1 tissue(P=0. 071),which was re1ated to the histo1ogic type(P=0. 029). Overa11 surviva1 was sig-nificant1y shortened in co1orecta1 cancer with DPD high expression( P=0. 011). Conclusions TS,TP and DPD might be app1ied as important index of prognosis in co1orecta1 cancer patients using 5-FU adjuvant chemotherapy. The expression of TS re1ated c1ose1y with the c1inica1 stage is a bio1ogica1 marker of tumor progression. TP expression is c1ose1y re1ated to 1ymph nodes metastasis and recur-rence,which is an important factor of postoperative recurrence and metastasis.
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Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.
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Purpose To investigate the expression of IGF-Ⅱand IGFBP-6 in co1orecta1 cancer,and to exp1ore the c1inica1 significance in co1orecta1 cancer. Methods IGF-Ⅱand IGFBP-6 were detected by immunohistochemistry and RT-PCR in 50 cases of co1orecta1 cancer(experimenta1 group)and 50 cases of the adjacent mucosa(contro1 group). Results (1)In the experimenta1 group,the ex-pression 1eve1 of IGF-Ⅱprotein and mRNA was significant1y higher than the contro1 group. The expression 1eve1s of IGF-Ⅱprotein and mRNA in co1orecta1 cancer were significant1y 1ower than the contro1 group.(2)The expression 1eve1s of IGF-Ⅱand IGFBP-6 were sig-nificant1y different between different tumor infi1tration depth,1ymph node metastasis,invasion depth and Duke’s stages( P0. 05). Conclusions There is a obvious corre1a-tion between of IGF-Ⅱ and IGFBP-6 in c1inica1 patho1ogica1 parameters in co1orecta1 cancer. Combined detection of the two markers may be the bio1ogica1 indicators of occurrence and prognosis of co1orecta1 cancer,and provide a new scheme for diagnosis and treatment of co1orecta1 cancer.
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Purpose To investigate the expression of Netrin-1 in ovarian serous carcinoma and its c1inicopatho1ogica1 significance. Methods Netrin-1 protein expression was assessed by immunohistochemica1 method in tissue specimens from 20 cases of benign ovari-an serous cystadenomas,13 cases of border1ine ovarian serous neop1asms and 32 cases of ovarian serous carcinomas( OSC). Results The positive proportion of Netrin-1 protein in OSC tissues was significant1y higher than those in border1ine and benign ovarian serous ne-op1asms(P0. 05). Kap1an-Meier ana1ysis showed that the 5-year surviva1 rate of patients with Netrin-1 over-expression was significant1y 1ower than that of patients with 1ower expression( P<0. 05 ). Conclu-sions The high expression of Netrin-1 in OSC tissues indicates that Netrin-1 p1ays an important ro1e in cancer pathogenesis and deve1-opment and it may be a new assistant marker for prognosis of OSC.
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Purpose To investigate the corre1ation of the epiderma1 growth factor receptor( EGFR)gene mutation and amp1ification and protein expression with occurrence and deve1opment of non-sma11 ce11 1ung cancer( NSCLC),and to exp1ore the re1ationship be-tween the mutation and amp1ification of EGFR gene and other c1inica1 patho1ogica1 parameters. Methods qRT-PCR,FISH and immu-nohistochemistry were used to detect EGFR gene(exons 18,19,20 and 21)mutation,amp1ification and protein expression in paraf-fin-embedded tissues of NSCLC. Results EGFR gene(exons 18,19,20 and 21)mutation rate was 58. 18%(32/55)in NSCLC with qRT-PCR techno1ogy,in which the occurrence rate of exon 19 de1etions and exon 21 mutation of L858R was 87. 50%(28/32). EGFR gene mutation rate was significant1y different in gender,smoking history and patho1ogica1 type(P0. 05). EGFR gene amp1ification rate was 23. 64%(13/55)and its protein expression rate was 70. 91%(39/55). Both EGFR gene mutation and amp1ification was c1ose1y corre1ated(P0. 05). Conclusion EGFR gene mutation with high pro-tein expression of NSCLC is common1y found in fema1e,no-smoking and adenocarinoma patients,who are main candidates of a tyrosine kinase inhibitor( TKI)screening. EGFR gene mutation and amp1ification is typica11y corre1ated,but their consequence is unknown, which needs to be further investigated. EGFR gene mutation and amp1ification is not consistent with protein expression,its under1ying machanism is to be determined.
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Purpose To investigate the serum prostate specific antigen( PSA)feature of high grade prostatic intraepithe1ia1 neop1asia ( HGPIN)patients,and the association of the number of cores positive for HGPIN on initia1 biopsy and the risk of cancer deve1opment in second biopsy. Methods 492 cases of patients with suspicious prostate cancer were schedu1ed for transrecta1 u1trasound prostatic biopsy with an 8-core temp1ate. In the first biopsy,186 cases of patients with PCa,34 cases of patients with iso1ated HGPIN( on1y one core invo1ved with HGPIN)and 13 cases of patients with extensive HGPIN( two or more cores invo1ved with HGPIN),64 cases of pa-tients with LGPIN,195 cases of patients with BPH. The va1ues of PSA were ana1yzed and compared within these groups. In patients with extensive HGPIN or iso1ated HGPIN we proposed a repeat 8-core biopsy after 6 months independent of serum PSA 1eve1. The same measure was app1ied for patients diagnosed as LGPIN or BPH in the first biopsy with accompanying increase or persistent e1evation of serum PSA 1eve1. The incidence of PCa was ana1yzed and compared within these groups. Results The serum PSA 1eve1s were no sig-nificant1y different between LGPIN and BPH(P>0. 05),between iso1ated HGPIN and LGPIN(P>0. 05),and between iso1ated HG-PIN and BPH(P>0. 05). The serum PSA 1eve1s were significant1y different between extensive HGPIN and LGPIN(P<0. 05),be-tween extensive HGPIN and BPH(P<0. 05),and between extensive HGPIN and iso1ated HGPIN(P<0. 05). In the second biopsy, the incidence of PCa in patients with extensive HGPIN was 38. 48%,that in patients with iso1ated HGPIN was 9. 68%,that in patients with LGPIN was 12. 50%,and that in patients with BPH was 12. 20%. Conclusions The features of PSA in patients with iso1ated HGPIN are simi1ar to BPH,PSA 1eve1 in patients with extensive HGPIN were between PCa and BPH,and patients with extensive HG-PIN have a higher incidence of PCa in second biopsy than iso1ated HGPIN and BPH.
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PURPOSE: To access the usefulness of newly designed Leven tube inserted drip infusion spiral CT for theevaluation of remnant stomach and anastomosis site in patients who have undergone subtotal gastrectomy for stomachcancer. MATERIAL AND METHODS: A new technique named Levin tube inserted drip infusion spiral CT was used toprospectively study 23 patients. A 16Fr Levin tube was inserted into the remnant stomach ; 500ml of tap water wasdrip infused just before CT scanning and an additional 500ml of water was infused during IV contrast injection.Water was infused by gravity, using a water bottle suspended at a height of 90cm(Group A). The 31 patients whounderwent conventional spiral CT scanning immediately after the divided ingestion of 900ml diluted gastrografinwere selected as a control group(Group B). The anatomic delineation of the anastomosis site was graded by tworadiologists as excellent(3), good(2), fair(1) or poor(0). To evaluate the degree of distension, the maximaldiameters of remnant stomach and the anastomosis site, and the thickness of the stomach wall, were also measured. RESULTS: In group A, anatomic delineation of the anastomosis site was excellent, compared to group B(mean score:2.91 vs 1.19, P<0.01). In addition, the maximum diameters of remnant stomach and anastomosis site weresignificantly larger in group A than in group B(transverse A-P remnant stomach and anastomosis site : 92.4+/-16.0mm, 97.6+/-26.5mm, 29.7+/-7.3mm vs 50.6+/-12.9mm, 53.5+/-14.4mm, 7.7+/-4.4mm, P<0.01). The mean thickness of distended stomach wallin group A was 3.2+/-1.7mm ; in group B, measurement was possible in only a few cases, but their number was too smallfor comparison. CONCLUSION: In patients who had undergone subtobal gastrectomy, Levin tube inserted drip infusionspiral CT showed excellent anatomic delineation of the site of anastomosis and remnant stomach. We found thatbecause it increases the distension of remnant stomach and the anastomosis site, this technique is effective forthe evaluation of postoperative stomach.