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Resumen El carcinoma renal de células claras (CRCC) es una neoplasia maligna poco común que representa el 3% de todos los tumores malignos en adultos. Este tumor presenta una alta tendencia a desarrollar metástasis sincrónicas o metacrónicas en diferentes sitios anató micos. Aunque la metástasis en la vesícula biliar por CRCC es extremadamente rara, se han reportado casos esporádicos en la literatura médica. Presentamos el caso de una mujer de 78 años con antecedentes de carcinoma indiferenciado de cavum, carcinoma basocelular y CRCC en riñón derecho. Se sometió a nefrectomía radical. El análisis histopatológico confirmó el diagnóstico de CRCC sin invasión vascular ni ureteral. Dos años después, du rante el seguimiento, se detectó una lesión nodular en la vesícula biliar mediante tomografía computarizada. A pesar de la ausencia de síntomas, se decidió la resección quirúrgica. Se realizó colecistectomía laparoscópica sin complicaciones. El examen histopatológico confirmó la presencia de metástasis de CRCC en la vesícula biliar. La paciente evolucionó favorablemente encontrándose en seguimiento sin recurrencia. La metástasis vesicular por CRCC es extremadamente rara, pero los cirujanos deben considerarla en pacientes con antecedentes de CRCC. El diagnóstico diferencial prequirúrgico entre el carcinoma primario de vesícula biliar y la metástasis de CRCC puede ser desafiante y, a menudo, se confirma mediante el examen histopatológi co. La resección quirúrgica completa parece ser la mejor opción de tratamiento para lograr una supervivencia libre de enfermedad.
Abstract Clear cell renal cell carcinoma (ccRCC) is an uncom mon malignant neoplasm that accounts for 3% of all malignant tumors in adults. This tumor exhibits a high tendency to develop synchronous or metachronous me tastases in different anatomical sites. Although gallblad der metastasis from ccRCC is extremely rare, sporadic cases have been reported in the medical literature. We present the case of a 78-year-old woman with a history of undifferentiated nasopharyngeal carcinoma, basal cell carcinoma, and ccRCC in the right kidney. She un derwent radical nephrectomy. Histopathological analysis confirmed the diagnosis of ccRCC without vascular or ureteral invasion. Two years later, during follow-up, a nodular lesion was detected in the gallbladder through computed tomography. Despite the absence of symp toms, surgical resection was decided. Laparoscopic cho lecystectomy was performed without complications. Histopathological examination confirmed the presence of ccRCC metastasis in the gallbladder. The patient had a favorable outcome and is currently under follow-up without recurrence. Gallbladder metastasis from ccRCC is extremely rare, but surgeons should consider this possibility in patients with a history of ccRCC. Preoperative differential diagno sis between primary gallbladder carcinoma and ccRCC metastasis can be challenging and is often confirmed through histopathological examination. Complete sur gical resection is the best treatment option to achieve disease-free survival.
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Aim To explore the relationship between IL-8 and ELMO1 in breast carcinoma and the mecha-nisms of IL-8 induced invasion and metastasis. Meth-ods Under the IL-8 stimulation, chemotaxis assay was examined to detect the chemotaxis ability of breast cancer cell line MDA-MB-231 and MCF-7 . ELMO1 protein levels in breast cancer cell lines were detected using Western blot. MDA-MB-231 cells were transfect-ed with small RNA interference plasmids in order to downregulate ELMO1 expression, and overexpression plasmids were used to upregulate the expression of EL-MO1 in MCF-7 cells. Matrigel invasion assay and chemotaxis assay were used to detect the in vitro inva-sion and chemotaxis ability of breast cancer cells with IL-8 stimulation. Results IL-8 induced chemotaxis of the different breast cancer cell lines in a dose-depend-ent manner. After transient transfection, Western blot results showed that ELMO 1 protein levels observably decreased in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells, while the expression of ELMO1 protein levels significantly increased in MCF-7/ELMO1 cells compared with the MCF-7/Con cells;with IL-8 stimulation, SiELMO1/MDA-MB-231 cells showed significantly decreased chemotaxis ability com-pared with Scr/MDA-MB-231 cells. MCF-7/ELMO1 cells showed significantly increased chemotaxis ability compared with MCF-7/Con cells; the invasion assay showed under the stimulation of IL-8 , and the invasion ability was significantly reduced in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells ( P<0. 05 ) . The invasion ability was significantly en-hanced in MCF-7/ELMO1 cells compared with MCF-7 cells( P<0. 05 ) . Conclusion IL-8 promotes the in-vasion and migration of breast cancer cells MDA-MB-231 and MCF-7 , and ELMO1 plays an important role in IL-8 induced chemotaxis and invasion.
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Objective To evaluate the expression of serum vascular endothelial growth factor ( VEGF ) on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma,and to ana1yze the relationship between serum VEGF and serum thyroglobulin levels.Methods The serum samples were obtained from 25 patients with pulmonary metastasis, 43 cases with locoregional recurrence, 30 cases without recurrence and/or metastasis and 30 normal subjects were selected as control.The levels of serum VEGF were analyzed by enzyme-linked immunosorbent assay( ELISA) ,the levels of serum thyroglobulin were analyzed by chemiluminescence method. Results The level of serum VEGF[(864.3 ±200.3)ng/L] in patients with pulmonary metastasis were significantly higher than that in patients with locoregional recurrence[(393.3 ±96.3)ng/L],without recurrence and /or metasta-sis[(276.6 ±47.7)ng/L] and normal subjects[(268.6 ±36.9)ng/L](t=11.04,14.34,14.66,all P0.05).It showed linear correlation between serum VEGF and thyroglobulin levels on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma ( r=0.902 2, P<0.001) .Conclusion The serum VEGF level was significantly elevated in patients with locoregional recurrence and pulmonary metastases, the serum VEGF can be used as a auxiliary index to predict recurrence and /or metastasis following surgery in patients with differentiated thyroid carcinoma.
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Objective:To investigate the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods:Data of 65 IMPC cases obtained from the Fourth Hospital of Hebei Medical University between Janu-ary 2009 and December 2011 were retrospectively analyzed. The expression of epithelial membrane antigen (EMA) was evaluated us-ing immunohistochemistry (IHC) to detect the micropapillary component in the tumor. The patients were divided into 4 groups based on the percentage of micropapillary component:≤10%, 11%-30%, 31%-50%, and>50%. Expressions of estrogen receptor (ER), pro-gesterone receptor (PR), and HER-2 were analyzed by IHC. Kaplan-Meier method, Log rank test, and multivariate Cox proportional hazard model were used to determine the factors affecting post-treatment survival. Results:Of the 65 cases, 12 were simple IMPC, 46 were IMPC with invasive ductal carcinoma, and 7 were other invasive carcinoma cases. The≤10%, 11%-30%, 31%-50%, and>50%micropapillary component groups comprised 7.69%(5/65), 44.62%(29/65), 26.15%(17/65), and 21.54%(14/65) of the total cases, re-spectively. Statistically significant differences were found in the four groups (P<0.01). IHC results showed that the positive rates of ER, PR, and HER-2 in the IMPC tissues were 76.92%(50/65), 67.69%(44/65), and 24.62%(16/65), respectively. Statistical differences ex-isted among the groups (P<0.05). Kaplan-Meier method indicated that positive rate of lymph node metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 significantly affect survival time of IMPC cases (P<0.05). Conclusion:Positive rate of nodal metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 are correlated with the prognosis of IMPC.
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The lymphatic vessel is a crucial pathway for tumor metastasis. The discovery of more lymphatic growth factors and lymphatic vessel markers signifies the significant progress of studies on the role of vascular endothelial growth factor-C/D (VEGF-C/D) and one of its specific receptors in the mechanisms of tumor lymph-angiogenesis and lymph node metastasis. VEGF-C/D expression is related to the clinicopathologic features of gastric cancer, including lymph metastasis, micro-lymphatic vessel density in the paraneo-plastic tissues, survival rate, and prognosis. Experimental animal models and in vitro experiments show that suppression of VEGF-C/D expression is beneficial in gastric cancer treatment. This article provides an overview of the association between VEGF-C/D and lymph node metastasis in gastric cancer.
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ObjectiveTo compare the diagnostic efficiency of 18F- FDG coincidence SPECT/CT and 99Tcm- MDP whole body bone scan (WBBS) in detecting malignancy.MethodsA total of 71 cases (male 45,female 26,mean age 59.2 ± 15.4 years) with clinically confirmed malignancy underwent both 99TcmMDP WBBS and 18F-FDG coincidence imaging within three weeks.The sensitivity,specificity,accuracy,positive and negative prediction value of these two imaging methods in detecting bone metastases were compared based on the results from pathology or clinical follow-up.x2test was used for data analysis.ResultsA total of 350 lesions (including primary,second malignancy and benign disease) in 71 patients were eval-uated.81.7％ (286/350) malignant lesions were identified by either 99Tcm-MDP WBBS (209/350,59.7％ ) or 18F-FDG coincidence imaging ( 141/350,40.3％ ) (x2 =25.65,P ＜ 0.01 ).The imaging findings of osteoblastic,osteolytic,mixed types of bone metastases by99Tcm-MDP WBBS and 18F-FDG coincidence imaging were significantly different (x2 =20.78,2.89 and 9.94,all P ＜ 0.05 ).The sensitivity,specificity,accuracy,false-positive,false-negative,positive and negative predictive values for detecting bone metastases by 18 F-FDG coincidence study and 99Tcm-MDP WBBS were as follows:11.72％ ( 15/128),91.67％(22/24),24.34％ (37/152),8.33％ (2/24),88.28％ (113/128),88.24％ (15/17),16.30％ (22/135) ; and 53.91％ (69/128),75.00％ ( 18/24),57.24％ (87/152),25.00％ (6/24),46.09％ (59/128),92.00％ (69/75),23.38％ ( 18/77 ).The sensitivity,accuracy,false-negative,positive-predicting value of the two methods had been significant different (x2 =32.70- 46.21,all P ＜ 0.01 ).When two methods were combined,the diagnostic efficiency could been improved.ConclusionThe 99Tcm-MDP WBBS and 18F-FDG coincidence imaging has a complementary role in detecting bone metastases.
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Objective To evaluate the expression of macrophage migration inhibitor factor (MiF) and cyclinD1 in pancreatic carcinoma and their relationships with clinical pathology characteristics. Methods The expression of MIF and eyclinD1 in 89 carcinoma and 5 normal pancreatic tissues was detected with immunohis-tochemistry methods, and the relationships among MIF and cyclinD1 expression and clinicopathological factors were studied. Results The overexpression of MIF and cyclinD1 was found in 88.8%, and 50. 6% of pancre-atic carcinoma tissues respectively. The overexpression of MIF had a significant correlation with Ⅰ,Ⅱ,Ⅲ,Ⅳ tumor stage (69. 2%, 94. 7%, 96. 4%, 100%, P <0.05), while the positive expression rate of cyclinD1 only had a significant correlation with tumor stages Ⅲ,Ⅳ (33. 3%, 68. 8%, P <0. 05). Both of the two proteins had a correlative tendency with pathological grade and lymph node metastasis. The different expression of MIF between pancreatic carcinoma with and without liver metastasis had no statistical significance, (100% ,85.9%, P >0. 05)while there was a statistically significant difference about cyclinD1 (66. 7% ,46. 5% ,P <0. 05). A significant positive correlation was also found between MIF and cyclinD1 (P < 0. 05). Conclusion The ex-pression of MIF and CyclinD1 was higher in pancreatic cancer tissues than in normal tissue, and they may be associated with the malignant stage, tumor differentiation, local lymph node and liver metastasis of this tumor.