Assessment of risk factors of lymph node metastasis and follow-up of Siewert Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction / 国际外科学杂志

Objective:To explore the risk factors of lymph node metastasis and prognosis in Siewert Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction (AEG) patients.Methods:A total of 134 patients who underwent surgical operation between June 2013 and December 2019 at the Beijing Friendship Hospital, Capital Medical University were retrospectively reviewed, including 112 males and 22 females, with a male to female ratio of 5.5∶1 and an average age of 62.1(27-82 years old). The primary outcomes were lymph node metastasis risk and 3-years overall survival. The secondary outcomes were the rate and pattern of lymph node metastasis. Follow-up methods mainly include outpatient and telephone. During the follow-up period, the patient needs to receive physical examination, laboratory examinations, chest and abdominal CT scan and gastroscopy to evaluate the status of disease. The patients were followed up until January 2020. Chi-square test or Fisher test was used for the comparison between count data group, and rank sum test was used for the comparison between grade data group. Stepwise Logistic regression was used for multivariate analysis, and COX regression risk model was used for survival analysis.Results:Multivariate analysis revealed that the parameters infiltration depth ( OR=4.341, 95% CI: 2.498-7.545, P=0.000), gross type ( OR=3.626, 95% CI: 1.425-9.228, P=0.007) and intravascular cancer embolus ( OR=2.888, 95% CI: 1.106-7.544, P=0.030) correlated with lymph node metastasis. For all patients, the lymph nodes No. 1, 2, 3, 4, 7, 11 indicated higher lymph node metastatic rate in the abdominal cavity. However, No.5 and No. 6 indicated different tendency, which was higher in Siewert Ⅲ AEG and lower in Siewert Ⅱ AEG patients. Mediastinal lymph node metastasis of Siewert Ⅱ AEG mainly occurred in No. 110 and No. 111 cases corresponding to 7.1 and 3.0%, respectively, compared with those noted in Siewert Ⅲ AEG patients. The 3-year overall survival analysis revealed that lymph node metastasis (82.1% vs 46.1%, P=0.046) and chemotherapy (60.6% vs 39.4%, P=0.007) exhibited significant differences. Conclusions:The infiltration depth, gross type and intravascular cancer embolus are independent risk factors of lymph node metastasis. In addition, patients with lymph node metastasis exhibite worse long-term prognosis. The data indicate that perioperative chemotherapy could improve the prognosis of AEG patients.

The association of gastric hyperplastic polyps and autoimmune metaplastic atrophic gastritis / 中华消化内镜杂志

Objective:To study the association of gastric hyperplastic polyps (GHPs) and autoimmune metaplastic atrophic gastritis (AMAG).Methods:A retrospective analysis was conducted on data regarding 56 GHPs patients who underwent endoscopic resection at Beijing Friendship Hospital, Capital Medical University from January 2011 to June 2017, including 17 patients with neoplasia and 39 patients without neoplasia. The characters of GHPs in serology, gastroscopic manifestation and pathology were analyzed.Results:The data of patients including 34 females and 22 males were collected in the study. The age was 61.88±9.01 years. The increase rate of fast serum gastrin was 50.0% (28/56), the positive rate of serum gastric parietal cell antibody (PCA) was 62.5% (35/56), the rate of anemia was 37.5% (21/56), and the negative rate of Helicobacter pylori was 64.3% (36/56). Compared with the patients with negative serum PCA, the patients with positive serum PCA were mostly female ( P=0.034), prone to hypergastrinemia ( P<0.001), anemia ( P=0.001), especially iron deficiency anemia ( P=0.044), and multiple GHPs ( P=0.019). There were 108 GHPs in 35 PCA positive patients, GHPs were more distributed in the gastric fundus and corpus (91/108, 84.3%) than in antrum (17/108, 15.7%, P=0.005). There were 63 GHPs in 21 anemia patients, 54 (85.7%) GHPs located in the gastric fundus and corpus, and 9 (14.3%) GHPs in antrum ( P=0.075). There were total 142 GHPs in 56 patients, 73.2% GHPs (104/142) were pedunculated, 69.0% (98/142) were "strawberry-like" polyps. Among 17 patients of GHP with neoplasia, there were 6 high differentiated adenocarcinomas, 2 moderate adenocarcinomas, 3 high grade dysplasia, and 6 low grade dysplasia. Conclusion:GHPs are associated with AMAG. GHP with AMAG is probably one of the reasons of neoplastic transformation.

Clinical and pathological characteristics of gastric hyperplastic polyps coexisting with gastric cancers / 中华消化内镜杂志

Objective:To investigate the clinical, endoscopic and pathologic characteristics of gastric hyperplastic polyps coexisting with gastric cancers.Methods:A retrospective study was performed involving 18 patients who were pathologically confirmed with gastric hyperplastic polyps coexisting with gastric cancers. The clinical features, endoscopic findings, pathological characteristics and treatment strategy were analyzed.Results:The age of 18 patients was 67. 2±7. 8 years (ranged 45-79), including 6 males and 12 females. The symptoms included abdominal pain, distention, and some patients were asymptomatic. Multiple polyps (13/18) were common. Single lesions were often located in the gastric corpus (7/18). Endoscopy showed various morphological changes. Pedunculated polyp was the most common type (15/18). All polyps were larger than 10 mm in diameter, and the polyps in 9 patients were larger than 20 mm. Fourteen patients had atrophic gastritis in the background mucosa, and 4 patients had Helicobacter pylori ( HP) infection. Conclusion:Gastric hyperplastic polyps coexisting with gastric cancers shows no specific symptoms. For HP (-) atrophic gastritis patients accompanied with multiple gastric polyps, malignant transformation of those larger and pedunculated polyps is of possibility.

A clinicopathological analysis of 21 cases of hepatolenticular degeneration / 中华肝脏病杂志

Objective@#To improve the diagnostic quality of hepatolenticular degeneration by summarizing the clinicopathological features.@*Methods@#A retrospective analysis of 21 cases that were diagnosed as hepatolenticular degeneration with liver biopsy in our hospital from January 2013 to August 2018 was reviewed, and then their clinicopathologic features were analyzed. The pathomorphological differences between liver biopsy and liver biopsy after transplantation, and the relationship between histopathological patterns and biopsy types and clinical indicators were analyzed by Fisher's exact test.@*Results@#Of the 21 patients with hepatolenticular degeneration, 10 patients had liver biopsy, and 11 patients underwent liver biopsy after liver transplantation. Among them, four cases were presented as simple fatty liver pattern (19.0%, 4/21), eight cases as steatohepatitis pattern (38.1%, 8/21), four cases as inflammatory necrosis without cirrhosis pattern (19.0%, 4/21), and five cases as inflammatory necrosis with cirrhosis pattern (23.9%, 5/21). Twelve cases had copper deposition in the liver (57.1%, 12/21), and the pattern of copper distribution in the liver was uneven.@*Conclusion@#A clinicalpathological features of hepatolenticular degeneration mainly manifests in four patterns, but lack characteristic changes. Hence, comprehensive judgment should rely on clinical history, laboratory examination, genetic test results and liver histopathological changes.

Discrepancies in pathologic evaluation of dyaplasia/early cancer in 60 gastric endoscopic submucosal dissection specimens / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the reasons for the discrepancies in pathologic diagnosis of gastric dysplasia/early cancer in endoscopic submucosal dissection (ESD) specimens, and how to cope with the discrepancies.</p><p><b>METHODS</b>The pathologic diagnoses in 60 cases of ESD specimens according to the three currently used classification systems (namely Western criteria, Japanese criteria and Vienna classification) were compared. The diagnostic discrepancies were analyzed.</p><p><b>RESULTS</b>Fifteen of the 17 cases diagnosed as low-grade intraepithelial neoplasia according to the Western criteria were revised as adenoma by the Japanese criteria. Amongst the 43 cases of gastric intramucosal adenocarcinoma diagnosed according to the Japanese criteria, 23 cases had concordant diagnosis by the Western criteria. While the diagnosis of low-grade intraepithelial neoplasia/adenoma was basically similar irrespective of classification system used, there were significant differences in the interpretation of gastric early cancer.</p><p><b>CONCLUSIONS</b>The diagnostic discrepancies in the gastric dysplasia/early cancer are mainly related to the morphologic criteria applied in different classifications. In order to facilitate clinical and pathologic communication, a consensus using Vienna/WHO classifications, supplemented with Japanese system, is desirable.</p>

Suppressive effect of herbal compound 861 on chemical hepatocarcinogenesis in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of herbal compound 861 (Cpd861) on hepatocarcinogenesis induced by diethylntrosamine and 2-acetylaminofluorene (DEN-AAF) in female Sprague Dawley rats.</p><p><b>METHODS</b>Liver preneoplastic foci were induced using the DEN-AAF method in female Sprague Dawley rats, which were then treated with Cpd861. For quantitative assessment of liver preneoplastic foci, the placental form of glutathione-S-transferase (GST-P) positive foci were measured using immunohistochemical staining and image analysis. GST-P protein expression was measured by Western blotting, mRNA expression was assessed by Northern blotting.</p><p><b>RESULTS</b>Treatment using DEN-AAF caused a significant decrease in body weight and increase in liver weight compared to the control group. Oral Cpd861 administration essentially prevented DEN-AAF-induced body weight loss and liver weight increase. When 2-AAF was followed by treatment with Cpd861, there was a decrease in the number of large foci as compared to 2-AAF alone. However, there were still considerable numbers of small mixed clear/vacuolated cell foci, some of which were positive for GST-P. Significant increase in GST-P protein and mRNA expression were observed in the DEN-AAF group, while treatment with Cpd861 inhibited the increase. The effect of Cpd861 on hepatocarcinogenesis occurred in a concentration-dependent manner.</p><p><b>CONCLUSION</b>Chinese herbal compound Cpd861 prevents hepatocarcinogenesis in DEN-AAF-induced liver preneoplastic lesions in rats.</p>

The influence of heat-induced epitope retrieval on endogenous avidin-binding activity (EABA) and blocking of EABA in immunohistochemistry / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the influence of heat-induced epitope retrieval (HIER) on endogenous avidin-binding activity (EABA) and to establish an effective way to block EABA in immunohistochemistry.</p><p><b>METHODS</b>Systematically screening EABA in 164 (679 samples) formalin-fixed and paraffin-embedded human tissues including 76 (102 samples) normal tissues and 88 (577 samples) tumor tissues as well as 4 (80 samples) formalin-fixed and paraffin-embedded rat normal tissues using tissue array (tissue chip), HIER, immunohistochemistry and egg white solution blocking. In addition, EABA was also examined in 9 (15 samples) human frozen tissues.</p><p><b>RESULTS</b>(1) EABA was detected in frozen tissues. (2) No staining for EABA was seen in formalin-fixed and paraffin-embedded tissues. (3) EABA was revealed after the tissues treated with microwave HIER. (4) The density of signal for EABA was variable from tissue to tissue and cell to cell. (5) The signals of EABA expressed in scatter or diffuse in tissues and in granular form in cytoplasm. (6) EABA was found in a wide range of epithelial tissues, especially in gland epithelia of normal and tumor tissues. These included kidney, adrenal cortex, liver, C cells of thyroid gland, oxyphil cells of parathyroid, fundal gland of stomach, sebaceous gland of skin, duct of salivary; oncocytoma and papillary adenocarcinoma of kidney and thyroid gland, adenolymphoma of parotid, carcinoma of liver cell, adenocarcinoma of stomach, colon, prostate, gall bladder and endometrium, and so on. (7) EABA was easier revealed by higher pH value buffer (EGTA pH 9.0) than that with lower pH value (EDTA pH 8.0 and citrate pH 6.0). (8) The revealed EABA could be effectively blocked using 20% egg white solution.</p><p><b>CONCLUSIONS</b>HIER could unmask EABA in formalin-fixed and paraffin-embedded tissues. The unmasked EABA present in a wide range of human normal and tumor tissues as well as in rat normal tissues. The EABA could influence routine immunohistochemistry staining when using (strept)avidin-horseradish peroxidase detective system. The egg white solution could effectively block EABA and eliminate the influence of EABA on immunohistochemistry.</p>

Retrovirus-mediated HSV_1-tk gene therapy for androgen-independent prostate cancer / 中华泌尿外科杂志

Objective To use HSV 1 tk (herpes simplex virus type Ⅰthymidine kinase)/GCV (ganciclovir) in androgen independent prostate cancer cells(C4 2,PC3) in vitro in order to provide useful basis for clinical use. Methods HSV 1 tk gene was ligated to a pN 2A retroviral vector. Recombinant DNA molecules being introduced into a packaging cell line PA317,the high titer virus producer cells (VPC) were screened.The integration and expression of HSV 1 tk gene in VPC was observed by PCR and RT PCR. VPC was co cultured with these cancer cells in the light of 1∶1,1∶2,1∶4,1∶8.Cell viability (cytotoxicity) was assessed by SRB (sulforhodamine B protein dye binding)after the first day,the third day,the fifth and the seventh day. Results The highest titer VPC producing HSV 1 tk gene was isolated. Retrovirus mediated HSV 1 tk gene therapy was effective and active against such prostate cancer cells.The best one was co culture of VPC and cancer cells at 1∶1 and the fifth day followed by GCV. Compared with C4 2, PC3 decreased remarkably.The activation of apoptosis and other ways failed to be found. Conclusions Retrovirus mediated HSV 1 tk gene therapy in Vitro directly killed the tumor cells by cytolytic activity.