Diagnostic value of absent ductular reaction at hepatocellular-stromal boundaries in early stage hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the role of absent ductular reaction (DR) at hepatocellular-stromal boundaries in early stage hepatocellular carcinoma (HCC) with cirrhosis in patients with chronic hepatitis B.</p><p><b>METHODS</b>Cytokeratin (CK)7 and CK19 expression was detected by the SP immunohistochemistry method in 112 hepatic nodules taken from 20 cases of early HCC, 26 cases of HCC with nodules more than 3 cm, 20 cases of high-grade dysplastic nodule (HGDN), 26 cases of low-grade dysplastic nodule (LGDN), and 20 cases of cirrhosis (CIR). DR/CK7 and DR/CK19 were assessed separately on a semi-quantitative scale and statistically analyzed.</p><p><b>RESULTS</b>The mean age of the patients in the study was 53.71 years-old, and the study population consisted of 73 males and 39 females. The follow-up time ranged from 3 to 90 months. Positive CK7 and CK19 staining was detected in the cytoplasm of DR-positive hepatobiliary cells, interlobular bile duct, and a portion of hepatic cells. All of the DR/CK7- and DR/CK19-positive cells were localized around the non-invasive nodules. Specimens with focal or diffuse DR/CK7- and DR/CK19-loss had more robust stromal invasion. Specimens from early HCC cases showed greater DR/CK19 loss than specimens from HGDN cases, LGDN cases and CIR cases (all P less than 0.01). DR/CK7 loss of early HCC was less than HCC with nodules more than 3 cm (P less than 0.05), and more than LGDN cases and CIR cases (both P less than 0.01).The area under the receiver operating characteristic curve of DR/CK7 was very similar to that of DR/CK19 (P more than 0.05). Pearson's correlation analysis indicated that DR/CK7 and DR/CK19 were positively correlated with tumor-free time (P less than 0.01) and negatively correlated with early recurrence time as well as death rate (both P less than 0.01). Furthermore, cases showing DR/CK7 or DR/CK19 loss had lower overall survival rate and tumor-free survival rate (P less than 0.01) and higher early recurrence rate (P less than 0.01).</p><p><b>CONCLUSION</b>DR/CK7 and DR/CK19 immunostaining may help to distinguish non-invasive HGDNs from both minimally-invasive and overtly-invasive HCCs by identifying small foci of invasion and predicting increased risk of invasiveness.</p>

X-chromosomal inactivation skewing in blood cells is associated with early development of lung / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the relationship between skewed X-chromosomal inactivation (SXCI) and development of lung cancer in females.</p><p><b>METHODS</b>DNA was isolated from peripheral blood cells from patients with primary lung cancer (n = 148) and control subjects (n =289). Exon 1 of androgen receptor ( AR) gene was amplified, with its products from different alleles resolved on denaturing polyacrylamide gels and visualized by silver staining. The corrected ratio (CR) between products from different AR alleles before and after Hpa II pretreatment was calculated. All statistical tests were two-sided.</p><p><b>RESULTS</b>With CR> or = 10 adopted as the criterion, SXCI was found more frequently in the younger patients ( C50 years; 7. 9%) than in the controls of the same age group (1. 2% ; P = 0. 046). The SXCI frequency, however, were not significantly different between the old patients ( > 50 years; 4. 5% ) and the controls of the same age group (5. 4% ; P =0. 488). Whether taking CR> or =3 or CR> or =10 as the criteria, the average ages of the patients with SXCI were more than 10 years younger than those without SXCI (P < 0. 05).</p><p><b>CONCLUSION</b>SXCI in blood cells is associated with early development of lung cancer in females.</p>

The prevention of hemorrhoea after superior position sacral tumor was resected / 中国基层医药

Objective To investigate methods and effect of preventing hemorrhoea when superior position sacral tumor was resected.Methods 36 patients with superior position sacral tumor were operated by excision of presacral tumor from May 2000 to May 2007.14 cases were performed with double hypogastric artery ligation.Hy- pogastric arteries were embolismed temporarily through intervention in 7 cases and permanently in 10 cases.Distal end of abdominal aorta was placed with sacculus in advance in 5 cases.Average volume of blood was calculated ac- cording to different methods of preventing blood.Results Blood loss was 500～2000ml(average 1100ml)by hy- pogastric artery ligation.Blood loss was 600～2100ml(average 1200ml)by temporary double hypogastric arterial em- bolism while blood loss was 550～1900ml(average 1150ml)by temporary embolism.Blood loss was 200～1000ml (average 560ml)by placing sacculus in advance at distal end of abdominal aorta.Conclusion Hemorrhoea may be prevented completely through temporarily or temporarily reducing blood supply of pars sacralis when sacral tumor was resected.Especially,it is a best method when distal end of abdominal aorta was placed with sacculus in advance.