Endoscopic lateral neck dissection via the breast and transoral approaches for papillary thyroid carcinoma: a report of 10 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the feasibility of endoscopic lateral neck dissection via the breast and transoral approaches (ELNDBTOA) for papillary thyroid carcinoma (PTC). Methods: From February 2015 to April 2019, 10 patients with PTC (cN1b) including 1 male and 9 females aged from 22 to 53 years old received ELNDBTOA in the General Surgery Department of Zhongshan Hospital, Xiamen University. Total thyroidectomy, the central lymph node dissection and the selective neck dissection (levels Ⅱ, Ⅲ and Ⅳ) were performed endoscopically via the breast approach, and then the residual lymph nodes were dissected via transoral approach. The medical records, operation time, blood loss, complications and postoperative follow-up outcomes were analyzed retrospectively. SPSS 22.0 software package was used for statistical processing of clinical data of patients. Results: All cases were successfully treated with ELNDBTOA without transfer to open surgery. The average operative time was (362.5±79.7) min, the blood loss was (23.0±14.9) ml, and the postoperative hospital stay was (5.1±1.3) days. The mean number of harvested cervical lymph nodes were (34.2±25.8), and the mean number of positive lymph nodes were (6.5±4.9). Lymph nodes were dissected by the further dissection via oral approach in 6 patients and a total of 9 lateral lymph nodes were havested from 2 of the 6 patients, with 3 positive lymph nodes. Two patients had transient skin numbness in the mandibular area and recovered within two weeks. One patient developed transient hypoparathyroidism and recovered within two months. No secondary bleeding, recurrent laryngeal nerve paralysis, chylous leakage, neck infection, permanent hypoparathyroidism or other complications were observed. The follow-up time was from 16 to 66 months with a median of 42.5 months, no tumor recurrence or metastasis occurred, and also no obvious deformity, abnormal sensation or movement in the chest, neck and mouth was observed. Conclusions: ELNBTOA is safe and feasible, with good cosmetic outcome.

Metformin induces apoptosis in hepatocellular carcinoma Huh-7 cells in vitro and its mechanism / 中华肿瘤杂志

<p><b>OBJECTIVE</b>to investigate the effects of antidiabetic drug metformin on proliferation and apoptosis in human hepatocellular carcinoma cell line Huh-7 cells.</p><p><b>METHODS</b>Huh-7 cells were treated with metformin at different concentrations. Cell viability was determined by MTT assay. Cell apoptosis and CD133(+) expression rate were detected by flow cytometery (FCM). Expressions of PTEN, Akt, p-Akt, Bcl-2, Bax proteins in the cells were measured by Western blot. The effect of metformin on the hepatosphere formation was observed in the serum-free suspension culture. Reverse transcription-polymerase chain reaction (RT-PCR) was used to validate the expression levels of stemness marker genes CD133, β-catenin, and ABCG2 mRNA in the hepatospheres.</p><p><b>RESULTS</b>The proliferation of Huh-7 cells was inhibited by metformin in a dose- and time-dependent manner. The early and late cell apoptosis rates induced by metformin at dose of 10 mmol/L for 48 hrs were (22.29 ± 0.8)% and (13.87 ± 1.2)%, respectively, and 25 mmol/L for 48 hrs (15.28 ± 2.1)% and (25.89 ± 2.3)%, respectively. Western blotting results revealed that the expression of CD133, phosphorylated Akt and the Bcl-2/Bax ratio were downregulated, and PTEN was upregulated in the Huh-7 cells after treated with 25 mmol/L metformin for 48 hrs. Metformin inhibited the formation of hepatospheres. Metformin also downregulated the expression of several cancer stem cells (CSCs)-related genes which are involved in the signaling pathways governing the self-renewal, proliferation and differentiation of CSCs in the hepatospheres.</p><p><b>CONCLUSIONS</b>Metformin inhibits the proliferation of human hepatocellular carcinoma Huh-7 cells and enhances their apoptosis in vitro. It may be related to the downregulation of PI3K/Akt signal pathway and selectively targeting CD133(+) cells.</p>

Association between tumor necrosis factor alpha gene polymorphism and colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the association of TNF-alpha-308G/A gene functional polymorphism with the development and progression of colorectal cancer.</p><p><b>METHODS</b>PCR-RFLP was employed to detect the TNF-alpha-308 G/A genotypes in 157 colorectal cancer patients and 117 healthy controls.</p><p><b>RESULTS</b>The frequency of TNF-alpha-308 genotype and allele were not significantly different between colorectal cancer patients and healthy controls (genotype chi(2)=1.054, P=0.591, allele chi(2)=0.404, P=0.525). The frequency of A/A genotype and A allele in III+IV stage (62 patients in total) were higher than those in I+II stages (85 patients in total) (A allele: 22.6% vs 12.9%, A/A genotype: 8.1% vs 1.2%), and the differences were significant (genotype P=0.048, OR=7.368, 95% CI=0.839-64.743, allele chi(2)=4.720, P=0.03, OR=1.962, 95% CI=1.061-3.628). The frequency of TNF-alpha-308 genotype were not significantly different among different colorectal cancer grades (chi(2)=3.009,P=0.591).</p><p><b>CONCLUSION</b>TNF-alpha-308G/A gene polymorphism is not associated with the development of colorectal cancer, but TNF-alpha-308 A/A genotype and A allele are related to the progression of colorectal cancer.</p>

Association between vascular endothelial growth factor gene 936 T/C polymorphism and colorectal cancer together with anastomotic leakage / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the association between VEGF gene 936 T/C polymorphism and colorectal cancer together with anastomotic leakage.</p><p><b>METHODS</b>Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the VEGF 936 T/C genotypes in colorectal cancer patients and healthy controls.</p><p><b>RESULTS</b>There was no significant difference in the frequency of VEGF 936 C/C genotype or C allele between colorectal cancer patients and healthy controls (P > 0.05). The C/C genotype or C allele in colorectal cancer patients with anastomotic leakage was less frequently found than in the group without anastomotic leakage (P < 0.05).</p><p><b>CONCLUSIONS</b>VEGF 936 C/C genotype or C allele is not related to the development of colorectal cancer, but they can reduce the risk of anastomotic leakage after surgery in colorectal cancer patients.</p>