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Objective:To investigate the prognostic factors of patients with pancreatic body and tail carcinoma.Methods:The clinical data of 64 patients with pancreatic body and tail carcinoma who underwent surgical resection or endoscopic ultrasound biopsy and were pathologically confirmed in the Second Affiliated Hospital of Jiaxing University from January 2013 to March 2020 were retrospectively analyzed. Age, gender, diabetes mellitus, serum CEA and CA19-9 levels at initial diagnosis, tumor site, maximum tumor diameter, TNM stage and treatment method were collected. Kaplan-Meier method was used to draw survival curve, and Log-rank test was used to analyze survival rate. Univariate and multivariate Cox proportional risk regression models were used for prognostic analysis.Results:Among the 64 patients, 24 patients were complicated with diabetes; serum CEA level was increased in 36 cases, and serum CA19-9 level was increased in 46 cases; 8 cases were in TNM stage ⅠA, 4 cases were in ⅠB stage, 4 cases were ⅡA stage, 4 cases were in ⅡB stage, 8 cases were in Ⅲ stage, and 36 cases were in Ⅳ stage. Symptomatic treatment was performed in 18 cases, chemotherapy combined with immunotherapy were in 18 cases, and surgical comprehensive therapy (surgery combined with chemotherapy and immunotherapy) were in 26 cases. Univariate analysis showed that diabetes mellitus, serum CEA and CA19-9 levels, TNM stage and treatment mode were related factors affecting the prognosis of patients with pancreatic body and tail carcinoma (all P value <0.05). Multivariate analysis indicated that TNM stage ( HR=2.536) and surgical comprehensive therapy ( HR=0.285) were the independent factors affecting the prognosis of patients with pancreatic body and tail carcinoma ( P<0.05). Median survival was 25 months (95% CI 21.416-28.584) for patients with TNM stage Ⅲ+ Ⅳ pancreatic body and tail carcinoma treated with surgical comprehensive therapy, 11 months (95% CI 7.246-14.754) for patients treated with chemotherapy combined with immunotherapy, and 6 months (95% CI 3.819-8.181) for patients treated with symptomatic treatment; the median survival time of patients with surgical comprehensive therapy was significantly longer than that of patients with chemotherapy combined with immunotherapy and symptomatic treatment, and the difference was statistically significant ( P<0.05). Conclusions:TNM stage and surgical comprehensive therapy were the prognostic factors affecting the prognosis of patients with pancreatic body and tail carcinoma, and surgical comprehensive therapy may be the best choice for long-term survival of patients.
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Objective:To investigate the correlation of c-MET expression with circulating miR-34a and miR-449 level in pancreatic cancer tissue and its clinical significance.Methods:A total of 41 patients with pancreatic cancer treated surgically and pathologically confirmed from March 2015 to March 2017 were collected in Second Affiliated Hospital of Jiaxing Medical College. The expression of hepatocyte growth factor receptor (c-MET) in pathological tissues and matching adjacent normal tissues was determined by immunohistochemistry. The patients were divided into c-MET positive group ( n=26) and c-MET negative group ( n=15) according to the results. Peripheral blood was collected before and 3 months after the operation, and the expressions of circulating miRNA34a (miR-34a) and miR-449 were determined by fluorescence quantitative PCR. The relationships between c-MET in pancreatic cancer tissue and clinicopathological features, prognosis, circulating miR-34a expression, and miR-449 expression were analyzed. The effects of circulating miR-34a and miR-449 expression on TNM stage, lymph node metastasis and prognosis of pancreatic cancer patients were analyzed. Results:The positive rate of c-MET in pancreatic cancer was obviously higher than that in adjacent normal tissue (63.4% vs 24.4%), and the difference was statistically significant ( P<0.05). Compared with c-MET negative group, the TNM stage Ⅲ/Ⅳ cases in c-MET positive group were more (73.1% vs 33.4%), the lymph node metastasis rate in c-MET positive group (76.9% vs 46.7%) were higher, and the follow-up survival time of c-MET positive group was shorter (29.5 mo vs 35 mo), and the survival rate of the c-MET positive group was lower (38.5% vs 53.3%), and the differences were statistically significant (all P<0.05). Before surgery, the expressions of circulating miR-34a and miR-449 in the c-MET positive group were lower than those in the c-MET negative group (0.228±0.068 vs 0.524±0.106, 0.252± 0.063 vs 0.432±0.094, P<0.05). After surgery, the miR-449 expression in c-MET positive group was still lower than that in c-MET negative group (0.414±0.088 vs 0.512±0.114, P<0.05), while there was no statistically significant difference on miR-34a between the two groups. Preoperative miR-34a and miR-449 expression had predictive value for TNM stage, lymphatic metastasis and prognosis ( P<0.05). Conclusions:miR-34a and miR-449 may target c-MET in pancreatic cancer tissue, which could be used as potential tumor markers for pancreatic cancer.
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ObjectiveTo investigate the value of endoscopic ultrasonography (EUS) in the diagnosis of pancreatic space-occupying diseases. MethodsA total of 85 patients with suspected pancreatic space-occupying diseases who were treated in The Second Affiliated Hospital of Jiaxing College from January 2015 to January 2017 were enrolled. Surgical pathological results or follow-up results were used as the gold standard for evaluating the value of EUS and EUS-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic space-occupying diseases. The chi-square test was used for comparison of categorical data between groups. ResultsEUS had an imaging detection rate of 96.7% (59/61), a specificity of 100% (24/24), and an accuracy rate of 97.6% (83/85) in the diagnosis of pancreatic space-occupying diseases; EUS had significantly higher detection rate and accuracy rate than abdominal ultrasound, computed tomography, and magnetic resonance imaging (detection rate: χ2=4.344, 3.873, and 15.445, all P＜0.05; accuracy rate: χ2=6.675, 8.685, and 17389, all P＜0.05). EUS-FNA had a detection rate of 81.8% (45/55) and an accuracy rate of 81.0% (47/58). Among the patients who underwent surgery to have pathological results, the overall coincidence rate of preoperative EUS-FNA was 84.2% (16/19). ConclusionCompared with conventional imaging examinations, EUS has a higher diagnostic accuracy for pancreatic space-occupying diseases, and EUS-FNA can further clarify the nature and pathological type of space-occupying lesions. EUS may help with the early diagnosis and treatment of pancreatic tumors.
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Objective@#To detect the expression of B cell transposition gene 3(BTG3) in pancreatic ductal adenocarcinoma(PDAC), and explore its relationship with postoperative recurrence and metastasis of tumor.@*Methods@#Six self-paired frozen PDAC specimens and 3 normal pancreatic tissues from the Second Hospital of Jiaxing Affiliated to Jiaxing University were collected and the expression of BTG3 was detected by qPCR. Ten normal pancreatic tissues and 52 cases of PDAC tumor and paracarcinomatous tissues from the Second Hospital of Jiaxing Affiliated to Jiaxing University were collected from June 2009 to December 2016. The expression of BTG3 and relationship among BTG3 and clinicopathological characteristics of PDAC and patients′ prognosis were detected and analyzed using immunohistochemistry.χ2 test, Kaplan-Meier method and Cox regression model were used to analyzed the data.@*Results@#The results of qPCR showed that expression level of BTG3 in PDAC (0.63±0.17) was lower significantly than that in paracarcinomatous (0.96±0.04) and normal tissues (1.00)(t=4.673, 5.502; both P<0.05). Immunohistochemistrv showed that BTG3 mainly expressed in the cytoplasm.The high expression rate of BTG3 in PDAC tumor tissues was 25.0%(13/52), which was remarkably lower than that in paracarcinomatous tissues(65.4%) and normal liver tissues(7/10)(χ2=17.120 and 5.849, both P<0.05). The low expression of BTG3 in PDAC was correlated with primary tumor, and TNM stage(χ2=7.704, P=0.006; U=154.000, P=0.018, respectively). Survival analysis showed that disease free survival rate of patients with low expression of BTG3 was significantly less than that with high expression(χ2=192.493, P<0.01). The Cox multivariate analysis demonstrated that low expression of BTG3 was independent risk factors for disease free survival in patients with PDAC after a curative resection(RR=3.366, 95%CI: 1.040-10.889, P=0.043).@*Conclusion@#BTG3 may be involved in the occurence and development of tumor, and its low expression may be associated with poor prognosis in patients with PDAC.
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Objective To study the expressions of metadherin (MTDH),E-cadherin and β-catenin in the tissues of hepatocellular carcinoma (HCC),to investigate the relationship between them and the clinical-pathological features,and to evaluate the prognostic values after surgical resection for hepatocellular carcinoma.Methods The protein expressions of MTDH,E-cadherin and β-catenin were studied by immunohistochemistry in tumor tissues of 107 HCC patients who underwent curative surgical resection.The data were correlated with the clinical-pathological data,tumor free time and recurrence rate.Results Positive expression of MTDH and nuclear β-catenin accumulation were correlated with the Edmondson grade (P＜0.05) and decreased E-cadherin expression was correlated with the preoperative serum level of α-fetoprotein (AFP) (P＜0.05).All these expressions were associated with a shorter tumor-free survival and a higher recurrence rate (P＜0.05).Positive MTDH expression was correlated with decreased E-cadherin expression and nuclear β-catenin accumulation (P＜0.05).On Cox regression analysis,MTDH was an independent risk factor of tumour recurrence (RR=3.431,CI=1.254～ 7.318).Conclusions Positive MTDH expression,decreased E-cadherin expression,and nuclear β-catenin accumulation indicated a higher recurrence rate after curative surgical resection for HCC.MTDH was an independent risk factor of recurrence.
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Objective To explore the value of endoscopic nasopancreatic drainage (NPD) in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) in a high-risk population.Methods From April 2009 to February 2012,a total of 105 cases of PEP high risk population were collected and divided into non NPD group (n=58) and NPD group (n=47) according to the situation during the endoscopic retrograde cholangiopancreatography(ERCP) operation.NPD was placed in NPD group,the head of the drainage passed the neck of pancreas under X-ray.Nasobiliary drainage or no drainage was assigned to the group of non NPD group according to the situation during operation.x2 test and t-test were performed for comparing and analyzing the clinical data before and post operation,the incidence and risk ratio of PEP between the two groups.Results Twenty-four hours after ERCP,the mean level of serum amylase at 24 h (t=2.419),the degree of abdominal pain (t3h=2.585,t24h=7.236) and relief time (t=4.996) of NPD group were better than those of non NPD group (all P＜0.05).The incidence of PEP in NPD group was 6.7％(3/45) and non NPD group was 29.3 ％ (17/58),the incidence of PEP in the NPD group was significantly lower than that in the non NPD group (x2 =8.304,P＜0.01),and the relative risk was 0.172 (95％CI:0.047 to 0.632,P＜0.01).Conclusion The regular placement of endoscopic NPD is a practical,effective and easy way to prevent PEP in high risk population.
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Objective To explore the efficacy of transthoracic endoscopic T2～3 sympathectomy in the treatment of palmar hyperhidrosis with chilblain. Methods A total of 16 patients underwent bilateral transthoracic endoscopic T_2～3 sympathectomy. The sympathetic chain was cut off on the third posterior rib. Palmar skin temperature was monitored simultaneously during the operation. Results The procedure was successfully completed without complications in all the 16 patients. The palmar temperature on the side of prior thoracotomy was significantly higher at 15 min after sympathectomy (33.8?1.3 ℃) than before operation (29.8?0.8 ℃; q=12.513, P