Research advances in the diagnosis and treatment of benign gallbladder disease / 中华肝胆外科杂志

Benign gallbladder diseases are common in general surgery practice, and laparoscopic cholecystectomy (LC) has become the standard treatment for these conditions. With the widespread adoption of LC and the improved understanding of gallbladder disease, it is necessary to re-evaluate the diagnosis and treatment of benign gallbladder disease. Based on the latest expert consensus on the diagnosis and treatment of benign gallbladder disease, this review aims to provide an overview of the diagnostic and treatment strategies for benign gallbladder diseases. Specifically, it focuses on enhancing our understanding of the role of benign gallbladder diseases in the development of gallbladder cancer, the impact of congenital biliary anomalies on the diagnostic and treatment processes of benign gallbladder diseases, and the significance of the preoperative examinations.

Risk factors in predicting lymph node metastases in intrahepatic cholangiocarcinoma / 中华肝胆外科杂志

Objective:To study the risk factors of lymph node metastases in patients with intrahepatic cholangiocarcinoma (ICC) and to establish a risk prediction model of lymph node metastases in ICC.Methods:The clinicopathological data of 587 ICC patients who underwent radical hepatectomy and lymph node dissection at Third Affiliated Hospital of Naval Medical University (Shanghai Eastern Hepatobiliary Surgery Hospital) from January 2007 to December 2011 were retrospectively analyzed. There were 395 males and 192 females with ages which ranged from 20 to 82 (54.7±10.8) years. Independent risk factors of lymph node metastases were studied using univariate and multivariate logistic regression analysis, and a risk prediction model was established. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of this model.Results:Of 587 patients, 158 (26.9%) had lymph node metastases. Multivariate logistic regression analysis showed that platelet count >300×10 9/L ( OR=1.985, 95% CI: 1.030-3.824, P=0.041), carbohydrate antigen 19-9 >37 U/ml ( OR=2.978, 95% CI: 1.994-4.448, P<0.001), tumor situated in left hemiliver ( OR=1.579, 95% CI: 1.065-2.341, P=0.023), multiple tumors ( OR=1.846, 95% CI: 1.225-2.783, P=0.003), and absence of cirrhosis ( OR=2.125, 95% CI: 1.192-3.783, P=0.011) were independent risk factors for lymph node metastases in ICC. The area under the ROC curve was 0.714, with a cutoff value of 0.215, and the sensitivity and specificity being 75.9% and 58.3%, respectively. Conclusions:The risk prediction model of ICC lymph node metastases was established using readily available clinical data obtained before operation. This model has good predictive values and can provide a reference for treatment decision on patients with ICC.

Progress of immunotherapy of cholangiocarcinoma / 中华肝胆外科杂志

Cholangiocarcinoma (CCA) is a group of solid tumors with high malignant degree and poor prognosis. Surgical resection has still been the main therapy options. Targeting therapy and immunotherapy are the main anti-tumor methods that have been paid more and more attention in recent years, especially immunotherapy. The tumor microenvironment of CCA is complex, which encompasses not only interstitial and endothelial cells, but also a large number of immune cells. In addition, the innate and adaptive immune systems also play a role. This article summarizes the immune-related studies of cholangiocarcinoma and the latest clinical trials of immunotherapy.

Controversies and Considerations on Surgical Treatment of Gallbladder Cancer / 肿瘤防治研究

Gallbladder cancer is a high malignancy which is predisposed to invade adjacent organs and have lymph node metastasis. Gallbladder cancer is not sensitive to radiotherapy or chemotherapy with the worst prognosis among biliary tract cancers. At present, radical resection is the only possible method to cure gallbladder cancer. However, there are still many controversies about the surgical strategies, the extent of liver resection and lymph node dissection, and the treatment of incidental gallbladder cancer. In addition, under the background of the great success of immunotherapy and targeted therapy in a variety of solid tumors, it is also a question worthy of further considerations that whether the status of surgery in the treatment of advanced gallbladder cancer will be changed in the near future.

Expression and clinical significance of CXCR4, CXCL12 and PTEN in breast cancer / 国际肿瘤学杂志

Objective To analyse the expressions and clinical significances of CXCR4,CXCL12 and PTEN in breast cancer.Methods The expressions of CXCR4,CXCL12 and PTEN in 60 cases of breast cancer were detected by immunohistochemistry technique SABC method.The correlations of levels of CXCR4,CXCL12 and PTEN expression and the age of patient,tumor diameter,histological grade,TNM stage,lymph node metastasis,ER status,Her-2 status,and vessel invasion were analysed.Twenty cases of breast fibroadenoma tissues and 20 cases of normal breast tissues were analysed as controls.Results The expressions of CXCR4 (x2 =48.754,P =0.000),CXCL12 (x2 =47.611,P =0.000) and PTEN (x2 =19.994,P =0.000) in breast cancer,normal breast tissues and breast fobroadenoma showed significant differences.The positive expressions of CXCR and CXCL12 were significantly correlated with histological grade (x2 =11.080,P =0.004;x2 =6.978,P =0.031),TNM stage (x2 =9.819,P =0.007;X2 =10.163,P =0.006),lymph node metastasis (x2 =6.213,P =0.013;x2 =8.031,P =0.005),ER (x2 =12.774,P =0.000;x2 =7.330,P=0.007),vessel invasion (x2 =5.860,P=0.013; x2 =5.185,P=0.020) and Her-2 (x2 =5.487,P =0.019;x2 =4.689,P =0.030).The expression of PTEN in breast cancer was significantly correlated with TNM stage (x2=7.366,P =0.025),lymph node metastasis (x2 =5.511,P =0.019) and ER state (x2 =4.077,P =0.043).There was a positive correlation between the expression of CXCR4 and the expression of CXCL12 in breast cancer (r =0.336,P =0.004).There was a negative correlation between the expression of CXCR4 and the expression of PTEN in breast cancer (r =-0.362,P =0.004).There was a negative correlation between the expression of CXCL12 and the expression of PTEN in breast cancer (r =-0.360,P =0.004).Conclusion The high expression of the chemokine CXCL12 and its receptor CXCR4 and the low expression of PTEN are closely related to the carcinogenesis and metastasis of breast cancer,which may play an important role in the development of breast cancer.

Cadherins and triple-negative breast cancer / 国际肿瘤学杂志

Cadherins that mediate the adhesion of the same type of cells by specific binding to calciumdependent adhesions of the same type with cadherins mainly consist of three subtypes including E-cadberin,P-cadherin and N-cadherin.In recent years,more and more studies have indicated that cadherins are closely related to triple-negative breast cancer(TNBC)and play an important role in prognosis and treatment of TNBC.