Diffuse liver infiltration by melanoma of unknown primary origin: one case report and literature review.

Diffuse liver infiltration by melanoma of unknown primary origin is rare. We encountered a unique case of diffuse liver infiltration by melanoma of unknown primary origin in our hospital. A 62-year-old woman was referred to our hospital for anorexia of 6 months duration and abdominal distension for 1 month. Ultrasonography (US), computerized tomography (CT) and magnetic resonance imaging (MRI) revealed an obvious enlarged liver without detectable nodules. She was diagnosed as liver metastasis by melanoma of unknown primary origin via percutaneous liver biopsy. The report demonstrates the difficulty of making a noninvasive diagnosis of diffuse hepatic infiltration on metastatic melanoma.

Relationship between matrix metalloproteinase-2 mRNA expression and clinicopathological and urokinase-type plasminogen activator system parameters and prognosis in human gastric cancer.

AIM: To investigate the relationship between matrix metalloproteinase-2 (MMP-2) mRNA expression and clinicopathologic and urokinase-type plasminogen activator (uPA) system parameter and prognosis in human gastric cancer. METHODS: Expression of MMP-2 mRNA, uPA, and uPA-R mRNA in tumor tissues and > or =5 cm adjacent normal tissues from 67 cases of gastric cancer was studied using RT-PCR and Northern blot respectively. Survival analyses were done using the Kaplan-Meier method. RESULTS: The expression rates of MMP-2 mRNA, uPA and uPA-R mRNA in tumor tissues (31%, 41%, and 51%, respectively) were significantly higher than those in > or =5 cm adjacent tissues (19%, 11%, and 9%; chi(2) = 4.59, 43.58, and 53.24 respectively, P<0.05, 0.0001, and 0.0001, respectively). Expression of MMP-2 mRNA was significantly correlated with lymph node metastasis (metastasis: 61.9%, no metastasis: 39.1%, chi(2) = 7.61, P<0.05), Lauren's classification of diffuse/mixed types: 54.2%, intestinal type: 26.3%, chi(2) = 4.25, P<0.05, expression of uPA and uPA-R mRNA (uPA+: 55.1%, uPA-: 22.2% and uPA-R+: 54.9%, uPA-R-: 18.8%, chi(2) = 5.72 and 6.40 respectively, P<0.05). Kaplan-Meier survival analysis of MMP-2 mRNA expression did not show significant difference in all 67 cases, but revealed an association of the expression of MMP-2 mRNA, uPA, and uPA-R mRNA with worse prognosis (P = 0.0083, 0.0160, and 0.0094, respectively). CONCLUSION: MMP-2 may play an important role in the development of invasion and metastasis of gastric cancer.

[The clinical value of miniature ultrasonic probes on diagnosis and treatment of digestive tract diseases].

OBJECTIVE: To investigate the clinical value of miniature ultrasonic probes (MUP) in the diagnosis and treatment of digestive tract diseases. METHODS: 537 patients who were indicated for endoscopic ultrasorography (EUS) underwent EUS with 7.5 - 20 MHz MUP and double-cavity electronic endoscope. According to the diagnoses of MUP, those patients who presented the indication of treatment were treated by endoscopic resection or surgical excision respectively, the postoperative histological results were compared with the preoperative diagnoses of MUP. A follow-up with MUP was periodically made for a few patients without endoscopic resection or surgical excision. RESULTS: Among the 537 patients the diagnosis of gastrointestinal submucosal lesions was made in the 256 cases, polyp in 56 cases, inflammatory prominence in 37 cases, extrinsic compression 53 cases, digestive tract cancer 50 cases, peptic ulcer 17 cases, cholecystolithiasis 11 cases, chronic pancreatitis in 8 cases, and achalasia 2 cases and 47 cases were diagnosed as normal, After examination of MUP, 220 patients were treated by endoscopic resection or surgical excision respectively, the postoperative histological results of 211 patients were completely consistent with the preoperative diagnosis of MUP, and diagnostic accuracy of MUP was 95.9%. The result of follow-up with MUP indicated that gastrointestinal leiomyoma, lipoma, phlebangioma and cyst were unchanged within 1 - 2 years. The patients who were treated by endoscopic resection or centesis showed no complication. CONCLUSION: EUS with MUP is a valuable method in diagnosis of gastrointestinal submucosal lesions, staging of digestive tract cancer and diagnosis of biliary-pancreatic diseases. It plays a very important role for making scientific, effective, safe and economic therapeutic plan.