Multi-omics characterization of the unsaturated fatty acid biosynthesis pathway in colon cancer.

The biosynthesis of unsaturated fatty acids is involved in the initiation and progression of colon adenocarcinoma (COAD). In this study, we aimed to investigate the multi-omics characteristics of unsaturated fatty acid biosynthesis-related genes and explore their prognostic value in colon cancer by analyzing the data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. An unsaturated fatty acid biosynthesis pathway related-genes enrichment score (BUFAS) was constructed utilizing the single sample gene set enrichment analysis (ssGSEA). We discovered that a high BUFAS was associated with longer overall survival (OS) in both the training and the validation sets. Multivariable analysis including the clinical characteristics further verified the independent prognostic value of the BUFAS in both the TCGA-COAD and the GSE39582 datasets. In addition, GSEA analysis revealed that BUFAS was positively associated with several signaling pathways, including MTORC1, peroxisome, and pathways related to fatty acid metabolism, while was negatively associated with other signaling pathways, such as hedgehog, NOTCH, and Wnt/beta-catenin pathway. Furthermore, in the COAD cell lines of the Genomics of Drug Sensitivity in Cancer (GDSC) database, we found that BUFAS was positively correlated with the drug sensitivities of cisplatin, gemcitabine, camptothecin, lapatinib, and afatinib, while was negatively correlated with that of ponatinib. Moreover, in the COAD single-cell transcriptomic dataset (GSE146771), the BUFAS varied among different cell types and was enriched in mast cells and fibroblasts. Taken together, the BUFAS we constructed could be used as an independent prognostic signature in predicting the OS and drug resistance of colon cancer. Unsaturated fatty acid biosynthesis pathway might serve as potential therapeutic targets for cancer treatment.

[Expression and clinical significance of matrilysin (MMP-7) in human rectal cancer].

OBJECTIVE: To detect the matrilysin (MMP-7) expression in human rectal cancer and to investigate whether it is correlated with invasion and metastasis of human rectal cancer. METHODS: The paired samples obtained from 100 inpatients were allocated into cancer group and control group. By Quantitative-Real-Time RT-PCR, immunohistochemical staining and computerized image analysis, the mRNA and protein expressions of MMP-7 in human rectal cancer were measured and further analyzed for the relationship between MMP-7 expression and clinicopathologic characters. RESULTS: MMP-7 mRNA expression in cancer group was higher than that in control group (P = 0.001), the mRNA expression ratio of 67 (7%) samples was over 1. The mRNA expression level of MMP-7 was correlated with age, Dukes's Staging, lymph node metastasis and histological differentiation grade. The positive degree of immunohistochemical staining for MMP-7 in cancer group (1.94 +/- 0.21) was higher than that in control group (1.15 +/- 0.20, P = 0.002). The protein expression of MMP-7 was correlated with age, Dukes's Staging and lymph node metastasis. CONCLUSION: MMP-7 expression in human rectal cancer increases significantly and plays a key role in the invasion and metastasis of human rectal cancer.

Overexpression of connective tissue growth factor WISP-1 in Chinese primary rectal cancer patients.

AIM: To clarify the expression change of Wnt-induced secreted protein-1 (WISP-1) in human rectal cancer and to determine whether it is correlated with invasion and metastasis of human rectal cancer. METHODS: Eighty-six paired samples of rectal cancer and surgically resected distant normal rectal tissue were collected and allocated into cancer group and control group respectively. WISP-1 mRNA was detected by relative quantitative real-time RT-PCR and WISP-1 protein was examined by immunohistochemical staining. RESULTS: WISP-1 gene overexpression was found in 65% (56/86) primary rectal cancers, 2-30 times that of the level in normal matched rectal tissues (P = 0.001). The mRNA expression level was correlated with Duke's staging, histological differentiation grade and lymph node status. The WISP-1 protein expression was in accordance with mRNA expression level. The positive degree of immunohistochemical staining in the cancer group (1.40 +/- 0.35) was different from that in control group (1.04 +/- 0.08, P < 0.001). Moreover, in cancer group the positive staining degree in high-level mRNA cancers (1.46 +/- 0.37, n = 56) was higher than that in low-level mRNA (1.28 +/- 0.28, n = 30, P = 0.018). CONCLUSION: Aberrant levels of WISP-1 expression may play a role in rectal tumorigenesis. WISP-1 may be used as a specific clinical diagnosis and prognosis marker in rectal cancer.

Hepatic venous outflow reconstruction in right lobe graft without middle hepatic vein.

BACKGROUND: We explored the pattern of hepatic venous outflow reconstruction in adult right lobe (segments V5-8) living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). The difficulty and challenge of LDLT without MHV is the outflow reconstruction of hepatic vein. We have modified the surgical procedure and here report the results. METHODS: Retrospective analysis was made of the clinical data of 50 recipients who underwent LDLT using right lobe without MHV. RESULTS: Forty-five recipients (90.0%, 45/50) are alive at median follow up of 10 months. The graft-to-recipient bodyweight ratio (GRWR) was 1.21% +/- 0.49% (range, 0.72% to 1.98%). The recipients of GRWR <0.8% (extra-small graft), 0.8% < GRWR < 1.2% (small graft) and GRWR > 1.2% (ideal graft) were 14, 27 and 9, respectively. Total ratio venous outflowreconstruction of V5, V8 and inferior right hepatic vein was 66.0% (33/50). The overall incidence of small-for-size syndrome was 10.0% (n = 5), the overall graft survival rate was 92.0% (46/50). CONCLUSIONS: Graft function and survival rates are not only influenced by graft size, but also by hepatic venous outflow reconstruction; the 'multiple-opening vertical anastomosis' for reconstruction of hepatic vein outflow was used when the GRWR was smaller than 1.2%. This technique alleviates surgical risk in living donors, ensures excellent venous drainage, and reduces the incidence of small-for-size syndrome.

Clinicopathological characteristics of 15 patients with combined hepatocellular carcinoma and cholangiocarcinoma.

BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare subtype of primary liver cancer, and clinicopathological features of cHCC-CC have seldom been reported in detail. This study was undertaken to explore the diagnosis and clinicopathological characteristics of cHCC-CC in comparison with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), respectively. METHODS: The clinical data from 15 patients with cHCC-CC, 132 patients with HCC and 44 patients with CC who had undergone hepatic resection were analyzed retrospectively. Clinicopathological characteristics of cHCC-CC, HCC and CC such as hepatitis B viral infection, serum hepatitis C virus (HCV) antibody, serum alpha-fetoprotein (AFP) level, cirrhosis, vascular invasion, lymph node metastasis, surgical procedure and adjuvant treatment were also analyzed. Follow up was carried out in the patients, and their 1-, 3-, and 5-year survival rates were calculated. RESULTS: Two patients with cHCC-CC were correctly diagnosed by enhanced CT before operation, the other 13 patients were diagnosed by histology and immunohistochemistry after operation. Radical (8/15) and conservative hepatectomy (7/15) for cHCC-CC was similar to that for HCC and CC (P>0.05). Pathologically cHCC-CC showed more significantly vascular invasion and lymph node metastasis than HCC (P<0.05), and a similarity to CC (P>0.05). Hepatitis B viral infection, serum HCV antibody, cirrhosis, and serum AFP level of cHCC-CC patients were similar to those of HCC patients (P>0.05) but different from CC patients (P<0.05). The cumulative 1-, 3-, and 5-year survival rates in patients with cHCC-CC were poorer than in patients with HCC or CC (P<0.05). CONCLUSIONS: Patients with cHCC-CC are seldom diagnosed before operation. The progression of cHCC-CC is more rapid than that of HCC or CC. Survival rate of patients with cHCC-CC after hepatic resection is poorer than that of patients with HCC or CC.

Improved early diagnosis of cystadenocarcinoma of the pancreas.

BACKGROUND: Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the definitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for increasing the five-year survival rate and the resectable rate. There is no definitive and effective method of early diagnosis of cystadenocarcinoma of the pancreas in China and other countries. METHODS: We compared endoscopic ultrasonography-guided (EUS-guided) fine needle aspiration biopsy combined with cyst fluid carcinoembryonic antigen (CEA), CA19-9 examination with computed tomography (CT), B-ultrasonography (B-US) and serum CEA and CA19-9, to explore methods of early diagnosis of cystadenocarcinoma of the pancreas. Retrospective analysis was made on the clinical data of 126 cases of benign pancreatic lesion (90 cases) and cystadenocarcinoma (36). RESULTS: The sensitivity of B-US and CT for cystadeno-carcinoma was 52.8% and 77.8%, while the specificity was 78.9% and 86.7%, respectively. When measurement of CEA and CA19-9 of cyst fluid was combined with EUS-guided fine needle aspiration biopsy, the sensitivity was 94.4%, higher than that of B-US and CT (P<0.05). The sensitivity of cyst fluid CEA, CA19-9 examinations was considerably higher than that of serum CEA, CA19-9 (P<0.05). Upper gastrointestinal barium meal and endoscopic retrograde cholangiopancreatography (ERCP) had low sensitivity and specificity. CONCLUSIONS: EUS-guided fine needle aspiration biopsy combined with examination of cyst fluid CEA, CA19-9 is a credible means for early diagnosis of cystadenocarcinoma of the pancreas. B-US, CT and serum CEA, CA19-9 measurements are in common use, their findings are also very important.

[Quantification of PPARdelta mRNA by real-time RT-PCR in rectal cancer tissues].

OBJECTIVE: To clarify the expression change of PPARdelta gene in human rectal cancer tissues and determine the correlation of PPARdelta expression with the clinical and pathological parameters of rectal cancer. METHODS: Applying real-time RT-PCR, we quantified PPARdelta mRNA in 86 tissues from excised primary rectal cancers. In each case, accompanying normal mucosa was collected for comparison. RESULTS: Among the 86 rectal cancer tissues, 48 (55.8%) cases showed PPARdelta overexpression: 39 (81.3%) tumors gave an expression level 1.5 to 5.0 times, 5 (10.4%) tumors 10 to 20 times, and 4 (8.3%) tumors more than 20 times relative to normal mucosa. However, the general level of PPARdelta mRNA in rectal cancer tissues is not statistically different from that in normal mucosa. There was no evidence for the relationships of PPARdelta expression with cell differentiation, pathological categories and Dukes stages. CONCLUSION: The expression of PPARdelta gene in rectal cancers is not statistically different from that in normal mucosa, and it is not correlated with cell differentiation, pathological categories and Dukes stages.

Association of E1AF mRNA expression with tumor progression and matrilysin in human rectal cancer.

OBJECTIVE: To examine E1AF mRNA expression and to determine whether it is correlated with tumor progression and matrilysin in human rectal cancer. METHODS: Real-time RT-PCR was used to determine E1AF and matrilysin expression in 100 matched rectal cancers and normal tissues. RESULTS: Among the 100 rectal cancers, 69 cases of E1AF mRNA overexpression were observed. E1AF mRNA overexpression correlated well with matrilysin. In carcinomas, E1AF mRNA overexpression correlated significantly with depth of invasion, lymph node metastasis, venous involvement and advanced pTNM stage. CONCLUSIONS: E1AF was correlated significantly with tumor progression of human rectal cancer and may be an important factor in rectal cancer progression.

Caudate lobectomy by the third porta hepatis anatomical method: a study of 16 cases.

BACKGROUND: The treatment for primary tumor in the caudate lobe of the liver is difficult because of its unique anatomical location. This study was undertaken to improve operative techniques and results by a new anatomical method of caudate lobectomy. METHODS: Clinical data of 16 patients who had had caudate lobectomy for the liver from January 1996 to November 2004 were retrospectively analyzed. The third porta hepatis anatomical method was performed in all 16 patients. Operative time, intraoperative blood loss, postoperative complications were recorded. The 1-, 3-, and 5-year survival rates of 13 patients with caudate lobe carcinoma were followed up. Anatomical status, operative routes, operative procedures, liver blood supply were evaluated. RESULTS: The operation was successful in the 16 patients. The operative time was 255+/-70 minutes and blood loss 740+/-402 ml. None of the patients died from massive bleeding during the operation, nor did complications such as biliary fistula and liver failure occurred. In 13 patients with malignant tumor, 7 died from recurrence and metastasis of the tumor and the other 6 are still alive at the end of follow-up. One patient has survived for 6 years. The 1-, 3-, and 5-year survival rates in the 13 patients were 83.9%, 58.7% and 39.2%, respectively. CONCLUSION: Caudate lobectomy by the third porta hepatis anatomical method can improve operative effect and increase the resection probability for solitary tumor in the caudate lobe.

Clinicopathologic and prognostic significance of MMP-7 (matrilysin) expression in human rectal cancer.

OBJECTIVE: There is increasing evidence to indicate that MMP-7 plays a more important role in tumor progression than other MMPs. The aim of this study was to detect MMP-7 expression in human rectal cancer and normal rectal tissue and to determine whether it is correlated with invasion and metastasis of human rectal cancer. METHODS: Eighty-six paired samples of rectal cancer and distant normal rectal tissue obtained from 100 inpatients were allocated into two groups (cancer group and control group). MMP-7 mRNA was detected by relative quantitative real-time RT-PCR and MMP-7 protein was examined by immunohistochemical staining and computerized image analysis. RESULTS: MMP-7 mRNA expression in cancer group was higher than that in control group (P = 0.006), the expression ratios of 31 samples (37.35%) were <1 and 52 (62.65%) were >1. The mRNA expression level was correlated with Dukes Staging, histological differentiation grade and CEA level. The MMP-7 protein expression was in accordance with mRNA expression level. The positive degree of immunohistochemical staining in cancer group (1.82 +/- 0.03) was different from that in control group (1.17 +/- 0.13, P = 0.002). Moreover, in cancer group the positive staining degree in high-level mRNA cancers (2.04 +/- 0.18, n = 52) was higher than that in low-level mRNA ones (1.58 +/- 0.23, n = 31, P = 0.008). CONCLUSIONS: Our results suggest that MMP-7 plays an important role in the progression of human rectal cancer. MMP-7 may be selected as a clinical diagnosis and prognosis index in rectal cancer.

Expression of HOXA11 gene in human endometrium.

OBJECTIVE: This study was conducted to examine HOXA11 gene expression in the human endometrium during normal menstrual cycle. STUDY DESIGN: Expression of HOXA11 was examined in the endometrium by in situ hybridization and semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: In the proliferative and early secretory endometrium, both glandular and stromal cells expressed HOXA11 after hybridization. It is interesting to note that the expression in glandular epithelium was dramatically decreased or disappeared in the midsecretory phase at the time of implantation. This expression patterning was kept in the late secretory endometrium and decidua of early pregnancy, whereas in stromal cells, a high-level expression was found and no variations were detected during the menstrual cycle. Semiquantitative RT-PCR analysis demonstrated that total HOXA11 messenger RNA levels were markedly increased in the midsecreatory endometrium. CONCLUSION: This study reveals a novel expression pattern for HOXA11 gene in human endometrium and the downregulation of HOXA11 in glandular epithelium may be necessary for the differentiation and receptivity of endometrium.