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BACKGROUND: Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail. As a congenital disease, caudal cysts are very rare, and their canceration is even rarer, which makes the disease prone to misdiagnosis and delayed treatment. We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990. CASE SUMMARY: A 35-year-old woman found a mass in her lower abdomen 2 mo ago. She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic. Two weeks ago, the patient developed abdominal distension and right waist discomfort and came to our hospital. Except for the high level of serum carcinoembryonic antigen, the medical history and laboratory tests were not remarkable. Magnetic resonance imaging showed a well-defined, slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm × 9 cm in the presacral space, slightly high signal intensity on T2-weighted imaging, and moderate signal intensity on T1-weighted imaging. The mass was completely removed by laparoscopic surgery. Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma, and the multidisciplinary team decided to implement postoperative chemotherapy. The patient recovered well, the tumor marker levels returned to normal, and tumor-free survival has been achieved thus far. CONCLUSION: The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.
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Interdigitated photodetectors (IPDs) based on the two-dimensional electron gas (2DEG) at the AlGaN/GaN interface have gained prominence as high sensitivity ultraviolet (UV) PDs due to their excellent optoelectronic performance. However, most 2DEG-IPDs have been built on rigid substrates, thus limiting the use of 2DEG-IPDs in flexible and wearable applications. In this paper, we have demonstrated high performance flexible AlGaN/GaN 2DEG-IPDs using AlGaN/GaN 2DEG heterostructure membranes created from 8 in. AlGaN/GaN on insulator (AlGaN/GaNOI) substrates. The interdigitated AlGaN/GaN heterostructure has been engineered to reduce dark current by disconnecting the conductive channel at the heterostructure interface. Photocurrent has been also boosted by the escaped carriers from the 2DEG layer. Therefore, the utilization of a 2DEG layer in transferrable AlGaN/GaN heterostructure membranes offers great promises for high performance flexible 2DEG-IPDs for advanced UV detection systems that are critically important in myriad biomedical and environmental applications.
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Placement of a nasointestinal ileus tube or long tube for gastrointestinal decompression is a new and effective treatment for small bowel obstruction. Such tubes are associated with very few adverse effects. However, several cases of intussusception caused by a nasointestinal ileus tube have been reported. No general diagnosis or treatment guideline has been established for such a complication. We herein present three cases of intussusception caused by nasointestinal ileus tube placement along with a literature review that summarizes some important clinical characteristics of nasointestinal ileus tube-induced intussusception. A diagnosis of intussusception should be considered if severe abdominal pain and distension recur after insertion of a nasointestinal ileus tube. Computed tomography may assist making the diagnosis, especially in patients with typical features such as the "Target sign," "Glasses sign," or "Mickey Mouse sign." Although nasointestinal ileus tube-induced intussusception is rare, clinicians should give more attention to the risk of this complication.
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Ileus , Obstrucción Intestinal , Intususcepción , Humanos , Ileus/diagnóstico por imagen , Ileus/etiología , Ileus/cirugía , Intestino Delgado/diagnóstico por imagen , Intestino Delgado/cirugía , Intubación Gastrointestinal/efectos adversos , Intususcepción/diagnóstico por imagen , Intususcepción/etiología , Intususcepción/cirugíaRESUMEN
AIM: To investigate the efficacy and safety of transcutaneous electroacupuncture (TEA) to alleviate postoperative ileus (POI) after gastrectomy. METHODS: From April 2014 to February 2017, 63 gastric cancer patients were recruited from the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. After gastrectomy, the patients were randomly allocated to the TEA (n = 33) or control (n = 30) group. The patients in the TEA group received 1 h TEA on Neiguan (ST36) and Zusanli (PC6) twice daily in the morning and afternoon until they passed flatus. The main outcomes were hours to the first flatus or bowel movement, time to nasogastric tube removal, time to liquid and semi-liquid diet, and hospital stay. The secondary outcomes included postoperative symptom assessment and complications. RESULTS: Time to first flatus in the TEA group was significantly shorter than in the control group (73.19 ± 15.61 vs 82.82 ± 20.25 h, P = 0.038), especially for open gastrectomy (76.53 ± 14.29 vs 87.23 ± 20.75 h, P = 0.048). Bowel sounds on day 2 in the TEA group were significantly greater than in the control group (2.30 ± 2.61/min vs 1.05 ± 1.26/min, P = 0.017). Time to nasogastric tube removal in the TEA group was earlier than in the control group (4.22 ± 1.01 vs 4.97 ± 1.67 d, P = 0.049), as well as the time to liquid diet (5.0 ± 1.34 vs 5.83 ± 2.10 d, P = 0.039). Hospital stay in the TEA group was significantly shorter than in the control group (8.06 ± 1.75 vs 9.40 ± 3.09 d, P = 0.041). No significant differences in postoperative symptom assessment and complications were found between the groups. There was no severe adverse event related to TEA. CONCLUSION: TEA accelerated bowel movements and alleviated POI after open gastrectomy and shortened hospital stay.
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To investigate the antitumor effect of anthocyanins extracted from Chinese bayberry fruit (Myrica rubra Sieb. et Zucc.), a nude mouse tumor xenograft model was established. Treatments with C3G (cyanidin-3-glucoside, an anthocyanin) significantly suppressed the growth of SGC-7901 tumor xenografts in a dose-dependent manner. Immunohistochemical staining showed a significant increase in p21 expression, indicating that the cell cycle of tumor xenografts was inhibited. qPCR screening showed that C3G treatment up-regulated the expression of the KLF6 gene, which is an important tumor suppressor gene inactivated in many human cancers. Western blot showed that C3G treatments markedly increased KLF6 and p21 protein levels, inhibited CDK4 and Cyclin D1 expression, but did not notably change the expression of p53. These results indicated that KLF6 up-regulates p21 in a p53-independent manner and significantly reduces tumor proliferation. This study provides important information for the possible mechanism of C3G-induced antitumor activity against gastric adenocarcinoma in vivo.
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INTRODUCTION: Correct interpretation of a patient's anatomy and changes that occurs secondary to a disease process are crucial in the preoperative process to ensure optimal surgical treatment. In this study, we presented 3 different pancreatic cancer cases to surgical residents in the form of 3D-rendered images and 3D-printed models to investigate which modality resulted in the most appropriate preoperative plan. METHODS: We selected 3 cases that would require significantly different preoperative plans based on key features identifiable in the preoperative computed tomography imaging. 3D volume rendering and 3D printing were performed respectively to create 2 different training ways. A total of 30, year 1 surgical residents were randomly divided into 2 groups. Besides traditional 2D computed tomography images, residents in group A (n = 15) reviewed 3D computer models, whereas in group B, residents (n = 15) reviewed 3D-printed models. Both groups subsequently completed an examination, designed in-house, to assess the appropriateness of their preoperative plan and provide a numerical score of the quality of the surgical plan. RESULTS: Residents in group B showed significantly higher quality of the surgical plan scores compared with residents in group A (76.4 ± 10.5 vs. 66.5 ± 11.2, p = 0.018). This difference was due in large part to a significant difference in knowledge of key surgical steps (22.1 ± 2.9 vs. 17.4 ± 4.2, p = 0.004) between each group. All participants reported a high level of satisfaction with the exercise. CONCLUSION: Results from this study support our hypothesis that 3D-printed models improve the quality of surgical trainee's preoperative plans.
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Cirugía General/educación , Imagenología Tridimensional , Modelos Anatómicos , Neoplasias Pancreáticas/cirugía , Planificación de Atención al Paciente , Impresión Tridimensional , Educación de Postgrado en Medicina , Humanos , Internado y Residencia , Tomografía Computarizada por Rayos XRESUMEN
Intestinal obstruction is a common clinical entity encountered in surgical practice. The objective of this report is to corroborate an atypical scenario of intestinal obstruction in a Chinese patient and to focus on the diagnosis and treatment. A 27-year-old male presented with a history of gastric pain combined with nausea and abdominal distension that had been present for 5 d. The presence of a foreign body was detected by computed tomography and observed as an abnormal density within the stomach. A diospyrobezoar was revealed during gastroscopy, the extraction of which was prevented due to its size and firmness. An endoscopic holmium laser joined with a snare was used to fragment the obstruction, which was followed by management with a conservative "sandwich" treatment strategy involving intestinal decompression with an ileus tube and Coca-Cola lavage between endoscopic lithotripsy fragmentation procedures. This strategy resulted in the successful removal of the diospyrobezoar along with multiple small bowel obstructions. The patient was discharged after abatement of symptoms. The case presented here demonstrates the implementation of a conservative, yet successful, treatment as an alternative to conventional surgical removal of intestinal obstructions.
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Bezoares/cirugía , Bebidas Gaseosas , Descompresión Quirúrgica/métodos , Diospyros/efectos adversos , Obstrucción Intestinal/cirugía , Litotripsia por Láser/métodos , Irrigación Terapéutica/métodos , Adulto , Bezoares/diagnóstico , Bezoares/etiología , Gastroscopía , Humanos , Obstrucción Intestinal/diagnóstico , Obstrucción Intestinal/etiología , Láseres de Estado Sólido/uso terapéutico , Litotripsia por Láser/instrumentación , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
AIM: To investigate the potential roles of Delta-like ligand 4 (DLL4) on the biological behavior of gastric cancer cells and its molecular mechanisms. METHODS: A recombinant eukaryotic expression vector containing human DLL4 gene was constructed and transfected into the human gastric cancer cell line SGC7901. Clones with up-regulated DLL4 were selected and amplified. The effect of DLL4 up-regulation on gastric cancer cell growth was assessed using cell growth assay. The migration and invasion were assessed using a transwell migration assay and matrigel invasion assay. Matrix metalloproteinases were detected using the zymogram technique. Cells were implanted subcutaneously into male BALB/c nu/nu mice. Tumor volumes were then calculated and compared. DLL4 staining in the implanted tumor was performed using immunohistochemistry technique. RESULTS: Growth curves over a six-day time course showed significantly promoted cell proliferation of SGC7901 cells with up-regulated DLL4. DLL4 up-regulation in SGC7901 cells promoted the migration (205.4 ± 15.2 vs 22.3 ± 12.1, P < 0.05) and invasion (68.8 ± 5.3 vs 18.2 ± 6.0, P < 0.05) in vitro and tumorigenicity in vivo (2640.5 ± 923.6 mm(3) vs 1115.1 ± 223.8 mm(3), P < 0.05). Furthermore, significantly increased mRNA level and increased secretion of matrix metalloproteinase-2 (MMP-2) proenzyme were observed in SGC7901 cells with up-regulated DLL4. However, increased MMP-9 mRNA level but decreased extracellular MMP-9 proenzyme level was observed. CONCLUSION: Our observations indicated a mechanism by which activation of DLL4-mediated Notch signaling promotes the expression and secretion of MMP-2 proenzyme and influences the progress of gastric cancer.
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Péptidos y Proteínas de Señalización Intercelular/metabolismo , Receptores Notch/metabolismo , Neoplasias Gástricas/metabolismo , Proteínas Adaptadoras Transductoras de Señales , Animales , Proteínas de Unión al Calcio , Línea Celular Tumoral , Movimiento Celular , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Humanos , Péptidos y Proteínas de Señalización Intercelular/genética , Ligandos , Masculino , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Invasividad Neoplásica , Transducción de Señal , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología , Factores de Tiempo , Transfección , Carga Tumoral , Regulación hacia ArribaRESUMEN
OBJECTIVE: The study compared laparoscopy-assisted gastrectomy (LAG) with open gastrectomy (OG) in the management of advanced gastric cancer (AGC). METHODS: Literature search was performed in the Medline, Embase, and Cochrane Library databases to identify control studies that compared LAG and OG for AGC. A meta-analysis was conducted to examine the surgical safety and oncologic adequacy, using the random-effect model. RESULTS: Seven eligible studies including 815 patients were analyzed. LAG was associated with less blood loss, less use of analgesics, shorter time of flatus and periods of hospital stay, but longer time of operation. The incidence of most complications was similar between the two groups. However, LAG was associated with a lower rate of pulmonary infection (odds ratio (OR) 0.19; 95% confidence interval (CI) 0.05 to 0.68; P<0.05). No significant differences were noted in terms of the number of harvested lymph nodes (weighted mean difference (WMD) 1.165; 95% CI -2.000 to 4.311; P>0.05), overall mortality (OR 0.65; 95% CI 0.39 to 1.10; P>0.05), cancer-related mortality (OR 0.64; 95% CI 0.32 to 1.25; P>0.05), or recurrence (OR 0.62; 95% CI 0.33 to 1.16; P>0.05). CONCLUSIONS: LAG could be performed safely for AGC with adequate lymphadenectomy and has several short-term advantages compared with conventional OG. No differences were found in long-term outcomes. However, these results should be validated in large randomized controlled studies (RCTs) with sufficient follow-up.
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Gastrectomía/mortalidad , Laparoscopía/mortalidad , Complicaciones Posoperatorias/mortalidad , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Humanos , Prevalencia , Factores de Riesgo , Análisis de Supervivencia , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
AIM: To quantitatively assess the ability of double contrast-enhanced ultrasound (DCUS) to detect tumor early response to pre-operative chemotherapy. METHODS: Forty-three patients with gastric cancer treated with neoadjuvant chemotherapy followed by curative resection between September 2011 and February 2012 were analyzed. Pre-operative chemotherapy regimens of fluorouracil + oxaliplatin or S-1 + oxaliplatin were administered in 2-4 cycles over 6-12 wk periods. All patients underwent contrast-enhanced computed tomography (CT) scan and DCUS before and after two courses of pre-operative chemotherapy. The therapeutic response was assessed by CT using the response evaluation criteria in solid tumors (RECIST 1.1) criteria. Tumor area was assessed by DCUS as enhanced appearance of gastric carcinoma due to tumor vascularity during the contrast phase as compared to the normal gastric wall. Histopathologic analysis was carried out according to the Mandard tumor regression grade criteria and used as the reference standard. Receiver operating characteristic (ROC) analysis was used to evaluate the efficacy of DCUS parameters in differentiating histopathological responders from non-responders. RESULTS: The study population consisted of 32 men and 11 women, with mean age of 59.7 ± 11.4 years. Neither age, sex, histologic type, tumor site, T stage, nor N stage was associated with pathological response. The responders had significantly smaller mean tumor size than the non-responders (15.7 ± 7.4 cm vs 33.3 ± 14.1 cm, P < 0.01). According to Mandard's criteria, 27 patients were classified as responders, with 11 (40.7%) showing decreased tumor size by DCUS. In contrast, only three (18.8%) of the 16 non-responders showed decreased tumor size by DCUS (P < 0.01). The area under the ROC curve was 0.64, with a 95%CI of 0.46-0.81. The effects of several cut-off points on diagnostic parameters were calculated in the ROC curve analysis. By maximizing Youden's index (sensitivity + specificity - 1), the best cut-off point for distinguishing responders from non-responders was determined, which had optimal sensitivity of 62.9% and specificity of 56.3%. Using this cut-off point, the positive and negative predictive values of DCUS for distinguishing responders from non-responders were 70.8% and 47.4%, respectively. The overall accuracy of DCUS for therapeutic response assessment was 60.5%, slightly higher than the 53.5% for CT response assessment with RECIST criteria (P = 0.663). Although the advantage was not statistically significant, likely due to the small number of cases assessed. DCUS was able to identify decreased perfusion in responders who showed no morphological change by CT imaging, which can be occluded by such treatment effects as fibrosis and edema. CONCLUSION: DCUS may represent an innovative tool for more accurately predicting histopathological response to neoadjuvant chemotherapy before surgical resection in patients with locally-advanced gastric cancer.
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Terapia Neoadyuvante , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/tratamiento farmacológico , Adulto , Anciano , Medios de Contraste/farmacología , Femenino , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/irrigación sanguínea , Compuestos Organoplatinos/administración & dosificación , Oxaliplatino , Curva ROC , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , UltrasonografíaRESUMEN
The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultrasonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.
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Hiperparatiroidismo Primario/epidemiología , Hiperparatiroidismo Primario/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/estadística & datos numéricos , Paratiroidectomía/estadística & datos numéricos , Nódulo Tiroideo/epidemiología , Nódulo Tiroideo/cirugía , Tiroidectomía/estadística & datos numéricos , Adulto , Anciano , China/epidemiología , Comorbilidad , Diagnóstico por Imagen/estadística & datos numéricos , Femenino , Humanos , Hiperparatiroidismo Primario/diagnóstico , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios/estadística & datos numéricos , Pronóstico , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Sensibilidad y Especificidad , Nódulo Tiroideo/diagnóstico , Resultado del TratamientoRESUMEN
AIM: To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma. METHODS: A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods, associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed. RESULTS: Colonic injuries were caused mainly by motor vehicle accidents. Of the 82 patients, 58 (70.3%) had other associated injuries. Laparotomy was performed within 6 h after injury in 69 cases (84.1%), laparoscopy in 3 because of haemodynamic instability. The most commonly injured site was located in the transverse colon. The mean colon injury scale score was 2.8. The degree of faecal contamination was classified as mild in 18 (22.0%), moderate in 42 (51.2%), severe in 14 (17.1%), and unknown in 8 (9.8%) cases. Sixty-seven patients (81.7%) were treated with primary repair or resection and anastomosis. Faecal stream diversion was performed in 15 cases (18.3%). The overall mortality rate was 6.1%. The incidence of colonic injury-related abdominal complications was 20.7%. The only independent predictor of complications was the degree of peritoneal faecal contamination (P = 0.02). CONCLUSION: Colonic injuries following blunt trauma are especially important because of the severity and complexity of associated injuries. A thorough physical examination and a combination of tests can be used to evaluate the indications for laparotomy. One stage management at the time of initial exploration is most often used for colonic injuries.
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Colon/lesiones , Heridas no Penetrantes/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Humanos , Laparotomía , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Tiempo , Heridas no Penetrantes/terapiaRESUMEN
The use of periosteum-derived progenitor cells (PCs) combined with bioresorbable materials is an attractive approach for tissue engineering. The aim of this study was to characterize the osteogenic differentiation of PC in 3-dimensional (3D) poly-lactic-co-glycolic acid (PLGA) fleeces cultured in medium containing allogeneic human serum. PCs were isolated and expanded in monolayer culture. Expanded cells of passage 3 were seeded into PLGA constructs and cultured in osteogenic medium for a maximum period of 28 d. Morphological, histological and cell viability analyses of three-dimensionally cultured PCs were performed to elucidate osseous synthesis and deposition of a calcified matrix. Furthermore, the mRNA expression of type I collagen, osteocalcin and osteonectin was semi-quantitively evaluated by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The fibrin gel immobilization technique provided homogeneous PCs distribution in 3D PLGA constructs. Live-dead staining indicated a high viability rate of PCs inside the PLGA scaffolds. Secreted nodules of neo-bone tissue formation and the presence of matrix mineralization were confirmed by positive von Kossa staining. The osteogenic differentiation of PCs was further demonstrated by the detection of type I collagen, osteocalcin and osteonectin gene expression. The results of this study support the concept that this tissue engineering method presents a promising method for creation of new bone in vivo.
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Ácido Láctico/química , Ácido Poliglicólico/química , Polímeros/química , Células Madre/citología , Materiales Biocompatibles , Desarrollo Óseo , Técnicas de Cultivo de Célula/métodos , Diferenciación Celular , Supervivencia Celular , Células Cultivadas , Colágeno/química , Humanos , Microscopía Fluorescente , Modelos Estadísticos , Osteogénesis , Periostio/metabolismo , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Ingeniería de TejidosRESUMEN
OBJECTIVE: To investigate whether vascular endothelial growth factor (VEGF) gene plasmid carried by polytetrafluoroethylene (PTFE) vascular graft materials could transfect endothelial cells (ECs) and promote their growth. METHODS: PTFE vascular graft materials carried with pCDI-hVEGF(121), pCDI or pEGFP were incubated in Tris-buffer solution and the values of optical density of 260 nm at different time were plotted, then the DNA controlled release curve was made. ECs derived from human umbilical vein were seeded on the pCDI-hVEGF(121)/pCDI/pEGFP-PTFE materials or tissue culture plates, ECs numbers were counted and VEGF protein concentrations at different time were measured by enzyme-linked immunoadsorbent assay method. Green fluorescent protein (GFP) expression in ECs on pEGFP-PTFE materials was examined with fluorescence microscopy. RESULTS: The controlled release curve showed that the gene released from PTFE materials was rapid within 8 h, then slowed down and that the gene released continuously even after 72 h. At 24, 72 and 120 h, ECs number and proliferation rate of pCDI-hVEGF(121)-PTFE materials were higher than those of pCDI or pEGFP-PTFE materials (P<0.05). VEGF protein concentration of pCDI-hVEGF(121)-PTFE materials was higher than that of pCDI or pEGFP-PTFE materials at 6, 24, 72 and 120 h (P<0.01). GFP expression in ECs on the pEGFP-PTFE materials could be detected by fluorescence microscopy. CONCLUSION: PTFE graft can be used as a carrier of VEGF gene plasmid, VEGF gene carried by PTFE can transfect ECs and promote ECs growth.
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Prótesis Vascular , ADN/genética , Células Endoteliales/fisiología , Plásmidos/genética , Politetrafluoroetileno , Transfección/métodos , Factor A de Crecimiento Endotelial Vascular/genética , Adhesión Celular/fisiología , Procesos de Crecimiento Celular/fisiología , ADN/química , Células Endoteliales/citología , Humanos , Plásmidos/químicaRESUMEN
BACKGROUND/AIMS: To investigate whether the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) are of prognostic significance in ampullary carcinoma. METHODOLOGY: Twenty-two resected tumor specimens from patients with ampullary carcinoma were immunohistochemically stained for VEGF and CD34 (surrogate for vessels) by streptavidin-peroxidase method. RESULTS: Expression of VEGF in tumor tissue was found in 50% of patients. The mean MVD for entire group was 26.4 +/- 12.8. A significantly higher MVD was observed in the tumors with positive VEGF expression (35.0 +/- 9.6) compared with that of negative VEGF expression (17.7 +/- 9.3) (p<0.01). The expression of VEGF and MVD were closely related lymph node status and tumor TNM stage. The positive expression rate of VEGF and the average MVD in patients with lymph node metastases were 85.7% and 33.1 +/- 10.8 respectively, which were significantly higher than those in patients without lymph node metastases (33.3% and 22.8 +/- 11.8 respectively) (p<0.05). The positive expression rate of VEGF and the average MVD in patients with stage III and were 75% and 36.3 +/- 8.4 respectively, which were significantly higher than those in patients with stage I (25% and 18.4 +/- 10.1 respectively) or stage II (50% and 23.8 +/- 13.4 respectively) (p<0.05). The Kaplan-Meier survival curves showed that the 3-year survival rate for patients with positive VEGF expression or a high MVD (9.1% and 10% respectively) were lower than those in patients with negative VEGF expression or a low MVD (63.64% and 58.33% respectively) (p<0.05). CONCLUSIONS: VEGF is positively correlated with MVD in ampullary carcinoma. VEGF and angiogenesis may play an important role in lymph node metastasis and progression of ampullary carcinoma. VEGF and MVD appear to be important prognostic predictor in patients with ampullary carcinoma.
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Ampolla Hepatopancreática , Carcinoma/irrigación sanguínea , Carcinoma/metabolismo , Neoplasias del Conducto Colédoco/irrigación sanguínea , Neoplasias del Conducto Colédoco/metabolismo , Factor A de Crecimiento Endotelial Vascular/biosíntesis , Adulto , Anciano , Carcinoma/patología , Neoplasias del Conducto Colédoco/patología , Femenino , Humanos , Masculino , Microcirculación , Persona de Mediana Edad , PronósticoRESUMEN
OBJECTIVE: This study was designed to detect the expression of bcl-2 and p53 proteins in colorectal carcinomas and to determine their association with the patient survival and stage of the diseases. METHODS: Immunohistochemistry method was used to detect the expression of bcl-2 and p53 proteins in 93 cases of colorectal carcinoma. The stain results were obtained by analyzing the clinic-pathological characteristics of patients. RESULTS: Fifty-seven percent (53/93) of the colorectal carcinomas were bcl-2 protein positive. The positive rate of bcl-2 protein in lymph node involvement cases was lower (15/37) than the cases without node involvement (38/58, P<0.01). The positive rate of p53 protein was 43% (40/93) in colon-rectum carcinomas. No significant correlation was observed between p53 protein expression and clinic-pathological manifestations (P>0.05) but the survival was significantly worse (P=0.0001) in the p53 protein positive cases. Neither bcl-2 nor p53 alone was correlated with stage of the disease. When combined bcl-2/p53 status was analyzed, a group with bcl-2(+) and p53(-) had the best prognosis. This group was significantly associated with earlier Dukes' stages (P=0.1763). In multivariate Cox regression analysis, lymph node involvement and p53 protein expression were two independent factors correlated with survival time. CONCLUSION: The expression of bcl-2 and p53 represent biological characteristics of colorectal carcinomas. Assessment of both bcl-2 and p53 status may be valuable in predicting the prognosis of patients.
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Biomarcadores de Tumor/metabolismo , Neoplasias Colorrectales/metabolismo , Neoplasias Colorrectales/mortalidad , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Medición de Riesgo/métodos , Proteína p53 Supresora de Tumor/metabolismo , China/epidemiología , Neoplasias Colorrectales/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Factores de Riesgo , Análisis de Supervivencia , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To clone vascular endothelial growth factor (VEGF) cDNA gene, construct its eukaryotic expression vector and to express this recombinant plasmid in COS-7 cells. METHODS: Human VEGF165 cDNA was amplified by RT PCR from human ovarian carcinoma. After DNA sequenced, the VEGF165 cDNA was inserted into eukaryotic expression vector pcDNA3.1(-). The recombinant plasmid pcDNA3.1 VEGF165 containing VEGF165 cDNA was identified by enzyme digestion and transferred into COS-7 cells mediated by liposome. The transient expression of VEGF was detected by immunohistochemical staining. RESULTS: The cloned VEGF165 cDNA was confirmed by enzyme digestion and DNA sequence analysis. The immunohistochemical results showed that the VEGF165 protein was expression in COS-7 cells 72 h after gene transfer. CONCLUSION: VEGF165 cDNA gene successfully cloned and expressed in COS-7 cells.