Expression of KIF20A and its clinical significance in colorectal cancer / 中国肿瘤临床

Objective: To explore the expression of KIF20A (kinesin family member 20A) in colorectal cancer (CRC) tissues and adjacent normal tissues, and to analyze the relationship between KIF20A expression level and clinicopathological factors in CRC patients. Meth-ods: Data from The Cancer Genome Atlas (TCGA) database were used to analyze KIF20A mRNA expression in CRC tissues and adjacent normal tissues. A total of 105 paraffin samples were obtained from CRC patients who had undergone surgery at Huai He Hospital of Henan University, from January 2011 to December 2012. Immunohistochemical staining (IHC) was performed to examine KIF20A pro-tein expression in tumor samples for which complete clinical and pathological data were available. Statistical analyses were applied to analyze the association between KIF20A expression and the clinical data, as well as with survival outcomes. Results: Bioinformatics analysis showed that the mRNA expression level of KIF20A was upregulated in CRC tissues and normal tissues (P<0.001). IHC revealed significantly higher expression of KIF20A in CRC tissues from 67 patients (64%) and lower or undetectable expression in 38 patients (36%). The difference was statistically significant (P<0.05). Overexpression of KIF20A in CRC tissues was significantly associated with depth of invasion, lymphatic node metastasis, distant metastasis, and TNM stage (all P<0.05). Kaplan-Meier survival analysis showed that patients with high levels of KIF20A expression had poor prognosis compared to patients with low levels of KIF20A expression. Cox proportional hazard regression analysis revealed that KIF20A was an independent prognostic factor in patients with CRC. Conclusions:KIF20A is upregulated in CRC tissues and could serve as a novel prognostic biomarker for CRC patients.

miR-885-3p regulates radiosensitivity of colorectal cancer cell HT-29 by targeting AKT1 / 中华放射医学与防护杂志

Objective To investigate the effect and mechanism of miR-885-3p on the radiosensitivity of colorectal cancer cell HT-29. Methods The expression of miR-885-3p in HT-29 cells irradiated with different doses (0, 2, 4, 6, 8 Gy) of X-rays was detected by qPCR. The effect of miR-885-3p in modulating cell radiosensitivity was assessed in HT-29 cells with miR-885-3p overexpression. Bioinformatics prediction and dual luciferase reporter gene assay were employed to identify the direct target gene of miR-885-3p. Relationship between miR-885-3p and target gene tyrosine kinase 1 (AKT1) was investigated via regulation of miR-885-3p expression. The effect of AKT1 on radiosensitivity in HT-29 cells was evaluated through knockdown AKT1. The effect of AKT1 on miR-885-3p-induced radiosensitivity was detected by co-transferring miR-885-3p and AKT1 gene into HT-29 cells. Results miR-885-3p expression was up-regulated in radiation-induced HT-29 cells (F=46. 64, P<0. 05). Over-expression of miR-885-3p and knockdown of AKT1 enhanced cell radiosensitization by inhibiting survival and promoting apoptosis (t=12. 33, 12. 95, P <0. 05) with SER of 1. 602 and 1. 946, respectively. Inhibition of miR-885-3p promoted radioresistance by increasing cell survival and inhibiting apoptosis (t=11. 94, P<0. 05) with a SER of 0. 839. AKT1 is a target gene downstream of miR-885-3p, overexpression of AKT1 reversed the effect of miR-885-3p on cell radiosensitivity with a SER of 0. 680. Conclusions miR-885-3p can enhance the radiosensitivity of colorectal cancer HT-29 cells by directly targeting AKT1, which provides a target for improving the radiosensitivity of clinical colorectal cancer.

Treatment strategy of complete response cases after neoadjuvant radiotherapy in rec-tal cancer / 中国肿瘤临床

Objective:To discuss treatment of complete response cases after neoadjuvant radiotherapy in rectal cancer. Methods:This retrospective study analyzed clinical data of 84 rectal cancer cases with pre-operative neoadjuvant chemoradiotherapy in our hospital from January 2010 to Augnst 2014. Results:After neoadjuvant chemoradiotherapy, 33 patients presented clinically complete response at a rate of 39.3%. After post-operative pathologic examination, among clinically complete response cases, six cases exhibited patho-logically complete responses at a rate of 18.2%. No recurrence or disease progression occurred within 12-36 months of post-operative follow up. Conclusion:Neoadjuvant chemoradiotherapy can significantly lower tumor stage and promote clinically complete remission of some patients. However, for clinically complete remission cases, further radical surgery should be provided.

Prognostic value of mixed lineage kinase domain-like protein expression in the survival of patients with gastric caner.

The aim of this study was to detect mixed lineage kinase domain-like protein (MLKL) expression in gastric cancer (GC) and to analyze its association with the prognosis of GC patients. Immunohistochemical staining, Western blotting, and quantitative reverse-transcriptase polymerase chain reaction were performed to detect MLKL tissue expression in 117 GC patients. Clinicopathological characteristics and survival data were retrospectively analyzed to discover the clinical importance of MLKL expression. The chi-square test was used to analyze the relationship between MLKL expression and the clinicopathological characteristics. Survival curves were plotted by using the Kaplan-Meier method and compared using the log-rank test. Survival data were evaluated using univariate and multivariate Cox regression analyses. The expression of MLKL mRNA was significantly higher in adjacent normal samples than in the tumor tissues (P = 0.003). Clinicopathological analysis showed that MLKL expression was significantly correlated with age (P = 0.013), histologic type (P = 0.049), differentiation grade (P < 0.001), depth of invasion (P = 0.022), and lymph node metastasis (P = 0.003). Low MLKL expression was significantly associated with decreased overall survival (median 29 months vs. 56 months, P < 0.001). Multivariate analysis suggested that MLKL expression might be an independent prognostic indicator (HR = 0.645, 95 % CI, 0.446-1.165, P = 0.002) for GC patients. In conclusion, our findings provide evidence that MLKL might serve as a candidate tumor suppressor and a potential prognostic biomarker for GC.

Autocrine Sonic hedgehog signaling promotes gastric cancer proliferation through induction of phospholipase Cγ1 and the ERK1/2 pathway.

BACKGROUND: Sonic hedgehog (SHH) plays critical roles in cell growth and development. Tumor cells express SHH, which can promote cell proliferation and epithelial-to-mesenchymal transition. However, the autocrine SHH pathway has not been described in gastric cancer. The aim of this study was to explore molecular mechanisms underlying autocrine SHH signaling in gastric cancer cells. METHODS: SHH expression was assessed using immunohistochemistry and the results were compared with clinicopathologic parameters, including survival. Using gastric cancer cell lines, we measured SHH mRNA and protein expression, and studied the effects of SHH signaling on cell proliferation and SHH secretion. We also studied the effects of an inhibitor of PLC-γ1 on phosphorylation of phospholipase Cγ1 and extracellular signal-regulated kinases (ERK)1/2. RESULTS: SHH protein expression in gastric cancer tissue was significantly higher compared with that in normal gastric tissue (P < 0.001), and the increased expression was significantly associated with pT staging (P = 0.004), pN staging (P = 0.018), pM staging (P = 0.006), and pTNM staging (P < 0.001). In multivariate analyses, overall survival in gastric cancer was significantly shorter in cases with high SHH expression (HR = 1.734, 95% CI: 1.109-2.713, P = 0.016). The AGS and SGC-7901 gastric cancer cell lines expressed SHH mRNA and protein. In these cell lines, SHH promoted carcinogenesis through activation of the PLCγ1-ERK1/2 pathway, resulting in increased cell proliferation and survival. CONCLUSIONS: Increased SHH expression is associated with shorter survival in gastric cancer patients, and SHH could represent a useful biomarker or therapeutic target for this disease.

Low level of FOXL1 indicates a worse prognosis for gastric cancer patients.

The aim of this study was to detect forkhead box L1 (FOXL1) expression in gastric cancer (GC) and to analyze its association with the prognosis of GC patients. Immunohistochemical staining, Western blotting, and quantitative reverse transcriptase polymerase chain reaction were performed to detect FOXL1 tissue expression in 109 GC patients. Clinicopathological characteristics and survival data were retrospectively analyzed to discover the clinical importance of FOXL1 expression. The chi-square test was used to analyze the relationship between FOXL1 expression and the clinicopathological characteristics. Survival curves were plotted by using the Kaplan-Meier method and compared using the log-rank test. Survival data were evaluated using univariate and multivariate Cox regression analyses. The expression of FOXL1 messenger RNA (mRNA) was significantly higher in adjacent normal samples than in the tumor tissues (P = 0.043). Clinicopathological analysis showed that FOXL1 expression was significantly correlated with depth of invasion (P = 0.017), lymph node metastasis (P = 0.019), and distant metastasis (P = 0.047). FOXL1-negative as opposed to the FOXL1-positive patients had lower 5-year overall survival (14.06 vs. 37.78 %, P < 0.001). Multivariate analysis suggested that FOXL1 expression might be an independent prognostic indicator (hazard ratio = 0.307, 95 % confidence interval, 0.187-0.505; P < 0.001) for GC patients. In conclusion, our findings provide evidence that FOXL1 might serve as a candidate tumor suppressor and a potential prognostic biomarker for GC.

Experiences of scarless laparoscopic radical resection of rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer.</p><p><b>METHODS</b>Clinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision (TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique.</p><p><b>RESULTS</b>The operation time was (126±35) min. The intraoperative blood loss was (33±61) ml. The number of harvested lymph nodes was 17.0±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage.</p><p><b>CONCLUSION</b>Scarless laparoscopic radical resection of rectal cancer is feasible.</p>

Diagnosis and treatment of primary duodenal carcinoma / 中华普通外科杂志

Objective To evaluate the diagnosis, treatment and prognosis of primary duodenal carcinoma. Methods The clinical data of 41 cases with primary duodenal carcinoma admired during 2000-2007 were analyzed retrospectively. Results Clinical manifestation was not specific, including abdominal pain, abdominal distention, jaundice, bowel obstruction or bleeding. The correct diagnosis rate of endoscopy, duodenography, ultrasound and CT was 86%, 90%, 20% and 33% respectively. 23 cases underwent pancreaticoduodenectomy, 6 cases received segmental duodenectomy, 9 cases received bypass operation and 3 cases underwent biopsy. Overall postoperative 5-year survival rate was 18%. Univariate analysis revealed that the operation types, tumor histology, depth of tumor invatian, lymphatic invasion correlated with prognosis. Multivariate analysis showed that only the operative types, depth of tumor invasion and lymphatic invasion were independent prognostic factors. Conclusions Duodenography and endoscopy are major methods for diagnosis of primary duodenal carcinoma. Pancreaticoduodenectomy is the choice of therapy for primary duodenal carcinoma.

Diagnosis and treatment of blunt pancreatic injury:a report of 32 cases / 中国普通外科杂志

Objective To explore the methods for early diagnosis and treatment of blunt pancreatic injury.Methods The clinical data of 32 patients with blunt pancreatic injury treated in our hospital from Janurery 2004 to Janurery 2009 were retrospectively analyzed.Results The conformity diagnosis rate of CT was 79.3%.Four cases received nonoperative treatment including 3 cases of grade I and 1 of grade II injury.A total of 28 cases with blunt pancreatic injury underwent operation: 5 grade I and 7 grade II cases underwent debridement and drainage;among the patients with grade Ⅲ injury,4 underwent distal pancreatectomy in combination with splenectomy,and 2 pancreatectomy with spleen preservation;amongst the 5 patients with grade Ⅳ injury,4 underwent Roux-en-Y pancreaticojejunostomy and 1 underwent distal pancreatectomy in combination with splenectomy;of the 5 patients with grade Ⅴ injury,1 case was operated on using duodenorrhaphy and diverticulization,2 underwent the Whipple′s procedare and 2 had damage control surgery.Three patients died of multiple organ failure,and complications occurred in 19(76.0%).Pancreatic fistula and pancreatic pseudocysts were the main complications.Conclusions In the absence of major pancreatic ductal injury,and the clinical conditions were stable,pancreatic injuries can be treated with nonoperative management.Operative treatment is suitable for severe blunt pancreatic injury.Appropriate operation,based on patient condition and the classification of pancrecatic trauma,is the key to increase the cure rate and decrease mortality rate.

A report of 126 cases of laparoscopic cholecystectomy combined with laparoscopic appendectomy / 中国微创外科杂志

Objective To study the indication and the feasibility of laparoscopic cholecystectomy (LC) combined with laparoscopic appendectomy (LA). Methods Following routine LC under general anasthesia,a dissecting forceps was introduced from the 10 mm trocar on the right McBurney point.The appendix was excised outside the abdomen,or removed by using an electrotome after the mesoappendix and the appendix root were dipped. Results The operation time was 29～76 min (mean, 48 min) and the length of hospital stay was 2～7 days(mean,3 days).Complications occurred in 3 cases: 1 case of transection of the common bile duct, 1 case of appendicular artery bleeding, and 1 case of right lower abdominal pain with unknown causes. Conclusions LC combined with LA is feasible and applicable to cholecystic benign diseases accompanying simple or suppurative appendicitis.

Laparoscopic cholecystectomy combined with choledochoscopy in treatment of cholecystolithiasis and choledocholithiasis / 中国普通外科杂志

Objective To investigate the value of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Clinical data of 168 patients with cholecystolithiasis and choledocholithiasis treated in our haspital from June 2005 to June 2009 were analysed.Ninety patients were randomly selected and treated by laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage (group A),the other 78 patients,as control group,underwent routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy (group B).Results The hospital stay and the mean time to passage of flatus in group A was much shorter than that in group B (P0.05).Conclusions Laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage for cholecystolithiasis and choledocholithiasis is a microtrauma management with advantages of quick recovery and shorter hospital stay,that makes it superior to the open operation.