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OBJECTIVE: This study aims to explore the expression of decoy receptor 3 (DcR3) and the matrix metalloproteinase-2 (MMP-2) in esophageal carcinoma and their relationship with patient survival. METHODS: The EnVision(TM) immunohistochemistry method was used to examine DcR3 and MMP-2 expression in 150 surgical biopsies of esophageal carcinoma. Expression level was compared with clinical indices and with patient survival. RESULTS: In cancer tissues, the positive expression rate of DcR3 and MMP-2 was 54.00% and 54.67% respectively; this was higher than levels in adjacent normal tissue. DcR3 and MMP-2 were positively correlated with carcinoma size, lymphatic metastasis, invasion degree, clinical stage and 3-year survival. DcR3 and MMP-2 were not correlated with gender, age and tumor degree of differentiation. DcR3 and MMP-2 were positively correlated between in the two groups (r = 0.37, P < 0.01). Kaplan-Meier survival curve showed that higher rates of DcR3 and MMP-2 expression correlated with lower survival. CONCLUSIONS: Determining DcR3 and MMP-2 expression may be useful for the diagnosis, treatment and prognosis of patients with esophageal carcinoma.
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BACKGROUND: Budd-Chiari syndrome (BCS) is a rare disease with portal hypertension caused by the blockage of the hepatic vein and/or the inferior vena cava (IVC). Angiography is the "golden standard" for diagnosis, but it is an invasive examination. To assess the diagnostic value of a fresh blood imaging (FBI) relative to BCS, we used a magnetic resonance angiography (MRA) with an FBI sequence for a preoperative evaluation of the BCS patients in this study. METHODS: Fifty patients who were suspected of having BCS after they had been checked by a B-ultrasound were studied. 2D and 3D FBI were performed on a 1.5T superconductive MR scanner. Original images were rebuilt using a maximal intensity projection (MIP) method on the console. Two doctors reviewed all images before they learned of the angiography results. We then compared the diagnoses obtained from the FBI and angiography results to evaluate the diagnostic value of the FBI. RESULTS: Forty-one patients were diagnosed as BCS and 9 as non-BCS based on an angiography. The FBI correctly diagnosed 38 patients, incorrectly diagnosed 1 patient, and missed diagnosis in 3 patients. Thus, the diagnostic sensitivity of the FBI is 93% (38/41), the specificity is 89% (8/9) and the accuracy is 92% (46/50). The FBI images of the 13 membranous stenoses of the IVC showed a sudden stenosis of the post-liver segment of the IVC. The Images of the 5 patients with a membranous obstruction of the IVC showed IVC thickening and an absence of blood signals in the post-hepatic segment of the IVC. The images of the 4 patients with the segmental thrombosis of the IVC showed abnormal and intermittent signals in the IVC. The images of the 6 patients with a simple hepatic vein obstruction showed obstructive hepatic veins. The images of the 6 patients with the stenosis of both the IVC and the hepatic veins showed the stenosis of the IVC, the thickening of the hepatic veins and the formation of a compensatory circulation within the liver. Lastly, the images of the 7 patients showed a combination of the IVC thrombosis with stenosis or with the obstruction of one or two hepatic veins. CONCLUSIONS: An FBI can show a membranous stenosis, and an obstruction and thrombosis of the IVC. In addition, it can also demonstrate the thickening of the flexural hepatic vein and the development of intra-hepatic compensatory branches with slow blood flow. Thus, it can guide the puncturing and opening of the hepatic vein involved in an interventional therapy for BCS patients.
