RESUMO
PURPOSE: To detect and characterize amplified DNA sequences in cholangiocarcinoma (CCA). PATIENTS AND METHODS: We extracted DNA from tumor and corresponding normal tissues of 30 patients with CCA and amplified with 30 random ten-mer arbitrary primers by the arbitrarily primed polymerase chain reaction (AP-PCR) technique. RESULTS: Our results showed gains of genomic sequences at high frequency. Using the AX-11 arbitrary primer, we determined an amplified DNA fragment occurred frequently in the tumors analyzed. The DNA fragment was isolated and identified as two sequences mapped to chromosomes 2p25.3 and 7q11.23. Specific primers were designed employing these sequences and used for detecting amplification by real-time quantitative PCR. The amplification of the DNA sequences on chromosomes 2p25.3 and 7q11.23 was detected in 10 (33%) and 6 (20%) cases, respectively. Thirteen (43%) cases showed amplification on both or one of the chromosomes. In addition, amplification of the DNA on chromosome 2p25.3 was predominantly observed in poorly differentiated tumors. CONCLUSIONS: Our findings suggest that the novel amplified DNA on chromosomal regions at 2p25.3 and 7q11.23 might be involved in the development and progression of CCA.
Assuntos
Neoplasias dos Ductos Biliares/genética , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/genética , Cromossomos Humanos Par 2/genética , Cromossomos Humanos Par 7/genética , Técnicas de Amplificação de Ácido Nucleico/métodos , Adulto , Idoso , Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/patologia , Primers do DNA , DNA de Neoplasias/análise , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Análise de SobrevidaRESUMO
Hepatocellular carcinoma (HCC) is the most common cancer in Thailand. Hepatic resection has been accepted as the only chance for cure. However; very limited information about the operative treatment and survival of HCC in Thailand has been documented. The author reviewed the experiences of surgical treatment of HCC at the National Cancer Institute, Bangkok and reports herein the long term outcome. From January 1986 to January 1996 a total of 884 primary liver cancers admitted in our institute were reviewed. 112 consecutive hepatic resections were performed by the author. 67 of 112 patients were HCC of which clinical features, survival rate and recurrence were studied. Liver cirrhosis was associated in 49 patients (73.1%). HBsAg was positive in 58 patients (86.6%). Preoperative AFP level was more than 400 ng/ml in 35 patients. The resectability for HCC was 11.0 per cent. In 50 of 67 hepatic resection, major hepatic resection were carried out. Postoperative major complications were found in 14 patients (20.9%). Postoperative mortality rate of 5 patients was 7.5 per cent. Survival curve was calculated by Kaplan-Meier with the overall survival rate at 1, 2, 3, 4, 5 years was 63.2 per cent, 28.6 per cent, 21.1 per cent, 14.5 per cent and 11.5 per cent respectively. 1, 3, 5 years survival rate for a tumor less than 5 cm was 91.0 per cent, 57.0 per cent, 49.4 per cent, tumor size of 5-10 cm was 57.5 per cent, 16.0 per cent, 9.0 per cent and tumor size more than 10 cm was 52.2 per cent, 0 per cent, 0 per cent. A significant difference in survival rate was observed by size. Postoperative recurrences were observed in 45 patients (67.2%) and 82.8 per cent of the patients had intrahepatic recurrence within 2 years. Hepatic resection is an appropriate treatment for a tumor less than 10 cm. However, a tumor larger than 10 cm should be considered for multimodality approaches. Intrahepatic recurrence is high and similar to the reports from the Orient. Close follow-up with prompt treatment for recurrence is the important factor to obtain better results.
