Gastritis cystica profunda in a previously unoperated stomach:A case report

Gastritis cystica profunda is a relatively rare disease, usually observed at anastomotic sites in stomachs of patients that have undergone gastric procedures. We present the rare case of an elevated lesion in the anterior wall of the gastric antrum of a 43-year-old Chinese woman who had never undergone gastric surgery and had no gastrointestinal tract symptoms. Although the physical examination and laboratory data showed no abnormalities, endoscopic ultrasonography revealed an anechoic cystic structure. Abdominalcomputed tomography and magnetic resonance imaging showed the gastric wall of the greater curvature of the antrum was markedly and irregularly thickened, and mild to moderate enhancement was observed around the lesion with no enhancement in the central portion, suggestive of a gastrointestinal stromal tumor. The patient underwent a distal gastric resection of the 2.5 cm × 1.5 cm lesion. A postoperative pathologic examination showed dilated cystic glands in the muscularis mucosa and submucosal layers and erosion of the mucosal surface of the tumor, confirming the diagnosis of gastritis cystica profunda without malignancy.

Indocyanine green clearance in evaluating the recovery of liver reserve function after superselective transarterial chemoembolization

Transarterial chemoembolization(TACE)may ravage normal liver tissues apart from the neoplastic nodules which offset the anti-tumor effect.This study aimed to evaluate the recovery of liver reserve function(LRF)after TACE by indocyanine green(ICG)clearance test and other routine liver function tests.Forty-six newly diagnosed HCC patients who had undergone TACE as the initial treatment from January 2011 to January 2012 were enrolled in this study.The effects of age,basic ICG clearance rate and interval time between two assessments on the recovery of LRF were analyzed.We found that ICG retention rate at the 15 minutes(ICGR15)was significantly increased after TACE(12.3±8.1%vs 16.8±12.1%,P【0.01)in all the 46 patients.In particular,the ICGR15 value was increased in older patients(age】55 years,20.3±12.5%vs 13.7±7.2%,P【0.01).The interval of ICG test also affected the ICGR15 value(≤47days,17.8±11.4%after vs 12.1±7.1%before TACE,P【0.01).Our data suggested that TACE decreased LRF,especially in older patients.ICG test was more sensitive to evaluate the recovery of LRF after TACE than the Child-Pugh grade and routine liver function tests.

Diagnostic effect of capsule endoscopy in 31 cases of subacute small bowel obstruction

AIM： TO evaluate the effectiveness and safety of capsule endoscopy （CE） in patients with recurrent subacute small bowel obstruction.METHODS： The study was a retrospective analysis of 31 patients referred to hospital from January 2003 to August 2008 for the investigation of subacute small bowel obstruction, who underwent CE. The patients were aged 9-81 years, and all of them had undergone gastroscopy and colonoscopy previously. Some of them received abdominal computed tomography or small bowel follow-through.RESULTS： CE made a definitive diagnosis in 12 （38.7%） of 31 cases： four Crohn＇s disease （CD）, two carcinomas, one intestinal tuberculosis, one ischemic enteritis, one abdominal cocoon, one duplication of the intestine,one diverticulum and one ileal polypoid tumor. Capsule retention occurred in three （9.7%） of 31 patients, and was caused by CD （2） or tumor （1）. Two with retained capsules were retrieved at surgery, and the other one of the capsules was spontaneously passed the stricture by medical treatment in 6 too. No case had an acute small bowel obstruction caused by performance of CE.CONCLUSION： CE provided safe and effective visualization to identify the etiology of a subacute small bowel obstruction, especially in patients with suspected intestinal tumors or CD, which are not identified by routine examinations.

Apoptosis induced by preoperative oral 5′-DFUR administration in gastric adenocarcinoma and its mechanism of action

AIM： To study the apoptosis induced by preoperative oral 5＇-DFUR administration in gastric adenocarcinorna and its mechanism of action. METHODS： Sixty gastric cancer patients were divided randomly into three groups （20 each group） before operation： group one： 5＇-DFUR oral administration at the dose of 800-1200mg/d for 3 - 5 d, group two： 500mg 5-FU ± 200 mg/d CF by venous drip for 3 - 5 d, group three （control group）. One or two days after chemotherapy, the patients were operated. Fas/FasL, PD-ECGF and PCNA were examined by immunohistochemistry and apoptotic tumor cells were detected by in situ TUNEL method. Fifty-four patients received gastrectomy, including 12 palliative resections and 42 radical resections. Six patients were excluded. Finally 18 cases in 5＇-DFUR group, 16 cases in CF ± 5-FU group, and 20 cases in control group were analyzed. RESULTS： There was no significant difference in patient mean age, gender, white blood cell count, haernatoglobin （HB）, thromboplastin, perioperative complication incidence, radical or palliation resection, invasion depth （T）, Iymphonode involvement （N）, metastasis （M） and TNM staging among the three groups. However, the PCNA index （PI） in 5＇-DFUR group （40.51 ± 12.62） and 5-FU ±CF group （41.12± 15.26） was significantly lower than that in control group （58.33± 15.69） （F=9.083, P= 0.000）. The apoptotic index （AI） in 5＇-DFUR group （14.39 ±9.49） and 5-FU±CF group （14.11±9.68） was significantly higher than that in control group （6.88 ± 7.37） （F= 4.409, P= 0.017）. The expression rates of Fas and FasL in group one and group three were 66.7% （12/18） and 50% （9/18）, 43.8% （7/16） and 81.3% （13/16）, 45.0% （9/20） and 85% （17/20）, respectively. The expression rate of FasL in 5＇-DFUR group was significantly lower than that in the other two groups （X^2=6.708, P= 0.035）. Meanwhile, the expression rate of PD-ECGF was significantly lower in 5＇-DFUR group （4/18, 28.6%） than in CF±5-FU group （9/16, 56.3%） and control group （13/20, 65.0%） （7,2= 7.542, P= 0.023）. The frequency of Fas expression was significantly correlated with palliative or radical resection （X^2= 7.651, P= 0.006）, invasion depth （X^2= 8.927, P= 0.003）, lymphatic spread （7,2= 4.488, P=0.034） and UICC stages （X^2=8.063, P=0.045） respectively. By the end of March 2005, 45 patients were followed up. The 0.5-, 1-, 2-, 3-year survival rates were 96%, 73%, 60%, 48%, respectively, which were related with T, N, M and Fas expression, but not with PDECGF and FasL expression. CONCLUSION： Preoperative oral 5＇-DFUR administration may induce apoptosis of gastric carcinoma cells and decrease tumor cell proliferation index, but cannot improve the prognosis of patients with gastric cancer. Downregulation of FasL and PD-ECGF expression mediated by 5＇-DFUR may be one of its anti-cancer mechanisms. Fas expression correlates with the progression of gastric carcinoma and may be an effective prognostic factor.

Malignant transformation of biliary adenofibroma combined with benign lymphadenopathy mimicking advanced liver carcinoma:A case report

BACKGROUND Biliary adenofibromas(BAFs)are rare primary hepatic neoplasms,some of which can potentially undergo malignant transformation.Here,we describe a rare case of malignant transformation of BAF.CASE SUMMARY A 51-year-old female was referred to our hospital with epigastric pain.Computed tomography showed a solitary liver mass combined with the enlargement of multiple mediastinal and cervical lymph nodes,clinically mimicking a liver carcinoma with extensive lymph node metastasis.However,core needle biopsy suggested BAF with malignant transformation.Finally,the patient underwent curative resection of the neoplasm and was recurrence-free for 12 mo.CONCLUSION Our case serves as an example of a rare manifestation of BAF.Our report and the previously published experience,reinforce that curative resection should be considered the primary treatment for BAFs with malignant transformation,leading to a favorable prognosis.

Molecular biomarkers of colorectal cancer:prognostic and predictive tools for clinical practice

Colorectal cancer remains one of the most common types of cancer and leading causes of cancer death worldwide.Although we have made steady progress in chemotherapy and targeted therapy,evidence suggests that the majority of patients undergoing drug therapy experience severe,debilitating,and even lethal adverse drug events which considerably outweigh the benefits.The identification of suitable biomarkers will allow clinicians to deliver the most appropriate drugs to specific patients and spare them ineffective and expensive treatments.Prognostic and predictive biomarkers have been the subjects of many published papers,but few have been widely incorporated into clinical practice.Here,we want to review recent biomarker data related to colorectal cancer,which may have been ready for clinical use.

Quantitative profiles of the mRNAs of ER-α and its novel variant ER-α36 in breast cancers and matched normal tissues

Objective: The novel estrogen receptor-α (ER-α) variant ER-α36 is reported to be functional in the es-trogen signaling pathway and is related to tamoxifen resistance in breast cancer. However, ER-α36 tends to be a favorable factor for survival in patients without tamoxifen therapy. To investigate the mechanisms behind this paradox, we determined the differences between the transcriptional profiles of ER-α36 and full-length ER-α (ER-α66) in breast cancers and matched normal tissues. Methods: We analyzed ER-α36 and ER-α66 messenger RNA ( mRNA) levels in 74 pairs of breast cancers and matched normal tissues using a real-time quantitative polymerase chain reaction (PCR) assay, and correlated the results with their clinicopathological characteristics. Results: Breast cancers expressed lower ER-α36 mRNA levels than matched normal tissues regardless of their ER-α66 expression status. Down-regulation of ER-α36 mRNA was correlated with local progression, lymph node metastasis, and advanced cancer stage. The level of ER-α66 mRNA was lower in ER-α negative breast cancers compared with matched normal tissues. No differences in ER-α66 mRNA levels were observed during cancer progression. Conclusion: Down-regulation of ER-α36 is associated with carcinogenesis and progression of breast cancer.