Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

AIM： To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS： From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS： The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage （P 〈 0.05）. The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly （P 〈 0.001）. Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection （28 mo vs 18 mo; P 〈 0.05）. The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy （91.4% vs 68%; P 〈 0.05 ）. And it was also higher in detecting port vein involvement （90% vs 54.5%; P 〈 0.05）.CONCLUSION： The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of longterm survival. MRCP/MRA coupled with color Doppler UItrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.（OR = 2.46, 95% CI = 0.98-6.14）, and a significantly elevated risk of developing esophageal cancer among alcohol drinkers among alcohol drinkers （OR = 9.86, 95% CI = 3.10-31.38）. CONCLUSION： ADH2 and ALDH2 genotypes areassociated with esophageal cancer risk. ADH2＊1 allele and ALDH2＊2 allele carriers have a much higher risk of developing esophageal cancer, especially among alcohol drinkers.

Linc00675 is a novel marker of short survival and recurrence in patients with pancreatic ductal adenocarcinoma

AIM: To detect linc00675 expression in pancreatic ductal adenocarcinoma(PDAC),to analyze the relationship between the expression level of linc00675 and the clinical pathological characteristics,to explore the biological functions of linc00675,and to determine whether linc00675 has independent prognostic value in PDAC.METHODS: We studied linc00675 expression among eight histologically confirmed PDAC tissue samples and four chronic pancreatitis tissue samples through microarray screening. RT-q PCR was conducted to further investigate linc00675 expression in PDAC cell lines as well as archived tissues from a large cohort of PDAC patients. The correlations between the level of lnc00675 and clinicopathological characteristics and survival in patients with pancreatic cancer were evaluated using Correlation analysis. Univariate andmultivariate analyses were conducted to predict whether lnc00675 expression is an independent prognostic and recurrence factor in patients with pancreatic cancer. After downregulating the expression of linc00675 through si RNA,MTT assay,flow cytometry,transwell assay and Western blot were used to explore the biological function of linc00675 in proliferation,invasion,and cell cycle progression of pancreatic cancer cells. The relative molecular expression levels of epithelial-mesenchymal transition were determined by reverse transcription-polymerase chain reaction(RT-PCR) and Western blot.RESULTS: The expression of Linc00675 in PDAC tissue samples was shown to be 672 times that in chronic pancreatitis tissue samples by microarray screening(P = 3.69 × 10-5). This finding was confirmed in tumor tissues from 90 patients with PDAC compared with adjacent normal tissue samples by quantitative RTPCR. We found that linc00675 overexpression positively correlated with lymph node metastasis(P = 0.005),perineural invasion(P = 0.006),and poor survival(P < 0.001). Univariate and multivariate analyses showed that linc00675 expression served as an independent predictor of overall survival(P = 0.009). Additionally,receiver operating characteristic curve analysis showed that high linc00675 might serve as a predictor of tumor progression within 6 mo to a year after surgery. In vitro functional analysis demonstrated that knockdown of linc00675 attenuated pancreatic cancer cell proliferation and invasion as well as induced S phase arrest. Suppression of linc00675 in pancreatic cancer cells resulted can reverse the progress of epithelialmesenchymal transition.CONCLUSION: Linc00675 may function as an oncogene during PDAC development,and its expression is an independent predictor of unfavorable prognosis in patients with PDAC.

Low RASSF6 expression in pancreatic ductal adenocarcinoma is associated with poor survival

AIM:To analyze RASSF6 expression in pancreatic ductal adenocarcinoma(PDAC) and to determine whether RASSF6 has an independent prognostic value in PDAC.METHODS:We studied RASSF6 expression in 96 histologically confirmed PDAC samples and 20 chronic pancreatitis specimens using immunohistochemistry and real-time quantitative reverse transcription-PCR.PDAC issues were then classified as RASSF6 strongly positive,weakly positive or negative.RASSF6 mR NA and protein expression in PDAC samples with strong positive staining was further evaluated using real-time PCR and Western blot analysis.Lastly,correlations between RASSF6 staining and patients' clinicopathological variables and outcomes were assessed.RESULTS:RASSF6 was negatively expressed in 51(53.1%) PDAC samples,weakly positively expressed in 29(30.2%) and strongly positively expressed in16(16.7%),while its expression was much higher in para-tumor tissues and chronic pancreatitis tissues.Positive relationships between RASSF6 expression and T-stage(P = 0.047) and perineural invasion(P = 0.026) were observed.The median survival time of strongly and weakly positive and negative RASSF6 staining groups was 33 mo,15 mo and 11 mo,respectively.Cox multivariate analysis indicated that RASSF6 was an independent prognostic indicator of overall survival in patients with PDAC.A survival curve analysis revealed that increased RASSF6 expression was correlated with better overall survival(P = 0.009).CONCLUSION:RASSF6 expression is an independent biomarker of an unfavorable prognosis in patients with PDAC.