Potentially predictive microRNAs of gastric cancer with metastasis to lymph node

AIM:To detect the expression of 60 microRNAs(miRNAs)in gastric cancer tissues and find new predictive biomarkers of gastric cancer with metastasis.METHODS:The expressions of 60 candidate miRNAs in 30 gastric cancer tissues and paired normal tissues were detected by stem-loop real-time reverse transcription-polymerase chain reaction.After primary screening of miRNAs expression,5 selected miRNAs were further testified in another 22 paired gastric tissues.Based on the expression level of miRNAs and the status of metastasis to lymph node(LN),receiver-operating-characteristic(ROC)curve were used to evaluate their ability in predicting the status of metastasis to LN.RESULTS:Thirty-eight miRNAs expressions in gastric cancer tissues were significantly different from those in paired normal tissues(P<0.01).Among them,31miRNAs were found to be up-expressed in cancer tissues and 1 miRNAs were down-expressed≥1.5 fold vs paired normal gastric tissue.Five microRNAs(miR-125a-3p,miR-133b,miR-143,miR-195 and miR-212)were differently expressed between different metastatic groups in 30 gastric cancer biopsies(P<0.05).Partial correlation analysis showed that hsa-mir-212 and hsa-mir-195 were correlated with the status of metastasis to LN in spite of age,gender,tumor location,tumor size,depth of invasion and cell differentiation.ROC analysis indicated that miR-212 and miR-195 have better sensi-tivities(84.6%and 69.2%,respectively)and specifici-ties(both 100%)in distinguishing biopsies with metastasis to LN from biopsies without metastasis to LN.CONCLUSION:miR-212 and miR-195 could be independent biomarkers in predicting the gastric cancer with metastasis to LN.

Radical resection and outcome for malignant tumors of the pancreatic body and tail

AIM:To analyze the factors influencing radical(R0) resection rate and surgical outcome for malignant tumor of the pancreatic body and tail.METHODS:The clinical and operative data and followup results of 214 pancreatic body and tail cancer patients were analyzed retrospectively.RESULTS:One hundred and twenty/214 pancreatic body and tail cancer patients underwent surgical treatment;the overall resection rate was 59.2%(71/120) ,and the R0 resection rate was 40.8%(49/120) .Compared with non-R0 treatment,the patients receiving an R0 resection had smaller size tumor(P < 0.01) ,cystadenocarcinoma(P < 0.01) ,less lymph node metastasis(P < 0.01) ,less peri-pancreatic organ involvement(P < 0.01) and earlier stage disease(P < 0.01) .The overall 1-,3-and 5-year survival rates for pancreatic body and tail cancer patients were 12.7%(25/197) ,7.6%(15/197) and 2.5%(5/197) ,respectively,and ductal adenocarcinoma patients had worse survival rates [15.0%(9/60) ,6.7%(4/60) and 1.7%(1/60) ,respectively] than cystadenocarcinoma patients [53.8%(21/39) ,28.2%(11/39) and 10.3%(4/39) ](P < 0.01) .Moreover,the 1-,3-and 5-year overall survival rates in patients with R0 resection were 55.3%(26/47) ,31.9%(15/47) and 10.6%(5/47) ,respectively,significantly better than those in patients with palliative resection [9.5%(2/21) ,0 and 0] and in patients with bypass or laparotomy [1.2%(1/81) ,0 and 0](P < 0.01) .CONCLUSION:Early diagnosis is crucial for increasing the radical resection rate,and radical resection plays an important role in improving survival for pancreatic body and tail cancer patients.

Simple instruments facilitating achievement of transanal total mesorectal excision in male patients

AIM To assess the efficacy of a modified approach with transanal total mesorectal excision(ta TME) using simple customized instruments in male patients with low rectal cancer.METHODS A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor(tumor diameter ≥ 40 mm). Forty-one patients(group A) underwent a classical approach of transabdominal total mesorectal excision(TME) and transanal intersphincteric resection(ISR), and the other 74 patients(group B) underwent a modified approach with transabdominal TME,transanal ISR, and ta TME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform ta TME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated.RESULTS All 115 patients had successful sphincter preservation. The operative time in group B(240 min, range: 160-330 min) was significantly shorter than that in group A(280 min, range: 200-360 min; P = 0.000). Co m pa r e d w it h g r o up A, m o r e c o m p le t e d is t a l mesorectum and total mesorectum were achieved in group B(100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo followup, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant(5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION Retrograde ta TME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors.

The clinical significance of CD97, NF-kB and COX-2 ingastric MALT lymphomas

Background and Objectives: Increased expression of the CD97, nuclear factor-kB (NF-kB) and cyclooxygenase-2 (COX-2) has been found to play an important role in development of many cancers, including gastric neoplasm. However, the expression and biological behavior of CD97, NF-kB and COX-2 in gastric MALT (mucosa-associated lymphoid tissue) lymphoma has not been well investigated. Methods: The expressions of CD97, COX-2 and NF-kB in 47 cases of gastric MALT lymphoma were detected immunohistochemically, and the relevance between their expressions and the biological behavior was analyzed retrospectively. Results: 1) The expressions of CD97, NF-kB and COX-2 were 87.2%, 36.2% and 48.9%, respectively;2) The difference of CD97 expression between depth of invasion limited in mucosa and submucosa and beyond muscularis propria was significant (100.0% vs. 71.4%, P < 0.01). Moreover, the expression of nuclear CD97 between stage IIE, III, IV and stage I patients showed significant difference (96.4% vs. 73.7%, P < 0.05);3) The expression of NF-kB was significantly correlated with tumor size, depth of invasion and stage;4) The expression of COX-2 was significantly correlated with Helicobacter pylori infection, clinical stage, depth of invasion and tumor size (P < 0.05). Conclusions: Expressions of CD97, NF-κB and COX-2 were correlated with tumor invasion and metastasis in gastric MALT lymphoma.