Human cytomegalovirus-encoded US28 may act as a tumor promoter in colorectal cancer

AIM: To assess human cytomegalovirus-encoded US28 gene function in colorectal cancer(CRC) pathogenesis.METHODS: Immunohistochemical analysis was performed to determine US28 expression in 103 CRC patient samples and 98 corresponding adjacent noncancerous samples. Patient data were compared by age, sex, tumor location, histological grade, Dukes' stage, and overall mean survival time. In addition, the US28 gene was transiently transfected into the CRC LOVO cell line, and cell proliferation was assessed using a cell counting kit-8 assay. Cell cycle analysis by flow cytometry and a cell invasion transwell assay were also carried out.RESULTS: US28 levels were clearly higher in CRC tissues(38.8%) than in adjacent noncancerous samples(7.1%)(P = 0.000). Interestingly, elevated US28 amounts in CRC tissues were significantly associated with histological grade, metastasis, Dukes' stage, and overall survival(all P < 0.05); meanwhile, US28 expression was not significantly correlated with age, sex or tumor location. In addition, multivariate Coxregression data revealed US28 level as an independent CRC prognostic marker(P = 0.000). LOVO cells successfully transfected with the US28 gene exhibited higher viability, greater chemotherapy resistance, accelerated cell cycle progression, and increased invasion ability.CONCLUSION: US28 expression is predictive of poor prognosis and may promote CRC.

Duodenal ulcer caused by coil wiggle after digital subtraction angiography-guided embolization: A case report

BACKGROUND Acute gastrointestinal bleeding(GIB)is a life-threatening medical emergency with high morbidity and mortality.Transcatheter embolization with endovascular coils under digital subtraction angiography guidance is a common and effective method for the treatment of GIB with high technical success rates.Duodenal ulcers caused by coils wiggled from the branch of the gastroduodenal artery,which is a rare complication,have not previously been reported in a patient with right intrathoracic stomach.CASE SUMMARY A 62-year-old man had undergone thoracoscopy-assisted radical resection of esophageal cancer and gastroesophageal anastomosis 3 years ago,resulting in right intrathoracic stomach.He was admitted to the hospital 15 mo ago for dizziness and suffered acute GIB during his stay.Interventional surgery was urgently performed to embolize the branch of the gastroduodenal artery with endovascular coils.After 15 mo,the patient was re-admitted with a chief complaint of melena for 2 d,esophagogastroduodenoscopy and abdominal computed tomography revealed that some endovascular coils had migrated into the duodenal bulb,leading to a deep ulcer.Bleeding was controlled after conservative treatment.Seven months later,duodenal balloon dilatation was performed to relieve the stenosis after the removal of a few coils,and the patient was safely discharged with only one coil retained in the duodenum due to difficulties in complete removal and risk of bleeding.Mild melena recurred once during the long-term follow-up.CONCLUSION Although rare,coil wiggle after interventional therapy requires careful attention,effective precautionary measures,and more secure alternative treatment methods.