To examine the relationship between the levels of the serum vascular endothelial growth factor (VEGF) and the micrometastasis of peripheral blood in patients with non-small cell lung cancer (NSCLC), 108 NSCLC pati...To examine the relationship between the levels of the serum vascular endothelial growth factor (VEGF) and the micrometastasis of peripheral blood in patients with non-small cell lung cancer (NSCLC), 108 NSCLC patients, including 40 patients with benign lung diseases and 30 healthy controls, were investigated. The serum VEGF levels were detected by ELISA and CK19 mRNA in peripheral blood by reverse transcriptase-polymerase chain reaction (RT-PCR). In NSCLC group, the serum VEGF levels and the positive rate of CK19 mRNA in peripheral blood were 479.8±268.5 pg/mL and 66.7%, which were significantly higher than those of the other two groups respectively (P〈0.01), and both of them were increased significantly with the progression of clinical stage of the tumors (P〈0.01). Serum VEGF levels as well as the positive rate of CK19 mRNA in different pathological types of lung cancer had no significant differences (P〉0.05). Serum VEGF levels in the patients positive for CK19 mRNA was 561.7±325.6 pg/mL. It is significantly higher than that in the negative patients (P〈0.01). There existed a significant correlation between serum VEGF levels and expression of CK19 mRNA in peripheral blood in NSCLC patients (P〈0.001). The detection of serum VEGF levels and CK19 mRNA in peripheral blood is helpful in judging the condition and the prognosis of NSCLC patients, and serum VEGF levels and CK19 mRNA are independent of the pathological types of lung cancer. The micrometastasis in peripheral blood of NSCLC patients is significantly associated with serum VEGF levels.展开更多
Tumor dissemination to distant organ is the main cause of death. Therefore there is urgent need to set up sensitive methods for early detection of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in ...Tumor dissemination to distant organ is the main cause of death. Therefore there is urgent need to set up sensitive methods for early detection of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in peripheral blood (PB) and bone marrow (BM) specimens of breast cancer patients. We aim to detect MUC2 mRNA positive cells in PB and BM of breast cancer patients;to relate this to patient relapse. In this study to detect MUC2 mRNA positive cells (tumor marker), PB and BM samples were collected from 50 breast cancer patients after operation and before adjuvant therapy with 20 PB from healthy individuals as negative controls. Chi-square test was used to analyze data. MUC2 mRNA by using Real-time PCR was detected in 9 (18%) of PB and in 10 (20%) of BM samples and none of the healthy individuals. The relapse rate among MUC2-positive patients was significance in BM (P < 0.004) and MUC2-positive patients had a shorter disease free survival than the negative patients in BM samples (p < 0.05). This study shows MUC2 can be a suitable marker for detection of micrometastasis in breast cancer patients at early stages of cancer.展开更多
Objective The aim of this study was to investigate the effect of lymph node micrometastasis on the prognosis of patients with gastric cancer and the necessity of integrating it into the gastric cancer staging system.M...Objective The aim of this study was to investigate the effect of lymph node micrometastasis on the prognosis of patients with gastric cancer and the necessity of integrating it into the gastric cancer staging system.Methods In total,241 patients with gastric cancer were included.Hematoxylin and eosin staining of lymph nodes was performed,and negative lymph nodes were evaluated by immunohistochemistry to detect micrometastases.Differences in survival rates between stages were evaluated.Results(1)A total of 78 patients(32.4%)had lymph node micrometastases.Compared with the group without micrometastases,the overall recurrence rate,lymph infiltration,vascular invasion,and nerve invasion rate in the micrometastasis group were significantly higher(P<0.05).(2)According to the standard N staging system,the rates of disease-free survival(DFS)for the N0,N1,N2,N3a,and N3b groups were 96.0%,84.0%,67.6%,59.0%,and 21.7%,respectively.There was no significant difference in survival between N2 and N3a.The cumulative survival curves for N2 and N3a intersected.(3)The N stage of 38 patients(15.8%)differed between the traditional system and the new N staging system reflecting micrometastasis.The DFS for N0,N1,N2,N3a,and N3b were 97.0%,86.3%,74.2%,65.4%,and 29.2%,respectively.There was no significant difference in survival between N2 and N3a,but the cumulative survival curves for N2 and N3a did not intersect.(4)Based on a Cox multivariate analysis,various independent risk factors for recurrence were identified(P<0.05).Conclusion Lymph node micrometastasis is an important risk factor for gastric cancer recurrence.Lymph node micrometastasis should be considered in TNM staging to determine prognosis and optimal treatment strategies.展开更多
Objective This study aimed to investigate the occurrence of No.12 lymph node micrometastasis in patients with gastric cancer and its relationship with clinicopathological parameters and prognosis.Methods A cohort of 1...Objective This study aimed to investigate the occurrence of No.12 lymph node micrometastasis in patients with gastric cancer and its relationship with clinicopathological parameters and prognosis.Methods A cohort of 160 gastric cancer patients who underwent gastrectomy and lymph node dissection were selected as the research subjects.The immunohistochemical method was used to detect the micrometastasis of No.12 lymph node sections with negative routine pathological detection.At the same time,the clinical data of patients were collected and followed up to analyze the clinical significance of No.12 lymph node micrometastasis.Results A total of 370 No.12 lymph nodes were detected in 160 surgical specimens.Among 160 patients,27 patients were found to be positive for No.12 lymph nodes during routine pathological examination,with a positive rate of 16.8%.A total of 308 lymph nodes from 133 patients with negative routine pathological examinations were stained by immunohistochemistry.A total of 17 lymph nodes from 10 patients were found to be positive.The results showed that 37 of the 160 patients had No.12 lymph node metastasis,and the positive rate was 23.1%,which was 6.3%higher than that of routine pathological examination.Logistic multivariate analyses showed that the depth of invasion,lymph node metastasis in other groups,and clinical stage were independent risk factors for No.12 lymph node metastasis.The average follow-up time was 79.3 months,and the overall median survival time was 47.9 months.The survival time of the No.12 lymph node-negative group was 67.3±2.5Âmonths,the median survival time was 73.2 months;the survival time of the No.12 lymph node-positive group was(28.4±5.4)months,and the median survival time was 31.3 months.The survival time of the No.12 lymph node-negative group was significantly longer than that of the positive group(χ^(2)=12.75,P=0.000).Conclusion No.12 lymph node micrometastasis is a signal affecting the prognosis of patients with gastric cancer.Standardized dissection of No.12 lymph nodes is recommended for patients with gastric cancer who can undergo radical resection.展开更多
Tumor metastasis is generally agreed to be the major cause of cancer death. Over the last few years, studies of new diagnosis techniques and tumor immunotherapy have made great progress. Recent clinical studies on the...Tumor metastasis is generally agreed to be the major cause of cancer death. Over the last few years, studies of new diagnosis techniques and tumor immunotherapy have made great progress. Recent clinical studies on the occult metastases of breast, lung and colorectal cancer all suggested that the detection of micrometastases in bone marrow is prognostically important and provides substantial evidence of tumor dissemination. On the other hand, two kinds of the mAb-based immunotherapy have been approved for the treatment against epithelial cancer. Monoclonal antibody (mAb) 17-1A for colorectal carcinomas and mAb herceptin for breast cancer both have produced good curative effects. Potential therapeutics based on some antibodies with prominent antitumor activity also has shown obvious clinical effect. These studies indicate that detection of micrometasta-sis in circulatory system and immunotherapy by eliminating metastatic malignant cells suggested a new strategy against the metastatic cancer.展开更多
Radiofrequency ablation(RFA)is commonly applied for the treatment of hepatocellular carcinoma(HCC)because of the facile procedure,and the safety and effectiveness for the treatment of this type of tumor.On the other h...Radiofrequency ablation(RFA)is commonly applied for the treatment of hepatocellular carcinoma(HCC)because of the facile procedure,and the safety and effectiveness for the treatment of this type of tumor.On the other hand,it is believed that HCC cells should spread predominantly through the blood flow of the portal vein,which could lead to the formation of intrahepatic micrometastases.Therefore,monitoring tumor response after the treatment is quite important and accurate assessment of treatment response is critical to obtain the most favorable outcome after the RFA.Indeed,several reports suggested that even small HCCs of≤3 cm in diameter might carry intrahepatic micrometastases and/or microvascular invasion.From this point of view,for preventing local recurrences,RFA should be performed ablating a main tumor as well as its surrounding non-tumorous liver tissue where micrometastases and microvascular invasion might exist.Recent advancement of imaging modalities such as contrast-enhanced ultrasonic,computed tomography,and magnetic resonance imaging are playing an important role on assessing the therapeutic effects of RFA.The local recurrence rate tends to be low in HCC patients who were proven to have adequate ablation margin after RFA;namely,not only disappearance of vascular enhancement of main tumor,but also an adequate ablation margin.Therefore,contrast enhancement gives important findings for the diagnosis of recurrent HCCs on each imaging.However,hyperemia of non-tumorous liver surrounding the ablated lesion,which could be attributed to an inflammation after RFA,may well obscure the findings of local recurrence of HCCs after RFA.Therefore,we need to carefully address to these imaging findings given the fact that diagnostic difficulties of local recurrence of HCC.Here,we give an overview of the current status of the imaging assessment of HCC response to RFA.展开更多
Spread into regional lymph node is the major route of metastasis in cervical cancer. Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics staging system of uterine ce...Spread into regional lymph node is the major route of metastasis in cervical cancer. Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics staging system of uterine cervical cancer, the presence or absence of lymph node metastasis provides important information for prognosis and treatment. In this review, we have attempted to focus on the incidence and patterns of lymph node metastasis, and the issues surrounding surgical assessment of lymph nodes. In addition, the preoperative prediction of lymph node status, as well as the intraoperative assessment by sentinel nodes will be reviewed. Finally, lymph node micrometastasis also will be discussed.展开更多
The sentinel node(SN) technique has been established for the treatment of some types of solid cancers to avoid unnecessary lymphadenectomy. If node disease were diagnosed before surgery, minimal surgery with omission ...The sentinel node(SN) technique has been established for the treatment of some types of solid cancers to avoid unnecessary lymphadenectomy. If node disease were diagnosed before surgery, minimal surgery with omission of lymph node dissection would be an option for patients with early gastric cancer. Although SN biopsy has been well ascertained in the treatment of breast cancer and melanoma, SN navigation surgery(SNNS) in gastric cancer has not been yet universal due to the complicated lymphatic flow from the stomach. Satisfactory establishment of SNNS will result in the possible indication of minimally invasive surgery of gastric cancer. However, the results reported in the literature on SN biopsy in gastric cancer are widely divergent and many issues are still to be resolved, such as the collection method of SN, detection of micrometastasis in SN, and clinical benefit. The difference in the procedural technique and learning phase of surgeons is also varied the accuracy of SN mapping. In this review, we outline the current status of application for SNNS in gastric cancer.展开更多
AIM: To investigate the early metastasis-associated proteins in sentinel lymph node micrometastasis (SLNMM) of colorectal cancer (CRC) through comparative proteome. METHODS: Hydrophobic protein samples were extracted ...AIM: To investigate the early metastasis-associated proteins in sentinel lymph node micrometastasis (SLNMM) of colorectal cancer (CRC) through comparative proteome. METHODS: Hydrophobic protein samples were extracted from individual-matched normal lymph nodes (NLN) and SLNMM of CRC. Differentially expressed protein spots were detected by two-dimensional electrophoresis and image analysis, and subsequently identified by matrix assisted laser desorption/ionization-time of flight mass spectrometry-mass spectrometry and Western blotting, respectively.RESULTS: Forty proteins were differentially expressed in NLN and SLNMM, and 4 metastasis-concerned proteins highly expressed in SLNMM were identified to be hnRNP A1, Ezrin, tubulin β-2C and Annexin A1. Further immunohistochemistry staining of these four proteins showed their clinicopathological characteristics in lymph node metastasis of CRC. CONCLUSION: Variations of hydrophobic protein expression in NLN and SLNMM of CRC and increased expression of hnRNP A1, Ezrin, tubulin β-2C and Annexin A1 in SLNMM suggest a significantly elevated early CRC metastasis.展开更多
Due to a lack of substantial improvement in the outcome of patients suffering from oral squamous cell carcinoma(OSCC) during the past decades, current staging methods need to be revised. This disease is associated wit...Due to a lack of substantial improvement in the outcome of patients suffering from oral squamous cell carcinoma(OSCC) during the past decades, current staging methods need to be revised. This disease is associated with poor survival rates despite considerable advances in diagnosis and treatment. The early detection of metastases is an important indicator of survival, prognosis and relapse. Therefore, a better understanding of the mechanisms underlying metastasis is crucial. Exploring alternative measures apart from common procedures is needed to identify new prognostic markers. Similar to previous findings predominantly for other solid tumours, recently published studies demonstrate that circulating tumour cells(CTCs) and disseminated tumour cells(DTCs) might serve as prognostic markers and could supplement routine staging in OSCC. Thus, the detection of CTCs/DTCs is a promising tool todetermine the individual need for therapeutic intervention. Encouraging results and new approaches point to the future use of targeted therapies for OSCC, an exceedingly heterogeneous subgroup of head and neck cancer. This review focuses on summarising technologies currently used to detect CTCs/DTCs. The translational relevance for OSCC is highlighted. The inherent challenges in detecting CTCs/DTCs will be emphasised.展开更多
Objective: Stanniocalcin-1 (STC-1), a kind of glycoprotein hormone, is universally up-regulated in various tumor tissues compared to corresponding normal tissues, suggesting it may be used as a tumor marker, whilst...Objective: Stanniocalcin-1 (STC-1), a kind of glycoprotein hormone, is universally up-regulated in various tumor tissues compared to corresponding normal tissues, suggesting it may be used as a tumor marker, whilst disseminated tumor cells usually exist in peripheral blood. The aim of this study is to investigate the mRNA expression STC-1 in peripheral blood of colorectal cancer (CRC) and analyze its clinicopathological significance. Methods: The peripheral blood mononuclear cells (PBMNCs) were isolated from 78 CRC patients and 33 cancer-free controls. The expression status of STC-1 mRNA in PBMNCs was assessed by RT-PCR, its correlation with clinicopathological parameters and 5-year overall survival was analyzed as well. Results: In the 78 blood samples from CRC patients, 33 (42.31%) showed positive expression of STC-1 mRNA, and all of 15 gastrointestinal tumor tissues were positive for STC-1 mRNA. In contrast, all the blood samples from 14 healthy donors and 19 patients with inflammatory gastrointestinal disease were negative. Furthermore, STC-1 mRNA expression status was associated with patients’ advanced stage, distant metastasis and shortened overall survival. Conclusion: The detection of STC-1 mRNA in peripheral blood by RT-PCR was highly sensitive and specific for the patients with CRC. STC-1 mRNA may be a potential biomarker for detecting tumor micrometastasis and predicting prognosis.展开更多
Detection of cancer cells using molecular targets is achieved by combining immunochemical reactions with gene amplification techniques.This enables the detection of cancer cells in specimens that are traditionally det...Detection of cancer cells using molecular targets is achieved by combining immunochemical reactions with gene amplification techniques.This enables the detection of cancer cells in specimens that are traditionally determined to be cancer-free.These improvements in detection can lead to prognoses that are different from those derived by conventional pathological staging.Survival is worse when cancer cells are detected in regional lymph nodes compared to when the nodes are cancer-free.Furthermore,the circulating tumor cell(CTC) count increases as the cancer progresses.Consequently,there is a correlation between CTC count and prognosis.However,large-scale prospective studies are required to confirm this.The development of more convenient and cost-effective analysis techniques will facilitate the practical application of these findings.展开更多
There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma(PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring in...There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma(PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma. In both cases, the histological type of the daughter lesion was quite similar to that of the main lesion. Hence, we diagnosed the daughter lesions as metastatic foci in the pancreas. Although intrapancreatic metastasis of PDAC has been regarded as a poor prognostic factor, few reports of intrapancreatic metastasis are available. This article reports two such cases and provides a review of the literature.展开更多
BACKGROUND: Some patients with colorectal carcinoma have liver metastases(LMs) which cannot be detected by conventional imaging. This study aimed to assess whether hepatic perfusion changes induced by micrometastases ...BACKGROUND: Some patients with colorectal carcinoma have liver metastases(LMs) which cannot be detected by conventional imaging. This study aimed to assess whether hepatic perfusion changes induced by micrometastases can be detected by perfusion computed tomography(CT).METHODS: LMs were produced in rats by injecting carcinoma cells into the portal vein. Perfusion CT was performed at microscopic(day 10), interval(day 17), and macroscopic stage(day 34). Perfusion parameters were computed using a dualinput one-compartmental model.RESULTS: Micro and macro LMs presented a mean diameter of 0.5 and 2.6 mm, respectively. Compared to controls, LMs at interval(1.1 mm) and macroscopic stage induced significant perfusion changes: a decrease of 42%(P=0.004) and 41%(P=0.029) in hepatic transit time and an increase of 292%(P=0.073) and 240%(P=0.001) in portal delay, respectively.CONCLUSIONS: LMs with a mean diameter between 1.1 and2.6 mm induced significant hepatic perfusion changes, detected by CT. Such detection may help to select patients and propose chemotherapy at the time of primary tumor resection.展开更多
基金supported by a grant from Scientific Research Foundation of Hubei Health Bureau of PR China(No.2005JX2B18)
文摘To examine the relationship between the levels of the serum vascular endothelial growth factor (VEGF) and the micrometastasis of peripheral blood in patients with non-small cell lung cancer (NSCLC), 108 NSCLC patients, including 40 patients with benign lung diseases and 30 healthy controls, were investigated. The serum VEGF levels were detected by ELISA and CK19 mRNA in peripheral blood by reverse transcriptase-polymerase chain reaction (RT-PCR). In NSCLC group, the serum VEGF levels and the positive rate of CK19 mRNA in peripheral blood were 479.8±268.5 pg/mL and 66.7%, which were significantly higher than those of the other two groups respectively (P〈0.01), and both of them were increased significantly with the progression of clinical stage of the tumors (P〈0.01). Serum VEGF levels as well as the positive rate of CK19 mRNA in different pathological types of lung cancer had no significant differences (P〉0.05). Serum VEGF levels in the patients positive for CK19 mRNA was 561.7±325.6 pg/mL. It is significantly higher than that in the negative patients (P〈0.01). There existed a significant correlation between serum VEGF levels and expression of CK19 mRNA in peripheral blood in NSCLC patients (P〈0.001). The detection of serum VEGF levels and CK19 mRNA in peripheral blood is helpful in judging the condition and the prognosis of NSCLC patients, and serum VEGF levels and CK19 mRNA are independent of the pathological types of lung cancer. The micrometastasis in peripheral blood of NSCLC patients is significantly associated with serum VEGF levels.
文摘Tumor dissemination to distant organ is the main cause of death. Therefore there is urgent need to set up sensitive methods for early detection of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in peripheral blood (PB) and bone marrow (BM) specimens of breast cancer patients. We aim to detect MUC2 mRNA positive cells in PB and BM of breast cancer patients;to relate this to patient relapse. In this study to detect MUC2 mRNA positive cells (tumor marker), PB and BM samples were collected from 50 breast cancer patients after operation and before adjuvant therapy with 20 PB from healthy individuals as negative controls. Chi-square test was used to analyze data. MUC2 mRNA by using Real-time PCR was detected in 9 (18%) of PB and in 10 (20%) of BM samples and none of the healthy individuals. The relapse rate among MUC2-positive patients was significance in BM (P < 0.004) and MUC2-positive patients had a shorter disease free survival than the negative patients in BM samples (p < 0.05). This study shows MUC2 can be a suitable marker for detection of micrometastasis in breast cancer patients at early stages of cancer.
基金Supported by a grant from the scientific research project of Sichuan Health Committee(No.19pj045)。
文摘Objective The aim of this study was to investigate the effect of lymph node micrometastasis on the prognosis of patients with gastric cancer and the necessity of integrating it into the gastric cancer staging system.Methods In total,241 patients with gastric cancer were included.Hematoxylin and eosin staining of lymph nodes was performed,and negative lymph nodes were evaluated by immunohistochemistry to detect micrometastases.Differences in survival rates between stages were evaluated.Results(1)A total of 78 patients(32.4%)had lymph node micrometastases.Compared with the group without micrometastases,the overall recurrence rate,lymph infiltration,vascular invasion,and nerve invasion rate in the micrometastasis group were significantly higher(P<0.05).(2)According to the standard N staging system,the rates of disease-free survival(DFS)for the N0,N1,N2,N3a,and N3b groups were 96.0%,84.0%,67.6%,59.0%,and 21.7%,respectively.There was no significant difference in survival between N2 and N3a.The cumulative survival curves for N2 and N3a intersected.(3)The N stage of 38 patients(15.8%)differed between the traditional system and the new N staging system reflecting micrometastasis.The DFS for N0,N1,N2,N3a,and N3b were 97.0%,86.3%,74.2%,65.4%,and 29.2%,respectively.There was no significant difference in survival between N2 and N3a,but the cumulative survival curves for N2 and N3a did not intersect.(4)Based on a Cox multivariate analysis,various independent risk factors for recurrence were identified(P<0.05).Conclusion Lymph node micrometastasis is an important risk factor for gastric cancer recurrence.Lymph node micrometastasis should be considered in TNM staging to determine prognosis and optimal treatment strategies.
基金Supported by a grant from the Hebei Medical Science Research Project(No.20191831).
文摘Objective This study aimed to investigate the occurrence of No.12 lymph node micrometastasis in patients with gastric cancer and its relationship with clinicopathological parameters and prognosis.Methods A cohort of 160 gastric cancer patients who underwent gastrectomy and lymph node dissection were selected as the research subjects.The immunohistochemical method was used to detect the micrometastasis of No.12 lymph node sections with negative routine pathological detection.At the same time,the clinical data of patients were collected and followed up to analyze the clinical significance of No.12 lymph node micrometastasis.Results A total of 370 No.12 lymph nodes were detected in 160 surgical specimens.Among 160 patients,27 patients were found to be positive for No.12 lymph nodes during routine pathological examination,with a positive rate of 16.8%.A total of 308 lymph nodes from 133 patients with negative routine pathological examinations were stained by immunohistochemistry.A total of 17 lymph nodes from 10 patients were found to be positive.The results showed that 37 of the 160 patients had No.12 lymph node metastasis,and the positive rate was 23.1%,which was 6.3%higher than that of routine pathological examination.Logistic multivariate analyses showed that the depth of invasion,lymph node metastasis in other groups,and clinical stage were independent risk factors for No.12 lymph node metastasis.The average follow-up time was 79.3 months,and the overall median survival time was 47.9 months.The survival time of the No.12 lymph node-negative group was 67.3±2.5Âmonths,the median survival time was 73.2 months;the survival time of the No.12 lymph node-positive group was(28.4±5.4)months,and the median survival time was 31.3 months.The survival time of the No.12 lymph node-negative group was significantly longer than that of the positive group(χ^(2)=12.75,P=0.000).Conclusion No.12 lymph node micrometastasis is a signal affecting the prognosis of patients with gastric cancer.Standardized dissection of No.12 lymph nodes is recommended for patients with gastric cancer who can undergo radical resection.
基金This work was supported by the Fund for Doctoral Station of MOE the National Natural Science Foundation of China for Outstanding Young Scientists (Grant No. 30025038).
文摘Tumor metastasis is generally agreed to be the major cause of cancer death. Over the last few years, studies of new diagnosis techniques and tumor immunotherapy have made great progress. Recent clinical studies on the occult metastases of breast, lung and colorectal cancer all suggested that the detection of micrometastases in bone marrow is prognostically important and provides substantial evidence of tumor dissemination. On the other hand, two kinds of the mAb-based immunotherapy have been approved for the treatment against epithelial cancer. Monoclonal antibody (mAb) 17-1A for colorectal carcinomas and mAb herceptin for breast cancer both have produced good curative effects. Potential therapeutics based on some antibodies with prominent antitumor activity also has shown obvious clinical effect. These studies indicate that detection of micrometasta-sis in circulatory system and immunotherapy by eliminating metastatic malignant cells suggested a new strategy against the metastatic cancer.
文摘Radiofrequency ablation(RFA)is commonly applied for the treatment of hepatocellular carcinoma(HCC)because of the facile procedure,and the safety and effectiveness for the treatment of this type of tumor.On the other hand,it is believed that HCC cells should spread predominantly through the blood flow of the portal vein,which could lead to the formation of intrahepatic micrometastases.Therefore,monitoring tumor response after the treatment is quite important and accurate assessment of treatment response is critical to obtain the most favorable outcome after the RFA.Indeed,several reports suggested that even small HCCs of≤3 cm in diameter might carry intrahepatic micrometastases and/or microvascular invasion.From this point of view,for preventing local recurrences,RFA should be performed ablating a main tumor as well as its surrounding non-tumorous liver tissue where micrometastases and microvascular invasion might exist.Recent advancement of imaging modalities such as contrast-enhanced ultrasonic,computed tomography,and magnetic resonance imaging are playing an important role on assessing the therapeutic effects of RFA.The local recurrence rate tends to be low in HCC patients who were proven to have adequate ablation margin after RFA;namely,not only disappearance of vascular enhancement of main tumor,but also an adequate ablation margin.Therefore,contrast enhancement gives important findings for the diagnosis of recurrent HCCs on each imaging.However,hyperemia of non-tumorous liver surrounding the ablated lesion,which could be attributed to an inflammation after RFA,may well obscure the findings of local recurrence of HCCs after RFA.Therefore,we need to carefully address to these imaging findings given the fact that diagnostic difficulties of local recurrence of HCC.Here,we give an overview of the current status of the imaging assessment of HCC response to RFA.
基金This work is supported by the Natural Science Foundation of Hubei Provice (No. 2015CKB739).
文摘Spread into regional lymph node is the major route of metastasis in cervical cancer. Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics staging system of uterine cervical cancer, the presence or absence of lymph node metastasis provides important information for prognosis and treatment. In this review, we have attempted to focus on the incidence and patterns of lymph node metastasis, and the issues surrounding surgical assessment of lymph nodes. In addition, the preoperative prediction of lymph node status, as well as the intraoperative assessment by sentinel nodes will be reviewed. Finally, lymph node micrometastasis also will be discussed.
基金Partially funded by KAKENHI(Grant-in-Aid forScientific Research),No.23390329by the National Cancer Center Research and Development Fund(23-A-9)by PriorityResearch Fund of Osaka City University
文摘The sentinel node(SN) technique has been established for the treatment of some types of solid cancers to avoid unnecessary lymphadenectomy. If node disease were diagnosed before surgery, minimal surgery with omission of lymph node dissection would be an option for patients with early gastric cancer. Although SN biopsy has been well ascertained in the treatment of breast cancer and melanoma, SN navigation surgery(SNNS) in gastric cancer has not been yet universal due to the complicated lymphatic flow from the stomach. Satisfactory establishment of SNNS will result in the possible indication of minimally invasive surgery of gastric cancer. However, the results reported in the literature on SN biopsy in gastric cancer are widely divergent and many issues are still to be resolved, such as the collection method of SN, detection of micrometastasis in SN, and clinical benefit. The difference in the procedural technique and learning phase of surgeons is also varied the accuracy of SN mapping. In this review, we outline the current status of application for SNNS in gastric cancer.
基金Supported by The Natural Science Basic Research Project,Education Department of Jiangsu Province, No. 08KJT310005the 5th "Six Talent-Person-Peak Program", Jiangsu Province,ChinaSuperior Item of Nanjing Medical University Science and Technology Progress Fund, No. 07NMUM047
文摘AIM: To investigate the early metastasis-associated proteins in sentinel lymph node micrometastasis (SLNMM) of colorectal cancer (CRC) through comparative proteome. METHODS: Hydrophobic protein samples were extracted from individual-matched normal lymph nodes (NLN) and SLNMM of CRC. Differentially expressed protein spots were detected by two-dimensional electrophoresis and image analysis, and subsequently identified by matrix assisted laser desorption/ionization-time of flight mass spectrometry-mass spectrometry and Western blotting, respectively.RESULTS: Forty proteins were differentially expressed in NLN and SLNMM, and 4 metastasis-concerned proteins highly expressed in SLNMM were identified to be hnRNP A1, Ezrin, tubulin β-2C and Annexin A1. Further immunohistochemistry staining of these four proteins showed their clinicopathological characteristics in lymph node metastasis of CRC. CONCLUSION: Variations of hydrophobic protein expression in NLN and SLNMM of CRC and increased expression of hnRNP A1, Ezrin, tubulin β-2C and Annexin A1 in SLNMM suggest a significantly elevated early CRC metastasis.
基金Supported by Hamburger Stiftung zur Forderung der KrebsbekampfungNo.188 to Grobe A and Riethdorf SERC Advanced Investigator Grant "DISSECT"(Pantel K),No.269081.
文摘Due to a lack of substantial improvement in the outcome of patients suffering from oral squamous cell carcinoma(OSCC) during the past decades, current staging methods need to be revised. This disease is associated with poor survival rates despite considerable advances in diagnosis and treatment. The early detection of metastases is an important indicator of survival, prognosis and relapse. Therefore, a better understanding of the mechanisms underlying metastasis is crucial. Exploring alternative measures apart from common procedures is needed to identify new prognostic markers. Similar to previous findings predominantly for other solid tumours, recently published studies demonstrate that circulating tumour cells(CTCs) and disseminated tumour cells(DTCs) might serve as prognostic markers and could supplement routine staging in OSCC. Thus, the detection of CTCs/DTCs is a promising tool todetermine the individual need for therapeutic intervention. Encouraging results and new approaches point to the future use of targeted therapies for OSCC, an exceedingly heterogeneous subgroup of head and neck cancer. This review focuses on summarising technologies currently used to detect CTCs/DTCs. The translational relevance for OSCC is highlighted. The inherent challenges in detecting CTCs/DTCs will be emphasised.
基金supported by the grants from the Department of Health, Jiangsu Province, China (No.H200116)
文摘Objective: Stanniocalcin-1 (STC-1), a kind of glycoprotein hormone, is universally up-regulated in various tumor tissues compared to corresponding normal tissues, suggesting it may be used as a tumor marker, whilst disseminated tumor cells usually exist in peripheral blood. The aim of this study is to investigate the mRNA expression STC-1 in peripheral blood of colorectal cancer (CRC) and analyze its clinicopathological significance. Methods: The peripheral blood mononuclear cells (PBMNCs) were isolated from 78 CRC patients and 33 cancer-free controls. The expression status of STC-1 mRNA in PBMNCs was assessed by RT-PCR, its correlation with clinicopathological parameters and 5-year overall survival was analyzed as well. Results: In the 78 blood samples from CRC patients, 33 (42.31%) showed positive expression of STC-1 mRNA, and all of 15 gastrointestinal tumor tissues were positive for STC-1 mRNA. In contrast, all the blood samples from 14 healthy donors and 19 patients with inflammatory gastrointestinal disease were negative. Furthermore, STC-1 mRNA expression status was associated with patients’ advanced stage, distant metastasis and shortened overall survival. Conclusion: The detection of STC-1 mRNA in peripheral blood by RT-PCR was highly sensitive and specific for the patients with CRC. STC-1 mRNA may be a potential biomarker for detecting tumor micrometastasis and predicting prognosis.
文摘Detection of cancer cells using molecular targets is achieved by combining immunochemical reactions with gene amplification techniques.This enables the detection of cancer cells in specimens that are traditionally determined to be cancer-free.These improvements in detection can lead to prognoses that are different from those derived by conventional pathological staging.Survival is worse when cancer cells are detected in regional lymph nodes compared to when the nodes are cancer-free.Furthermore,the circulating tumor cell(CTC) count increases as the cancer progresses.Consequently,there is a correlation between CTC count and prognosis.However,large-scale prospective studies are required to confirm this.The development of more convenient and cost-effective analysis techniques will facilitate the practical application of these findings.
文摘There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma(PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma. In both cases, the histological type of the daughter lesion was quite similar to that of the main lesion. Hence, we diagnosed the daughter lesions as metastatic foci in the pancreas. Although intrapancreatic metastasis of PDAC has been regarded as a poor prognostic factor, few reports of intrapancreatic metastasis are available. This article reports two such cases and provides a review of the literature.
文摘BACKGROUND: Some patients with colorectal carcinoma have liver metastases(LMs) which cannot be detected by conventional imaging. This study aimed to assess whether hepatic perfusion changes induced by micrometastases can be detected by perfusion computed tomography(CT).METHODS: LMs were produced in rats by injecting carcinoma cells into the portal vein. Perfusion CT was performed at microscopic(day 10), interval(day 17), and macroscopic stage(day 34). Perfusion parameters were computed using a dualinput one-compartmental model.RESULTS: Micro and macro LMs presented a mean diameter of 0.5 and 2.6 mm, respectively. Compared to controls, LMs at interval(1.1 mm) and macroscopic stage induced significant perfusion changes: a decrease of 42%(P=0.004) and 41%(P=0.029) in hepatic transit time and an increase of 292%(P=0.073) and 240%(P=0.001) in portal delay, respectively.CONCLUSIONS: LMs with a mean diameter between 1.1 and2.6 mm induced significant hepatic perfusion changes, detected by CT. Such detection may help to select patients and propose chemotherapy at the time of primary tumor resection.