AIM： To evaluate hepatic recurrence and prognostic factors for survival in patients with surgically resected hilar cholangiocarcinoma in a single institution over the last 13 years. METHODS： From 1994 to 2007, all p...AIM： To evaluate hepatic recurrence and prognostic factors for survival in patients with surgically resected hilar cholangiocarcinoma in a single institution over the last 13 years. METHODS： From 1994 to 2007, all patients with hilar cholangiocarcinoma referred to a surgical clinic were evaluated. Demographic data, tumor characteristics, and outcome were analyzed retrospectively. Outcome was compared in patients who underwent additional liver resection with resection of the tumor. RESULTS： Of the 69 patients submitted to laparotomy for tumor resection, curative resection （Ro resection） was performed in 40 patients, and palliative resection in 29. Thirty-one patients had only duct resection, and 38 patients had combined duct resection with liver resection including 34 total or part caudate lobes. Curative rates with the combined hepatectomy were significantly improved compared with those without additional hepatectomy （27/38 vs 13/31; X^2 = 5.94, P 〈 0.05）. Concomitant liver resection was associated with a decreased incidence of initial recurrence in liver one year after surgery （11/38 vs 23/31; X^2 = 13.98, P 〈 0.01）. The 3-year survival rate after Ro resection was 30.7% and was 10.5% for palliative resection. R0 resection improved the 3-year survival rate （30.7% vs 10.5%; X^2 = 12.47, P 〈 0.01）.CONCLUSION： Hepatectomy, especially including the caudate lobe combined with bile duct resection should be considered standard treatment to cure hilar cholangiocarcinoma.展开更多
目的:探讨趋化因子受体CCR7诱导血管生成拟态形成促进了QBC939细胞的增殖、迁移和侵袭以及CCR7作用的信号途径.方法:应用三维细胞培养检测各组QBC939细胞中血管生成拟态形成;细胞划痕实验、Transwell小室和Boyden小室检测CCL21-CCR7对QB...目的:探讨趋化因子受体CCR7诱导血管生成拟态形成促进了QBC939细胞的增殖、迁移和侵袭以及CCR7作用的信号途径.方法:应用三维细胞培养检测各组QBC939细胞中血管生成拟态形成;细胞划痕实验、Transwell小室和Boyden小室检测CCL21-CCR7对QBC939细胞体外迁移、侵袭能力的影响;应用MTT法检测CCL21-CCR7对QBC939细胞增殖能力的影响.Real-time PCR检测三组细胞株中CCR7及相关6个基因Twist1/GAPDH/IL-8/VEGF/PDEF/PDCD4的表达.方差分析后组间比较采用LSD-t检验.结果:与对照组相比,CCR7过表达组形成VM能力和细胞增殖明显增强(t=3.104,P<0.05),而在CCR7沉默表达组形成VM和细胞增殖能力减弱(t=2.971,P<0.05),3组不同CCR7表达组加入CCL21形成VM和细胞增殖能力没有变化.划痕实验、Transwell小室和Boyden小室测定细胞的运动、迁移和侵袭能力得到的结果一致,与对照组相比,CCR7过表达组爬行能力、穿膜细胞数量明显增加(Transwell:t=2.652;Boyden:t=2.967,P<0.05),而CCR7沉默组爬行能力、穿膜细胞数量明显减少(Transwell:t=2.691;Boyden:t=2.330,P<0.05);在对照组和C C R7过表达组加入CCL21后爬行能力、穿膜细胞数量明显增加.qPCR检测发现,Twist1基因在3组细胞中的变化趋势同CCR7的变化一致.结论:CCL21-CCR7生物学轴的不同表达影响了血管生成拟态的形成,从而使胆管癌细胞的增殖能力、迁移和侵袭能力改变;CCR7影响VM形成、细胞增殖、迁移和侵袭的信号途径可能是通过Twist1的上皮-间质转化来实现的.展开更多
基金Professor Development Fund of Fujian Medical University
文摘AIM： To evaluate hepatic recurrence and prognostic factors for survival in patients with surgically resected hilar cholangiocarcinoma in a single institution over the last 13 years. METHODS： From 1994 to 2007, all patients with hilar cholangiocarcinoma referred to a surgical clinic were evaluated. Demographic data, tumor characteristics, and outcome were analyzed retrospectively. Outcome was compared in patients who underwent additional liver resection with resection of the tumor. RESULTS： Of the 69 patients submitted to laparotomy for tumor resection, curative resection （Ro resection） was performed in 40 patients, and palliative resection in 29. Thirty-one patients had only duct resection, and 38 patients had combined duct resection with liver resection including 34 total or part caudate lobes. Curative rates with the combined hepatectomy were significantly improved compared with those without additional hepatectomy （27/38 vs 13/31; X^2 = 5.94, P 〈 0.05）. Concomitant liver resection was associated with a decreased incidence of initial recurrence in liver one year after surgery （11/38 vs 23/31; X^2 = 13.98, P 〈 0.01）. The 3-year survival rate after Ro resection was 30.7% and was 10.5% for palliative resection. R0 resection improved the 3-year survival rate （30.7% vs 10.5%; X^2 = 12.47, P 〈 0.01）.CONCLUSION： Hepatectomy, especially including the caudate lobe combined with bile duct resection should be considered standard treatment to cure hilar cholangiocarcinoma.
文摘目的:探讨趋化因子受体CCR7诱导血管生成拟态形成促进了QBC939细胞的增殖、迁移和侵袭以及CCR7作用的信号途径.方法:应用三维细胞培养检测各组QBC939细胞中血管生成拟态形成;细胞划痕实验、Transwell小室和Boyden小室检测CCL21-CCR7对QBC939细胞体外迁移、侵袭能力的影响;应用MTT法检测CCL21-CCR7对QBC939细胞增殖能力的影响.Real-time PCR检测三组细胞株中CCR7及相关6个基因Twist1/GAPDH/IL-8/VEGF/PDEF/PDCD4的表达.方差分析后组间比较采用LSD-t检验.结果:与对照组相比,CCR7过表达组形成VM能力和细胞增殖明显增强(t=3.104,P<0.05),而在CCR7沉默表达组形成VM和细胞增殖能力减弱(t=2.971,P<0.05),3组不同CCR7表达组加入CCL21形成VM和细胞增殖能力没有变化.划痕实验、Transwell小室和Boyden小室测定细胞的运动、迁移和侵袭能力得到的结果一致,与对照组相比,CCR7过表达组爬行能力、穿膜细胞数量明显增加(Transwell:t=2.652;Boyden:t=2.967,P<0.05),而CCR7沉默组爬行能力、穿膜细胞数量明显减少(Transwell:t=2.691;Boyden:t=2.330,P<0.05);在对照组和C C R7过表达组加入CCL21后爬行能力、穿膜细胞数量明显增加.qPCR检测发现,Twist1基因在3组细胞中的变化趋势同CCR7的变化一致.结论:CCL21-CCR7生物学轴的不同表达影响了血管生成拟态的形成,从而使胆管癌细胞的增殖能力、迁移和侵袭能力改变;CCR7影响VM形成、细胞增殖、迁移和侵袭的信号途径可能是通过Twist1的上皮-间质转化来实现的.
