Diagnostic value of conventional endoscopic ultrasound for lymph node metastasis in upper gastrointestinal neoplasia:A metaanalysis

BACKGROUND Upper gastrointestinal neoplasia mainly includes esophageal cancer and gastric cancer,both of which have high morbidity and mortality.Lymph node metastasis(LNM),as the most common metastasis mode of both diseases,is an important factor affecting tumor stage,treatment strategy and clinical prognosis.As a new fusion technology,endoscopic ultrasound(EUS)is becoming increasingly used in the diagnosis and treatment of digestive system diseases,but its use in detecting LNM in clinical practice remains limited.AIM To evaluate the diagnostic value of conventional EUS for LNM in upper gastrointestinal neoplasia.METHODS Using the search mode of“MeSH+Entry Terms”and according to the predetermined inclusion and exclusion criteria,we conducted a comprehensive search and screening of the PubMed,EMBASE and Cochrane Library databases from January 1,2000 to October 1,2022.Study data were extracted according to the predetermined data extraction form.The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool,and the results of the quality assessment were presented using Review Manager 5.3.5 software.Finally,Stata14.0 software was used for a series of statistical analyses.RESULTS A total of 22 studies were included in our study,including 2986 patients.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic score and diagnostic odds ratio of conventional EUS in the diagnosis of upper gastrointestinal neoplasia LNM were 0.62[95%confidence interval(CI):0.50-0.73],0.80(95%CI:0.73-0.86),3.15(95%CI:2.46-4.03),0.47(95%CI:0.36-0.61),1.90(95%CI:1.51-2.29)and 6.67(95%CI:4.52-9.84),respectively.The area under the summary receiver operating characteristic curve was 0.80(95%CI:0.76-0.83).Sensitivity analysis indicated that the results of the meta-analysis were stable.There was considerable heterogeneity among the included studies,and the threshold effect was an important source of heterogeneity.Univariable meta-regression and subgroup analysis showed that tumor type,sample size and EUS diagnostic criteria were significant sources of heterogeneity in specificity(P<0.05).No significant publication bias was found.CONCLUSION Conventional EUS has certain clinical value and can assist in the detection of LNM in upper gastrointestinal neoplasia,but it cannot be used as a confirmatory or exclusionary test.

Risk factors,prognostic predictors,and nomograms for pancreatic cancer patients with initially diagnosed synchronous liver metastasis

BACKGROUND Liver metastasis(LM)remains a major cause of cancer-related death in patients with pancreatic cancer(PC)and is associated with a poor prognosis.Therefore,identifying the risk and prognostic factors in PC patients with LM(PCLM)is essential as it may aid in providing timely medical interventions to improve the prognosis of these patients.However,there are limited data on risk and prognostic factors in PCLM patients.AIM To investigate the risk and prognostic factors of PCLM and develop corresponding diagnostic and prognostic nomograms.METHODS Patients with primary PC diagnosed between 2010 and 2015 were reviewed from the Surveillance,Epidemiology,and Results Database.Risk factors were identified using multivariate logistic regression analysis to develop the diagnostic mode.The least absolute shrinkage and selection operator Cox regression model was used to determine the prognostic factors needed to develop the prognostic model.The performance of the two nomogram models was evaluated using receiver operating characteristic(ROC)curves,calibration plots,decision curve analysis(DCA),and risk subgroup classification.The Kaplan-Meier method with a logrank test was used for survival analysis.RESULTS We enrolled 33459 patients with PC in this study.Of them,11458(34.2%)patients had LM at initial diagnosis.Age at diagnosis,primary site,lymph node metastasis,pathological type,tumor size,and pathological grade were identified as independent risk factors for LM in patients with PC.Age>70 years,adenocarcinoma,poor or anaplastic differentiation,lung metastases,no surgery,and no chemotherapy were the independently associated risk factors for poor prognosis in patients with PCLM.The C-index of diagnostic and prognostic nomograms were 0.731 and 0.753,respectively.The two nomograms could accurately predict the occurrence and prognosis of patients with PCLM based on the observed analysis results of ROC curves,calibration plots,and DCA curves.The prognostic nomogram could stratify patients into prognostic groups and perform well in internal validation.CONCLUSION Our study identified the risk and prognostic factors in patients with PCLM and developed corresponding diagnostic and prognostic nomograms to help clinicians in subsequent clinical evaluation and intervention.External validation is required to confirm these results.

Effect of remedies of supporting resistance and relieving blood stasis on metastasis of postoperative gastric cancer and ornithine decarboxylase

Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｓｔｏｍａｃｈｎｅｏｐｌａｓｍｓ／ｓｕｒｇｅｒｙ；ｎｅｏｐｌａｓｍｓｍｅｔａｓｔａｓｉｓ；ｏｒｎｉｔｈｉｎｅｄｅｃａｒｂｏｘｙｌａｓｅ；ｔｒａｄｉｔｉｏｎａｌＣｈｉｎｅｓｅｍｅｄｉｃｉｎｅＡｂｓｔｒａｃｔＡＩＭＴｏｓｔｕｄｙｔｈｅａｃｔｉｏｎｏｆｒｅｍｅｄｉｅｓｏｆｓｕｐｐｏｒｔｉｎｇｒｅｓｉｓｔａｎｃｅａｎｄｒｅｌｉｅｖｉｎｇｂｌｏｏｄｓｔａｓｉｓｏｎｍｅｔａｓｔａｓｉｓｏｆｐｏｓｔｏｐｅｒａｔｉｖｅｇａｓｔｒｉｃｃａｎｃｅｒａｎｄｉｔｓｉｎｆｌｕｅｎｃｅｏｎｏｒｎｉｔｈｉｎｅｄｅｃａｒｂｏｘｙｌａｓｅ（ＯＤＣ）．ＭＥＴＨＯＤＳＳｉｘｔｙｔｈｒｅｅｐｏｓｔｏｐｅｒａｔｉｖｅｇａｓｔｒｉｃｃａｎｃｅｒｐａｔｉｅｎｔｓｗｅｒｅｒａｎｄｏｍｌｙｄｉｖｉｄｅｄｉｎｔｏｔｗｏｇｒｏｕｐｓ．ＴｈｉｒｔｙｏｎｅｐａｔｉｅｎｔｓｗｅｒｅｔｒｅａｔｅｄｗｉｔｈｗｅｓｔｅｒｎｍｅｄｉｃｉｎｅｃｏｎｓｉｓｔｉｎｇｏｆｔｈｅＦＡＰｓｃｈｅｍｅ（５ｆｌｕｒｏｕｒａｃｉｌ，ａｄｒｉａｍｙｃｉｎａｎｄｃｉｓｐｌａｔｉｎ）ａｎｄｔｈｅＣＯＤＰｓｃｈｅｍｅ（ｃｙｃｌｏｐｈｏｓｐｈａｍｉｄｅ，ｖｉｎｃｒ?

Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs:A case report

BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and brain.CASE SUMMARY A 69-year-old male was referred to our hospital due to suspected cholangiocarcinoma.Laboratory tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in serum.Endoscopic retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic duct.Peroral cholangioscopy delineated a tumor in the CBD that had a papillary pattern.Multidetector computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of metastasis.Therefore,a diagnosis of IPNB cT1N0M0 was established.Left hepatectomy with bile duct reconstruction was performed.Pathological examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection achievement.The patient was monitored carefully by regular examinations.However,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 level.Video-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are indicated.In addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct cancer.CONCLUSION This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.

CD44v6 in peripheral blood and bone marrow of patients with gastric cancer as micro-metastasis

瞄准：为了检测 CD44 的表示，与能力相关在有胃的癌症并且到的病人的外部血和骨髓微转移推出它的临床的意义。方法：从有胃的癌症和 6 控制的 46 个病人的外科手术前的外部血和骨髓标本被 CD44v6mRNA 的半量的 RT-PCR 扩大学习。从有胃的癌症和 14 控制的 40 个病人的外科手术前、手术后的外部血标本被 CD44v6mRNA 的量的 RT-PCR 扩大在相应经期学习。结果：半量的 RT-PCR 扩大证明外部血和骨髓的那 CD44v6mRNA 表情在 39 是积极的(84.8%) 并且 40 (86.9%) 有胃的癌症的 46 个病人分别地。在外部血， CD44v6mRNA 表示为 diffuse 是积极的 32 个病人并且为 14 个病人的在 9 的肠的类型(64.3%) 的在 30 的类型(93.8%) 。在另一方面在骨髓， CD44v6mRNA 表示为 diffuse 是积极的 32 个病人并且为 14 个病人的在 10 的肠的类型(71.4%) 的在 31 的类型(96.9%) 。在弥漫的类型和肠的类型之间有有效差量。量的 RT-PCR 扩大证明 CD44v6mRNA 没在控制的外部血被表示， CD44v6mRNA 表示为在有胃的癌症的 40 个病人的外科手术前的外部血是积极的，从 4.9 x 10 的表示层次(8 )- 3.2 x 10 (11 ) copies/g RNA。在外部血的 CD44v6mRNA 的平均表示水平是 3.9 x 10 (10 ) copies/g RNA。在在在到 7.6 x 10 的从 5.5 x 10 增加的药品操作(6 )(9 ) 以后的胃的癌症病人的外部血的 CD44v6mRNA 的表示层次 copies/g RNA 和平均水平是 2.4 x 10 (8 ) copies/g RNA (图 3B )(P = 0.00496 ) 。在药品操作以后，表示水平显著地减少了。结论：为 CD44v6mRNA 的半量、量的 RT-PCR 扩大是为察觉的一个敏感、特定的方法在外部血和骨髓微转移，它可能被用作肿瘤负担和治疗学的效果的指示物。

Risk factors for lymph node metastasis in patients with pancreatic neuroendocrine neoplasms

BACKGROUND Although PNENs generally have a better prognosis than pancreatic cancers,some PNENs display malignant behavior including lymph node(LN)metastasis.Complete tumor resection can be the only potentially curative treatment for patients with resectable PNENs.However,the indications for LN dissection are still controversial.Over the last decade,minimally invasive surgery such as laparoscopic pancreatic surgery(LPS)has been increasingly performed for pancreatic tumors including PNENs.AIM To investigate the risk factors for LN metastasis in PNENs and to select appropriate patients for limited surgery by LPS.METHODS From April 2001 to December 2019,92 patients underwent pancreatic resection for PNENs at Kumamoto University Hospital.Finally,82 patients were enrolled in this study.Using perioperative factors,we examined the predictive factors for LN metastasis in PNENs.RESULTS Among the 82 patients,the percentage of LN metastasis according to the pathological findings was 12%(10/82 cases).The median tumor size was 12 mm(range:5-90 mm).The median tumor size in the LN-positive group(37 mm)was significantly larger than that in the LN-negative group(12 mm)(P=0.0001).Multivariate analyses revealed that larger tumor size(≥20 mm)was an independent risk factor for LN metastasis(odds ratio 16.8,P=0.0062).In patients with small tumors(≤10 mm),LN metastasis was not found.CONCLUSION Larger tumor size(≥20 mm)is an independent risk factor for LN metastasis in PNENs.In smaller PNENs(≤10 mm),we may be able to choose limited surgery without LN dissection.

Primary research on neoplasm needle track implantation metastasis after radioactive seeds implantation and preventive measures

Objective:To observe the possibility of neoplasm needle track implantation after radioactive seeds implantation and seek preventive measures to avoid it.Methods:Superficial tissue of 250 seeding needle cores and 250 stylophores employed in neoplasm radioactive seeds implantation was smeared on slides to search for tumor cells.All patients received chemotherapy or endocrine therapy after operations.Ultrasound B-mode or computer tomography(CT)was performed at 10th day,30th day,60th day,and 180th day post operation to detect neoplasm implantation metastasis through needle tracks. Results:Positive cells were found on 13 of 250(5.20%)cores,and 7 of 250(2.80%)stylophores.The difference was not sta- tistically significant(P>0.05).The positive cells frequency of needles those traversed distance less than 3 cm in normal tissue was 6.19%(13/210),while the frequency of the others those traversed longer distance in normal tissue was 2.41%(7/290). The positive cells frequency of needles traversing different distances in normal tissues is significantly different(P<0.05).No neoplasm was detected through needle tracks by ultrasound B-mode or CT in 180 days after operation.Conclusion:Tumor cells could ablate into the needle track during radioactive seed implantation.Some preventive measures,such as optimization of pre-operation and intra-operation treatment plan,chemotherapy or endocrine therapy after operation,may be beneficial to avoid the implantation metastasis of neoplasm in seeding needle tracks.

Study on Proteomics in Hepatic Metastasis of Colorectal neoplasms

Colorectal cancer is one of the most frequent cancers in the world. Hepatic metastasis is the most common site metastatic disease and dominant cause of death in colorectal cancer patients. In the large majority of cases, cell dysfunction in CRC results from multiple rather than single, gene interactions, so to be able to predict occurrence of disease and treatment outcome, more studies on comparative proteomics are needed both in sporadic and in hereditary colorectal cancer. This article is about the proteomic study on hepatic metastasis of colorectal cancer which helps to identify the specific proteins that play important roles in hepatic metastasis. The study of protein molecules with their expressions correlated to the metastatic process would help to understand the metastatic mechanisms and thus facilitate the development of strategies for the therapeutic interventions and clinical management of cancer.

THE EFFECTS OF CHINESE DRUGS FOR SUPPORTING HEALTHY ENERGY AND REMOVING BLOOD STASIS ON POSTOPERATIVE METASTASIS OF GASTRIC CARCINOMA AND ORNITHINE DECARBOXYLASE

32 postoperative cases of gastric carcinoma were treated by traditional Chinese medicine (TCM) drugs for supporting healthy energy and removing blood stasis, and their therapeutic results were compared with those in the control group treated by western medicine. After 6 months of treatment, in the TCM group, the rate of metastatic recurrence was significantly reduced, and the level of ornithine decarboxylase was also markedly lowered. Therefore, it is considered that the action of anti-metastatic recurrence of TCM drugs in postoperative cases of gastric carcinoma is probably related to the lowered activity of ornithine decarboxylase.

Recurrence or metastasis of HCC:predictors,early detection and experimental antiangiogenic therapy

AIM To investigate the predictors forrecurrence or metastasis of HCC,and toevaluate the effect of antiangiogenic therapy onthe growth of transplantable human HCC in nudemice.METHODS RT-PCR was used to measure theexpression of matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)in 56 pairs of nontumorous liver andtumor samples.Sixty blood samples from humanHCC were examined by nested RT-PCR to find outAFP mRNA.Recombinant human endostatin andpolyclonal antibody against VEGF wereadministered to treat human HCC transplanted innude mice.RESULTS Thirty of 56 HCC samples showedstronger expression of MMP-9 in tumoroustissues than in nontumorous tissues.Fifteen ofthe 26 patients with relative expression level ofMMP-9 more than 0.34 developed tumorrecurrence or metastasis,whereas only 7 of 30patients with relative expression level less than0.34 developed tumor recurrence(P【0.05).There was no significant difference in therelative expression level of VEGF betweenpatients with postoperative recurrence ormetastasis and those without recurrence.AFPmRNA was detectable in 53.3% of patients withHCC.The sensitivity and specificity of AFPmRNA as a marker to detect hematogenousdissemination of HCC cells was 81.8% and84.4%,respectively.Recombinant human endostatin and polyclonal antibody against VEGFinhibited the growth of transplantable HCC innude mice by 52.2% and 45.7%,respectively.CONCLUSION MMP-9 expression in HCCcorrelates with the postoperative recurrence ormetastasis of HCC.Patients with high level ofMMP-9 expression in HCC are susceptible tometastasis.AFP mRNA could serve as anindicator of hematogenous spreading of HCCcells in circulation and a predictor of recurrenceor metastasis of HCC.Antiangiogenesis may bean adjuvant therapy for HCC.

Clinical significance of lymph node metastasis in gastric cancer

Gastric cancer,one of the most common malignancies in the world,frequently reveals lymph node,peritoneum,and liver metastases.Most of gastric cancer patients present with lymph node metastasis when they were initially diagnosed or underwent surgical resection,which results in poor prognosis.Both the depth of tumor invasion and lymph node involvement are considered as the most important prognostic predictors of gastric cancer.Although extended lymphadenectomy was not considered a survival benefit procedure and was reported to be associated with high mortality and morbidity in two randomized controlled European trials,it showed significant superiority in terms of lower locoregional recurrence and disease related deaths compared to limited lymphadenectomy in a 15-year followup study.Almost all clinical investigators have reached a consensus that the predictive efficiency of the number of metastatic lymph nodes is far better than the extent of lymph node metastasis for the prognosis of gastric cancer worldwide,but other nodal metastatic classifications of gastric cancer have been proposed as alternatives to the number of metastatic lymph nodes for improving the predictive efficiency for patient prognosis.It is still controversial over whether the ratio between metastatic and examined lymph nodes is superior to the number of metastatic lymph nodes in prognostic evaluation of gastric cancer.Besides,the negative lymph node count has been increasingly recognized to be an important factor significantly associated with prognosis of gastric cancer.

Prediction of risk factors for lymph node metastasis in early gastric cancer

AIM:To explore risk factors for lymph node metastases in early gastric cancer(EGC) and to confirm the appropriate range of lymph node dissection.METHODS:A total of 202 patients with EGC who underwent curative gastrectomy with lymphadenectomy in the Department of Surgery,Xinhua Hospital and Ruijin Hospital of Shanghai Jiaotong University Medical School between November 2003 and July 2009,were retrospectively reviewed.Both the surgical procedure and the extent of lymph node dissection were based on the recommendations of the Japanese gastric cancer treatment guidelines.The macroscopic type was classified as elevated(type Ⅰ or Ⅱa),flat(Ⅱb),or depressed(Ⅱc or Ⅲ).Histopathologically,papillary and tubular adenocarcinomas were grouped together as differentiated adenocarcinomas,and poorly differentiated and signet-ring cell adenocarcinomas were regarded as undifferentiated adenocarcinomas.Univariate and multivariate analyses of lymph node metastases and patient and tumor characteristics were undertaken.RESULTS:The lymph node metastases rate in patients with EGC was 14.4%.Among these,the rate for mucosal cancer was 5.4%,and 8.9% for submucosal cancer.Univariate analysis showed an obvious correlation between lymph node metastases and tumor location,depth of invasion,morphological classification and venous invasion(χ 2 = 122.901,P = 0.001;χ 2 = 7.14,P = 0.008;χ 2 = 79.523,P = 0.001;χ 2 = 8.687,P = 0.003,respectively).In patients with submucosal cancers,the lymph node metastases rate in patients with venous invasion(60%,3/5) was higher than in those without invasion(20%,15/75)(χ 2 = 4.301,P = 0.038).Multivariate logistic regression analysis revealed that the depth of invasion was the only independent risk factor for lymph node metastases in EGC [P = 0.018,Exp(B) = 2.744].Among the patients with lymph node metastases,29 cases(14.4%) were at N1,seven cases were at N2(3.5%),and two cases were at N3(1.0%).Univariate analysis of variance revealed a close relationship between the depth of invasion and lymph node metastases at pN 1(P = 0.008).CONCLUSION:The depth of invasion was the only independent risk factor for lymph node metastases.Risk factors for metastases should be considered when choosing surgery for EGC.

Relationship between expression of CD44v6 and nm23-H1 and tumor invasion and metastasis in hepatocellular carcinoma

ＩＮＴＲＯＤＵＣＴＩＯＮＣＤ４４ｉｓａｃｅｌｓｕｒｆａｃｅｔｒａｎｓｍｅｍｂｒａｎｅｇｌｙｃｏｐｒｏｔｅｉｎ．Ａｓａｋｉｎｄｏｆａｄｈｅｓｉｖｅｍｏｌｅｃｕｌｅ，ｉｔｐａｒｔｉｃｉｐａｔｅｓｉｎｃｅｌｃｅｌａｎｄｃｅｌｍａｔｒｉｘａｄｈｅｓｉｏｎ...

Study on the risk factors of lymphatic metastasis and the indications of less invasive operations in early gastric cancer

INTRODUCTIONThe principle of surgical treatment for gastric cancer is theradical resectioning although the suitable resetting range fordifferent cases of gastric cancer is still being arguedupon.However,the diagnostic accuracy of

Molecular mechanism about lymphogenous metastasis of hepatocarcinoma cells in mice

AIM To investigate the correlation between lymphogenous metastasis and matrix metalloproteinases (MMPs) activity and the expression of Fas Iigand of tumor cells in lymph nodes.METHODES Fifty-six inbred 615-mice were equally divided into 2 groups and inoculated with Hca-F and Hca-P cells. Their lymph node metastatic rates were examined.Growth fraction of lymphocytes in host lymph nodes was detected by flow cytometry. The Hca-F and Hca-P cells were cultured with extract of lymph node, liver or spleen.The quantity of MMPs in these supernatants was examined by zymographic analysis. The expression of Fas ligand,PCNA, Bcl-2 protein of Hca-F and Hca-P cells in the mice were examined by immunohistochemistry. The apoptosis signals of macrophages in lymph nodes were observed with in situ DNA fragmentation.RESULTS On the 28th day post-inoculation, the lymph node metastatic rate of Hca-F was 80% (16/20), whereas that of Hca-P was 25% (5/20). The growth fraction of lymphocytes was as follows: in the Hca-F cells, the proliferating peak of lymphocytes appeared on the 14th day post-inoculation and then decreased rapidly, while in HcaP cells, the peak appeared on the 7th day post-inoculation and then kept at a high level. With the extract of lymph node, the quantity of the MMP-9 activity increased (P＜0.01) and active MMP-9 and MMP-2 were produced by both Hca-F and Hca-P tumor cells, which did not produce MMPs without the extract of lymph node or with the extracts of the liver and spleen. The expression of Fas Ligand of Hca-F cells was stronger than that of Hca-P cells (P＜0.01). The expressions of PCNA and Bcl-2 protein of Hca-F cells in the tumors of inoculated area were the same as that of Hca-P cells. In situ DNA fragmentation showed that the positive signals of macrophages were around HcaF cells.CONCLUSION Secretion of MMPs which was associated with metastatic ability of Hca-F and Hca-P tumor cells depends on the environment of lymph nodes. The increased expression of Fas ligand protein of Hca-F tumor cells with high lymphogenous metastatic potential in lymph nodes may help tumor cells escape from being killed by host lymphocytes.

Hepatectomy vs radiofrequency ablation for colorectal liver metastasis:A propensity score analysis

AIM:To compare outcomes from radiofrequency ablation(RFA) and hepatectomy for treatment of colorectal liver metastasis(CRLM).METHODS:From January 2000 to December 2009,408 patients underwent curative intent treatment for CRLM.We excluded patients using the criteria:size of CRLM > 3 cm,number of CRLM ≥ 5,percutaneous RFA,follow-up period < 12 mo,double primary cancer,or treatment with both RFA and hepatectomy.We matched 51 patients who underwent RFA with 102 patients who underwent hepatectomy by propensity scores.RESULTS:The median follow-up period was 45 mo(range,12 mo to 158 mo).Hepatic recurrence was more frequent in the RFA than the hepatectomy group(P = 0.021) although extrahepatic recurrence curves were similar(P = 0.716).Survival curves of hepatectomy group were better than that of RFA for multiple,large(> 2 cm) CRLM(P = 0.034).However,survival curves were similar for single or small(≤ 2 cm) CRLM(P = 0.714,P = 0.740).CONCLUSION:Hepatectomy is better than RFA for the treatment of CRLM.However,RFA might be suitable for selected patients with single,small(≤ 2 cm) CRLM.

Relationship between DNA ploidy, expression of ki-67 antigen and gastric cancer metastasis

ＮＴＲＯＤＵＣＴＩＯＮＫｉ６７ｉｓａｍｏｕｓｅｍｏｎｏｃｌｏｎａｌａｎｔｉｂｏｄｙｗｈｉｃｈｒｅｃｏｇｎｉｚｅｓａｎｕｃｌｅａｒａｎｔｉｇｅｎｅｘｐｒｅｓｅｄｉｎａｌｐｈａｓｅｓｏｆｔｈｅｃｅｌｃｙｃｌｅｅｘｃｅｐｔＧｏａｎｄｅａｒｌｙＧ１［１］...

Patterns of lymph node metastasis are different in colon and rectal carcinomas

AIM:To describe patterns of lymph node metastasis in invasive colon and rectal carcinomas.METHODS:Clinical data of 2340 patients with colorectal carcinoma(stageⅠ to Ⅲ) who received radical resection,was retrospectively reviewed.Of the 2340 patients,1314 patients suffered from rectal carcinoma and 1026 from colon carcinoma.Patients with rectal cancer who received neoadjuvant chemoradiation therapy were excluded.Statistical analysis was performed using MannWhitney,χ 2 and Cochran's and Mantel-Haenszel tests(SPSS 15.0).A two-tailed P < 0.05 was considered statistically significant.RESULTS:Lymph node retrieval in the rectal carcinoma group was significantly lower than that in the colon carcinoma group(P < 0.001),while positive lymph node retrieval in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).The proportion of lymph node positive(N+) cases was higher(patients with one or more positive lymph nodes) in the rectal carcinoma group(P = 0.004).The number of N+ cases was compared at different T stages(T1-T4) to eliminate background bias and the results were confirmed(P < 0.001).In addition,the lymph node ratio(the ratio of number of positive lymph nodes over the number of lymph nodes examined) of stage Ⅲ cases in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).CONCLUSION:Rectal carcinomas seem more prone to metastasize to the lymph nodes than colon carcinomas,which may be of potential clinical significance.

Choroidal and cutaneous metastasis from gastric adenocarcinoma

Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earlier literature. The frequency of gastric cancer as a primary lesion was 6% in cutaneous metastasis of men, and cutaneous metastasis occurs in 0.8% of all gastric cancers. We report a patient with gastric adenocarcinoma who presented with visual disorder in his left eye and skin pain on his head as his initial symptoms. These symptoms were diagnosed to be caused by choroidal and cutaneous metastasis of gastric adenocarcinoma. Two cycles of chemotherapy consisted of oral S-1 and intravenous cisplatin (SPIRITS regimen); this was markedly effective to reduce the primary gastric lesion and almost all the metastatic lesions.

Expression of nm23 gene in hepatocellular carcinoma tissue and its relation with metastasis

Ｅｘｐｒｅｓｓｉｏｎｏｆｎｍ２３ｇｅｎｅｉｎｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａｔｉｓｓｕｅａｎｄｉｔｓｒｅｌａｔｉｏｎｗｉｔｈｍｅｔａｓｔａｓｉｓＨＵＡＮＧＢｅｉ，ＷＵＺｈｏｎｇＢｉａｎｄＲＵＡＮＹｏｕＢｉｎｇＳｕｂｊｅｃｔｈｅａｄｉ...