Objective： To analyze the clinicopathologic characteristics and prognostic factors of small gastrointestinal stromal tumor （GIST） of the stomach. Methods： A total of 31 small gastric GIST patients, including 10 ma...Objective： To analyze the clinicopathologic characteristics and prognostic factors of small gastrointestinal stromal tumor （GIST） of the stomach. Methods： A total of 31 small gastric GIST patients, including 10 males and 21 females, with a median age of 58 years （37- 81 years）, who underwent surgery at any time from 1999 to 2012 were included in this study. The clinical records of the patients were analyzed retrospectively. Results： Abdominal discomfort and pain （10 cases, 32.3%, respectively） were the two most common complaints among the patients. All patients received surgery, 11 received gastric wedge resection, 11 received subtotal gastrectom）5 5 received laparoscopic gastric wedge resection, and 4 received endoscopic submucosal dissection. No severe adverse complication was observed. A total of 29 patients （93.5%） were followed up. During the follow-up, 2 patients were found to exhibit tumor recurrence, and 1 patient had liver metastases. One patient died of tumor progressionwhile another died of another malignant tumor. Median progression free survival （PFS） time was 120.3 months, and median overall survival （OS） time was 130.4 months. Conclusion： Small gastric GIST has better prognosis. Surgery is the best choice for therapy. Micro-invasive procedures are safe and effective for elective patients. Tumor necrosis, tumor bleeding, and muscle invasion are potential prognostic factors of small gastric GIST.展开更多
AIM： To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS： Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and e...AIM： To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS： Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and endoscopic ultrasound （EUS） were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios. RESULTS： Endoscopically, esophageal gastrointestinal stromal tumors （GISTs） and leiomyomas （LMs） had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells： spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcornas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisher＇s exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 （P 〉 0.05）. All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 （P 〈 0.005）. All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 115 （P 〈 0.005）. CONCLUSION： The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs are less common. Most of esophageal LMs and GISTs are benign. Endoscopy and EUS are the effective methods to diagnose esophageal mesenchymal tumors and they can provide useful information for the treatment of these tumors. However, they cannot exactly differentiate esophageal GISTs from LMs. Pathological, especially immunohistochemical features are useful to differentiate GISTs from leiomyomas.展开更多
Autoimmune pancreatitis is a disease characterized by specific pathological features,different from those of other forms of pancreatitis,that responds dramatically to steroid therapy.The pancreatic parenchyma may be d...Autoimmune pancreatitis is a disease characterized by specific pathological features,different from those of other forms of pancreatitis,that responds dramatically to steroid therapy.The pancreatic parenchyma may be diffusely or focally involved with the possibility of a low-density mass being present at imaging,mimicking pancreatic cancer.Clinically,the most relevant problems lie in the diagnosis of autoimmune pancreatitis and in distinguishing autoimmune pancreatitis from pancreatic cancer.Since in the presence of a pancreatic mass the probability of tumour is much higher than that of pancreatitis,the physician should be aware that in focal autoimmune pancreatitis the first step before using steroids is to exclude pancreatic adenocarcinoma.In this review,we briefly analyse the strategies to be followed for a correct diagnosis of autoimmune pancreatitis.展开更多
OBJECTIVE It is unclear whether differentiation disturbances or deregulation of neural stem cells (NSCs) are the early key steps for gliomagenesis and tumor development. Furthermore, relevant molecular changes and gen...OBJECTIVE It is unclear whether differentiation disturbances or deregulation of neural stem cells (NSCs) are the early key steps for gliomagenesis and tumor development. Furthermore, relevant molecular changes and gene-regulation pathways are unknown. This study focused on screening and validating differentiation-associated genes from both human NSCs and glioma cells with malignant progression, for the purpose of offering an experimental basis for the cellular origin of gilomas and molecular pathology of gliomagenesis. METHODS The differential-gene expression profiles of malignant progression of gliomas were established, then the differentiation related genes were screened out with a bioinformatics analysis. Expression levels of these genes was further analyzed in cultured human fetal NSCs undergoing differentiation processes with a semi-quantitative RT-PCR assay. RESULTS Eight genes were screened out from the gene-expression profiling of which the expression levels were associated with the differentiation processes of NSCs, namely CXCR4, TN-C, GLT1, IL1-RI, EGFR-8, CDC2, Ndr3 and MAPKK4. Three of them, ie., GLT1, CDC2 and MAPKK4, were further analyzed, showing that expression levels decreased with the differentiation processes of NSCs, and increased with the malignant progression of ganglioglioma. CONCLUSION Three differentiation associated genes were found negatively associated with NSCs differentiation and positively associated with malignant progression of gliomas, suggesting that differentiation disturbances of neural stem cells may be involved in oncogenesis, and that further studies on their roles in gliomagenesis should be conducted.展开更多
AIM： To investigate the expressions of leptin and per- oxisome proliferator-activated receptor y （PPARG） in relation to body mass index （BMI）. METHODS： We evaluated leptin and PPARG expres- sion in 30 adenomas o...AIM： To investigate the expressions of leptin and per- oxisome proliferator-activated receptor y （PPARG） in relation to body mass index （BMI）. METHODS： We evaluated leptin and PPARG expres- sion in 30 adenomas over 1 cm in size by immunohisto- chemical staining. In addition, clinicopathologic features including BMI were assessed. RESULTS： PPARG and leptin expression showed a strong positive correlation （P = 0.035）. The average BMI of the leptin-positive group was higher than that of the leptin-negative group （25.4 ＋ 3.4 kg/m2 vs 22.6 ＋ 2.4 kg/m2, P = 0.018）, and leptin expression was sig- nificantly correlated with high BMI （P = 0.024）. Leptinexpression was more frequently observed in intermedi- ate/high grade dysplasia than in low grade dysplasia （P = 0.030）. However, PPARG expression was not cor- related with BMI and grade of dysplasia. CONCLUSION： BMI has influenced on the leptin ex- pression of colorectal adenoma. The exact mechanism underlies the strong correlation between leptin and PPARG expression needs further study.展开更多
文摘Objective： To analyze the clinicopathologic characteristics and prognostic factors of small gastrointestinal stromal tumor （GIST） of the stomach. Methods： A total of 31 small gastric GIST patients, including 10 males and 21 females, with a median age of 58 years （37- 81 years）, who underwent surgery at any time from 1999 to 2012 were included in this study. The clinical records of the patients were analyzed retrospectively. Results： Abdominal discomfort and pain （10 cases, 32.3%, respectively） were the two most common complaints among the patients. All patients received surgery, 11 received gastric wedge resection, 11 received subtotal gastrectom）5 5 received laparoscopic gastric wedge resection, and 4 received endoscopic submucosal dissection. No severe adverse complication was observed. A total of 29 patients （93.5%） were followed up. During the follow-up, 2 patients were found to exhibit tumor recurrence, and 1 patient had liver metastases. One patient died of tumor progressionwhile another died of another malignant tumor. Median progression free survival （PFS） time was 120.3 months, and median overall survival （OS） time was 130.4 months. Conclusion： Small gastric GIST has better prognosis. Surgery is the best choice for therapy. Micro-invasive procedures are safe and effective for elective patients. Tumor necrosis, tumor bleeding, and muscle invasion are potential prognostic factors of small gastric GIST.
基金Supported by the Scientific and Technological Foundation of the Jiangxi Provincial Department of Science and Technology
文摘AIM： To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS： Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and endoscopic ultrasound （EUS） were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios. RESULTS： Endoscopically, esophageal gastrointestinal stromal tumors （GISTs） and leiomyomas （LMs） had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells： spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcornas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisher＇s exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 （P 〉 0.05）. All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 （P 〈 0.005）. All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 115 （P 〈 0.005）. CONCLUSION： The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs are less common. Most of esophageal LMs and GISTs are benign. Endoscopy and EUS are the effective methods to diagnose esophageal mesenchymal tumors and they can provide useful information for the treatment of these tumors. However, they cannot exactly differentiate esophageal GISTs from LMs. Pathological, especially immunohistochemical features are useful to differentiate GISTs from leiomyomas.
文摘Autoimmune pancreatitis is a disease characterized by specific pathological features,different from those of other forms of pancreatitis,that responds dramatically to steroid therapy.The pancreatic parenchyma may be diffusely or focally involved with the possibility of a low-density mass being present at imaging,mimicking pancreatic cancer.Clinically,the most relevant problems lie in the diagnosis of autoimmune pancreatitis and in distinguishing autoimmune pancreatitis from pancreatic cancer.Since in the presence of a pancreatic mass the probability of tumour is much higher than that of pancreatitis,the physician should be aware that in focal autoimmune pancreatitis the first step before using steroids is to exclude pancreatic adenocarcinoma.In this review,we briefly analyse the strategies to be followed for a correct diagnosis of autoimmune pancreatitis.
基金This work was supported by the NationalNatural Science Foundation of China(No. 30371457, 30400457).
文摘OBJECTIVE It is unclear whether differentiation disturbances or deregulation of neural stem cells (NSCs) are the early key steps for gliomagenesis and tumor development. Furthermore, relevant molecular changes and gene-regulation pathways are unknown. This study focused on screening and validating differentiation-associated genes from both human NSCs and glioma cells with malignant progression, for the purpose of offering an experimental basis for the cellular origin of gilomas and molecular pathology of gliomagenesis. METHODS The differential-gene expression profiles of malignant progression of gliomas were established, then the differentiation related genes were screened out with a bioinformatics analysis. Expression levels of these genes was further analyzed in cultured human fetal NSCs undergoing differentiation processes with a semi-quantitative RT-PCR assay. RESULTS Eight genes were screened out from the gene-expression profiling of which the expression levels were associated with the differentiation processes of NSCs, namely CXCR4, TN-C, GLT1, IL1-RI, EGFR-8, CDC2, Ndr3 and MAPKK4. Three of them, ie., GLT1, CDC2 and MAPKK4, were further analyzed, showing that expression levels decreased with the differentiation processes of NSCs, and increased with the malignant progression of ganglioglioma. CONCLUSION Three differentiation associated genes were found negatively associated with NSCs differentiation and positively associated with malignant progression of gliomas, suggesting that differentiation disturbances of neural stem cells may be involved in oncogenesis, and that further studies on their roles in gliomagenesis should be conducted.
基金Supported by Grant from Inje University College of Medicine(2010)
文摘AIM： To investigate the expressions of leptin and per- oxisome proliferator-activated receptor y （PPARG） in relation to body mass index （BMI）. METHODS： We evaluated leptin and PPARG expres- sion in 30 adenomas over 1 cm in size by immunohisto- chemical staining. In addition, clinicopathologic features including BMI were assessed. RESULTS： PPARG and leptin expression showed a strong positive correlation （P = 0.035）. The average BMI of the leptin-positive group was higher than that of the leptin-negative group （25.4 ＋ 3.4 kg/m2 vs 22.6 ＋ 2.4 kg/m2, P = 0.018）, and leptin expression was sig- nificantly correlated with high BMI （P = 0.024）. Leptinexpression was more frequently observed in intermedi- ate/high grade dysplasia than in low grade dysplasia （P = 0.030）. However, PPARG expression was not cor- related with BMI and grade of dysplasia. CONCLUSION： BMI has influenced on the leptin ex- pression of colorectal adenoma. The exact mechanism underlies the strong correlation between leptin and PPARG expression needs further study.
