肝癌CT表现与癌组织病理分化程度及临床预后的相关性

目的探讨肝癌CT表现与癌组织病理分化程度及临床预后的相关性。方法选取我院经手术病理确诊为肝细胞性肝癌患者73例。所有患者在术前行CT平扫及3期增强扫描,比较患者术前肝癌CT表现与癌组织病理分化程度以及临床预后,分析肝癌CT表现与癌组织病理分化程度及患者生存时间的相关性。结果患者肿瘤形态与癌组织病理分化程度密切相关(χ^2=29.280,P<0.05),患者肿瘤厚度与癌组织病理分化程度密切相关(χ^2=42.635,P<0.05),患者CT增强与癌组织病理分化程度密切相关(χ^2=87.871,P<0.05),患者肿瘤最大直径与癌组织病理分化程度不相关(χ^2=0.956,P=0.619)。肿瘤形态规则、肿瘤厚度小于15mm、CT增强为轻度、不均匀增强患者生存时间显著比肿瘤形态不规则、肿瘤厚度大于等于15mm、CT增强为明显增强患者长(P<0.05);有侵袭转移组和病理分化低分组患者的平均生存时间明显低于无侵袭转移组和病理分化高分组(15.41vs28.21,2.18vs24.21)(P<0.05)。结论肝癌CT表现与癌组织病理分化程度存在相关性,能够反应患者临床预后情况。

颈部异位大汗腺癌一例报告

王某,女,49岁。1987年11月4日入院。1985年4月偶然发现右侧颈部一蚕豆大肿块,不痛。此后包块渐增大,1986年10月在外院按“淋巴结核”服中药治疗,效果不显入院手术。既往未患过结核。查体:右侧颈部外观正常,胸锁乳突肌下扪及3×5cm包块,界限清楚,与周围组织及皮肤不粘连。包块活动度大,与吞咽无关,无压痛。化验:血色素11.5g/L,白细胞总数8.6×10~9/L,血沉5mm/h,B超检查:右侧颈部实性包块,3.3×1.9×3.2cm,诊断为肿大淋巴结。肿块穿刺为血性液体,未作涂片。1987年11月10日手术,

直肠癌手术前后清栓酶导管升压热疗对术后复发和转移的影响临床观察

直肠癌手术前后清栓酶导管升压热疗对术后复发和转移的影响临床观察姚柏春湖北省十堰市卫生学校（４４２０００）为了减少腹膜返折平面以下直肠癌术后局部复发和远处转移，作者在１９８８年至１９９２年间对６４例ＤｕｋｅｓＢ、Ｃ和Ａ３期直肠癌患者进行了手术前后清栓酶...

Cancer stem cell markers CD133 and CD24 correlate with invasiveness and differentiation in colorectal adenocarcinoma

AIM:To verify that CD markers are available for detecting cancer stem cell populations and to evaluate their clinical significance in colon cancer.METHODS:Immunohistochemistry for CD133,CD24 and CD44 was performed on the tissue microarray of 523 colorectal adenocarcinomas.Medical records were reviewed and clinicopathological analysis was performed.RESULTS:In colorectal adenocarcinoma,128 of 523 cases(24.5%) were positive and 395 cases(75.5%) were negative for CD133 expression.Two hundred and sixty-four of 523 cases(50.5%) were positive and 259 cases(49.5%) were negative for CD24 expression.Five hundred and two of 523 cases(96%) were negative and 21 cases(4%) were positive for CD44 expression.Upon clinicopathological analysis,CD133 expression was present more in male patients(P = 0.002) and in advanced T stage cancer(P = 0.024).Correlation between CD24 expression and clinicopathological factors was seen in the degree of differentiation(P = 0.006).Correlation between CD44 expression and clinicopathological factors was seen in the tumor size(P = 0.001).Survival was not significantly related to CD133,CD24 and CD44 expression.CONCLUSION:CD markers were related to invasiveness and differentiation of colorectal adenocarcinoma.However,CD expression was not closely related to survival.

DEC1 nuclear expression:A marker of differentiation grade in hepatocellular carcinoma

AIM: To investigate the expression patterns of human differentiated embryo chondrocyte 1 (DEC1) in hepatocellular carcinoma (HCC) and corresponding adjacent non-tumor and the normal liver tissues, the association between DEC1 expression and histopathological variables and the role of DEC1 in hepatocarcinogenesis. METHODS: The expression of DEC1 was detected immunohistochemically in 176 paraffin-embedded sections from 63 patients with HCC and 50 subjects with normal liver tissues. RESULTS: DEC1 protein was persistently expressed in the cytoplasm of hepatocytes in normal liver and HCC tissues. Compared with adjacent non-tumor liver tissues, HCC tissues showed high nuclear expression of DEC1 protein. However, high DEC1 nuclear expression was more frequently detected in well-differentiated (83.3%) than in moderately (27.3%) and poorly differentiated HCC (16.7%). Low DEC1 expression was associated with poor histological differentiation and malignancy progression. A correlation was found between the nuclear expression of DEC1 protein and histological differentiation (r = 0.376, P = 0.024). CONCLUSION: DEC1 is expressed in the cytoplasm of hepatocytes and because nuclear DEC1 expression is decreased with decreasing differentiation status of HCC, nuclear DEC1 might be a marker of HCC differentiation.

Methylation of the PCDH8 (Protocadherin-8) gene in gastric cancer

Objective: To investigate the methylation status of the PCDH8 (Protocadherin-8) gene in gastric cancer tissues and find out the relationship between methylation status of the PCDH8 and clinicopathological features in gastric cancer patients. Methods: We first investigated the methylation status of the PCDH8 (Protocadherin-8) gene in 65 gastric cancer and detected aberrant promoter methylation in gastric cancers; and then analyzed he relationship between methylation status of the PCDH8 and clinicopathological status with SPSS 13.0 software. Results: We first investigated the methylation status of the PCDH8 (Protocadherin-8) gene in 65 gastric cancer and detected aberrant promoter methylation in 36 of 65 (55.4%) gastric cancers. There was no significant difference in the distribution of patients with methylation or unmethylation of PCDH8 in terms of age, sex, tumor size, distant metastasis, or TNM stage. Methylation of PCDH8 was significantly correlated to negative pathological lymph node metastasis (P=0.038) and tumor differentiation (P=0.01). These two factors were proved to be of prognostic importance. Conclusion: Methylated PCDH8 seems to have a trend for worse prognosis in gastric cancer. However, a further large series of tumor samples and a longer follow-up period are required to elucidate its potential role.

High level of ezrin expression in colorectal cancer tissues is closely related to tumor malignancy

AIM:To investigate the ezrin expression in normal colorectal mucosa and colorectal cancer tissues, and study the correlation between ezrin expression in colorectal cancer tissues and tumor invasion and metastasis.METHODS: Eighty paraffin-embedded cancer tissue samples were selected from primary colorectal adenocarcinoma. Twenty-eight patients had well-differentiated, 22 had moderately differentiated and 30 had poorly differentiated adenocarcinoma. Forty-five patients and 35 patients had lymph node metastasis. Forty-five patients were of Dukes A to B stage, and 35 were of C to D stage. Another 22 paraffi n-embedded tissue blocks of normal colorectal epithelium (>5 cm away from the edge of the tumor) were selected as the control group. All patients with colorectal cancer were treated surgically and diagnosed histologically, without preoperative chemotherapy or radiotherapy. The immunohistochemistry was used to detect the ezrin expression in paraffin-embedded normal colorectal mucosa tissues and colorectal cancer tissue samples.RESULTS: Ezrin expression in colorectal cancer was significantly higher than in normal colorectal mucosa (75.00% vs 9.09%, P<0.01), and there was a close relationship between ezrin expression and the degree of tumor differentiation, lymph node metastasis and Dukes stage (88.46% vs 50.00%, P<0.01; 94.28% vs 51.11%, P<0.01; 94.28% vs 51.11%, P<0.01).CONCLUSION: Ezrin expression is obviously higher in colorectal cancer tissues than in normal colorectal mucosa tissues, and the high level of ezrin expression is closely related to the colorectal cancer invasion and metastasis process.

Surgical treatment of intrahepatic cholangiocarcinoma: a retrospective study of 104 cases

Objective: To explore the clinicopathological features, surgical treatment techniques, and prognostic risk factors of intrahepatic cholangiocarcinoma(ICC).Methods: A total of 104 ICC cases were collected from January 2008 to December 2013 at Tianjin Medical University Cancer Institute and Hospital and divided into the hepatic hilum lymphadenectomy(HLL, 21 cases), extended hepatic hilum lymphadenectomy(EHLL, 12 cases), and non-lymphadenectomy(NL, 71 cases) groups. The clinical data of the patients were retrospectively analyzed, and the prognostic differences were compared among different groups.Results: The 1-, 2-, and 3-year overall survival(OS) rates of all cases were 72.1%, 56.1%, and 43.7%, respectively. The median survival duration was 34 months. The 1-, 2-, and 3-year OS rates of the HLL group(42.9%, 28.6%, and 28.6%, respectively) were significantly lower than those of the NL group(78.9%, 62.5%, and 47.8%, respectively). Meanwhile, the 1-, 2-, and 3-year OS rates of the EHLL group(75.0%, 56.1%, and 33.3%, respectively) were not significantly different from those of the other two groups.Univariate analysis showed that age, gender, American Joint Committee on Cancer(AJCC) stage, differentiation, ferritin(Fer),carbohydrate antigen19-9(CA19-9) and carcinoembryonicantigen(CEA) levels, lymph node metastasis(LNM), and lymph node dissection(LND) were prognostic factors for the long-term survival of ICC. Meanwhile, multivariate analysis revealed that age,AJCC stage, differentiation, Fer levels, and LNM were independent risk factors for survival.Conclusions: ICC patients will not benefit from lymphadenectomy in the absence of LNM. However, systematic lymphadenectomy may improve ICC outcomes if the location of lymphatic metastasis is known. Age, AJCC stage, differentiation,Fer level, and LNM are independent risk factors for survival in ICC.

A clinical study of thoracic esophageal carcinoma metastasis into abdominal lymph nodes

Objective The aim of this study was to analyze the potential of thoracic esophageal carcinoma to metas-tasize into abdominal lymph nodes. Methods The data on abdominal lymph node metastasis in 164 patients who had undergone resection of thoracic esophageal carcinoma were analyzed retrospectively and grouped according to tumor position in the upper, middle, or lower thoracic esophagus. The dif erence in tumor infiltration depth, dif erentiation degree, pathological type, pathological stage, and the metastasis rate in abdominal lymph nodes among the three groups was evaluated and the correlation of abdominal lymph node metastasis with tumor infiltra-tion depth, dif erentiation degree, and pathological type was analyzed. Results Clinical characteristics such as tumor infiltration depth, dif erentiation degree, pathological type, and pathological stage were not significantly dif erent between the patients with upper, middle, and lower thoracic esophageal carcinomas. Although there was a dif erence in the metastasis rate in abdominal lymph nodes between the three groups （6.9%, 27.4%, and 39.6% for the upper, middle, and lower thoracic esophageal carcinomas, respectively）, it was not statistical y significant. There was also no association between the rate of abdominal lymph node metastasis and tumor infiltration depth, dif erentiation degree, and pathological type. Conclusion Esophageal carcinoma specifical y metastasizes into lymph nodes. If the tumor infiltrates the upper thoracic submucosa, it could metastasize down to abdominal lymph nodes via the lymphatic cap-il ary net. The majority of esophageal carcinomas were of T1b or higher pathological stage at the diagnosis, indicating infiltration of the submucosa. Thus, tumors of the early stage, high degree of dif erentiation, or position in the upper thoracic esophagus were not less prone to metastasis into abdominal lymph nodes. Therefore, routine abdominal lymph node dissection during radical surgery for esophageal carcinoma is necessary.

Interleukin-24 is correlated with differentiation and lymph node numbers in rectal cancer

AIM:To assess the significance of interleukin(IL)-24 and vascular endothelial growth factor(VEGF)expression in lymph-node-positive rectal cancer. METHODS:Between 1998 and 2005,90 rectal adenocarcinoma patients with lymph node involvement were enrolled.All patients received radical surgery and postoperative pelvic chemoradiotherapy of 50.4-54.0 Gy.Chemotherapy of 5-fluorouracil and leucovorin or levamisole was given intravenously during the first and last week of radiotherapy,and then monthly for about 6 mo.Expression of IL-24 and VEGF was evaluated by immunohistochemical staining of surgical specimens, and their relations with patient characteristics and survival were analyzed.The median follow-up of surviving patients was 73 mo(range:52-122 mo). RESULTS:IL-24 expression was found in 81 out of 90 patients;31 showed weak intensity and 50 showedstrong intensity.VEGF expression was found in 64 out of 90 patients.Negative and weak intensities of IL-24 expression were classified as negative expression for analysis.IL-24 expression was significantly reduced in poorly differentiated tumors in comparison with well or moderately differentiated tumors(P=0.004),N2b to earlier N stages(P=0.016),and stageⅢc to stageⅢ a orⅢb(P=0.028).The number of involved lymph nodes was also significantly reduced in IL-24-positive patients in comparison with IL-24-negative ones. There was no correlation between VEGF expression and patient characteristics.Expression of IL-24 and VEGF was not correlated with survival,but N stage and stages were significantly correlated with survival. CONCLUSION:IL-24 expression was significantly correlated with histological differentiation,and inversely correlated with the degree of lymph node involvement in stageⅢrectal cancer.

The relationship of the expressions and the clinical pathology of Skp2 and p27 in the tissues of colorectal cancer

Objective:The aim of this study was to study the expression and the clinical pathological relationship of p27 and Skp2 in the tissues of colorectal cancer,discuss the correlation between them.Methods:To determine the expressions of p27 and Skp2 among 30 cases of colorectal cancer tissue specimen and 18 cases of normal colorectal tissue samples with immunohistochemistry SP method.Results:The average positive rate of p27 among the normal colorectal tissue samples was 55.2%,which was obviously higher than that of colorectal cancer tissue samples(27.5%,P < 0.05).The correlation between the expression of p27 and the degree of differentiation of colorectal cancer;Dukes stage and lymph node metastasis were distinctly negative(P < 0.05).The average positive rate of Skp2 among the colorectal cancer tissue specimens was 9.5%,which was obviously higher than that of normal colorectal tissue samples(1.8%,P < 0.05).There was an obviously negative correlation between the expression of Skp2 and the degree of differentiation of colorectal cancer(P < 0.05),and the expression of Skp2 had no significant correlation with patients' age,sex,Dukes stage and lymph node metastasis(P > 0.05).There was an negative correlation between the expression of p27 and Skp2(r =-0.806,P < 0.01).Conclusion:The expression of Skp2 in the colorectal cancer tissues is correlative with the degradation of p27;Skp2,the oncogene of colorectal cancer,is involved in colorectal carcinogenesis,which may be the new target for the treatment of colorectal cancer.

MSMO1在胰腺癌中的表达及其临床病理学意义

为了探讨甲基固醇单加氧酶1(methylsterol monooxygenase 1,MSMO1)在胰腺癌中的表达水平及其临床病理学意义,我们运用免疫组织化学方法检测67例胰腺腺癌组织及其中配对的45例癌旁组织中MSMO1的表达水平,并统计其与临床病理学参数的关系;再运用实时定量聚合酶链式反应(qRT-PCR)和蛋白质印迹法(Western blot)技术分别检测17例配对冷冻保存的新鲜胰腺癌标本中MSMO1 mRNA和蛋白的表达水平。并在不同分化程度的胰腺癌细胞株中检测相对表达量。免疫组化结果显示MSMO1在癌旁组织中的阳性表达率(38/45,84.4%)明显高于癌组织(30/67,44.8%)(t=-5.516,P<0.01);MSMO1的表达主要与肿瘤分化程度(χ^2=12.044,P=0.002)相关,与年龄、性别、肿瘤大小、T分期、淋巴结转移等无关;Kaplan-Meier生存分析显示MSMO1阴性表达的患者中位生存时间较短,预后较差(χ^2=12.327,P<0.01)。qRT-PCR及Western blot示MSMO1在1例癌旁组织mRNA和蛋白表达水平明显高于癌组织(均P<0.01)。随胰腺癌细胞分化程度增高,MSMO1表达逐步增强。由此推断:MSMO1在胰腺癌中呈明显低表达,与胰腺癌分化程度密切相关,提示不良预后。