AIM: To investigate whether malignant esophageal stromal tumors contain PAS-positive patterned matrix-associated vascular channels, which are lined by tumor cells, but not vascular endothelial cells. That is vasculoge...AIM: To investigate whether malignant esophageal stromal tumors contain PAS-positive patterned matrix-associated vascular channels, which are lined by tumor cells, but not vascular endothelial cells. That is vasculogenic mimicry (VM) independent of tumor angiogenesis. METHODS: Thirty-six tissue samples of malignant esophageal stromal tumors were analyzed. Tissue sections were stained for Vascular endothelial growth factor (VEGF), CD31 and periodic acid Schiff (PAS). The level of VEGF, the microvascular density (MVD) and the vasculogenic mimicry density (VMD) were determined. RESULTS: PAS-positive patterned matrix-associated vascular channels were detected in 33.3% (12/36) of tumor samples. Within these patterned channels, red blood cells were found. The level of VEGF and the MVD in tumors containing patterned channels were significantly higher than those in tumors not containing patterned channels (P < 0.05). At the same time, the malignant degree of tumors was higher, the proportions of tumors containing patterned channels were not only more, but also in the each kind of tumors containing patterned channels. CONCLUSION: In malignant esophageal stromal tumors, a VM mechanism causes some tumor cells to deform themselves and secrete extracellular matrix; thus, PAS-positive patterned matrix-associated vascular channels appear and supplying blood to the tumors to sustain their growth and metastasis.展开更多
Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and meta...Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network.Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents.Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic process.This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies.展开更多
Hepatic hemangiomas need to be treated surgically in cases where they are accompanied with symptoms, have a risk of rupture, or are hardly distinguishable from malignancy. The present authors conducted embolization of...Hepatic hemangiomas need to be treated surgically in cases where they are accompanied with symptoms, have a risk of rupture, or are hardly distinguishable from malignancy. The present authors conducted embolization of the right hepatic artery one day before an operation for a huge hemangioma accompanied with symptoms and confirmed a decrease in its size. The authors performed a right trisegmentectomy through a J-shape incision, using a thoracoabdominal approach, and safely removed a giant hemangioma of 32.0 cm × 26.5 cm × 8.0 cm in size and 2300 g in weight. Even for inexperienced surgeons, a J-shape incision with a thoracoabdominal approach is considered a safe and useful method when right-side hepatectomy is required for a large mass in the right liver.展开更多
We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastro...We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding.The patient had been diagnosed 3 years previously with an aortic dilation,which was treated with a stent.Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding,leading to operative stent explantation and aortic replacement.However,an aorto-intestinal fistula was not found,and the intestinal bleeding did not arrest postoperatively.The constant need for blood transfusions made an exploratory laparotomy imperative,which showed multiple bleeding sites,predominately in the jejunal wall.A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed.The histological analysis revealed a lessdifferentiated tumor with characteristic CD31,cytokeratin,and vimentin expression,which led to the diagnosis of small intestinal angiosarcoma.Consequently,the infiltrated part of the jejunum was successfully resected in a subsequent operation,and adjuvant chemotherapy with paclitaxel was planned.Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality.Early diagnosis and treatment are essential to improve outcome.A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity,nonspecific symptoms of altered intestinal function,nonspecific abdominal pain,severe melena,and acute abdominal signs.Therefore,a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.展开更多
IntroductionAngiosarcomas are rare highly malignant neoplasm that make up less than 2% of all soft-tissue sarcomas. Only 40 renal cases have been described. Their origin is from endothelial cells. They are frequently ...IntroductionAngiosarcomas are rare highly malignant neoplasm that make up less than 2% of all soft-tissue sarcomas. Only 40 renal cases have been described. Their origin is from endothelial cells. They are frequently hemorrhagic tumors, being able to simulate a retroperitoneal hematoma or cause massive hematuria. We present a case of primary renal angiosarcoma and emphasize its hemorrhagic behavior.展开更多
Contrast agents are increasingly being used to characterize the vasculature in an organ of interest,to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures.We rev...Contrast agents are increasingly being used to characterize the vasculature in an organ of interest,to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures.We review the mechanisms of action of first,second and third generation contrast agents and their use in various endoscopic procedures in the gastrointestinal tract.Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy,assessment of depth of invasion of esophageal,gastric and gall bladder cancers and visualization of the portal venous system and esophageal varices.In addition,contrast agents can be used to differentiate pancreatic lesions.The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies.The sensitivity of power Doppler sonography to depict tumor neovascularization can be increased by contrast agents.Contrast-enhanced harmonic imaging is a useful aid in identifying the tumor vasculature and studying pancreatic microperfusion.In the future,these techniques could potentially be used to quantify tumor perfusion,to assess and monitor the efficacy of antiangiogenic agents,to assist targeted drug delivery and allow molecular imaging.展开更多
Objective: To explore the method of 99 Tc m direct labeling of angiostatin (AS) and investigate the stability and bioactivity of the 99 Tc m labeled AS in vitro . Methods: AS was extracted, validated, and then labeled...Objective: To explore the method of 99 Tc m direct labeling of angiostatin (AS) and investigate the stability and bioactivity of the 99 Tc m labeled AS in vitro . Methods: AS was extracted, validated, and then labeled with 99 Tc m after having been reduced by 2 ME or SnCl 2. The best labeling condition was screened by cross design. The labeling efficiency was measured by TLC and column chromatography. The stability of 99 Tc m AS was observed and compared when BSA, saline and different molar ratios of Cys∶AS were separately added. The bioactivity of 99 Tc m AS was observed in human umbilical vein endothelial cell (CEV304). Results: The labeling efficiency can reach (97±1 5)% for the 2 ME reducing approach. Its best experimental condition was as follows: AS 100 μg,PB(0 5 mol/L, pH 7 3)1 ml, 2 ME 100 μg, MDP (dissolved in 1 ml saline) 10 μl, and 99 Tc mO 4 - 185 MBq. The labeling efficiency using SnCl 2 reducing method can reach (90±3 0)%. The best experimental procedure was as follows: AS 100 μg,boric acid buffer(0 1 mol/L, pH 9 0)1 ml, 2%SnCl 2 (dissolved in 1 mol/L hydrochloric acid) 20 μl, was added into MDP, which was diluted with 1 ml deoxygenized water, and then 20 μl, 99 Tc mO 4 - 185 MBq was added. The product of 99 Tc m labeled AS was stable in vitro and had the same bioactivity as AS. Conclusion: 99 Tc m direct labeling of AS is simple and efficient. And the bioactivity of 99 Tc m AS has no significant change compared with AS.展开更多
AIM:To identify possible predictive factors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.METHODS: From January 2000 to July 2007, 128 patients w...AIM:To identify possible predictive factors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.METHODS: From January 2000 to July 2007, 128 patients with acute non-variceal gastrointestinal bleeding had negative f indings after initial angiography. Clinical and laboratory parameters were analyzed retrospectively.RESULTS: Among 128 patients, 62 had no recurrent gastrointestinal bleeding and 66 had recurrent gastrointestinal bleeding within 30 d. As determined by the use of multivariate analysis, an underlying malignancy, liver cirrhosis and hematemesis were significant factors related to recurrent gastrointestinal bleeding.CONCLUSION: Clinical factors including underlying malignancy, liver cirrhosis, and hematemesis are important predictors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.展开更多
Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degen...Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degeneration of photoreceptors. But the precise mechanism has not been fully established, CAR may result from autoimmune mediated apoptosis. And in recent years, there also have been some results demonstrating that tumor derived angiogenic factors such as VEGF may also confer the development of CAR, which may offer novel avenues for the therapeutic intervention in CAR. Early initiation of immunosuppressive therapy is critical for vision preservation. Future developments in rapid identification and longitudinal quantification of antibody levels would enable individualized management in these patients. The goal of this review was to analyze the epidemiology, the clinical features, the diagnosis and management of retinopathy in the context of recent advances in the elucidation of breast cancer-associated retinopathy (BCAR) pathogenesis.展开更多
基金Grant from the Natural Science Foundation of Shandong Province, No. Q2005C05
文摘AIM: To investigate whether malignant esophageal stromal tumors contain PAS-positive patterned matrix-associated vascular channels, which are lined by tumor cells, but not vascular endothelial cells. That is vasculogenic mimicry (VM) independent of tumor angiogenesis. METHODS: Thirty-six tissue samples of malignant esophageal stromal tumors were analyzed. Tissue sections were stained for Vascular endothelial growth factor (VEGF), CD31 and periodic acid Schiff (PAS). The level of VEGF, the microvascular density (MVD) and the vasculogenic mimicry density (VMD) were determined. RESULTS: PAS-positive patterned matrix-associated vascular channels were detected in 33.3% (12/36) of tumor samples. Within these patterned channels, red blood cells were found. The level of VEGF and the MVD in tumors containing patterned channels were significantly higher than those in tumors not containing patterned channels (P < 0.05). At the same time, the malignant degree of tumors was higher, the proportions of tumors containing patterned channels were not only more, but also in the each kind of tumors containing patterned channels. CONCLUSION: In malignant esophageal stromal tumors, a VM mechanism causes some tumor cells to deform themselves and secrete extracellular matrix; thus, PAS-positive patterned matrix-associated vascular channels appear and supplying blood to the tumors to sustain their growth and metastasis.
基金Supported by Research Grant,No.239/2007,entitled OCTEUS,financed by the CNCSIS Romaniaby the Sectoral Operational Programme Human Resources Development (SOP HRD),financed from the European Social Fundby the RomanianGovernment under the contract number POSDRU/89/1.5/S/64109
文摘Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network.Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents.Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic process.This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies.
文摘Hepatic hemangiomas need to be treated surgically in cases where they are accompanied with symptoms, have a risk of rupture, or are hardly distinguishable from malignancy. The present authors conducted embolization of the right hepatic artery one day before an operation for a huge hemangioma accompanied with symptoms and confirmed a decrease in its size. The authors performed a right trisegmentectomy through a J-shape incision, using a thoracoabdominal approach, and safely removed a giant hemangioma of 32.0 cm × 26.5 cm × 8.0 cm in size and 2300 g in weight. Even for inexperienced surgeons, a J-shape incision with a thoracoabdominal approach is considered a safe and useful method when right-side hepatectomy is required for a large mass in the right liver.
文摘We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma.The patient initially presented with anemia and melena.Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding.The patient had been diagnosed 3 years previously with an aortic dilation,which was treated with a stent.Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding,leading to operative stent explantation and aortic replacement.However,an aorto-intestinal fistula was not found,and the intestinal bleeding did not arrest postoperatively.The constant need for blood transfusions made an exploratory laparotomy imperative,which showed multiple bleeding sites,predominately in the jejunal wall.A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed.The histological analysis revealed a lessdifferentiated tumor with characteristic CD31,cytokeratin,and vimentin expression,which led to the diagnosis of small intestinal angiosarcoma.Consequently,the infiltrated part of the jejunum was successfully resected in a subsequent operation,and adjuvant chemotherapy with paclitaxel was planned.Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality.Early diagnosis and treatment are essential to improve outcome.A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity,nonspecific symptoms of altered intestinal function,nonspecific abdominal pain,severe melena,and acute abdominal signs.Therefore,a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.
基金a grant from the Outstanding Youth Foundation of Jilin Pro-vincial Scientific Development Program (No.20060103)
文摘IntroductionAngiosarcomas are rare highly malignant neoplasm that make up less than 2% of all soft-tissue sarcomas. Only 40 renal cases have been described. Their origin is from endothelial cells. They are frequently hemorrhagic tumors, being able to simulate a retroperitoneal hematoma or cause massive hematuria. We present a case of primary renal angiosarcoma and emphasize its hemorrhagic behavior.
文摘Contrast agents are increasingly being used to characterize the vasculature in an organ of interest,to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures.We review the mechanisms of action of first,second and third generation contrast agents and their use in various endoscopic procedures in the gastrointestinal tract.Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy,assessment of depth of invasion of esophageal,gastric and gall bladder cancers and visualization of the portal venous system and esophageal varices.In addition,contrast agents can be used to differentiate pancreatic lesions.The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies.The sensitivity of power Doppler sonography to depict tumor neovascularization can be increased by contrast agents.Contrast-enhanced harmonic imaging is a useful aid in identifying the tumor vasculature and studying pancreatic microperfusion.In the future,these techniques could potentially be used to quantify tumor perfusion,to assess and monitor the efficacy of antiangiogenic agents,to assist targeted drug delivery and allow molecular imaging.
文摘Objective: To explore the method of 99 Tc m direct labeling of angiostatin (AS) and investigate the stability and bioactivity of the 99 Tc m labeled AS in vitro . Methods: AS was extracted, validated, and then labeled with 99 Tc m after having been reduced by 2 ME or SnCl 2. The best labeling condition was screened by cross design. The labeling efficiency was measured by TLC and column chromatography. The stability of 99 Tc m AS was observed and compared when BSA, saline and different molar ratios of Cys∶AS were separately added. The bioactivity of 99 Tc m AS was observed in human umbilical vein endothelial cell (CEV304). Results: The labeling efficiency can reach (97±1 5)% for the 2 ME reducing approach. Its best experimental condition was as follows: AS 100 μg,PB(0 5 mol/L, pH 7 3)1 ml, 2 ME 100 μg, MDP (dissolved in 1 ml saline) 10 μl, and 99 Tc mO 4 - 185 MBq. The labeling efficiency using SnCl 2 reducing method can reach (90±3 0)%. The best experimental procedure was as follows: AS 100 μg,boric acid buffer(0 1 mol/L, pH 9 0)1 ml, 2%SnCl 2 (dissolved in 1 mol/L hydrochloric acid) 20 μl, was added into MDP, which was diluted with 1 ml deoxygenized water, and then 20 μl, 99 Tc mO 4 - 185 MBq was added. The product of 99 Tc m labeled AS was stable in vitro and had the same bioactivity as AS. Conclusion: 99 Tc m direct labeling of AS is simple and efficient. And the bioactivity of 99 Tc m AS has no significant change compared with AS.
文摘AIM:To identify possible predictive factors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.METHODS: From January 2000 to July 2007, 128 patients with acute non-variceal gastrointestinal bleeding had negative f indings after initial angiography. Clinical and laboratory parameters were analyzed retrospectively.RESULTS: Among 128 patients, 62 had no recurrent gastrointestinal bleeding and 66 had recurrent gastrointestinal bleeding within 30 d. As determined by the use of multivariate analysis, an underlying malignancy, liver cirrhosis and hematemesis were significant factors related to recurrent gastrointestinal bleeding.CONCLUSION: Clinical factors including underlying malignancy, liver cirrhosis, and hematemesis are important predictors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.
文摘Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degeneration of photoreceptors. But the precise mechanism has not been fully established, CAR may result from autoimmune mediated apoptosis. And in recent years, there also have been some results demonstrating that tumor derived angiogenic factors such as VEGF may also confer the development of CAR, which may offer novel avenues for the therapeutic intervention in CAR. Early initiation of immunosuppressive therapy is critical for vision preservation. Future developments in rapid identification and longitudinal quantification of antibody levels would enable individualized management in these patients. The goal of this review was to analyze the epidemiology, the clinical features, the diagnosis and management of retinopathy in the context of recent advances in the elucidation of breast cancer-associated retinopathy (BCAR) pathogenesis.
