Minimally invasive multivisceral resection in rectal cancer:Preparation or Precipitation?

Rectal cancer is a malignant neoplasm that constitutes a significant public health challenge due to its high incidence and associated mortality.In this editorial,we comment on the article by Chan et al.In recent years,there has been progress in the development of new treatments for initial and metastatic rectal cancer due to introduction of techniques of innovative and minimally-invasive surgery(MIS)such as laparoscopy and robotic surgery.However,only a few studies have ana-lyzed the feasibility,safety,and results of MIS in relation to open surgery,thereby highlighting the promising and superior results of MIS in functional and oncolo-gical terms.The findings were corroborated by the comparative study of Chan et al which evaluated the feasibility and safety of minimally invasive multivisceral resection(miMVR).A comparison of postoperative outcomes between open MVR and miMVR showed that miMVR presented less blood loss,fewer postoperative complications,and less morbidity.This editorial article is focused specifically on analysis of the characteristics of new minimally-invasive surgical techniques in rectal cancer,particularly in advanced stages.The importance of future research is emphasized by progress in knowledge,training,and clinical practice in the appli-cation of these surgical procedures for the treatment of advanced colorectal cancer.

Tumors with macroscopic bile duct thrombi in non-HCC patients:Dynamic multi-phase MSCT findings

Non-hepatocellular carcinoma （non-HCC） with macroscopic bile duct tumor thrombus （BDTI） formation is rare, few radiological studies have been reported. In this case report, we retrospectively analyzed the imaging findings of three cases of non-HCC with macroscopic BDTT on dynamic enhanced multislice computed tomography （MSCT） scan. One case of primary hepatic carcinosarcoma was presented as a solitary, large welldefined tumor with significant necrotic changes. One case of liver metastasis from colon cancer was presented as a Iobulated, large ill-defined tumor. One case of intraductal oncocytic papillary neoplasm involved the entire pancreas, presented as a cystic and solid mass with multilocular changes （the individual Ioculi were less than 5.0 mm in diameter）. The bile duct was dilated due to expansible growth of the BDFE in all three patients. The BDTT was contiguous with hepatic or pancreatictumor, and both of them showed the same enhancement patterns on dynamic contrast-enhanced computed tomography scan： early enhancement in the hepatic arterial phase and a quick wash out of contrast agent in the portal and equilibrium phases. Macroscopic BDTT- in non-HCC patient is rare, dynamic enhanced MSCT scan may be valuable in the diagnosis of non-HCC with BDTT.

Ultrasound-guided microwave ablation for abdominal wall metastatic tumors: A preliminary study

AIM: To evaluate the feasibility, safety and efficacy of ultrasound-guided microwave (MW) ablation for abdominal wall metastatic tumors. METHODS: From August 2007 to December 2010, a total of 11 patients with 23 abdominal wall nodules (diameter 2.59 cm ± 1.11 cm, range 1.3 cm to 5.0 cm) were treated with MW ablation. One antenna was inserted into the center of tumors less than 1.7 cm, and multiple antennae were inserted simultaneously into tumors 1.7 cm or larger. A 21 gauge thermocouple was inserted near important organs which required protection (such as bowel or gallbladder) for real-time temperature monitoring during MW ablation. Treatment outcome was observed by contrast-enhanced ultrasound and magnetic resonance imaging (MRI) [or computed tomography (CT)] during follow-up. RESULTS: MW ablation was well tolerated by all patients. Six patients with 11 nodules had 1 thermocouple inserted near important organs for real-time temperature monitoring and the maximum temperature was 56 ℃. Major complications included mild pain (54.5%), post-ablation fever (100%) and abdominal wall edema (25%). All 23 tumors (100%) in this group were completely ablated, and no residual tumor or local recurrence was observed at a median follow-up of 13 mo (range 1 to 32 mo). The ablation zone was well defined on contrast-enhanced imaging (contrast-enhanced CT, MRI and/or contrast-enhanced ultrasound) and gradually shrank with time. CONCLUSION: Ultrasound-guided MW ablation may be a feasible, safe and effective treatment for abdominal wall metastatic tumors in selected patients.

Polyphyllin I inhibits proliferation and metastasis of ovarian cancer cell line HO-8910PM invitro

OBJECTIVE： To study the anticancer mechanism of polyphyllin I （PPI）, a Traditional Chinese Medicine, on the ovarian cancer cell line HO-8910PM in vitro. METHODS： Transwell chamber invasive assays were used to investigate the inhibitory capacity of PPI on HO-8910PM metastasis. Gene expression profiling chips was used to screen differentially ex- pressed genes between experiment group and con- trol group. Reverse transcription PCR and Western blotting were used to determine mRNA and pro- tein levels. RESULTS： With increasing PPI concentration, the metastatic capacity of cells decreased, with signifi- cance differences between the experimental and control groups （P〈0.01） as well as between two concentration groups. Gene expression profiling identified 123 differentially expressed genes, of which 70 were downregulated and 53 were upregu- lated. The genes were involved in multiple signal transduction pathways, including apoptosis, prolif- eration and metastasis. Real-time PCR （RT-PCR） showed that differential genes PIK3C2B, Caspase 9and WntSA were downregulated with increasing PPI, showing an evident dose-effect relationship. The c-Jun was an exception. As the PPI dosage in- creased and the exposure time was extended, c-Jun relative expression showed an upward trend. There were significant differences between the ex- periment and control （P〈0.05）. Western blot analy- ses showed that PPI treatment decreased levels of Caspase 9, WntSA and PIK3C2B and increased acti- vated Caspase 9,c-Jun and p-c-Jun expression levels. CONCLUSION＂ PPI has strong antitumor and anti transfer activity. It can activate c-Jun expression and the JNK signaling pathway, elicit cell apoptosis via the mitochondrial-mediated Caspase activation pathway, and finally inhibit tumor growth and mi- gration in vitro. The downregulation of PIK3C2B and Wnt5A jointly inhibit the proliferation and me- tastasis of HO-8910PM. PPI may be a novel treat- ment for ovarian cancer.

Expression of PC-cell-derived growth factor in breast cancer

This study is mainly aimed at evaluating the expression of PC-cell-derived growth factor(PCDGF)in breast cancer and breast adenofibroma,and to compare with other commonly used clinical pathological indices,then to investigate the diagnostic and targeted therapeutic purpose of PCDGF in breast cancer tissue.In this study,we detected the expression of PCDGF,p53 and CerbB-2 in breast cancer tissue and the expression of PCDGF in breast adenofibroma tissue by immunohistochemical method,and analyzed the relationship between them.We found that PCDGF was expressed in most breast cancer tissue,but was not in breast adenofibroma tissue,and the expression of PCDGF was related with the tumor’s pathological category and the expression of estrogen receptor(ER)and progesterone receptor(PR)and p53,but there was no statistical dependability between PCDGF and cerbB-2.From this study,we predict that PCDGF may serve as a marker in the secondary diagnosis of breast cancer,and may participate in the generation and differentiation of breast cancer cells,and become an effective target of therapy for breast cancer.