Objective To determine the safety and efficacy of surgical biliary bypass on the elderly patients with unresectable pancreatic head cancer. Methods The clinical data of 55 cases with unresectable pancreatic head cancer treated with palliation methods from July 2002 to June 2009 in our hospital were retrospectively analyzed. The patients were divided into three groups according to different age and therapeutic program: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (group A), 19 patients under 65 years of age were treated by surgical biliary bypass (group B) and 17 patients with the age of 65 years or older received percutaneous transhepatic biliary drainage (group C). Then the therapeutic results were compared.Results With respect to the postoperative level of serum bilirubin, the incidence of early complications, postoperative hospitalization and mean survival time, no statistically significant difference was found between group A and B (Pgt;0.05). There was one case of recurrent jaundice and one case of gastric output obstruction in group B, while no one suffered postoperative complication in group A, and the difference was statistically significant (Plt;0.01). Compared with group A, the postoperative level of serum bilirubin, the number of patient readmitted, the rate of recurrent jaundice and gastric output obstruction were higher in group C (Plt;0.05 or Plt;0.01). The mean postoperative hospitalization and overall survival time were significantly shorter in group C than group A (Plt;0.05 or Plt;0.01, respectively). Conclusion Surgical palliation does not increase the morbidity rate, but it does improve the quality of life in elderly patients with unresectable pancreatic head cancer.
【Abstract】 Objective To investigate the expression patterns of vascular endothelial growth factor (VEGF) mRNA as markers for isolated tumor cells in the peripheral blood of patients with hepatocellular carcinoma (HCC) following liver transplantation, and to evaluate the correlation between VEGF and the recurrence and metastasis of HCC following liver transplantation. Methods In this prospective study, 97 patients were divided into four groups according to the pathological results: HCC following liver transplantation group (HCC+LT group, n=53), advanced HCC group (n=8), benign liver diseases group (n=26) and healthy volunteers group (n=10), among which the 53 cases in HCC group were collected from April, 2002 to December, 2003. RNA was purified from the peripheral blood of the other 44 control patients and also from the patients in HCC group before, during and after liver transplantation in order to study the expression specificity of VEGF mRNA in HCC patients and its dynamic change during perioperative period. The correlation between VEGF and the tumor recurrence and metastasis was also analyzed by fluorescent quantitative reverse transcriptase and polymerase chain reaction (FQ RT-PCR). Results VEGF mRNA could be used as marker of isolated tumor cells for its high specificity. The positive rate of VEGF mRNA in HCC group and in advanced HCC group were 37.5% and 75.0%, respectively, which were significantly higher than that in benign liver diseases group (11.5%) and healthy volunteers group (10.0%), P＜0.01. The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA might be relevant with the recurrence and metastasis HCC following liver transplantation （P＜0.01）. Conclusion The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA may predict the recurrence and metastasis HCC following liver transplantation.
ObjectiveTo summarize the role of epithelial-mesenchymal-transition （EMT） in occurrence and development of gastrointestinal cancer. MethodsDomestic and international publications online involving EMT of gastrointestinal cancer in recent years were collected and reviewed. ResultsEMT was a highly conserved process that has been well characterised in embryogenesis. Studies had shown that the aberrant activation of EMT in adult epithelia could promote tumour metastasis by repressing cell adhesion molecules. E-cadherin， one of the epithelial cell markers, maybe involved in the process of the EMT, especially of the Ecadherin transcriptional repressors， these transcriptional repressors significantly increased in the gastrointestinal cancer. Further more， EMT might involve in the process of gastrointestinal cancer stem cells formation. ConclusionsEMT and it’s regulators play a very important role in gastrointestinal cancer， and may provide a newsight into the gastrointestinal cancer. It also can provide a novel clinical targets to treat the gastrointestinal cancer.
OBJECTIVE To introduce a method to repair the vagina following pelvic exenteration for carcinoma of rectum in which the posterior wall of the vagina and cervix of the uterus were often involved. METHODS From 1990 to 1997 segment of the vascularized ileum was used to repair the vagina in 5 cases, and in 2 of which the whole vagina was repaired while in the other 3 cases only the posterior wall of the vagina was repaired. RESULTS All of the patients had successful results after operation repair. CONCLUSION Vascularized graft was an ideal material for the repair of vagina defect following pelvic exenteration for carcinoma of rectum, because this material was easily accessible, and its vascular pedicle was long enough for its transferring to the perineal region and the ileum had good blood supply which made healing easy. The vagina following repair had a thick posterior wall, good elasticity and very little scar tissue surrounded.
Objective To evaluate the effect of laparoscopy-assisted surgery for lymph node dissection in patients with carcinoma of gastric cardia. Methods The clinical data of patients with carcinoma of gastric cardia who underwent either laparoscopy-assisted or open gastrectomy between January 2004 and September 2009 in the Department of General Surgery, the Nanchong Central Hospital were analyzed retrospectively. The number of lymph node dissection was compared. Results Thirty-nine patients underwent laparoscopy-assisted gastrectomy (laparoscopy group) and 63 patients underwent open gastrectomy (open group). There was no significant difference in preoperative complications, type of pathology or pTNM stage between two groups (Pgt;0.05). The number of lymph node dissection was 16.44±6.25 in the laparoscopy group， of which the number of first station lymph node was 10.56±3.78 (metastasis rate was 74.4%), the second station was 3.82±1.82 (metastasis rate was 46.2%), the third station was 2.00±1.36 (metastasis rate was 5.1%); in the open group, the numbers of corresponding lymph node were 16.38±5.83, 10.94±3.91 (metastasis rate was 71.4%), 3.71±1.55 (metastasis rate was 42.9%), and 1.75±1.06 (metastasis rate was 3.2%), respectively. There was no significant difference between two groups (Pgt;0.05). Conclusion The effectiveness of lymph node dissection is satisfactory by laparoscopy-assisted surgery for patients with carcinoma of gastric cardia, but prospective efficacy is still being followed up.
Objective To introduce the current study on 18F-fluorodexyglucose positron emission tomography (18F-FDG PET) scanning in diagnosis and treatment of carcinoma of large intestine. Methods The literatures about 18F-FDG PET scanning in diagnosis and treatment of carcinoma of large intestine in recent years were reviewed. Results 18F-FDG PET scanning is superior to CT and MRI in identificating carcinoma of large intestine recurrence, metastasis in the early stage after operation and staging carcinoma of large intestine. Conclusion 18F-FDG PET scanning may be one of the accessory examinations in carcinoma of large intestine and may be helpful for the choice of treatment.
Objective To investigate the role of KiSS-1 gene in the metastatic process of carcinoma of gallbladder and the clinicopathologic significance of KiSS-1 gene expression in carcinoma of gallbladder. Methods Pathological specimens from 59 gallbladder carcinoma tissues (13 hepatic invasion and 13 lymphatic invasion tissues were included), matched with 7 para-tumor and 6 normal gallbladder tissues, were examined for the expression of KiSS-1 gene by tissue microarray technique and immunohistochemistry (EnVision). Results The positive rate of KiSS-1 expression was down-regulated (P＜0.05) in tumor tissues, as compared with normal and para-tumor tissues. In carcinoma of gallbladder, the expression of KiSS-1 had no relationship with the gender, age, tumor size, histological grade or differentiation, and metastasis of lymph node, while was associated with the depth of infiltration, invasion of liver and the clinical stages (Nevin). In Ⅰ+Ⅱ, Ⅲ+Ⅳ and Ⅴ stage, the positive rates of KiSS-1 were 92.3%, 57.1% and 27.8% respectively, with an undeniably clear lowering tendency (P=0.002). Conclusion Down-regulating expression of KiSS-1 is closely associated with the processes of genesis, invasion and metastasis in carcinoma of gallbladder, and may participate in regulating these processes.
Objective To detect the expression of transferrin receptor 1 (TfR1) in laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma, exploring the relationship between the expression of the four cancers and their occurrence and progression. Methods A total of 24 specimens of head-neck carcinoma were collected in surgery from April 2015 to March 2017, including 8 cases of laryngeal carcinoma, 8 cases of thyroid carcinoma, 4 cases of maxillary sinus carcinoma, and 4 cases of parotid carcinoma. Fluorescence quantitative polymerase chain reaction technique for TfR1 mRNA and western blot for TfR1 protein was performed in those tumor tissues and their adjacent normal tissues. Results The relative expression level of TfR1 mRNA in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma was 0.078±0.002, 0.065±0.044, 0.076±0.014, 0.067±0.004, respectively; while the relative expression level of TfR1 mRNA in the adjacent normal tissues of the four cancers was 0.021±0.012, 0.011±0.007, 0.017±0.013, 0.028±0.007, respectively. The relative expression level of TfR1 protein in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma, and parotid carcinoma was 0.668±0.206, 0.640±0.066, 0.452±0.095, 0.925±0.221, respectively; while the relative expression level of TfR1 protein in the adjacent normal tissues of the four cancers was 0.359±0.113, 0.424±0.096, 0.280±0.093, 0.519±0.037, respectively. The expression levels of TfR1 mRNA and TfR1 protein in the tumor tissues of the four cancers were all higher than those in their adjacent normal tissues (P<0.05). Conclusions The expression levels of TfR1 mRNA and TfR1 protein in the tumor tissues of laryngeal carcinoma, thyroid carcinoma, maxillary sinus carcinoma and parotid carcinoma are up-regulated. TfR1 may be involved in the occurrence and progression of the four cancers, and it may be responsible for tumor proliferation by providing necessary raw materials for the proliferation of tumor cells.
ObjectiveTo summarize recent research advancement on radically surgical therapy of carcinoma of the body and tail of pancreas． MethodsRelevant literatures about radically surgical therapy of carcinoma of the body and tail of pancreas were collected and reviewed． ResultsRecent experimental researches indicated that distal pancreatectomy was the common used surgical way to treat carcinoma of the body and tail of pancreas. Besides， spleenpreserving distal pancreatectomy, distal pancreatectomy with en bloc celiac axis resection, and laparoscopic distal pancreatectomy were also the choices to the treatment of carcinoma of the body and tail of pancreas. ConclusionThe surgical way to treat carcinoma of the body and tail of pancreas has advanced for these years, but furthermore development requires more great efforts.