RESUMEN
Objective:To investigate the expression of glypican1 (GPC1) in pancreatic ductal adenocarcinoma (PDAC) and its relationship with the prognosis of patients with PDAC.Methods:From January 2015 to December 2018, 125 PDAC tumor specimens and corresponding para-carcinoma normal pancreatic tissue were collected from the Department of Pathology of Peking University Third Hospital. The expression of GPC1 protein was detected by the immunohistochemical Envision two-step method in all specimens. The specimens were divided into high and low GPC1 expression groups according to immunohistochemical scores, and the correlation between GPC1 protein expression and clinicopathological features and overall survival time was analyzed.Results:The positive expression rate of GPC1 protein was 0 score in 30.4% of PDAC tissues, 1 score in 15.2%, 2 score in 18.4% and 3 score in 36.0%, respectively, and high expression rate (2+ 3) was 54.4%. GPC1 protein was negatively expressed in para-carcinoma pancreatic tissues. The positive expression rate of GPC1 protein in PDAC tissue was significantly higher than that in para-carcinoma pancreatic tissue, and the difference was statistically significant ( P=0.000). The high expression of GPC1 protein was significantly correlated with tumor location and T stage ( P<0.05), but not with gender, age, history of diabetes and pancreatitis, preoperative blood CA19-9 level, postoperative surgical margin, tumor differentiation, lymph node metastasis, nerve invasion and vascular invasion (all P values >0.05). Univariate Cox proportional hazards analysis showed that GPC1 expression was associated with postoperative overall survival time in PDAC patients ( P<0.001). Multivariate Cox proportional hazards analysis showed that GPC1 protein expression level was an independent prognostic factor affecting overall survival time in PDAC patients ( P<0.001). The median survival time of PDAC patients with high GPC1 expression was significantly lower than that of PDAC patients with low GPC1 expression (11.00 months vs 18.00 months), and the difference was statistically significant ( P<0.01). Conclusions:GPC1 protein was abnormally high expressed in PDAC tumor tissue, and the high expression of GPC1 protein was positively correlated with tumor stage and negatively correlated with the overall survival time of patients. High expression of GPC1 was an independent risk factor for poor prognosis in PDAC patients.
RESUMEN
Objective@#To explore the feasibility of laparoscopic treatment for incidental gallbladder cancer(IGBCA) and analyze the factors influencing prognosis.@*Methods@#A retrospective study of 71 patients with IGBCA received laparoscopic treatment at Department of General Surgery, Peking University Third Hospital from January 2007 to December 2016 was conducted,the clinicopathological data and prognosis were analyzed. There were 18 males and 53 females,aged 23 to 81 years. They were divided into two groups based on the presence of intraluminal mass in the gallbladder. Sixty-five of the 71 patients received laparoscopic radical resection, the prognosis of them were compared with 14 patients with open radical resection.@*Results@#Among the 71 patients,65 patients received radical resection,3 patients simple gallbaldder resection and 3 patients palliative resection. Postoperative complications occurred in 6 patients. IGBCA were detected by frozen section in 57 patients,with the accuracy of 96.5%,while the accuracy of T stage is 43.8% in the 48 patients received T stage evaluation during frozen section examination. The T stages based on final pathology were Tis(n=6),T1a(n=5),T1b(n=10),T2(n=46),and T3(n=4).The number of harvested lymph node was 4.7±2.9(range:2-12).There are 14 patients with lymph node metastasis. The 50 patients with intraluminal gallbladder mass include 21 patients with ≤T1b stage and 29 patients with ≥T2 stage, while the 21 patients without intraluminal gallbladder mass are all with ≥T2 stage. The median survival time of the 71 patients was 33 months, with the 5-year cumulative survival rate 67.3%. The 5-year cumulative survival rate is 78.5% for the 65 patients who received radical resection,comparable with those who received open radical resection(P=0.485).Univariate analysis demonstrated that T stage, lymph node metastasis, G grade, lymphovascular invasion, neural invasion, acute cholecystectomy, bile spillage, gallbladder mass and preoperative CA19-9/CEA were the most important prognostic factors(P<0.05).@*Conclusions@#Laparoscopic treatment for IGBCA is feasible, especially for those with intraluminal gallbladder mass. The accuracy of frozen section examination in evaluating T stage is low.
RESUMEN
Objective To investigate MR T2-mapping in evaluating birth-related levator ani muscle injury.Methods 25 primiparas at 6 weeks after first vaginal delivery as primiparous group and 12 nulliparous volunteers as control group were prospectively studied. All the subjects underwent pelvic MRI including T2-mapping,mDIXON-T2 WI sequences.Levator ani muscle were divided into two subgroups:levator ani muscle injury group and non-injury group according to if there were edema,avulsion,or rupture in each levator ani muscle subdivisions[puborectal muscle(PRM);iliococcygeal muscle(ICM)],which were showed on mDIXON-T2 WI images.Two radiologists evaluated T2 values of PRM,ICM and observed artificial color images respectively.The consistency between two observers for T2 values of PRM,ICM were evaluated using the intraclass correlation coefficient (ICC ),the difference of T2 values in each levator ani muscle subdivisions among control group,non-injury group and muscle injury group were analyzed using ANOVA .Results There were 26 PRM injury cases and 24 non-injury cases in primiparous group on mDIXON-T2 WI images,and no ICM injured cases in our study.Inter-rater reliability for T2 values between two observers were good(ICC >0.75).T2 values in PRM injury group,non-injury group and control group were(62.78±1.23)ms,(49.75±3.17)ms,(49.96±4.37)ms respectively and the difference was significant. There were significant difference between PRM injury group and non-injury group,control group respectively(P =0.000,P =0.000). The T2 values of ICM in PRM injury group,non-injury group and control group were(70.80±6.50)ms,(62.41±7.32)ms,(62.78±6.91)ms and there were significant difference(P =0.000),meanwhile the difference between PRM injury group and non-injury group,control group were significant respectively(P =0.000,P =0.000).The color gradation of PRM in PRM injury group were mixed with blue, green,and yellow,and tone were lightened on T2-mapping artificial color images;ICM color gradation were uneven with green and yellow, a d tone were higher than those of control group and non-injurygroup.Conclusion T2-mapping can quantitatively assess birth-related levator ani muscle injury and T2-mapping artificial color images show the range and degree of levator ani muscle injury visually.It is hopeful to find micro lesions that T2 WI images are difficult to find.
RESUMEN
Objective To investigate MR T2-mapping in evaluating birth-related levator ani muscle injury.Methods 25 primiparas at 6 weeks after first vaginal delivery as primiparous group and 12 nulliparous volunteers as control group were prospectively studied. All the subjects underwent pelvic MRI including T2-mapping,mDIXON-T2 WI sequences.Levator ani muscle were divided into two subgroups:levator ani muscle injury group and non-injury group according to if there were edema,avulsion,or rupture in each levator ani muscle subdivisions[puborectal muscle(PRM);iliococcygeal muscle(ICM)],which were showed on mDIXON-T2 WI images.Two radiologists evaluated T2 values of PRM,ICM and observed artificial color images respectively.The consistency between two observers for T2 values of PRM,ICM were evaluated using the intraclass correlation coefficient (ICC ),the difference of T2 values in each levator ani muscle subdivisions among control group,non-injury group and muscle injury group were analyzed using ANOVA .Results There were 26 PRM injury cases and 24 non-injury cases in primiparous group on mDIXON-T2 WI images,and no ICM injured cases in our study.Inter-rater reliability for T2 values between two observers were good(ICC >0.75).T2 values in PRM injury group,non-injury group and control group were(62.78±1.23)ms,(49.75±3.17)ms,(49.96±4.37)ms respectively and the difference was significant. There were significant difference between PRM injury group and non-injury group,control group respectively(P =0.000,P =0.000). The T2 values of ICM in PRM injury group,non-injury group and control group were(70.80±6.50)ms,(62.41±7.32)ms,(62.78±6.91)ms and there were significant difference(P =0.000),meanwhile the difference between PRM injury group and non-injury group,control group were significant respectively(P =0.000,P =0.000).The color gradation of PRM in PRM injury group were mixed with blue, green,and yellow,and tone were lightened on T2-mapping artificial color images;ICM color gradation were uneven with green and yellow, a d tone were higher than those of control group and non-injurygroup.Conclusion T2-mapping can quantitatively assess birth-related levator ani muscle injury and T2-mapping artificial color images show the range and degree of levator ani muscle injury visually.It is hopeful to find micro lesions that T2 WI images are difficult to find.
RESUMEN
Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers.Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy.The clinicopathological and follow-up data were compared.Results Laparoscopic cholecystectomy was performed in 32 patients,the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy (P =1.000).26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection.There was no statistical difference in operation time (P =0.953),blood loss (P =0.193)and postoperative complications (P =1.000),but the laparoscopic radical resection group is superior to the open group on postoperative pain grading (P =0.022),ambulation time (P =0.000),nothing per mouth time (P =0.000) and length of hospital stay (P =0.048).The mean number of lymph nodes retrieved was 5 ±4 (range 1-12) in the laparoscopic radical group and 6 ± 3 (range 1-12) in the open group (P =0.983);the 1,3,5 year survival rates was 92.3％,70.3％,61.5％ and 92.3％,76.3％,69.3％,respectively(P =0.473).Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma.Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients.
RESUMEN
Objective@#To explore the associations of Hand-Foot-Mouth disease (HFM) among children of different age groups in kindergartens, and to provide scientific evidence for HFM prevention and control.@*Methods@#Cluster sampling was used to select 9 912 children from 40 kindergartens. The major caregivers of children were invited to participate into the study and fulfill a self-administered questionnaire that consisted of general background, hand washing and the history of HFM among children in the recent 1 year. Chi-square and binary logistic regression were applied,to analyze the influencing factors of HFM among children of different age groups.@*Results@#In the 2 year-old-group, children who were male (OR=1.76, 95%CI=1.24-2.50), had the major caregiver with high school educational background or below (OR=1.54, 95%CI=1.06-2.24), had family income more than 100 000 yuan or more per year(OR=1.49, 95%CI=1.01-2.20), children whose major caregiver seldom wash hands immediately after coming home(OR=2.10, 95%CI=1.05-4.19)，and 3-5 times per week(OR=2.07, 95%CI=1.26-3.41) were more likely to have HFM. In the 3 year-old-group, the more time children spent in the outdoors, the less likely they got HFM(3-5 times per week: OR=0.58, 95%CI=0.43-0.81; ≥6 times per week: OR=0.45, 95%CI=0.29-0.70). Children whose major caregiver did not use soap were more likely to have HFM(OR=1.67, 95%CI=1.11-2.49). In the 4 year-old-group, children who occasionally took toys when going out were less likely to get HFM (vs always, OR=0.57, 95%CI=0.38-0.88). No significant factors were found in the 5 year-old-group.@*Conclusion@#The behaviors and activities of major caregivers and children could influence the HFM incidence.To prevent HFM, it was advised that the major caregivers should wash hands immediately after coming home, and develop the habit of using soap for handwashing together with children at the earlier age, and encourage children to take more outside-door activities according to the age characteristics. Attention should be paid to avoid contaminating takeout snacks, and to clean the takeout toys timely.
RESUMEN
<p><b>OBJECTIVE</b>To evaluate the sensitivity and specificity of immunohistochemical (IHC) staining of DNA mismatch repair (MMR) protein for the screening of microsatellite instability (MSI) colorectal cancer (CRC).</p><p><b>METHODS</b>A total of 255 CRC cases were studied, including 140 cases of routine paraffin-embedded tissue samples and 115 cases constructed on tissue microarray. Expressions of 4 MMR proteins including MHL1, MSH2, MSH6 and PMS2 were investigated by IHC. Negative protein expression was defined as complete absence of nuclear staining within tumor cells in the presence of positively labeled internal non-neoplastic cells. Focal staining was defined as the presence of staining in < 5% of the tumor cells. CRCs showing negative staining for any MMR proteins were interpreted as MMR deficient tumors. PCR-genescan MSI analysis was performed in each case by a five marker panel including Bat26, Bat25, NR-21, NR-24 and MONO-27.</p><p><b>RESULTS</b>Among the 140 CRCs with routine formalin-fixed paraffin embedded tissue sections, concordance rate between IHC and PCR-genescan was 98.6% (138/140), the sensitivity and specificity of IHC in detecting MSI tumors were 94.9% (37/39) and 100.0% (101/101), respectively. The 2 disconcordant cases showed focal staining in at least one of the MMR proteins but were confirmed to be MSI-H CRCs by PCR-genescan assay. On tissue microarray, 91.3% (105/115) of the cases had informative results. The concordance rate between IHC and PCR-genescan was 100.0% (105/105). Both the specificity and sensitivity of IHC in detecting MSI tumors on available tissue microarray samples were 100.0%. Ten cases were inclusive due to the presence of negative stains of MMR proteins in both the tumor and internal control cells.</p><p><b>CONCLUSIONS</b>Detection of 4 MMR proteins expression by IHC is reliable for identifying MSI CRCs and is recommended for routine practice. Tumors with focal MMR protein staining are highly suspected for the presence of MSI-H and PCR-genescan based MSI analysis should be performed to confirm.</p>
Asunto(s)
Humanos , Neoplasias Colorrectales , Genética , Reparación de la Incompatibilidad de ADN , Proteínas de Unión al ADN , Genética , Inmunohistoquímica , Inestabilidad de Microsatélites , Reacción en Cadena de la Polimerasa , Sensibilidad y EspecificidadRESUMEN
<p><b>BACKGROUND</b>Autoimmune pancreatitis (AIP) is a chronic inflammatory disease of pancreas. We evaluated the clinical manifestations, imaging, and histological presentations of AIP in Chinese patients, and investigated the roles of immunoglobulin E (IgE) and allergic diseases in the diagnosis and pathogenesis of AIP.</p><p><b>METHODS</b>The clinical records of 22 patients diagnosed with AIP were reviewed and analyzed. All patients with AIP fulfilled the 2006 revised diagnostic criteria proposed by Japan Pancreas Society or the Korean Criteria for AIP.</p><p><b>RESULTS</b>Half (11/22) of AIP patients had allergic diseases. Twenty-one patients had elevated serum IgE levels, and 14 patients had IgE levels more than 3 times that of normal. There were no significant differences between the patients with higher or lower IgE, with or without allergic disease, in clinical features, laboratory tests, diffuse or focal lesions, or the choice of treatment methods; however, more complaints of body weight loss were observed in patients with higher IgE levels. Patients with higher IgE levels and with allergic diseases were more likely to have onset in March, April, May, August, September, or October. IgE levels decreased after therapy, but increased again during recurrence. Increased number of mast cells was found in the pancreatic tissue in AIP.</p><p><b>CONCLUSIONS</b>IgE maybe a useful marker for monitoring therapeutic response and recurrence of AIP. Allergic processes may play an important role in the pathogenesis of AIP.</p>
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Autoinmunes , Sangre , Hipersensibilidad , Sangre , Inmunoglobulina E , Sangre , Pancreatitis , Sangre , Estudios RetrospectivosRESUMEN
Objective To explore the effects of Dolandin-phenergan injection on painless abortion in terms of abortion timing,amount of bleeding,etc.Methods 120 cases of abortion were selected,Dolandin-phenergan injection was used to perform painless abortion.Analgesic effect,heart rate,Bp and other symptoms were observed.Results Little pain was felt in 120 cases,and surgery duration was short,the incidence of heart rate and blood pressme falling were low,namse and vomit were minor.Total bleeding was less.Conclusion It is superior of Dolandin-phenergan in the course of painless abortion.