RESUMEN
OBJECTIVES: This study was conducted to measure the soft tissue of the alar base and the piriform aperture area of the maxillary bone of unilateral cleft lips with secondary nasal deformities when secondary operation are necessary to classify the alar base depression and to provide a clinical reference for the second surgery. METHODS: Twenty-six patients with unilateral cleft lip with secondary nasal deformity were treated at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medial University. Nose data were attained preoperatively and postoperatively. Correlations were made between the soft tissue and the bony depression and patient satisfaction with the nasi basis. Classifications were then made based on these data. RESULTS: When the distance discrepancy of the bilateral piriform aperture depression was less than 4.5 mm, we obtained a fine appearance for the nose by repairing only the soft tissues. When it was more than 5 mm, we had to combine repair of the soft tissue with a bone graft or the restitution of the alveolar cleft. When the distance was between 4.5 mm and 5 mm, the surgeon considered both the wishes of the patient and the clinic's standard procedure. CONCLUSIONS: For patients with cleft lips and palates, the bony depression was not the only factor that resulted in postoperative alar depression. Anthropometry of the nose prior to surgery was important for choosing the methods that would yield satisfactory results.
Asunto(s)
Antropometría , Labio Leporino/clasificación , Labio Leporino/cirugía , Maxilar/anomalías , Maxilar/cirugía , Nariz/anomalías , Nariz/cirugía , Adolescente , Adulto , Niño , China , Femenino , Humanos , Masculino , RinoplastiaRESUMEN
BACKGROUND: Severe endoplasmic reticulum (ER) stress elicits apoptosis to suppress lung cancer. Our previous research identified that Cepharanthine (CEP), a kind of phytomedicine, possessed powerful anti-cancer efficacy, for which the underlying mechanism was still uncovered. Herein, we investigated how CEP induced ER stress and worked against lung cancer. METHODS: The differential expression genes (DEGs) and enrichment were detected by RNA-sequence. The affinity of CEP and NRF2 was analyzed by cellular thermal shift assay (CETSA) and molecular docking. The function assay of lung cancer cells was measured by western blots, flow cytometry, immunofluorescence staining, and ferroptosis inhibitors. RESULTS: CEP treatment enriched DEGs in ferroptosis and ER stress. Further analysis demonstrated the target was NRF2. In vitro and in vivo experiments showed that CEP induced obvious ferroptosis, as characterized by the elevated iron ions, ROS, COX-2 expression, down-regulation of GPX4, and atrophic mitochondria. Moreover, enhanced Grp78, CHOP expression, ß-amyloid mass, and disappearing parallel stacked structures of ER were observed in CEP group, suggesting ER stress was aroused. CEP exhibited excellent anti-lung cancer efficacy, as evidenced by the increased apoptosis, reduced proliferation, diminished cell stemness, and prominent inhibition of tumor grafts in animal models. Furthermore, the addition of ferroptosis inhibitors weakened CEP-induced ER stress and apoptosis. CONCLUSION: In summary, our findings proved CEP drives ferroptosis through inhibition of NRF2 for induction of robust ER stress, thereby leading to apoptosis and attenuated stemness of lung cancer cells. The current work presents a novel mechanism for the anti-tumor efficacy of the natural compound CEP.
Asunto(s)
Bencilisoquinolinas , Chaperón BiP del Retículo Endoplásmico , Estrés del Retículo Endoplásmico , Ferroptosis , Neoplasias Pulmonares , Factor 2 Relacionado con NF-E2 , Bencilisoquinolinas/farmacología , Bencilisoquinolinas/uso terapéutico , Estrés del Retículo Endoplásmico/efectos de los fármacos , Factor 2 Relacionado con NF-E2/metabolismo , Factor 2 Relacionado con NF-E2/genética , Ferroptosis/efectos de los fármacos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/genética , Humanos , Animales , Ratones , Línea Celular Tumoral , Ensayos Antitumor por Modelo de Xenoinjerto , Células A549 , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Simulación del Acoplamiento Molecular , BenzodioxolesRESUMEN
OBJECTIVE: To study the feasibility and clinical value of 13th lymph nodes in predicting general lymph nodes metastases for periampullary carcinoma. METHODS: A total of 77 patients with pathologically confirmed periampullary carcinoma were recruited. And 26 (18 males and 8 females, age 38-79 years) of them underwent Whipple procedures during which 1% methylene blue or nanogate carbon was injected into tumor bed. The other 51 patients as controls (33 males, 18 females, age 38-78 years) . The dyed 13th lymph nodes were biopsied. Then routine lymphadenectomy was performed and their pathological results were analyzed. RESULTS: In the experimental group, the lymph node drainage area of cancer was identified. However, in contrast with 51 patients in the control group, the labeling of 13th lymph nodes did not significantly increase the number of cleaned lymph nodes (15.8 (3-54) vs 17.6 (6-40) , P = 0.460). CONCLUSION: 13th lymph nodes are non-suitable as sentinels for predicting general lymph nodes metastases of periampullary carcinoma.
Asunto(s)
Neoplasias Duodenales/patología , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Biopsia del Ganglio Linfático Centinela/métodos , Adulto , Anciano , Femenino , Humanos , Metástasis Linfática/diagnóstico , Masculino , Persona de Mediana EdadRESUMEN
To study the chemical effect of direct current arc plasma igniter, the emission spectrum of plasma jet was measured, and the active particles produced by the interaction of plasma jet with atmospheric air were analyzed. The NO and CO volume fractions were measured quantificationally by smoke analyzer at the 8cm downstream the plasma igniter exit, and the changing law between arc current and NO, CO volume fractions was obtained. The results show that the plasma jet interacting with atmospheric air produced active particles (H, O, N), charged particles (O2 +, N2+), and excited particles (N2 (A3), N2 (B3), N2 (C3), N2 (a1), O2 (a1), O2 (b1)). The NO and CO volume fractions increased with rising of are current and feedstock argon flow rate.
RESUMEN
BACKGROUND: Gastric neuroendocrine carcinoma (GNEC) is a rare histological subtype of gastric cancer, which is categorized into small cell and large cell neuroendocrine carcinomas. It is characterized by strong invasiveness and poor prognosis. Mixed large and small cell neuroendocrine carcinoma (L/SCNEC) is an extremely rare pathological type of gastric cancer, and there have been no reports on this situation until now. CASE SUMMARY: Herein, we first present a 57-year-old patient diagnosed with L/SCNEC of the stomach. A 57-year-old Chinese male presented with epigastric discomfort. Outpatient gastroscopic biopsy was performed, and pathological examination revealed that the cardia was invaded by adenocarcinoma. The patient underwent laparoscopic-assisted radical proximal subtotal gastrectomy and was diagnosed with L/SCNEC. He refused adjuvant treatment and was followed up every 3 mo. Eight months after the operation, the patient showed no evidence of local recurrence or distant metastasis. CONCLUSION: We advocate conducting further genomic studies to explore the origin of gastric large cell and small cell neuroendocrine carcinoma and using different chemotherapy schemes according to large or small cell neuroendocrine carcinoma of the stomach for clinical research to clarify the heterogeneity of GNEC and improve the prognosis of patients with GNEC.
RESUMEN
Objective: We evaluated and compared the efficacy and safety of neoadjuvant chemoradiotherapy (NACRT) versus neoadjuvant chemotherapy (NACT) for locally advanced gastric cancer (LAGC) in a single-center randomized phase II trial. Methods: Patients with LAGC were enrolled and received either NACT or NACRT, followed by gastrectomy and adjuvant chemotherapy. The primary endpoint was an R0 resection rate. Results: We enrolled 75 patients: 75.7% (NACT, 28/37 patients) and 76.3% (NACRT, 29/38 patients) underwent surgery; R0 resection rates were 73.0% (27/37) and 73.7% (28/38), respectively. The NACRT group had significantly better major pathological response than the NACT group (37.9% vs 17.9%, p = 0.019). Between-group postoperative complications were not significantly different. The median follow-up was 59.6 months; 5-year overall survival (OS) rate was 50.1% (NACT) and 61.9% (NACRT); neither group reached the median OS; median progression-free survival was 37.3 and 63.4 months, respectively. Conclusions: S-1-based NACRT did not improve the R0 resection rate, although it presented better tumor regression with similar safety to NACT. Trial registration: ClinicalTrial.gov NCT02301481.
RESUMEN
OBJECTIVE: To assess the value of intraoperative radiotherapy (IORT) in the combined treatment of locally advanced pancreatic cancer. METHODS: All patients with locally advanced pancreatic cancer at our hospital from January 2007 to December 2009, judged as unresectable and confirmed by histology or cytology, were recruited into this prospective study. They were randomly assigned into the IORT group (n=31) and control group (n=34). The IORT group received IORT plus internal drainage or laparotomy. The control group had internal drainage or laparotomy only. The evaluation of adverse results of two groups included: intraoperative and postoperative adverse events, recent post-operative side effects, analgesic effect, the level of tumor marker such as CA19-9 and the long-term survival. RESULTS: There was no difference in operation duration, intraoperative hemorrhage and postoperative recovery. Significant differences were found in hematotoxicology, analgesic effect, tumor marker decreasing and long-term survival. CONCLUSION: IORT is a safe, reliable and easy-to-master technique without any obvious side effect. Its analgesic effect is better than the control group. Also IORT can retard the tumor growth and improve the patient survival.
Asunto(s)
Adenocarcinoma/radioterapia , Neoplasias Pancreáticas/radioterapia , Adenocarcinoma/patología , Adenocarcinoma/terapia , Anciano , Terapia Combinada , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/terapia , Estudios ProspectivosRESUMEN
OBJECTIVE: To assess the risk factors of stress-related ulcer and gastrointestinal hemorrhage after pancreaticoduodenectomy. METHODS: From May 1999 to July 2007, 285 periampullary cancer patients underwent pancreaticoduodenectomy in our hospital. The clinical data, pathological results, type of operation, and postoperative treatment were retrospectively analyzed. Patients with stress-related ulcer and gastrointestinal hemorrhage were selected for risk factor analysis, and other patients were taken as control group. RESULTS: 35 patients (12.3%) developed stress-related ulcer and gastrointestinal hemorrhage following pancreaticoduodenectomy. Pathological examination showed pancreatic cancer in 5 cases, duodenal cancer in 8, common bile duct cancer in 10, ampullary carcinoma in 11, and solid-pseudopapillary tumors in 1. Single variate analysis demonstrated that alcohol, preoperative bilirubin level, operation time, lymph node metastasis, prealbumin decrease after operation and other complication were significantly associated with the stress-related ulcer and gastrointestinal hemorrhage. Logistic regression in multivariate analysis revealed that preoperative bilirubin level, operation time, other complication, prealbumin decrease after surgery were independent risk factors. CONCLUSION: Stress-related ulcer and gastrointestinal hemorrhage are one of the most common complications after pancreaticoduodenectomy. Preoperative bilirubin level, operation time, other complications, and prealbumin decrease after operation are four independently risk factors.
Asunto(s)
Neoplasias del Conducto Colédoco/complicaciones , Hemorragia Gastrointestinal/etiología , Neoplasias Pancreáticas/complicaciones , Pancreaticoduodenectomía/efectos adversos , Úlcera Péptica/etiología , Adolescente , Adulto , Anciano , Alcoholismo/complicaciones , Ampolla Hepatopancreática , Bilirrubina/sangre , Neoplasias del Conducto Colédoco/patología , Neoplasias del Conducto Colédoco/cirugía , Neoplasias Duodenales/complicaciones , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , Prealbúmina/metabolismo , Estudios Retrospectivos , Factores de Riesgo , Estrés Psicológico/complicaciones , Adulto JovenRESUMEN
OBJECTIVE: To study the role of slow-release 5-fluorouracil implantation in treatment of unresectable pancreatic cancer. METHODS: 85 cases of untreated patients with locally advanced pancreatic cancer (LAPC) were randomized into two groups: Trial group: slow-release 5-fluorouracil implantation (50 patients) and control group (35 patients). Observing the objective tumor response, clinical benefit response, toxicity, complications and survival of patients of the two groups. RESULTS: In the trial group the overall response rate (PR + NC) was 76.0%, and the clinical benefit response rate was 52.0%. No toxicity was observed. Pancreatic fistula occurred in 2 patients. The median survival time of the two groups was 9.0 months and 4.0 months, respectively. The survival rates of 6- and 12-month were 56.8% vs. 31.4% and 22.9% vs. 2.9% in the two groups, respectively (P = 0.012). CONCLUSION: Slow-release 5-fluorouracil implantation is a simple, safe and effective method in treatment of LAPC.
Asunto(s)
Antimetabolitos Antineoplásicos/administración & dosificación , Fluorouracilo/administración & dosificación , Neoplasias Pancreáticas/tratamiento farmacológico , Antimetabolitos Antineoplásicos/uso terapéutico , Implantes de Medicamentos/efectos adversos , Femenino , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Humanos , Masculino , Microesferas , Persona de Mediana Edad , Estadificación de Neoplasias , Fístula Pancreática/etiología , Neoplasias Pancreáticas/patología , Estudios Prospectivos , Inducción de Remisión , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To compare the difference of clinicopathological characteristics between colorectal signet-ring cell carcinoma and mucinous adenocarcinoma. METHODS: The clinicopathological and survival data of 65 patients with colorectal signet-ring carcinoma and 166 with mucinous adenocarcinoma were retrospectively analyzed. RESULTS: Such clinical characteristics as gender, gross anatomical classification, preoperative carcinoembryonic antigen level and hepatic metastasis or not had no significant difference between two groups (P > 0.05) while the difference of such characteristics as age, location of tumor, vascular tumor embolus, N stage, T stage, AJCC stage, preoperative obstruction and the ratio of radical resection between them was significant (P < 0.05). The overall 3, 5-year survival of the whole group was 56.7% and 31.6% respectively. The 3, 5-year survival and median survival time (MST) in the signet-ring cell carcinoma and the mucinous adenocarcinoma groups were 33.1%, 14.8%, 24.0 months and 64.1%, 36.6%, 41.5 months respectively. The pathological type of signet-ring cell carcinoma was an independent risk factor of survival in the whole group. CONCLUSION: Compared to colorectal mucinous adenocarcinoma, signet-ring cell carcinoma has a higher degree of malignancy and the patients have a worse survival.
Asunto(s)
Adenocarcinoma Mucinoso/patología , Carcinoma de Células en Anillo de Sello/patología , Neoplasias Colorrectales/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Adulto JovenRESUMEN
OBJECTIVE: To study the role of (125)I seed implantation in the treatment of unresectable pancreatic cancer. METHODS: From April 2004 to march 2006, 66 untreated patients with locally advanced pancreatic cancer (LAPC) were randomized into two groups: Group A: (125)I seeds implantation (n = 31) and Group B: control (n = 34). The objective tumor response, clinical benefit response, toxicity, complications and survival of two groups were observed. RESULTS: In Group A, the overall response rate (PR + NC) was 80.6%. Clinical benefit response rate was 54.8%. No toxicity was observed. Gastrointestinal hemorrhage and pancreatic fistula occurred in 1 patient respectively in Group A. The survival rates of 6 and 12 months were 56.0% vs 31.4% and 16.8% vs 2.9% respectively in two groups (P < 0.05). The median survival time of two groups was 8.0 months vs 4.0 months (P < 0.05). CONCLUSION: (125)I seed implantation is a simple, safe and effective method in the treatment of locally advanced pancreatic cancer.
Asunto(s)
Radioisótopos de Yodo/uso terapéutico , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Pancreáticas/terapia , Radiografía , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate the method and value of tru-cut biopsy (TCB) combined with fine needle aspiration biopsy (FNAB) in the pathological diagnosis of pancreatic carcinoma during operation. METHODS: From April 2007 to October 2008, 22 cases who were suspected to suffer from pancreatic carcinoma were enrolled into this prospective study. All of them underwent a tru-cut biopsy combined with fine needle aspiration biopsy for the pathological diagnosis during operation. RESULTS: Of the 22 patients, 20 were finally diagnosed as having pancreatic carcinoma, while 2 having pancreatitis. The diagnosis of pancreatic carcinoma was confirmed in 19 by tru-cut biopsy combined with fine needle aspiration biopsy, while other 3 cases were not confirmed as pancreatic carcinoma. Among those 3 cases, one was diagnosed as having pancreatic carcinoma with hepatic metastasis by liver nodular biopsy, one as suffering from autoimmune pancreatitis, and another case as having chronic pancreatitis confirmed by follow-up for 9 months without any changes after the operation. The accuracy of FNA, TCB and FNA combined with TCB in the diagnosis for suspected pancreatic cancer were 86.4%, 90.9%, and 95.5%, respectively. No pancreatic fistula and bleeding developed after operation. CONCLUSION: Tru-cut biopsy is more accurate in diagnosis for the suspected pancreatic cancer than fine needle aspiration biopsy during operation. Tru-cut biopsy combined with fine needle aspiration biopsy can improve the accuracy of diagnosis, and is a safe and effective diagnostic method.
Asunto(s)
Biopsia con Aguja Fina/métodos , Biopsia con Aguja/métodos , Neoplasias Pancreáticas/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Periodo Intraoperatorio , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Páncreas/patología , Neoplasias Pancreáticas/patología , Pancreatitis/diagnóstico , Pancreatitis/patología , Estudios ProspectivosRESUMEN
A well-known observation with respect to cancer biology is that transformed cells display a disturbed cytoskeleton. The underlying mechanisms, however, remain only partly understood. In an effort to identify possible mechanisms, we compared the proteome of pancreatic cancer with matched normal pancreas and observed diminished protein levels of gelsolin--an actin filament severing and capping protein of crucial importance for maintaining cytoskeletal integrity--in pancreatic cancer. Additionally, pancreatic ductal adenocarcinomas displayed substantially decreased levels of gelsolin as judged by Western blot and immunohistochemical analyses of tissue micoarrays, when compared with cancerous and untransformed tissue from the same patients (P < 0.05). Importantly, no marked downregulation of gelsolin mRNA was observed (P > 0.05), suggesting that post-transcriptional mechanisms mediate low gelsolin protein levels. In apparent agreement, high activity ubiquitin-proteasome pathway in both patient samples and the BxPC-3 pancreatic cancer cell line was detected, and inhibition of the 26s proteasome system quickly restored gelsolin protein levels in the latter cell line. The status of ubiquitinated gelsolin is related to lymph node metastasis of pancreatic cancer. In conclusion, gelsolin levels are actively downregulated in pancreatic cancer and enhanced targeting of gelsolin to the ubiquitin-proteasome pathway is an important contributing factor for this effect.
Asunto(s)
Adenocarcinoma/patología , Carcinoma Ductal Pancreático/patología , Regulación hacia Abajo , Gelsolina/metabolismo , Neoplasias Pancreáticas/patología , Complejo de la Endopetidasa Proteasomal/metabolismo , Ubiquitina/metabolismo , Adenocarcinoma/metabolismo , Carcinoma Ductal Pancreático/metabolismo , Línea Celular Tumoral , Gelsolina/genética , Humanos , Inmunohistoquímica , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Páncreas/metabolismo , Páncreas/patología , Conductos Pancreáticos/metabolismo , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/metabolismo , Complejo de la Endopetidasa Proteasomal/genética , Proteómica , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células Tumorales Cultivadas , Ubiquitina/genéticaRESUMEN
OBJECTIVE: To analyze the clinicopathological features and their relation to treatment and prognosis in different gastric carcinoid subtypes. METHODS: The data of surgically treated 39 patients with gastric carcinoids (9 of type I and 30 of type III) were retrospectively analyzed. Univariate and multivariate analysis were performed using Chi square test (chi(2)) and Cox model, respectively. The survival rates were analyzed by Kaplan-Meier method, and the factors affecting survival by Log rank test. RESULTS: Of the 9 patients with type I carcinoids, 5 underwent endoscopic or surgical resection, and extra antrectomy was performed in 2 patients simultaneously. 3 cases had a proximal gastrectomy, and 1 underwent total gastrectomy. Among the 30 patients with type III gastric carcinoids, 21 underwent radical resection, 6 had a palliative resection, and the remaining 3 underwent exploration and biopsy only due to invasion into adjacent organs and distant metastasis. Infiltration beyond the submucosa was found in all 30 type III gastric carcinoid patients, but in only 1 of 9 patients with type I gastric carcinoids. Regional lymph node metastases were found in 27 of 30 type III carcinoid cases, but in none of type I. Distant metastases occurred in 5 patients of type III carcinoid (4 in the liver and 1 in the ovary). There were statistically significant differences between type I and type III carcinoids in the sex, tumor number, location, size and infiltration depth of the tumors, the regional lymph node metastasis, distant metastasis and lymphatic emboli (P < 0.05 in all). The overall 5-year survival rate was 49.7% for the whole group, and 100.0% and 37.2% for type I and type III carcinoids, respectively. Univariate analysis revealed that the number of tumor, tumor size (> 2 cm), serosal invasion, regional lymph node metastasis and distant metastasis were all significant factors affecting the survival (P < 0.05 in all). However, by multivariate analysis, only distant metastasis was found to be a significant prognostic predictor. CONCLUSION: The prognosis of type III carcinoids is much poorer than that of type I. Subtyping of gastric carcinoids is helpful in guiding clinical management, and also in prediction of malignant potential and prognosis.
Asunto(s)
Tumor Carcinoide/cirugía , Gastrectomía/métodos , Neoplasias Hepáticas/secundario , Neoplasias Gástricas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Tumor Carcinoide/clasificación , Tumor Carcinoide/patología , Tumor Carcinoide/secundario , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/patología , Tasa de Supervivencia , Adulto JovenRESUMEN
OBJECTIVE: To investigate the factors influencing recurrence and metastasis following curative resection of pancreatic ductal adenocarcinoma and analyze the prognosis. METHODS: The clinicopathological and follow-up data of 56 patients who underwent curative resection for pancreatic ductal adenocarcinoma between Jan. 1997 and Dec. 2006 in this hospital were analyzed retrospectively. RESULTS: The recurrence rate after curative resection was 73.2% (41/56). The recurrence rate after operation at the time of 3 months, half year, 1 year and 2 years was 26.8% (15/56), 51.8% (29/56), 64.3% (36/56) and 69.6% (39/56), respectively. Hepatic metastasis and local recurrence accounted for 36.6% and 31.7% of the cases, respectively. The 3-year accumulated survival of this group was 22.7%. The symptom presenting time, back pain, preoperative level of CA19-9, tumor size, AJCC stage and T stage were correlated with metastasis/recurrence. Univariate analysis revealed that the preoperative level of CA19-9, T stage and the tumor size were prognostic factors. Cox regression analysis revealed that only tumor size was an independent prognostic factor. CONCLUSION: The metastasis or recurrence mostly occurs within 2 years after curative resection, and the liver is the most common site of metastasis. High recurrence rate is the major reason causing the failure of curative resection and short survival time after operation. The symptom presenting time, back pain, preoperative level of CA19-9, tumor size, AJCC stage and T stage are correlated with metastasis/recurrence. The tumor size is an independent prognostic factor.
Asunto(s)
Carcinoma Ductal Pancreático/patología , Neoplasias Pancreáticas/patología , Adulto , Anciano , Antígeno CA-19-9/metabolismo , Carcinoma Ductal Pancreático/inmunología , Carcinoma Ductal Pancreático/cirugía , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/secundario , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pancreatectomía/métodos , Neoplasias Pancreáticas/inmunología , Neoplasias Pancreáticas/cirugía , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Tasa de Supervivencia , Carga TumoralRESUMEN
OBJECTIVE: To analyze the prognostic factors of colorectal cancer patients with synchronous liver metastasis treated by simultaneous colorectal and liver resection. METHODS: The clinical and follow-up data of 44 colorectal cancer patients with synchronous liver metastases who underwent simultaneous colorectal and liver resection from Jan. 1993 to Jan. 2003 were analyzed retrospectively. Survival rate was estimated by Kaplan-Meier method, and was compared using log-rank test. Prognostic factors were analyzed by multivariate Cox proportional hazards model. RESULTS: The overall 1-, 3- and 5-year survival rates were 86.3%, 40.9% and 25.0%, respectively. The lymph node metastasis and vascular invasion by cancer cells from the primary tumour were found to affect prognosis significantly, while gender, age, tumor location, histopathological types, the number and distribution of liver metastases were not. Multivariate analysis revealed that the lymph node metastasis was the only independent prognostic factor. CONCLUSION: Simultaneous liver and colorectal resection can be performed and may achieve good outcome in colorectal cancer patients with synchronous liver metastases, especially in those without lymph node metastasis.
Asunto(s)
Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Colectomía , Femenino , Estudios de Seguimiento , Hepatectomía , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Células Neoplásicas Circulantes , Pronóstico , Modelos de Riesgos Proporcionales , Recto/cirugía , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To evaluate the prognostic factors of colorectal carcinoma in the elderly aged over 70 after radical surgery. METHODS: 263 colorectal carcinoma patients aged 74.9, 147 males and 115 females, underwent radical surgery, including right hemicolectomy (n=48), left hemicolectomy (n=11), transverse colectomy (n=8), sigmoid resection (n=27), low anterior resection (n=103), abdominoperineal resection (n=58), and Hartmann's operation (n=7). Survival analysis was conducted using Kaplan-Meier method, and multivariate analysis was conducted with Cox regression to analyze the prognostic factors. RESULTS: The post-operative complication rate was 14. 4%. The 30-day mortality was 1.1%. The overall 5-year survival rate was 70.5%, and the 5-year survival rates of the patients with ASA grades I, II, and III were 84.8%, 71.8%, and 61.9% respectively. Univariate analysis showed that the predictors of survival were age, co-morbidity, ASA score, postoperative complication, preoperative serum albumin concentration, preoperative hemoglobin level, gross tumor configuration, tumor stage, neoplastic intestinal obstruction, and lymph node metastasis. Multivariate analysis showed that patient sex, complication, operative complication, gross tumor configuration, depth of infiltration, lymph node metastasis, and tumor staging were independent influencing factors od prognosis. CONCLUSION: The prognosis of colorectal carcinoma in the elderly after radical surgery is good. The prognostic factors include age, postoperative complication, and pre-operative serum albumin concentration, and gross tumor configuration, depth of tumor invasion, lymph node metastasis, and tumor stage.
Asunto(s)
Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Factores de Edad , Anciano , Anciano de 80 o más Años , Colectomía/métodos , Neoplasias Colorrectales/mortalidad , Femenino , Humanos , Metástasis Linfática , Masculino , Análisis Multivariante , Invasividad Neoplásica , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To investigate the factors affecting the result and selection of local excision for low rectal cancer. METHODS: The clinical data of 101 patients with low rectal cancer treated by local excision were retrospectively analyzed. Survival was estimated using the Kaplan-Meier. The factors influencing on the survival were analyzed using univariate (Log rank) and multivariate (Cox model) analysis methods. RESULTS: Of 101 patients in this series, 91 patients underwent transanal excision, 9 had transsacral excision, 1 recieved transvaginal excision. Postopertative complication developed in 6 patients (5.9%). No death occurred within 30 postoperative days. Five T4 patients underwent preoperative radiotherapy, and 34 received postoperative radiotherapy. The overall 5-year survival rate was 91.0% for the whole group, and it was 100%, 92.6%, 77.1%, 83.3% for patients with Tis, T1, T2, and T3/T4 lesion, respectively. The incidence of local recurrence was 15. 8%. Univariate analysis revealed that pathological T stage, tumor size (> 3 cm), lymphovascular invasion, ulcerative lesion, adjuvant radiotherapy and local recurrence were significant factors affecting the survival (P <0.05). However, by multivariate analysis, only tumor size ( > 3 cm) and local recurrence were found to be the significant prognostic predictors. CONCLUSION: The important selection criteria for local excision in the treatment of low rectal cancer may include T1 stage, well or moderate differentiation,tumor size < or = 3 cm, no lymphovascular invasion.
Asunto(s)
Neoplasias del Recto/cirugía , Recto/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Radioterapia Adyuvante , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Recto/patología , Recto/efectos de la radiación , Estudios RetrospectivosRESUMEN
OBJECTIVE: To investigate the expression of annexin in human pancreatic cancer and to elucidate its role in oncogenesis of pancreatic cancer. METHODS: A pancreatic carcinoma cell line Suit-II with high-expression of annexin I gene was adopted. Three subtypes of annexin I -siRNA sequences and a non-related fragment were combined, and the eukaryotic expression vectors bearing siRNA fragments were constructed. Then they were transfected into pancreatic carcinoma cells to knock down the expression of annexin I by RNAi. After knocking down the expression of annexin I , the growth speed, cell cycling, morphological features and apoptosis of pancreatic carcinoma cells were examined by RT-PCR and MTT test. RESULTS: When the expression of annexin I was blocked, the growth speed of pancreatic carcinoma cells was significantly decreased, the morphological features were changed and pronounced apoptosis occurred. CONCLUSION: Annexin I can modulate pancreatic carcinoma cell cycle, promote the cell proliferation, increasingly stimulate the cell growth, and suppress the process of apoptosis in pancreatic carcinoma cells.
Asunto(s)
Anexina A1/genética , Apoptosis , Neoplasias Pancreáticas/patología , ARN Interferente Pequeño/genética , Anexina A1/metabolismo , Ciclo Celular , Línea Celular Tumoral , Proliferación Celular , Regulación hacia Abajo , Regulación Neoplásica de la Expresión Génica , Vectores Genéticos , Humanos , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/metabolismo , Interferencia de ARN , ARN Mensajero/metabolismo , TransfecciónRESUMEN
OBJECTIVE: To investigate the clinical pathological characteristics and treatment of primary splenic tumor. METHODS: The clinical data of 43 patients with primary splenic rumors, 23 males and 20 females, aged 44.7 (19 - 66), treated in the Cancer Hospital, Chinese Academy of Medical Science from Feb 1972 through Mar 2006 were analyzed. RESULTS: Of the 43 cases, 21 cases (48.8%) were found in physical examination. 42 cases underwent splenectomy and 1 case underwent rumor biopsy. Sixteen cases were with benign splenic tumors, including 15 cases of hemangioma and 1 case of lymphangioma. Of the 24 malignant cases, 16 suffered from splenic lymphoma and 8 from angiosarcoma. Most lymphoma cases survived and the mean three year surviving rate was 88.7%. The mean surviving time of angiosarcoma was only 10.4 months. CONCLUSION: Primary splenic tumors lack specificity; B-ultrasonography and CT are primary examination methods. Surgery is an effective method in treatment of primary splenic tumors.