[Chinese HER2 positive early breast cancer trastuzumab adjuvant therapy: preliminary outcomes].

OBJECTIVE: To evaluate the efficacy and safety of 1-year adjuvant trastuzumab (herceptin) versus 1-year non-trastuzumab observation in Chinese patients with HER2-positive early breast cancer during a median follow-up of 1 year. METHODS: The HERA trial was an international, multicenter, randomized, open-label, phase III trial comparing treatment with trastuzumab for 1 and 2 years with observation after standard adjuvant chemotherapy, radiotherapy or both in patients with HER2-positive node-positive or high-risk node-negative early breast cancer. The primary endpoint was disease-free survival. Secondary end points included recurrence-free survival, distant disease-free survival, overall survival and cardiac safety. The first planned interim analysis comparing the efficacy and safety of treatment with trastuzumab for 1 year versus observation were completed in April 2005. Only the outcomes of recruited Chinese patients were reported. RESULTS: A total of 122 Chinese patients from 8 participating centers were included for planned interim analysis. And they were divided into trastuzumab (n = 68) and observation (n = 54) groups. Three and eight disease-free survival events were observed in the trastuzumab and observation groups respectively. Two-year disease-free survival rates were 92.9% and 81.4% respectively (P = 0.0489); 2-year recurrence-free survival and distant disease-free survivals were 98.1% vs 81.4% (P = 0.0064) and 98.1% vs 83.3% (P = 0.0117) respectively. Trastuzumab was generally well-tolerated with a decent safety profile. Severe cardiotoxicity was not observed. CONCLUSION: One-year treatment with adjuvant trastuzumab improves disease-free survival, recurrence-free survival and distant disease-free survival in Chinese patients with HER2-positive early breast cancer.

Ultrasound features predicting the 3-week outcome of Pavlik harness treatment for developmental hip dysplasia.

BACKGROUND: The treatment protocol for children with developmental dysplasia of the hip (DDH) is routinely adjusted by assessing the hip reduction after 3 weeks of Pavlik harness treatment. However, there is a high risk of failure and complications in the treatment adjustment. The aim of this study was to explore the value of ultrasound features in predicting the treatment outcome of Pavlik harness after 3 weeks in DDH children. METHODS: A total of 215 DDH children were recruited and the demographics and the changes of ultrasound features [α and ß angle and femoral head coverage (FHC)] during the Pavlik harness treatment were recorded. The children were divided into the success group and the failure group according to the reduction outcome after 3 weeks. Univariate and multivariate analyses were performed to analyze the independent predictors for the treatment outcome. Repeated-measures analysis of variance was used to compare the changes of ultrasound features between the two groups during the treatment. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive accuracy of the ultrasound features. RESULTS: Graf type III (P=0.036), bilateral dislocation (P=0.031), and age at diagnosis (P=0.021) were associated with an increased risk of Pavlik harness failure in the multivariate analysis. The changes in α and ß angle and FHC were generally greater in the success group than in the failure group. The α angle and FHC were larger in the success group, while the ß angle was larger in the failure group (P<0.05). Each ultrasound parameter (α and ß angle and FHC) alone could not accurately predict the treatment outcome within 3 weeks. However, the combined ultrasonic features at the second week could accurately predict the outcome of Pavlik harness treatment after the third week. The combination of the ultrasound features at the first week and the influencing factors (Graf classification, age at diagnosis, and side of pathology) could accurately predict the outcome at the first week [area under curve (AUC) =0.931, sensitivity =82.14%, specificity =97.86%]. CONCLUSIONS: The combined model of ultrasonic features at the second week could accurately predict the reduction outcome of Pavlik harness after the third week. The combined model including independent predictors and ultrasonic features could accurately predict the reduction outcome at the first week.

Physicochemical and antibacterial properties of fabricated ovalbumin-carvacrol gel nanoparticles.

The applications of carvacrol are limited due to its poor stability and water solubility, and high volatility; however, ovalbumin can be used to encapsulate hydrophobic molecules, improve their aqueous solubility, and reduce their volatility. In this study, we fabricated ovalbumin-carvacrol nanoparticles (OCGns) under different pH (2, 5, 7, and 9) conditions using a gel embedding method and investigated their physicochemical and antibacterial properties. Rheological experiments revealed that the G' of ovalbumin gels (OGs) prepared under different pH conditions were OG-2 > OG-7 > OG-9 > OG-5. Carvacrol addition reduced the tight structure of ovalbumin and carvacrol under pH 5 and 7 conditions, with hardness first decreasing and then increasing, but increasing under pH 2 and 9 conditions. Fluorescence and infrared spectroscopy indicated complex formation, with carvacrol increasing the average diameter of nanoparticles prepared at pH 2, 5, 7, and 9. Encapsulation reached 89.34 and 91.86% at pH 2 and 9, respectively; however, inhibition experiments revealed that the minimum inhibitory concentration of OCGn-2 against Gram-positive Bacillus cereus and Salmonella (0.08 and 0.16 mg mL-1, respectively) was lower than that of OCGn-9 (both 0.28 mg mL-1). Moreover, OCGn-2 possessed a better dense gel structure and a higher stability, encapsulation rate, and antibacterial activity, suggesting that pH affects gel microstructure and thus the encapsulation efficiency and bacteriostatic properties of the prepared nanoparticles. These results contribute to our knowledge of the design and fabrication of polymeric nanoparticle delivery systems for bioactive compounds with beneficial properties.

Expression of 11 HOX genes is deregulated in esophageal squamous cell carcinoma.

PURPOSE: HOX genes are vital for all aspects of mammalian growth and differentiation, and recent data have shown that their deregulated expression is related to carcinogenesis. To date, there has been no systemic study on expression of HOX genes in esophageal carcinoma. We investigated the expression pattern of 39 known HOX genes in cancerous and noncancerous tissue from 36 patients with esophageal squamous cell carcinoma to determine whether their expression is altered in esophageal cancer. EXPERIMENTAL DESIGN: Thirty-six patients with resectable esophageal squamous cell carcinoma (ESCC) were enrolled in this study. Specific primers were designed for each of 39 HOX genes, and reverse transcription-PCR was done in cancerous and noncancerous samples of these 36 patients. Furthermore, the expression of HOXA9 protein was subjected to Western blot analysis in all 36 paired tissue samples. RESULTS: Eight of 39 HOX genes were expressed in cancerous but not in noncancerous tissue. Five of 39 HOX genes were expressed both in cancerous and noncancerous tissue. Of the latter, expression of HOXA7, HOXA9, and HOXC6 was significantly higher in cancerous tissue (P < 0.05). The remaining 26 HOX genes were not detected in either types of tissue. HOXA9 protein was expressed in both kinds of tissue (cancer tissue versus noncancerous mucosa: 0.34 +/- 0.32 versus 0.24 +/- 0.27, P = 0.121). CONCLUSIONS: This is the first comprehensive survey of 39 HOX gene expression in ESCC and noncancerous mucosa. Five of the 39 HOX genes were expressed in both types of tissue indicating their possible role in maintaining normal structure and function of adult esophageal mucosa. Eleven of the 39 HOX genes were deregulated in cancer tissue. These genes possibly participate in the carcinogenesis of ESCC.

Genetic polymorphisms of CYP2E1, GSTT1, GSTP1, GSTM1, ALDH2, and ODC and the risk of advanced precancerous gastric lesions in a Chinese population.

There have been few studies of the associations of genetic polymorphisms with precancerous gastric lesions. We conducted a cross-sectional study to compare the prevalences of several genetic polymorphisms in 302 subjects with mild chronic atrophic gastritis with prevalences in 606 subjects with deep intestinal metaplasia or dysplasia. This stratified random sample of 908 subjects was selected and analyzed for genetic polymorphisms from 2,628 individuals who had gastric biopsies with histopathology in 1989 in Linqu County, Shandong Province, China. In subjects with mild chronic atrophic gastritis, the frequencies of the variant (less common) alleles of CYP2E1 RsaI, CYP2E1 DraI, GSTP1, ALDH2, and ODC were, respectively, 0.156, 0.201, 0.189, 0.190, and 0.428. The frequencies of the null genotypes of GSTM1 and GSTT1 in the mild chronic atrophic gastritis group were 0.509 and 0.565, respectively. Comparing mild chronic atrophic gastritis with deep intestinal metaplasia or any degree of dysplasia, we found no statistically significant associations with any genotype from these loci for dominant, additive, or recessive inheritance models. There was no statistically significant evidence of multiplicative interactions between any pair of genotypes based on CYP2E1 RsaI, CYP2E1 DraI, GSTP1, GSTM1, or GSTT1; nor between Helicobacter pylori status and any of these five loci; nor between smoking status and GSTP1, GSTM1, or GSTT1; nor between alcohol consumption and ALDH2. Statistically significant interactions were noted between salt consumption and GSTP1 and between sour pancake consumption and CYP2E1 RsaI. There was, moreover, a statistically significant interaction (odds ratio, 1.78; 95% confidence interval, 1.03-3.08) between CYP2E1 DraI and smoking at least one cigarette per day. A positive but not statistically significant interaction was also seen between CYP2E1 RsaI and smoking status. These polymorphisms do not seem to govern progression from mild chronic atrophic gastritis to advanced precancerous gastric lesions, but the effects of smoking may be accentuated in individuals carrying variants of CYP2E1.

COX-2 expression and tumor angiogenesis in colorectal cancer.

AIM: Cyclooxygenase-2 (COX-2) is one of the rate-limiting enzymes in metabolism of arachidonic acid, and COX-2 inhibitors demonstrate preventive effects on cancer, especially on colorectal cancer. The underlying mechanism remains unclear. The aim of this study was to illustrate the relationship between angiogenesis and COX-2 in carcinogenesis of colorectal cancer. METHODS: One hundred and seventy patients with colorectal cancer were enrolled in our study from January 1993 to September 2001 in School of Oncology, Peking University. COX-2 and VEGF expression were detected with the immunohistochemistry (IHC) technique. IHC assays were carried out with the aid of tissue microarray (TMA) procedure. Specimens from 35 of these patients were examined with reverse transcriptase PCR (RT-PCR). RESULTS: COX-2 and VEGF expressions were stronger in colorectal cancer than those in the corresponding normal tissues, at both protein and mRNA levels. One hundred patients were eligible for analysis after IHC assay of COX-2 and VEGF. The positive rate of VEGF was much higher in COX-2 positive group (47/85) than in COX-2 negative group (chi (2) = 4.181, P = 0.041). The result was further verified by the result of RT-PCR (chi (2) = 8.517, P = 0.003). Correlation coefficient was 0.409 after Spearman correlation analysis (P = 0.015). CONCLUSION: COX-2 may be involved in the course of tumor angiogenesis of colorectal cancer and acts through VEGF.

Angiography for diagnosis and treatment of colorectal cancer.

AIM: To evaluate the role of preoperative angiography in the diagnosis and treatment of colorectal cancer. METHODS: The authors performed selective arterial cannulation by Seldinger's method in 47 patients to locate the primary cancer and to diagnose metastasis to the liver. Each patient was then given intra-arterial regional chemotherapy, and received 5-fluorouracil (5-Fu, 1 000 mg), mitomycin C (MMC, 20 mg), and cisplatinum (CDDP, 80 mg). RESULTS: The location and shape of each tumor were observed, including metastatic tumors in the liver, in 42 of the 47 (89.4 %) patients. The site of the primary tumor was difficult to identify in 5 cases because the patients had a recurrence of cancer. Arterial chemotherapy was performed successfully in all patients. The authors recorded no partial or significant morbidity resulted from angiography. The only incident was bleeding from the artery puncture site in one patient, which was successfully stopped by general medication. CONCLUSION: Preoperative selective arterial angiography can help the diagnosis and locate primary tumors and to detect liver metastasis. At the same time, regional arterial chemotherapy can be an important form of preoperative therapy.

Role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis.

AIM: Recent clinical epidemiological studies have demonstrated the preventive effect of non-steroidal anti-inflammatory drugs (NSAIDs) against colorectal cancer. The underlying mechanism might be the inhibition of rate-limiting enzyme cyclooxygenase-2 (COX-2) in metabolism of arachidonic acid. The role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis still remain unclear. This study was to investigate the role of COX-2 expression in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis. METHODS: A total of 139 colorectal cancers and 19 adenomas surgically treated in School of Oncology, Peking University, from January 1993 to September 2001 were retrospectively studied. COX-2 expression was detected with tissue microarray (TMA) and immunohistochemistry (IHC) procedure. The association between COX-2 expression and clinicopathological features and its influence on patients' prognosis were studied. RESULTS: COX-2 expression was strong in colorectal cancer, moderate in adenoma and weak in normal mucosa, which demonstrated statistically significant difference (chi(2)=46.997, P<0.001). COX-2 expression had no association with clinicopathological features such as gross type, differentiation, invasion depth, vessel emboli and TNM staging. Cox proportional hazards modeling analysis and Log rank test revealed no prognostic role of COX-2 expression in colorectal cancer patients. CONCLUSION: COX-2 may play an important role in the early stage of carcinogenesis, and its expression in colorectal cancer is not associated with clinicopathological features and patients' prognosis.

[Phase II clinical trial on gemcitabine in the treatment of stage IIIB-IV non-small cell lung cancer].

OBJECTIVE: To evaluate the efficacy and safety of domestic Gemcitabine in the treatment of patients with stage IIIB approximately IV non-small cell lung cancer (NSCLC). METHODS: 124 NSCLC patients were randomized into three groups: Group A: single drug group, 40 cases, gemcitabine 1 000 mg/m(2) + NS 100 ml or 200 ml was infused within 30 approximately 60 minutes on D1, 8 and 15, with 28 days taken as one cycle. Group B: combined treatment group, 36 cases, in addition to the above protocol, cisplatin 30 mg/m(2) was infused within 60 approximately 120 min, on D1, 2 and 3. Group C: combined control group: 39 cases, the protocol applied was the same as group B except domestic gemcitabine being replaced by imported gemzar. The efficacy and side effects of treatment were evaluated after 8 weeks of treatment. RESULTS: 115 patients could be evaluated for response rate. PR was observed in 9/40 (22.5%) of group A, 15/36 (41.6%) in group B and 15/39 (38.36%) in group C. There was no significant difference of PR rates between group B and group C (P = 0.552). 117 patients who received the second cycle of treatment were evaluated for toxicity. The incidence of grade III approximately IV nausea, vomiting and loss of appetite was much higher in group B. Hematological toxicity of groups B and C was higher than that of group A. There was no significant difference between groups B and C. CONCLUSION: The efficacy and incidence of side effects between domestic gemcitabine and the imported gemzar are similar.

[Correlation between polymorphisms of interleukin-1beta and RN genes and risk of gastric carcinoma: a case-control study].

OBJECTIVE: To investigate the correlation between polymorphisms of interleukin-1beta and RN genes and risk of gastric carcinoma. METHODS: PCR and denaturing high-performance liquid chromatography (DHPLC) were used to analyze the IL-1beta-31 and -511 C/T polymorphisms and to genotype the IL-1RN penta-allelic variable number of tandem repeats (VNTR): of the DNA from the peripheral blood of 143 patients of gastric carcinoma, 97 from Linqu County, Shandong Province, and 46 cases from the specimen bank of Beijing Cancer Hospital, and 337 controls without gastric carcinoma from Linqu County, most of which suffered from other gastric diseases. RESULTS: IL-1-511 polymorphisms (carriers of IL-1beta-511T) were correlated with the increased risk of interstitial gastric carcinoma in both sexes (OR = 3.833, 95% CI: 2.282 approximately 6.439) and increased risk of diffuse gastric carcinoma in males (OR = 3.464, 95% CI: 1.394 approximately 8.608). The frequencies of IL-1beta-31 polymorphisms and IL-1IRN VNTR were not different between the gastric carcinoma group and the control group, IL-1beta-511 T carrier could be seen in the controls at different precancerous stages, for chronic atrophic gastritis (OR = 5.164, 95% CI: 2.661 approximately 10022), for interstitial metaplasia (OR = 5.093, 95% CI: 2.708 approximately 9.463), and for dysphasia (OR = 8.438, 95% CI: 3.939 approximately 18.073). CONCLUSION: IL-1beta-31 genotypes and. IL-2RN VNTR do not increase the risk of gastric carcinoma. The IL-1beta-511 T genotype increases the risk of gastric carcinoma in every precancerous stage.

[Detection of human papillomavirus type 16 E6 mRNA in carcinomas of upper digestive tract].

OBJECTIVE: To investigate the relationship between human papillomavirus (HPV) infection and the development of upper digestive tract carcinomas. METHODS: In situ hybridization (ISH) technique was used to detect the expression of HPV16 E6 mRNA in 40 specimens of esophageal squamous cell carcinoma, 74 specimens of gastric cardiac adenocarcinoma, 40 specimens of adenocarcinoma of gastric corpus, 62 specimens of adenocarcinoma of gastric antrum, all resected during operation, and 58 specimens of normal tissues of gastric mucosa, obtained by endoscopy. RESULTS: The positive rate of HPV16 E6 mRNA was 70% (28/40) in esophageal squamous cell carcinomas, 67.6% (50/74) in gastric cardiac adenocarcinomas, 47.5% (19/40) in adenocarcinoma of gastric corpus, 35.5% (22/62) in adenocarcinoma of gastric antrum, and 20% (10/50) in normal tissues of gastric mucosa respectively, without a significant difference between esophageal squamous cell carcinoma and gastric cardiac adenocarcinoma (P = 0.955). The positive rate in gastric adenocarcinoma was significantly lower than that in gastric cardiac adenocarcinoma (P < 0.05) or in esophageal squamous cell carcinomas (P < 0.01). The positive rate in normal tissue of gastric mucosa was significantly lower than those in gastric adenocarcinoma (P < 0.05) in gastric cardiac adenocarcinoma (P < 0.01), and in esophageal squamous cell carcinoma (P < 0.01). The positive rate in gastric cardiac carcinomas was negatively correlated with TNM stage (P < 0.05). However, there was no correlation between HPV16 and gender, age, tumor size, depth of penetration, differentiation, lymph node metastasis, vascular invasion and prognosis of these patients with gastric cardiac carcinoma (all P > 0.05). CONCLUSION: HPV infects not only squamous epithelium, but also glandular epithelium. HPV16 may be an etiologic factor in the development of upper digestive tract carcinomas, especially esophageal and cardiac carcinomas.

Comparative analysis of essential components between the herbal pair Radix Saposhnikoviae-Rhizoma seu Radix Notopterygii and its single herbs by GC-MS combined with a chemometric resolution method.

Comparative analysis of essential components in the herbal pair Radix Saposhnikoviae-Rhizoma seu Radix Notopterygii and its single herbs is performed using two-dimensional gas chromatography-mass spectrometry data coupled with a chemometric method, named alternative moving window factor analysis. Identification of the compounds is also assisted by comparison of temperature-programmed retention indices (PTRIs) on the OV-1 column with authentic samples. The experimental results show that the main volatile chemical components in the herbal pair are mainly from Rhizoma seu Radix Notopterygii, and the number of essential chemical components in the herbal pair is almost equal to the sum of the number in the two single herbs but with a different quantity.

[Detection and significance of APC gene promoter hypermethylation in serum of breast cancer patients].

BACKGROUND & OBJECTIVE: Detection of circulating tumor markers is one of current hot spots in tumor research. Free tumor DNA may exist in the peripheral blood of malignant tumor patients. Identical DNA mutations existing in both peripheral serum and primary tumor are found in many kinds of malignant tumors. This study used adenomatous polyposis coli (APC) gene promoter hypermethylation as a tumor marker to investigate the correlations of free tumor DNA to primary tumor and clinicopathologic features of breast cancer. METHODS: The methylation status of APC gene in tumor tissue, paracancer normal tissue, and paired peripheral serum from 84 patients with breast cancer and 10 patients with benign breast diseases were detected by methylation-specific polymerase chain reaction (MSP). RESULTS: The detection rate of APC gene promoter hypermethylation was 45.2% in tumor tissues and 31.0% in paired peripheral sera. APC gene hypermethylation in peripheral serum was significantly correlated to that in tumor tissue (r=0.977, P=0.002). The sensitivity of detecting APC gene hypermethylation in peripheral serum was 68.4%; the specificity was 97.8%. The aberrant methylation of APC gene in tumor tissue and peripheral serum had no correlation to patients' age, tumor stage, tumor size, histological type, and receptor status (P>0.05). No aberrant methylation of APC gene was found in the serum samples from healthy control and the patients without gene methylation in tumor tissue. CONCLUSION: The aberrant tumor gene methylation in peripheral serum of breast cancer patients is significantly correlated to that in primary tumor.

Surgical treatment of complex malignant anterior mediastinal tumors invading the superior vena cava.

Determining the appropriate surgery-based treatment for complicated anterior mediastinal malignancies (CAMM), especially those invading the superior vena cava (SVC) and its branches, remains a challenge for general thoracic surgeons. In this report, we summarize our experience and lessons regarding this issue in order to discuss a reasonable strategy for diagnosis and treatment of CAMM. Between January 2001 and April 2003, 15 patients with CAMM invading the SVC and/or its branches with or without invasion of other neighboring organs were surgically treated in our institution by a single surgeon team. We collected clinical data from the medical charts and from surgeons' specific notes for complicated cases, and performed a comprehensive analysis. There were 9 patients with malignant thymoma. Thymic carcinoma, teratoma, embryonal carcinoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, and mixed teratoma with thymoma were diagnosed in 1 patient each. All procedures were performed via median sternotomy. Some angioplasty techniques were successfully used to resect and reconstruct the SVC. Ten of the 15 patients also underwent pulmonary resection due to involvement of pulmonary parenchyma. Four of the patients underwent perioperative chemotherapy. There were no perioperative deaths. Two patients suffered prolonged ventilation after surgery, and there were no other severe complications related to surgery. One patient died 10 months after surgery. The remaining 14 patients were still living and their progress is still monitored. As of August 2004, the median follow-up duration for all patients was 35 months, and the disease-free survival duration was 10-43 months. CAMM can be safely and completely resected via a median sternotomy, even if it has invaded other mediastinal structures. CAMM should be pathologically identified before initial treatment. A good outcome for patients with CAMM is possible if a suitable strategy combining accurate diagnosis and appropriate treatment, especially surgical resection, is established.

Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions.

BACKGROUND: Randomized trials have yielded mixed results on the effects of treatment for Helicobacter pylori and little information on the effects of vitamins or garlic supplements on precancerous gastric lesions. We conducted a randomized trial to test the effects of one-time H. pylori treatment and long-term vitamin or garlic supplements in reducing the prevalence of advanced precancerous gastric lesions. METHODS: Most of the adults aged 35-64 years in 13 randomly selected villages in Linqu County, Shandong Province, China, were identified and given baseline endoscopies in 1994. In 1995, 3365 eligible subjects were randomly assigned in a factorial design to three interventions or placebos: amoxicillin and omeprazole for 2 weeks in 1995 (H. pylori treatment); vitamin C, vitamin E, and selenium for 7.3 years (vitamin supplement); and aged garlic extract and steam-distilled garlic oil for 7.3 years (garlic supplement). Subjects underwent endoscopies with biopsies in 1999 and 2003, and the prevalence of precancerous gastric lesions was determined by histopathologic examination of seven standard biopsy sites. The 3365 eligible randomized subjects represented 93.5% of those with baseline endoscopy and included all baseline histologic categories except gastric cancer. Only 0.18% had normal gastric mucosa. Logistic regression was used to estimate the intervention effects on the odds of advanced precancerous gastric lesions, and t-tests were used to assess effects on histologic severity. All statistical tests were two-sided. RESULTS: H. pylori treatment resulted in statistically significant decreases in the combined prevalence of severe chronic atrophic gastritis, intestinal metaplasia, dysplasia, or gastric cancer in 1999 (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.62 to 0.95) and in 2003 (OR = 0.60; 95% CI = 0.47 to 0.75), and had favorable effects on the average histopathologic severity and on progression and regression of precancerous gastric lesions in 2003. H. pylori treatment did not reduce the combined prevalence of dysplasia or gastric cancer. However, fewer subjects receiving H. pylori treatment (19/1130; 1.7%) than receiving placebo (27/1128; 2.4%) developed gastric cancer (adjusted P = .14). No statistically significant favorable effects were seen for garlic or vitamin supplements. CONCLUSION: H. pylori treatment reduces the prevalence of precancerous gastric lesions and may reduce gastric cancer incidence, but further data are needed to prove the latter point. Long-term vitamin or garlic supplementation had no beneficial effects on the prevalence of precancerous gastric lesions or on gastric cancer incidence.

[Expression of cell cycle-regulatory proteins in squamous cell carcinoma of the esophagus].

BACKGROUND & OBJECTIVE: Tumor cell cycle analysis has indicated that tumors with a higher proliferation rate showed more aggressive clinical behavior. Cell cycle-regulatory proteins Ki-67, cyclin A, and p27 are associated with cell proliferation. The objective of this study was to observe the character of expression of cell cycle-regulatory proteins Ki-67, cyclin A, and p27 in esophageal carcinoma and to clarify the relationship between clinicopathologic and these proteins. METHODS: Immunohistochemistry for Ki-67, cyclin A, and p27 were carried out. Ki-67 and cyclin A staining index (SI), and p27 labeling index were examined and detailed pathologic examinations were conducted on tumors from 60 patients (48 males and 12 females with surgically resected esophageal squamous cell carcinoma). RESULTS: Ki-67, cyclin A, and p27 immunostaining were all confined to the nuclei in both neoplastic and non-neoplastic cells. The staining indexes(SIs) of Ki-67 and cyclin A, were significantly higher in poorly differentiated squamous cell carcinoma (SCC,27.2+/-4.9;15.4+/-5.3) than in well differentiated SCC(20.6+/-6.3;11.3+/-6.4,P< 0.05). The p27 positive immunostaining in the nuclei in well-differentiated SCC(36%)were higher than that in the other tumor types (29%;18%), but there was no significance(P< 0.25,P >0.05). CONCLUSION: The expression levels of Ki-67, cyclin A, and p27 may suggest the proliferative activity of cancer cells in Chinese patient with SCC of esophagus. The cell cycle-regulatory proteins Ki-67 and cyclin A over-expression correlates with poor SCC differentiation in patients with esophageal carcinoma.

Congenital expression of mdr-1 gene in tissues of carcinoma and its relation with pathomorphology and prognosis.

AIM:To detect the congenital expression patterns of mdr-1 gene in commonly encountered malignant tumors in clinic, and the relationship between the expression of mdr-1 gene and the prognostic morphology in esophageal carcinomas.METHODS:A total of 151 resected samples of malignant tumors without preoperative treatment were taken from Anyang City Tumor Hospital.The congenital expression of their mdr-1 gene was detected with reverse transcription polymerase chain reaction (RT-PCR) and was compared with each other.The positive incidence of mdr-1 gene in 46 samples of esophageal carcinoma was compared with their differentiated grades, TNM stages and macroscopic types, and the precautions and advantages of RT-PCR were evaluated.RESULTS:All the 151 samples were confirmed to be malignant histopathologically, including cancers of stomach and gastric cardia (n = 51), esophagus (n = 46), colorectum (n = 16),breast (n = 15), thyroid (n = 10), lung (n = 9) and uterine cervix (n = 24). The positive expression rate of their mdr-1 gene was 33.3%, 37%, 31.3%, 13.2%, 40%, 55%, and 0% respectively. All the 46 samples of esophageal carcinoma were pathologically confirmed to be squamous cell carcinoma. The total expression rate of their mdr-1 gene was 37% (17/46), 35% (6/17), 40% (8/20), and 33% (3/9) for differentiation grade I, II and III respectively. The expression rate of TNM classification was 33% (6/18), 40% (5/12) and 37% (6/16) in stage IIa, IIb andIII. The expression rate was 33% (3/9) in ulcerous type, 37% (3/8) in constrictive types, 33% (5/15) in fungoid types, and 40% (6/14) in medullary types.No statistically significant difference was found.CONCLUSION:Compared with other methods, RT-PCR is more simple, reliable and accurate in detecting mdr-1 gene expression in tissues of tumor. The overexpression of mdr-1 gene in these neoplasms suggested that cases should be handled differently for chemotherapy with rational use of drugs. Excision is the chief treatment for carcinoma of esophagus. The expression of mdr-1 gene in tissues of esophageal cancer is correlated with the parameters of tumor molecular biology which are independent of histopathological morphology.