Clinical significance and potential application of cuproptosis-related genes in gastric cancer.

BACKGROUND: Worldwide, gastric cancer (GC) is a common lethal solid malignancy with a poor prognosis. Cuproptosis is a novel type of cell death mediated by protein lipoylation and may be related to GC prognosis. AIM: To offer new insights to predict GC prognosis and provide multiple therapeutic targets related to cuproptosis-related genes (CRGs) for future therapy. METHODS: We collected data from several public data portals, systematically estimated the expression level and prognostic values of CRGs in GC samples, and investigated related mechanisms using public databases and bioinformatics. RESULTS: Our results revealed that FDX1, LIAS, and MTF1 were differentially expressed in GC samples and exhibited important prognostic significance in The Cancer Genome Atlas (TCGA) cohort. We constructed a nomogram model for overall survival and disease-specific survival prediction and validated it via calibration plots. Mecha-nistically, immune cell infiltration and DNA methylation prominently affected the survival time of GC patients. Moreover, protein-protein interaction network, KEGG pathway and gene ontology enrichment analyses demonstrated that FDX1, LIAS, MTF1 and related proteins play key roles in the tricarboxylic acid cycle and cuproptosis. Gene Expression Omnibus database validation showed that the expression levels of FDX1, LIAS, and MTF1 were consistent with those in the TCGA cohort. Top 10 perturbagens has been filtered by Connectivity Map. CONCLUSION: In conclusion, FDX1, LIAS, and MTF1 could serve as potential prognostic biomarkers for GC patients and provide novel targets for immunotarget therapy.

[Effect of Circular RNA hsa_circ_0067582 on the Proliferation and Invasion Ability of Gastric Cancer Cells].

Objective To investigate the effects on cell proliferation and invasion of the circular RNA hsa_circ_0067582 in gastric cancer(GC). Methods After hsa_circ_0067582 overexpression (Oe-circ_0067582) plasmid was transfected into AGS and SGC-7901 cells,the cell viability,proliferation,invasion ability,and apoptosis were detected by CCK-8,colony formation and EdU assays,Transwell assay,and flow cytometry,respectively.Western blotting was employed to detect the expression levels of proteins related to the cell apoptosis and epithelial-mesenchymal transition(EMT).The effect of Oe-circ_0067582 on the growth of SGC-7901 cells in nude mice was observed.Bioinformatics tools were used to predict the binding target miRNA of hsa_circ_0067582,and the competing endogenous RNA(ceRNA)regulatory network was established.Finally,functional enrichment was performed to analyze the biological functions of the target genes of the predicted miRNA. Results Compared with the pLO-ciR(empty plasmid)group,the Oe-circ_0067582 group in AGS and SGC-7901 cells attenuated the cell viability(t=7.883,P=0.001;t=5.679,P=0.005),proliferation(t=6.709,P=0.003;t=5.857,P=0.003),and invasion ability(t=7.782,P=0.002;t=6.342,P=0.003)and induced cell apoptosis(t=7.225,P=0.002;t=11.509,P=0.001).Western blotting showed that the Oe-circ_0067582 group in AGS and SGC-7901 cells up-regulated the protein levels of cysteinyl aspartate specific proteinase (Caspase) 3(t=6.863,P=0.002;t=7.024,P=0.001),Caspase 7(t=3.295,P=0.04;t=6.008,P=0.004),Caspase 9(t=4.408,P=0.012;t=6.278,P=0.004),and E-cadherin(t=12.453,P=0.002;t=10.867,P=0.001),while down-regulated those of Vimentin(t=7.242,P=0.002;t=5.694,P=0.004)and N-cadherin(t=6.480,P=0.003;t=7.446,P=0.001).Furthermore,Oe-circ_0067582 significantly inhibited the growth of tumor in the SGC-7901 tumor-bearing nude mice(t=3.526,P=0.017).The prediction based on TargetScan and miRnada suggested that hsa_circ_0067582 can competitively bind to hsa-miR-181b-3p,hsa-miR-337-3p,hsa-miR-421,and hsa-miR-548d-3p.The functional enrichment indicated that the target genes of miRNA were involved in multiple cancer-related biological processes including negative regulation of apoptotic process,gene expression,transcriptional misregulation in cancer,transforming growth factor-ß,and p53 signaling pathways. Conclusion Oe-circ_0067582 can inhibit the proliferation and attenuate EMT process to reduce the invasion ability of AGS and SGC-7901 cells,which provides a new target for the treatment of GC.

Signet ring cell carcinoma hidden beneath large pedunculated colorectal polyp: A case report.

BACKGROUND: Large pedunculated colorectal polyps are not frequent among colonic polyps. We present a clinical case of a large pedunculated colorectal polyp with signet ring cell cancer infiltrating the submucosa and lymph node invasion in a patient who ultimately underwent additional surgery. Clinicians should attach importance to pedunculated colorectal polyps and choose the most appropriate therapy. CASE SUMMARY: A 52-year-old female farmer underwent routine screening colonoscopy and denied constipation, diarrhea, hematochezia, or other gastrointestinal symptoms. Her past medical history and general biochemical examination results were unremarkable. During the colonoscopy, a 25-mm pedunculated polyp in the sigmoid colon was identified. The superficial epithelium was macroscopically congestive, rough, and granular, showing characteristic features of adenoma. We first ligated the root of the pedunculated polyp using nylon loops as well as a titanium clip. Histopathological examination revealed high-grade intraepithelial neoplasia of the tumor surface and a negative margin with signet ring cell adenocarcinoma infiltrating the submucosal layer. The deepest infiltration was approximately 0.9 cm from the tumor surface and 0.55 cm from the stratum basale. We performed radical resection of the left colon with lymph node dissection after two weeks. The lesion was completely resected, and pathological assessment revealed signet ring cell adenocarcinoma infiltrating the submucosal layer as well as lymph node invasion (stage PT1N1M0 and grade IIIA in pathological grading, NRAS-, BRAF V600E-, KRAS-). CONCLUSION: This case highlights the importance of paying attention to the malignancy of large pedunculated polyps. Polyps or adenomas removed via endoscopy must be evaluated histologically. Even if adenomas may be fragile, endoscopy doctors should still remove polyps as completely as possible and choose perpendicular sections through the stalk and base to fix by formaldehyde solution.

Non-coding RNAs and gastric cancer.

Non-coding RNAs (ncRNAs) play key roles in development, proliferation, differentiation and apoptosis. Altered ncRNA expression is associated with gastric cancer occurrence, invasion, and metastasis. Moreover, aberrant expression of microRNAs (miRNAs) is significantly related to gastric cancer tumor stage, size, differentiation and metastasis. MiRNAs interrupt cellular signaling pathways, inhibit the activity of tumor suppressor genes, and affect the cell cycle in gastric cancer cells. Some miRNAs, including miR-21, miR-106a and miR-421, could be potential markers for the diagnosis of gastric cancer. Long non-coding RNAs (lncRNAs), a new research hotspot among cancer-associated ncRNAs, play important roles in epigenetic, transcriptional and post-transcriptional regulation. Several gastric cancer-associated lncRNAs, such as CCAT1, GACAT1, H19, and SUMO1P3, have been explored. In addition, Piwi-interacting RNAs, another type of small ncRNA that is recognized by gastroenterologists, are involved in gastric carcinogenesis, and piR-651/823 represents an efficient diagnostic biomarker of gastric cancer that can be detected in the blood and gastric juice. Small interfering RNAs also function in post-transcriptional regulation in gastric cancer and might be useful in gastric cancer treatment.

Clinicopathological and prognostic features of hepatoid adenocarcinoma of the stomach.

BACKGROUND: Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of gastric carcinoma, which has its unique clinicopathological features and poorer prognosis than that of the ordinary gastric adenocarcinoma. At present, there is still a lack of understanding about this disease. The current study aimed to summarize and discuss the clinical, pathological, immunohistochemical, and prognostic features of this disease. METHODS: A total of 20 patients of HAS were retrospectively studied. All the patients were treated in Cancer Hospital of Chinese Academy of Medical Sciences between March 1998 and October 2009. Statistical analysis, including the Kaplan-Meier method, log-rank test and Cox model, were performed by the SPSS 15.0 software. RESULTS: Seventeen patients (85%) had at least 1 lymph node metastases; 17 patients (85%) received postoperative immunohistochemical examinations, with an alpha-fetoprotein (AFP) positive rate of 94.1% (16/17); 14 patients had distant metastases (including 12 liver metastases, 1 lung metastasis, and 1 celiac widespread metastases), and one simultaneously had anastomotic recurrence and liver metastases. The overall survival time was 2 - 99 months (median: 12.0 months). The 3-year survival rate of the 20 patients was 17.2%. The 3-year survival rate of patients with complete hepatocyte-like regions and those with both hepatocellular carcinoma and adenocarcinoma regions was 20.0% and 17.5%, respectively (P = 0.361). The survival difference among the radical surgery group, palliative surgery group and no surgery group was statistically significant (P = 0.022). The Kaplan-Meier method and log-rank test showed that surgery, pTNM stages, and adjuvant chemotherapy were associated with prognosis (P < 0.05). The Cox model only confirmed that the pTNM stages and adjuvant chemotherapy had statistical significance for the prognosis of HAS (P < 0.05) due to the limited cases. CONCLUSIONS: HAS is a special type of gastric carcinoma and has a poor prognosis. The pTNM stage is an independent risk factor for HAS. Multidisciplinary therapy, including surgery and chemotherapy, may improve the prognosis of HAS.

Mismatch repair, minichromosome maintenance complex component 2, cyclin A, and transforming growth factor ß receptor type II as prognostic factors for colorectal cancer: results of a 10-year prospective study using tissue microarray analysis.

BACKGROUND: The expression of genes encoding a number of pathogenetic pathways involved in colorectal cancer could potentially act as prognostic markers. Large prospective studies are required to establish their relevance to disease prognosis. METHODS: We investigated the relevance of 19 markers in 790 patients enrolled in a large randomised trial of 5-fluorouracil using immunohistochemistry and chromogenic in situ hybridisation. The relationship between overall 10-year survival and marker status was assessed. RESULTS: Minichromosome maintenance complex component 2 (MCM2) and cyclin A were significantly associated with overall survival. Elevated MCM2 expression was associated with a better prognosis (HR = 0.63, 95%CI: 0.46 - 0.86). Cyclin A expression above the median predicted an improved patient prognosis (HR = 0.71, 95%CI: 0.53 - 0.95). For mismatch repair deficiency and transforming growth factor ß receptor type II (TGFBRII) overexpression there was a borderline association with a poorer prognosis (HR = 0.69, 95%CI: 0.46 - 1.04 and HR = 2.11, 95%CI: 1.02 - 4.40, respectively). No apparent associations were found for other markers. CONCLUSION: This study identified cell proliferation and cyclin A expression as prognostic indicators of patient outcome in colorectal cancer.

Anorectal malignant melanomas: retrospective experience with surgical management.

AIM: To present the experience and outcomes of the surgical treatment for the patients with anorectal melanoma from the Cancer Hospital, Chinese Academy of Medical Sciences. METHODS: Medical records of the diagnosis, surgery, and follow-up of 56 patients with anorectal melanoma who underwent surgery between 1975 and 2008 were retrospectively reviewed. The factors predictive for the survival rate of these patients were identified using multivariate analysis. RESULTS: The 5-year survival rate of the 56 patients with anorectal melanoma was 20%, 36 patients underwent abdominoperineal resection (APR) and 20 patients underwent wide local excision (WLE). The rates of local recurrence of the APR and WLE groups were 16.13% (5/36) and 68.75% (13/20), (P = 0.001), and the median survival time was 22 mo and 21 mo, respectively (P = 0.481). Univariate survival analysis demonstrated that the number of tumor and the depth of invasion had significant effects on the survival (P < 0.05). Multivariate analysis showed that the number of tumor [P = 0.017, 95% confidence interval (CI) = 1.273-11.075] and the depth of invasion (P = 0.015, 95% CI = 1.249-7.591) were independent prognostic factors influencing the survival rate. CONCLUSION: Complete or R0 resection is the first choice of treatment for anorectal melanoma, prognosis is poor regardless of surgical approach, and early diagnosis is the key to improved survival rate for patients with anorectal melanoma.

Prognostic factors for 5-year survival after local excision of rectal cancer.

AIM: To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer, and to examine the therapeutic efficacy and surgical indications for this procedure. METHODS: Clinical data, obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005, were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier method, statistical comparisons were performed using the log-rank test, and multivariate analysis was performed using the Cox proportional hazards model. RESULTS: Transanal, transsacral, and transvaginal excisions were performed in 92, 12, and 2 cases, respectively. The rate of complication, local recurrence, and 5-year survival was 6.6%, 17.0%, and 86.7%, respectively. Univariate analysis showed that T stage, vascular invasion, and local recurrence were related to the prognosis of the cases (P < 0.05). Multivariate analysis showed that T stage [P = 0.011, 95% confidence interval (CI) = 1.194-3.878] and local recurrence (P = 0.022, 95% CI = 1.194-10.160) were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer. CONCLUSION: Local rectal cancer excision is associated with few complications, and suitable for stages Tis and T1 rectal cancer. Prevention of local recurrence, active postoperative follow-up, and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.

[Prognostic factors for elderly patients with pancreaticoduodenectomy for periampullary tumor].

OBJECTIVES: To analyze the prognostic factors for elderly patients with pancreaticoduodenectomy for periampullary tumor. METHODS: A retrospective analysis of the prognostic factors for the mortality rate was made in 127 elderly patients within 30 days of pancreaticoduodenectomy for periampullary tumor from January 1985 to November 2006 Chi-squared test, Fisher's exact test, t-test were used. RESULTS: The prognostic factors for the first-month mortality rate in elderly patients with pancreaticoduodenectomy included time length of the operation, operative hemorrhage, postoperative hemorrhage, pulmonary infection, and postoperative TP. CONCLUSIONS: An overall consideration should be paid to the factors that affect the prognosis of elderly patients with pancreaticoduodenectomy for periampullary tumor during the perioperative period. The security of the patients can be promoted by controlling these prognostic factors.

[Risk factors and surgical treatment of recurrent gastrointestinal stromal tumor in the rectum].

OBJECTIVE: To investigate the risk factors and surgical treatment of recurrent gastrointestinal stromal tumors in the rectum. METHODS: The clinical data of 24 cases,admitted to our hospital, were analyzed retrospectively. The possible risk factors were tested by chi(2)-test. The resectable rate and recurrent rate of recurrent cases were compared with the first-treated cases. RESULTS: The tumors with biggest diameter >or=3 cm and high invasive risk had higher recurrent rates (chi(2)=4.874, P=0.027, chi(2)=6.659, P=0.010). The resectable rate of recurrent gastrointestinal stromal tumors in rectum was 64.3% (9/14), which was significantly lower than that of first-treated ones (23/24) (chi(2)=6.618, P=0.010). There was no significant difference of recurrent rate between the recurrent group and the first-treated group (chi(2)=1.459, P>0.05). CONCLUSIONS: The size and invasive risk of tumor are associated with the recurrent rate of gastrointestinal stromal tumors in rectum. The resectable rate of recurrent gastrointestinal stromal tumors in rectum is significantly lower than that of first-treated ones, but recurrent rates are similar in the 2 groups.

[Outcome of malignant melanoma in gastrointestinal tract: clinical analysis of 70 cases].

OBJECTIVE: To investigate the diagnosis and treatments of malignant melanoma in gastrointestinal tract. METHOD: The clinical data of 70 cases of malignant melanoma in gastrointestinal tract treated between July 1965 and June 2007 were collected and analyzed. RESULTS: There were 27 male and 43 female patients in this group with a median age of 53 years. The melanoma arose from rectum in 50 cases, from anus in 10 cases and from esophagus in 10 cases. The overall 1, 3, 5 years survival rate were 48.3%, 14.6% and 6.5%, respectively, the median survival time was 379 days. Sixty-three cases received operations with or without adjuvant therapy after the operation. There was no significant differences in overall survival rate between the 25 cases received operation only (Group 1) and 38 cases supplemented by adjuvant therapy after operation (Group 2); whereas, the cases with clinical stage III tumor in Group 2 had significantly better survival than their counterparts in Group 1. It was found that the depth of tumor invasion was the risk factor of patient's prognosis on multivariate Cox regression analysis. CONCLUSIONS: Operation combined with adjuvant therapy can improve the survival of the patient with stage III melanoma in gastrointestinal tract. The depth of tumor invasion is a risk factor of survival in these patients.

[Clinicopathological comparison between young and old patients with rectal cancer].

OBJECTIVE: To compare the clinicopathological features and prognosis between patients under 40 years old (young group) and patients over 65 years old (old group) with rectal carcinoma. METHODS: The data of 138 young rectal cancer patients and 163 old patients, treated in our hospital from January 1990 to January 2000, were analyzed retrospectively by SPSS 11.5 software. Survival was estimated by the Kaplan-Meier method and comparison by the log-rank test. Cox regression was used in multivariate analysis. RESULTS: Stage III patients accounted for 53.6% (74/138) in young group, which was significantly higher as compared with 34.3% (55/163) in old group (P=0.001). The young group had significantly worse histologic grade with 28.2% of poorly differentiated tumors compared with 10.4% in the old group (P<0.001). The overall 5-year survival rates were 50.4% and 64.1% in young and old group respectively (P<0.05). However, the 5-year survival rates of the young group and old group with same TNM stage were similar. Cox regression showed that lymph node metastasis and T stage were independent prognostic factors. CONCLUSIONS: As compared to the old patients, advanced stage and poorly differentiated carcinoma are more common in young patients with rectal cancer. However, no significant difference of survival rate is found between the young and the old patients with same stage. Early examination and treatment are crucial to improve the survival rate of rectal cancer.

[Prognostic implication of common bile duct infiltration in adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy].

OBJECTIVE: To investigate the prognostic implication of common bile duct infiltration in the adenocarcinoma of the ampulla of Vater after panreaticoduodenectomy. METHODS: A retrospective study was conducted on clinical manifestation, pathological behavior and survival data in 102 patients with Vater's ampulla adenocarcinoma, who underwent pancreaticoduodenectomy from Jan 1980 to Dec 2003. The result of patients with the common bile duct infiltration were compared with that of those without. RESULTS: There were 42 cases in stage I (41.2%), 32 in stage II (31.3%), 27 in stage III (26.5%), and 1 in stage IV (1.0%). As for T stage: 9 cases in stage T1 (8.8%), 40 in T2 (39.2%), 25 in T3 (24.5%), and 28 in T4 (27.5%). As regarding to N stage: 76 cases in stage N0 (74.5%) and 26 in N1 (25.5%). Of these 102 cases, microscopic infiltration in the common bile duct (25.0%) was identified in 26 cases. A significant difference was observed between the patients with bile duct infiltration and those without, in the proportion of pancreatic medullae infiltration: 84.6% (infiltration group) versus 34.2% (non-infiltration group, P < 0.001). Twenty-five cases (24.5%) had recurrence and/or metastases postoperatively, with a median survival of 20 months (range, 2 to 93 months). The overall median survival of the whole group was 46.0 months (2 approximately 192 months), with a significant difference between the common bile duct infiltration group (36 months) and the non-infiltration group (49 months, P = 0.0061). The median non-recurrence survival of the whole group was 43 months (2 approximately 192 months), and a significant difference was observed between the common bile duct infiltration group (35 months) and non-infiltration group (47 months, P = 0.0002). CONCLUSION: If the adenocarcinoma of the Vater's ampulla infiltrated the common bile duct, the invasion to the pancreatic medulla is likely developed, and usually with a poor non-recurrence and overall survival. Therefore, postoperative chemotherapy/radiotherapy is suggested.

[Surgical treatment for colorectal cancer with simultaneous hepatic metastasis].

OBJECTIVE: To investigate the indication of surgical treatment for primary colorectal carcer with simultaneous hepatic metastasis. METHODS: 116 colorectal cancer patients with simultaneous hepatic metastasis underwent surgery from January 1990 to December 2001. The data were analyzed using Statistical Package for the Social Sciences (Release 11.5, SPSS, Inc). The survival was estimated using Kaplan-Meier method, and the survival comparison was carried out using the log-rank test. Multivariate analysis was performed using Cox regression. RESULTS: Totally, 116 patients received surgical resection for primary colorectal tumor, 18 of them underwent liver metastasis resection simultaneously. Postoperative complication developed in 14.7% of these patients with postoperative death in two patients. The overall 5-year survival rate was 14.29%. The 5-year survival rate of those who had liver metastasis resection was 32.12%. Multivariate analysis showed that liver metastasis resection, abdominal carcinomatosis, chemotherapy and intervention treatment were the most important prognostic factors. CONCLUSION: Surgical resection of primary colorectal cancer with simultaneous resection of liver metastasis or with combined modality therapies such as chemotherapy and intervention treatment is effective to prolong patient's survival for primary colorectal cancer patient with simultaneous hepatic metastasis.

[Analysis of recurrence and prognosis after surgical resection for anorectal melanoma].

OBJECTIVE: To investigate the clinicopathologic factors related with recurrence and prognosis after surgical resection for anorectal melanoma. METHODS: The clinicopathologic factors related to recurrence and prognosis of 50 patients with anorectal melanoma after surgical resection were retrospectively analyzed using univariate and multivariate methods. RESULTS: Forty-seven patients underwent radical operation, including 31 abdominoperineal resection (APR) and 16 sphincter preserving operation. The local recurrence rates were 16.1%(5/31) and 68.8%(11/16) respectively. chi(2) analysis revealed that operation pattern was associated with local recurrence rate. The 5-year survival rate was 18.2%. Univariate analysis revealed that single tumor, intramural infiltration and operation pattern were related with prognosis. Multivariate analysis revealed that intramural infiltration was the most important prognostic factor for anorectal melanoma. CONCLUSIONS: The prognosis of anorectal melanoma is poor. Early diagnosis and treatment are important for the improving of curative effect.

[Simultaneous liver and colorectal resection for synchronous colorectal liver metastasis].

OBJECTIVE: To investigate the safety and long term outcome of simultaneous liver and colorectal resection for synchronous colorectal liver metastasis. METHODS: Forty-three synchronous colorectal liver metastasis patients who received simultaneous colectomy and hepatectomy between May 1981 and November 2005 were analyzed retrospectively. RESULTS: The group included 21 male patients and 22 female patients, with the median age of 52 years. The overall median operative time was 180 minutes, 30 cases received blood transfusion, and the median volume was 800 ml. The median hospital stay was 15 days. The morbidity and mortality was 18.6% and 2.3%, respectively. The overall median survival time was 25 months, 5-year survival rate was 19.1%. The survival of patients underwent R0 resection were substantially better (median survival time 48 months, 5-year survival rate 33.8%) than that of the patients who did not undergo R0 resection (20 months, 7.6%) (P = 0.002). CONCLUSIONS: Simultaneous liver and colorectal resection is safe and effective for synchronous colorectal liver metastasis. Furthermore, simultaneous R0 resection should be the optimal surgery for the resectable cases.

[Outcome of surgical therapy for liver metastasis of colorectal cancer: analysis of 75 cases].

OBJECTIVE: To explore the strategy to improve the long term survival of liver metastasis of colorectal cancer after surgical treatment. METHODS: The clinical data of 75 patients with liver metastasis of colorectal cancer, 43 males and 32 females, aged 51.4, who received hepatectomy between January 1981 and November 2005, were analyzed. RESULTS: The primary tumor site was colon in 39 cases, and rectum in 36 cases. Liver metastasis was synchronous in 59 patients, and metachronous in 16 patients. 45 patients received simultaneous liver and colorectal resection, 29 patients received metachronous resection, and 1 patient did not receive primary rectal cancer resection. The operative complication rate and the mortality were 16% (12/75) and 1.33% (1/75) respectively. The overall 1- 3-, and 5-year survival rates were 86.7%, 35.5%, and 22.2% respectively, and the median survival time was 25 months. There were residual tumors in 35 patients. The 1-, 3-, and 5-year survival rates of the residual tumor group were 80.6%, 5.4%, and 5.4% respectively, all significantly lower than those of the radical resection group (91.6%, 58.1%, and 34.9% respectively, and the median survival time of the residual tumor group was 18 months, significantly shorter than that of the radical resection group (38 months) (all P = 0.000). CONCLUSION: Surgical resection of liver metastasis of colorectal cancer significantly prolongs the survival time, and resection of all liver deposits and the extrahepatic disease is the most important factor influencing survival.

[Clinicopathologic features and treatment of primary splenic tumors].

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.

[Clinical analysis of 14 cases of epithelioid sarcoma].

BACKGROUND & OBJECTIVE: Epithelioid sarcoma is a rare soft tissue sarcoma with a high propensity for aggressiveness, regional nodal spread, and distant metastases. This study was to investigate the clinical features, diagnosis, treatment, and prognosis of epithelioid sarcoma. METHODS: The clinical data of 14 patients with epithelioid sarcoma, admitted to our hospital from 1990 to 2005, were analyzed. All of the 14 patients received initial operations at other hospitals. Eleven patients received extensive excision (9 patients) or amputation (2 patients), and 4 of them also received local lymph node dissection at our hospital; 3 patients received another local excision or extensive excision at other hospitals again. Nine patients received adjuvant radiotherapy and 3 of them also received adjuvant chemotherapy. RESULTS: All diagnoses of epithelioid sarcoma were confirmed by pathology. Of the 14 patients, 12 (85.7%) had local recurrence and 4 (28.6%) had local lymph node metastasis, 9 (64.3%) died within 3 years after initial operation. The overall 1-, 2-, 5-, 10-year survival rates were 71.43%, 55.56%, 27.78%, 13.89%, respectively. CONCLUSIONS: The prognosis of epithelioid sarcoma is poor because of a high propensity for local recurrence, node metastases, and distant metastases. Extensive excision or radical excision combined local lymph node dissection is effective for epithelioid sarcoma.