Prognostic factors and therapeutic effects of different treatment modalities for colorectal cancer liver metastases.

BACKGROUND: Colorectal cancer (CRC) is one of the most common malignant tumors in China, and the liver is the most common metastatic site in patients with advanced CRC. Hepatectomy is the gold standard treatment for colorectal liver metastases. For patients who cannot undergo radical resection of liver metastases for various reasons, ablation therapy, interventional therapy, and systemic chemotherapy can be used to improve their quality of life and prolong their survival time. AIM: To explore the prognostic factors and treatments of liver metastases of CRC. METHODS: A retrospective analysis was conducted on 87 patients with liver metastases from CRC treated at the Liaoning Cancer Hospital and Institute between January 2005 and March 2011. According to different treatments, the patients were divided into the following four groups: Surgical resection group (36 patients); ablation group (23 patients); intervention group (15 patients); and drug group (13 patients). The clinicopathological data and postoperative survival of the four groups were analyzed. The Kaplan-Meier method was used for survival analysis, and the Cox proportional hazards regression model was used for multivariate analysis. RESULTS: The median survival time of the 87 patients was 38.747 ± 3.062 mo, and the 1- and 3-year survival rates were 87.5% and 53.1%, respectively. The Cox proportional hazards model showed that the following factors were independent factors affecting prognosis: The degree of tumor differentiation, the number of metastases, the size of metastases, and whether the metastases are close to great vessels. The results of treatment factor analysis showed that the effect of surgical treatment was better than that of drugs, intervention, or ablation alone, and the median survival time was 48.83 ± 4.36 mo. The drug group had the worst prognosis, with a median survival time of only 13.5 ± 0.7 mo (P < 0.05). For patients with liver metastases of CRC near the great vessels, the median survival time (27.3 mo) of patients undergoing surgical resection was better than that of patients using other treatments (20.6 mo) (P < 0.05). CONCLUSION: Patients with a low degree of primary tumor differentiation, multiple liver metastases (number of tumors > 4), and maximum diameter of liver metastases > 5 cm have a poor prognosis. Among drug therapy, intervention, ablation, and surgical treatment options, surgical treatment is the first choice for liver metastases. When liver metastases are close to great vessels, surgical treatment is significantly better than drug therapy, intervention, and ablation alone.

Diagnostic Value of (18)F-FDG PET/CT in Detecting Local Recurrent Colorectal Cancer: A Pooled Analysis of 26 Individual Studies.

Fluorine 18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) has emerged as a new modality for colorectal cancer (CRC) patients. The aim of this meta-analysis was to assess the diagnostic value of (18)F-FDG PET/CT in detecting local recurrence in patients with CRC. We searched PubMed, Medline, Embase, and ISI databases to collect articles in English that evaluated the diagnostic value of (18)F-FDG PET/CT in patients with CRC. Two reviewers independently assessed the methodological quality of each study using the quality assessment of diagnostic accuracy studies tool. The data were analyzed using Meta-Disc (Version 1.4) and Stata (Version 12.0) software. We estimated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC). A total of 26 studies were included. When all the eligible studies included, the pooled sensitivity and specificity for (18)F-FDG PET/CT in detecting CRC were 0.94 (95 % confidence interval [CI] 0.92-0.96) and 0.94 (95 % CI 0.93-0.95), respectively. The pooled PLR and NLR were 14.39 (95 % CI 7.37-28.09) and 0.08 (95 % CI 0.06-0.12), respectively. The DOR was 208.67 (95 % CI 109.56-397.44) and the area under the SROC curve was 0.9776. The overall diagnostic accuracy (Q* index) was 0.9329. (18)F-FDG PET/CT has good diagnostic performance in detecting local recurrence in patients with CRC. Further larger prospective studies are needed to establish its value for detecting local recurrence of CRC cancer patients.

Diagnostic Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Detecting Residual or Recurrent Prostate Cancer After Radical Prostatectomy: A Pooled Analysis of 12 Individual Studies.

The objective of this study is to determine the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) in patients with recurrent or residual prostate cancer (PCa) after radical prostatectomy. Studies were systematically searched in the PubMed, EMBASE, Cochrane library, SCI, CBM, CNKI, VIP, Wan Fang, and other databases. Additional studies were manually searched using the references of the retrieved articles. The retrieved deadline was Sep. 6th, 2014. Selection of eligible studies for inclusion was based on the inclusion and exclusion criteria, and the quality of the studies was reviewed based on the QUADAS criteria. The Meta Disc 1.4 and Stata 12.1 software were used for meta-analysis, and a summary receiver operating characteristic curve was constructed. The patient-based pooled weighted estimates of the sensitivity, specificity, diagnostic odds ratio, and 95 % confidence interval were calculated. Seven articles (12 studies) were included in the meta-analysis. The pooled estimates of the sensitivity, specificity, and the area under the curve were 0.88 (95 % CI 0.84-0.91), 0.87 (95 % CI  0.81-0.92), and 0.9391, respectively. The diagnostic odds ratio (DOR) was 50.4 (95 % CI 26.0-97.6) and Q* was 0.8764. DCE-MRI has high sensitivity and specificity in the evaluation of locally recurrent or residual PCa after radical prostatectomy.

[Clinicopathological characteristics, diagnosis and treatment of Castleman's disease].

OBJECTIVE: To explore the clinicopathological characteristics, diagnosis and treatment of Castleman's disease. METHODS: Seven teen cases of castleman's disease confirmed by surgery and pathology were presented, with the helping of relevant literatures, to discuss its clinical presentation, CT findings, pathology, diagnosis, treatment and prognosis, especially the cases with PNP. RESULTS: There were 10 males and 7 females with an age range of 28-56 years. They were all of local hyaline-vascular types according to histopathology. All cases were cured by surgical resection. CONCLUSIONS: Castleman's disease is a rare lyphoproliferative disorder with giant lymph node hyperplasia. Its diagnosis depends on its histopathological characteristics and clinical manifestations should also be taken into account. Surgical resection is the first choice and other treatments may be effective.

[Computed tomographic diagnosis of intrahepatic cholangiocarcinoma].

OBJECTIVE: To explore the computed tomographic (CT) manifestations and their values in the diagnosis of intrahepatic cholangiocarcinoma (IHC) and improve the understanding of IHC. METHODS: A total of 58 IHC patients confirmed pathologically from January 2006 to December 2012 were reviewed. RESULTS: On plain CT scans, all lesions were of low density with lower density region (n = 37), retraction of liver capsule (n = 11), dilation of intrahepatic biliary duct (n = 22), bile duct calculus (n = 13) and atrophy of liver lobe (n = 14).On enhanced scans, most tumor showed obvious circular enhancement on arterial phase, stripe and network enhancement of internal region on portal phase and obvious enhancement on delayed phase. CONCLUSION: CT manifestations of intrahepatic cholangiocarcinoma are specific for its diagnosis.

Evaluation of sequential inoculation of Saccharomyces cerevisiae and Oenococcus oeni strains on the chemical and aromatic profiles of cherry wines.

The current study was carried out to elucidate the effect of sequential inoculation of Saccharomyces cerevisiae (RC212, D254) and Oenococcus oeni (SG26, Lalvin 31 and Uvaferm Alpha) on the production of cherry wines, especially on the chemical and aromatic characteristics. SI-D culture required the shortest period (23 d) to complete the fermentation, while other inoculations needed longer time. Analysis from chemical composition showed that titratable acidity and content of l-malic acid exhibited evident differences among the samples after MLF. For volatile compounds, 49 major components were identified, mostly comprising of alcohols, acids and esters. Cherry wines obtained from SI-B and SI-C showed higher contents of total volatile alcohols, and SI-D wines produced the greatest amount of volatile acids. According to the odour active value (OAV), 9 out of 49 studied volatile components had OAV >1 in all the analyzed wines, while six volatile components showed OAV >1 only for some of them. Furthermore, a sensory analysis was performed to compare the sensory profile of these cherry wines, and results evidenced that wines resulting from different inoculations presented diverse sensory profiles. These findings suggest that sequential inoculations posed a great potential in affecting and modulating the aromatic profile of cherry wines.

On the local optimal solutions of metabolic regulatory networks using information guided genetic algorithm approach and clustering analysis.

Biological information generated by high-throughput technology has made systems approach feasible for many biological problems. By this approach, optimization of metabolic pathway has been successfully applied in the amino acid production. However, in this technique, gene modifications of metabolic control architecture as well as enzyme expression levels are coupled and result in a mixed integer nonlinear programming problem. Furthermore, the stoichiometric complexity of metabolic pathway, along with strong nonlinear behaviour of the regulatory kinetic models, directs a highly rugged contour in the whole optimization problem. There may exist local optimal solutions wherein the same level of production through different flux distributions compared with global optimum. The purpose of this work is to develop a novel stochastic optimization approach-information guided genetic algorithm (IGA) to discover the local optima with different levels of modification of the regulatory loop and production rates. The novelties of this work include the information theory, local search, and clustering analysis to discover the local optima which have physical meaning among the qualified solutions.

[A study of rat mesenchymal stem cells (MSCs) differentiating into liver cells when co-cultured with rat hepatocytes].

OBJECTIVE: To explore whether rat mesenchymal stem cells (MSCs) can be induced to develop into hepatocytes and the role of the microenvironment of hepatocytes growth in inducing MSCs differentiating into hepatocytes in vitro. METHODS: Mesenchymal stem cells were collected from the aspirates from femurs of SD rats by density gradient centrifugation and identified by flow cytometric analysis and alkaline phosphatase (ALP) staining. Rat hepatocytes were isolated by the modified two-step method described by Seglen. Two 6-well culture plates were piled up after the chambers' bottoms of the upper plate was removed. Then the upper and lower chambers were separated by a semi-permeable membrane. MSCs and hepatocytes of rats were plated separately in the upper and lower chambers of the two 6-well culture plates for co-culturing. MSCs cultured alone without co-culturing with hepatocytes served as controls. On days 1, 3, 7, 14, 21 and 28, mRNA of cytokeratin 18 (CK-18), alpha-fetoprotein (AFP) and albumin were detected by reverse transcriptase-polymerase chain reaction (RT-PCR), and immunocytochemistry staining of CK-18 AFP and albumin were also examined. RESULTS: The shapes of MSCs co-cultured with hepatocytes changed and their sizes and numbers increased in the course of the culturing. When MSCs were co-cultured with hepatocytes for 2 weeks, colonies composed of polygonal cells resembling mature hepatocytes were found. In the controls, shapes of cells also changed and their sizes and numbers increased, but colonies composed of polygonal cells resembling mature hepatocytes were not found. Of the MSCs co-cultured with hepatocytes, on day 7, the mRNA of AFP was detected by RT-PCR, and it increased on day 14, and then decreased on day 21. mRNA of albumin and CK-18 were detected by RT-PCR from day 14 to day 28 in the co-cultured cells, but mRNA of AFP and CK-18 and albumin were not detected in the controls in the course of the culturing. Immunocytochemical analysis for CK-18, albumin, and AFP, showed positive staining reaction for AFP on day 7, for CK-18 and AFP on day 14 in the co-cultured cells but not in the controls. CONCLUSIONS: Rat MSCs co-cultured with hepatocytes can differentiate into hepatocytes.

[Hepatocyte growth factor induces differentiation of adult rat mesenchymal stem cells into a hepatocyte lineage in vitro].

OBJECTIVE: To explore whether the mesenchymal stem cells (MSCs) of rats can be induced into hepatocytes and the condition of differentiation in vitro. METHODS: Mesenchymal stem cells were collected from the femora of SD rats by density gradient centrifugation and identified by flow cytometric analysis and alkaline phosphatase (AKP) staining. MSCs were divided into 4 groups to induce differentiation with the different concentration of hepatocyte growth factor (HGF) in culture medium. The concentration of each group was group A 0 ng/ml, group B 10 ng/ml, group C 20 ng/ml and group D 40 ng/ml, respectively. The morphological changes of MSCs were observed by phase-contrast microscope. On day 1, 3, 7, 14, 21 and 28, mRNA of albumin, AFP and CK18 of MSCs of each group were examined by reverse transcription polymerase chain reaction (RT-PCR), and the expressions of them were also detected with immunohistochemistry technique. RESULTS: Mesenchymal stem cells collected from the femora of SD rats expressed antigens of CD29, CD44 and CD90, but not CD34 and CD45. AKP staining was negative for all of MSCs. On day 7, AFP mRNA of MSCs in group C and D could be detected by RT-PCR, and increased on day 14, and then directed on day 21. Albumin and CK18 mRNA of MSCs in group C and D could also be detected from day 14 to day 28 by RT-PCR. On the contrary, mRNA of AFP, CK18 and albumin was not detected in group A and B of culture. Immunocytochemical analysis for CK18, albumin and AFP showed positive staining reaction for AFP on day 7, for CK18 and albumin on day 14 in group C and D, and negative staining reaction both in group A and B of culture. CONCLUSION: MSCs of adult rats cultured in high concentration of HGF can differentiate into hepatocytes.