[Clinical study on preserving right gastroepiploic vein during laparoscopic right hemicolectomy].

Objective: The operative approach and steps of laparoscopic right hemicolon cancer radical resection have been standardlized and professional consensus has been reached. However, some detailed issues such as the handling of Henle's trunk and whether to preserve the right gastroepiploic vein (RGEV) still remain controversial. This study investigates the safety, feasibility, short- and long-term outcomes of preserving RGEV during laparoscopic right hemicolectomy. Methods: A retrospective cohort study was carried out. Clinical data of 92 patients undergoing laparoscopic right hemicolectomy in Taizhou People's Hospital from March 2016 to May 2018 were retrospectively analyzed. All the patients were treated with complete mesocolon resection (CME) and had complete postoperative pathological data and follow-up data. Based on the tumor location, 49 patients preserved RGEV (preservation group) and 43 did not (non-preservation group). Pathological data, postoperative complications, short- and long-term outcomes were compared between the two groups. Results: There were no significant differences in baseline data between the two groups (all P>0.05). No significant differences were found in operation time, intraoperative blood loss, unplanned reoperation, anastomotic leak, number of harvested lymph nodes, number of metastatic lymph node, and time to food intake after surgery between two groups (all P>0.05). Compared with non-preservation group, the preservation group had faster recovery of anal gas passage after operation [(3.1±1.0) days vs. (4.0±1.7) days, t=-2.787, P=0.007], shorter length of hospitalization [(11.5±1.5) days vs. (15.0±7.9) days, t=-2.823, P=0.007], and reduced the hospitalization expenses [(46 000±5000) yuan to (57 000±33 000) yuan, t=-2.076, P=0.044]. No postoperative gastroparesis (PGS) occurred in the preservation group, while 6 cases in the non-preservation group developed gastroparesis during perioperative period (P<0.05). The median time of follow-up time was 31.8 (5.2-43.7) months. The overall survival time of the preservation group and non-preservation group was (35.4±1.8) months and (37.6±1.7) months, respectively without significant difference (P=0.336); the disease-free survival was (32.0±2.2) months and (35.5±2.0) months, respectively without significant difference as well (P=0.201). Conclusions: Dissection of the Henle's truck and preservation of RGEV is safe and feasible during laparoscopic right hemicolectomy, which can significantly reduce the incidence of postoperative gastroparesis, shorten the recovery time of postoperative intestinal function and hospitalization, and decrease the cost of hospitalization. The efficacy of RGEV preservation is similar to non-preservation of RGEV.

New taxane analogues from the needles of Taxus canadensis.

Eight minor taxanes have been identified for the first time in Taxus canadensis needles. Four of these metabolites are new taxane analogues: 7-acetyl-10-deacetyltaxol (1), 2'-acetyl-7-epi-cephalomannine (2), 10-deacetyl-10-oxo-7-epi-cephalomannine (3), and 10-acetylglycollylbaccatin VI (4).

Heregulin selectively upregulates vascular endothelial growth factor secretion in cancer cells and stimulates angiogenesis.

The interaction between the erbB tyrosine kinase receptors and their ligands plays an important role in tumor growth via the regulation of autocrine and paracrine loops. We report the effect of heregulin beta1, the ligand for erbB-3 and erbB-4 receptors, on the regulation of vascular endothelial growth factor (VEGF) expression, using a panel of breast and lung cancer cell lines with constitutive erbB-2 overexpression or engineered to stably overexpress the erbB-2 receptor. We demonstrate that heregulin beta1 induces VEGF secretion in most cancer cell lines, while no significant effect was observed in normal human mammary and bronchial primary cells. Overexpression of erbB-2 receptor results in induction of the basal level of VEGF and exposure to heregulin further enhances VEGF secretion. This is associated with increased VEGF mRNA expression. In contrast, VEGF induction is significantly decreased in a T47D cell line where erbB-2 is functionally inactivated. Conditioned media from heregulin-treated cancer cells, but not from normal cells, stimulates endothelial cell proliferation; this paracrine stimulation is inhibited by co-exposure to a specific VEGF neutralizing antibody. Furthermore, heregulin-mediated angiogenesis is observed in the in vivo CAM assay. This study reports the first evidence of VEGF regulation by heregulin in cancer cells. Oncogene (2000) 19, 3460 - 3469

Dual effect of erbB-2 depletion on the regulation of DNA repair and cell cycle mechanisms in non-small cell lung cancer cells.

Overexpression of the erbB-2 tyrosine kinase receptor, p185erbB-2, is a common alteration in non-small cell lung cancer (NSCLC) and has been associated with poor prognosis and a tumor drug resistance phenotype. In this study, we have examined the consequences of erbB-2 depletion on DNA repair, cell cycle, and apoptosis using a panel of NSCLC cell lines constitutively overexpressing erbB-2 receptor. Depletion of the erbB-2 was achieved using the tyrosine kinase inhibitor CP127,374 which promotes erbB-2 degradation. Treatment with CP127,374 concentrations which deplete erbB-2 and inhibit tyrosine phosphorylation resulted in downregulation of DNA repair mechanisms and cell accumulation at G1 phase of the cell cycle. GI arrest was observed in cells with mutated p53 as well as cells lacking p53 protein, suggesting a p53-independent mechanisms. NSCLC cells which overexpress erbB-2 were more resistant to cisplatin-induced cytotoxicity in comparison to cells expressing low levels of erbB-2. Treatment with CP127,374 alone did not result in any induction of apoptosis. A combination of CP127,374 and cisplatin, however, was more potent in cell growth inhibition and induction of apoptosis compared to treatment with cisplatin alone. Together, our results further support a pivotal role of erbB-2 signaling in the regulatory balance between DNA repair, cell cycle checkpoints and apoptosis; all these mechanisms are essential determinants for tumor cell destiny following chemotherapy stress.

Regulation of cellular response to cisplatin-induced DNA damage and DNA repair in cells overexpressing p185(erbB-2) is dependent on the ras signaling pathway.

We have examined the role of erbB-2 expression in the modulation of cellular toxicity to cisplatin. We have demonstrated that treatment of NIH3T3-erbB-2 cells, which overexpress the p185(erbB-2) product of the human erbB-2 gene, with a monoclonal antibody directed against the extracellular domain (TAb-250), results in enhanced cisplatin cytotoxicity. A similar enhancement was obtained when cells were exposed to herbimycin A and its analogue CP127 374, both of which inhibit tyrosine kinase activity. Using the host cell reactivation (HCR) of reporter gene expression from cisplatin-damaged plasmid and unscheduled DNA synthesis (UDS) following cisplatin treatment of cells, we have found that modulation of erbB-2 by TAb-250 was associated with inhibition of DNA repair. TAb-250 alone, under conditions which modulate DNA repair, slightly reduces the S-phase of the cell cycle, while cisplatin induced arrest at S and G2 phases. Combination of TAb-250 and cisplatin only slightly prevented cisplatin-induced S and G2 blocks. Since the ras pathway is one of the major signaling components coupled to erbB-2, we have examined the role of ras in DNA repair regulation. Transient expression of a ras dominant negative mutant, Asn-17-ras(H), prevents DNA repair modulation by TAb-250, suggesting that the erbB-2 receptor regulates DNA repair mechanism(s), at least in part, through ras-coupled pathway(s).