Endoscopic submucosal dissection treatment of metachronous early gastric adenocarcinoma in a case with diffuse large B-cell lymphoma.

Cases of primary gastric lymphoma complicated with gastric adenocarcinoma are rare in clinical practice. We report a case of metachronous early gastric adenocarcinoma diagnosed eight years after the onset of gastric diffuse large B-cell lymphoma (DLBCL) and treated with endoscopic submucosal dissection (ESD).

Protective effects of organic extracts of Alpinia oxyphylla against hydrogen peroxide-induced cytotoxicity in PC12 cells.

Alpinia oxyphylla, a traditional herb, is widely used for its neuroprotective, antioxidant and memory-improving effects. However, the neuroprotective mechanisms of action of its active ingredients are unclear. In this study, we investigated the neuroprotective effects of various organic extracts of Alpinia oxyphylla on PC12 cells exposed to hydrogen peroxide-induced oxidative injury in vitro. Alpinia oxyphylla was extracted three times with 95% ethanol (representing extracts 1-3). The third 95% ethanol extract was dried and resuspended in water, and then extracted successively with petroleum ether, ethyl acetate and n-butanol (representing extracts 4-6). The cell counting kit-8 assay and microscopy were used to evaluate cell viability and observe the morphology of PC12 cells. The protective effect of the three ethanol extracts (at tested concentrations of 50, 100 and 200 µg/mL) against cytotoxicity to PC12 cells increased in a concentration-dependent manner. The ethyl acetate, petroleum ether and n-butanol extracts (each tested at 100, 150 and 200 µg/mL) had neuroprotective effects as well. The optimum effective concentration ranged from 50-200 µg/mL, and the protective effect of the ethyl acetate extract was comparatively robust. These results demonstrate that organic extracts of Alpinia oxyphylla protect PC12 cells against apoptosis induced by hydrogen peroxide. Our findings should help identify the bioactive neuroprotective components in Alpinia oxyphylla.

Bile acids promote gastric intestinal metaplasia by upregulating CDX2 and MUC2 expression via the FXR/NF-κB signalling pathway.

Bile acids serve a critical role in the induction of gastric intestinal metaplasia (IM) and gastric carcinogenesis. The present study investigated the effects of bile acids on the induction of gastric IM formation. The results demonstrated that the expression levels of caudal­related homeobox transcription factor 2 (CDX2), mucin 2 (MUC2) and farnesoid X receptor (FXR) were increased in vitro and in vivo following treatment with bile acids, and CDX2 transcriptionally activated MUC2 expression. Furthermore, knockdown of FXR attenuated bile acid­enhanced CDX2 promoter activity and protein expression. Conversely, the FXR agonist GW4064 synergistically enhanced bile acid­induced CDX2 promoter activity. Bile acid treatment led to an increase in nuclear factor (NF)­κB activity and protein expression. Treatment with GW4064 or the FXR antagonist Z­guggulsterone enhanced or attenuated bile acid­induced NF­κB activity, respectively. In addition, quantitative chromatin immunoprecipitation confirmed that bile acids led to enhanced binding of p50 to the CDX2 promoter, whereas this effect was not observed for p65. Treatment with GW4064 or Z­guggulsterone enhanced and attenuated the binding activity of p50 to the CDX2 promoter, respectively. These results indicated that bile acids may activate the FXR/NF­κB signalling pathway, thereby upregulating CDX2 and MUC2 expression in normal gastric epithelial cells.

[Lynch Syndrome:Report of One Case and Literature Review].

This article reports a female type Ⅱ Lynch syndrome patient who suffered from colon cancer and endometrium carcinoma consecutively. We also briefly elucidate the pathogenesis,clinicopathological features,screening,and management of Lynch syndrome. Regular screening and early diagnosis and treatment may help to reduce the incidences and mortality rates of tumors associated with Lynch syndrome.

[Expressions of FOXC1 and MMP-7 in molecular subtypes of breast cancer and their association with clinicopathological characteristics].

OBJECTIVE: To investigate the expressions of FOXC1 and matrix metalloproteinase 7 (MMP-7) in different molecular subtypes of breast cancer and their association with clinicopathological characteristics of the disease. METHODS: Based on immunohistochemical results of ER, PR, HER2, CK5/6, CK14 and EGFR, 105 breast cancer patients were classified as 4 subtypes: luminal, HER2 positive, basal-like subtype (BLs) and normal breast-like subtype (NBLs). The association of FOXC1 and MMP-7 expressions with clinicopathological parameters in different molecular subtypes was analyzed. RESULTS: Out of 105 patients with breast cancer, the subtypes of luminal, HER2 positive, BLs and NBLs accounted for 52.4% (55/105), 16.2% (17/105), 17.1%(18/105) and 14.3% (15/105), respectively. Patients with luminal and/or NBLs subtypes had significantly higher 5-year survival rate than those with HER2 positive and/or BLs did (log-rank=22.161, P<0.01). The overall positive expression rate of FOXC1 was 26.7% (28/105) and the expression was higher in BLs patients than that in other subgroups (χ²=30.108, P<0.01). The expression of FOXC1 was correlated with histological grade, tumor size, distant metastasis and 5-year survival rate of breast cancer. The overall positive expression rate of MMP-7 was 67.6% (71/105) and the expression of MMP-7 was also higher in BLs patients than that in other molecular subtypes (χ²=11.328, P<0.05). The positive expression of MMP-7 was correlated with metastasis in ipsilateral axillary lymph nodes, distant metastasis and 5-year survival rate of the patients. FOXC1 was correlated with MMP-7 (r=0.325, P<0.01). CONCLUSION: Patients with luminal and/or NBLs breast cancer have more favorable prognosis than those with HER2 positive and/or BLs subtypes. The expressions of FOXC1 and MMP-7 are closely correlated with the clinicopathological features of breast cancer patients.

An uncommon malignant cutaneous squamomelanocytic tumor.

The intermingling of two malignant neoplasms within the same cutaneous tumor is rare. No consensus has been reached for a clear definition and categorization. In the current study, we describe a cutaneous neoplasm; a squamomelanocytic tumor (SMT) with histological features combining those of a squamous cell carcinoma (SCC) and a malignant melanoma (MM). This is the second report of an oculocutaneous SMT, and concerns a subject with a 20-year history of solar lentigo coexisting with solar keratosis in the primary lesion. This type of tumor is quite rare, with a distinct cytological architecture and immunohistochemical features, and the differential diagnosis of SMT may be considered. However, the histogenesis, biological behavior and malignant potential of SMTs remain a matter of speculation. With regard to the treatment, complete surgical resection and close follow-up are recommended.

Roux-en-Y choledochojejunostomy using novel magnetic compressive anastomats in canine model of obstructive jaundice.

BACKGROUND: The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated, and the incidence of postoperative complications has remained high. A set of novel magnetic compressive anastomats was introduced to facilitate choledochojejunostomy and improve the prognosis of patients. METHODS: After ligating the common bile duct for 7 days, 16 dogs were randomly divided into two groups (n=8 per group). Anastomats were used in the study group, and the traditional hand-sewn method was used in the control group for standard Roux-en-Y choledochojejunostomy. We compared the operation time, incidence of complications, gross appearance, and pathological disparity in stoma between the two groups in 1-month and 3-month follow-up examinations. RESULTS: The time spent on constructing the anastomosis for the study group was significantly shortened. Although no anastomotic stenosis occurred in the two groups, the narrowing rate of biliary-enteric anastomosis was much higher in the control group. There was one case of bile leakage in the control group, whereas no bile leakage occurred in the study group. A smoother surface, an improved layer apposition, and a lower local inflammatory response were identified in the anastomosis of the study group. CONCLUSION: The structures of the novel magnetic compressive anastomats are simple, and they are time-saving, safe and efficient for performing Roux-en-Y choledochojejunostomy procedures in a canine model of obstructive jaundice.

[Clinicopathological analysis and differential diagnosis of primary peritoneal adenocarcinoma].

OBJECTIVE: To investigate the clinicopathological characteristics and differential diagnosis of primary peritoneal adenocarcinoma. METHODS: The clinico-pathological data of 8 patients with primary peritoneal adenocarcinoma, all female, aged 55.7 (45 - 69), were analyzed retrospectively. Immunohistochemistry was used to detect the expression of pan-cytokine, cytokine (CK) 7, CK20, CA125, CEA, epithelial membrane antigen (EMA), vimentin, calretinin, and P63 in the specimens of tumor obtained during tumor reduction surgery. Microscopy was conducted for pathological examination. RESULTS: The common clinical symptoms of these 8 patients included abdominal distention and ascites. Pre-operationally, 6 cases were diagnosed as with ovarian cancer, I case as with malignant mesothelioma, and I as with peritoneal carcinoma. The misdiagnosis rate was 87.5%. Post-operational pathological examination showed 7 cases of serous papillary adenocarcinoma and one case of mucinous adenocarcinoma. Immunohistochemistry showed the positive rates of the different biological markers as follows: pan-CK (8/8), CK7 (8/8), CK20 (1/8), CA125 (7/8), CEA (7/8), EMA (8/8), vimentin (1/8), calretinin (1/8), and P53 (8/8). CONCLUSION: A rare malignant tumor arising from the secondary Müllerian system, primary peritoneal adenocarcinoma shares similar histopathological characters with ovary carcinoma, so is easy to be misdiagnosed. Immunohistochemical staining is helpful to the differential diagnosis.