Non-suture technique for rabbit oviduct anastomosis with 2-octyl cyanoacrylate: a histopathologic and biomechanical analysis.

AIM: The aim of this study was to investigate histological and biomechanical properties of oviduct anastomosis with 2-octyl cyanoacrylate (OCA) in the rabbit. MATERIAL AND METHODS: Sixty female rabbits were randomly divided equally into three groups: A (control), B (traditional catgut suture), and C (non-suture technique using OCA). After suture or OCA anastomosis, gross examination (adhesion formation) and histopathology (hematoxylin-eosin), ultrastructure (transmission electron microscopy), and biomechanics (bursting pressure) on para-anastomotic site were investigated on oviduct taken at 1 (A1, B1, C1) and 4 (A2, B2, C2) weeks, respectively. RESULTS: Adhesion score in group B was more severe than that in groups A and C at 1 and 4 weeks. Histopathology showed that acute endosalpingitis in group B was the most intense at 1 week, followed by significantly more tissue stimulation induced by catgut and foreign-body giant cells in group B than in group C at 4 weeks. Ultrastructural damage of ciliated cells was reversed partly (B2) and completely (C2) at 4 weeks. Bursting pressure in C1 was weaker than that in B1, followed by no significant difference at 4 weeks. CONCLUSION: Non-suture using OCA for oviduct anastomosis can be accepted as a new-perspective technique.

[Expression of survivin, bcl-2 in cervical carcinoma and its association with HPV16/18 infection].

OBJECTIVE: To investigate the expression and the correlation of surviving, bcl-2 and HPV16/18 in cervical carcinoma. METHODS: Hybridization in situ was used to detect the expression of survivin mRNA and HPV16/18 DNA in 74 cases of CIN and 81 cases of cervical carcinoma and 20 cases of normal cervical tissues. And immunohistochemical analysis was used to detect the expression of bcl-2 protein. RESULTS: The positive rates of survivin mRNA, bcl-2 and HPV16/18 in CIN were 44.6%, 39.2% and 41.0% respectively versus 77.8%, 70.4% and 81.2% in cervical carcinoma. The above three indices gradually rose in normal cervical tissue, CIN and cervical carcinoma. The expression of survivin and bcl-2 in CINIII were obviously higher than those in CINI/II. And it was obviously higher in cervical carcinoma with stage IIb-III than those in stage I-IIa. And it was also obviously higher in cervical carcinoma with a poor differentiation than those with a good or medium differentiation. The expression of survivin in cervical carcinoma with lymphatic metastasis was significantly higher than that without lymphatic metastasis. There were no relationship between the expression of survivin or bcl-2 and the pathological type or tumor type of cervical carcinoma. The infection of HPV16/18 also had nothing to do with the clinical stage or pathological type or tumor type of cervical carcinoma. Inverse correlation was both observed in the expression of survivin and bcl-2 with survival rate. Thus a positive correlation between surviving, bcl-2 and HPV 16/18 was observed in cervical carcinoma. CONCLUSION: Survivin, bcl-2 and HPV16/18 participate in the development of cervical carcinoma. It may be a useful guide in early diagnosis of cervical carcinoma, evaluation of surgery and chemotherapy and prediction of outcome.

Coexpression of VEGF-C and COX-2 and its association with lymphangiogenesis in human breast cancer.

BACKGROUND: Lymphangiogenesis has become a new research frontier in tumor metastasis since the discovery of reliable lymphatic markers that have allowed observation and isolation of lymphatic endothelium. Cyclooxygenase-2 (COX-2) has been reported to be involved in the critical steps in carcinogenesis. However, possible role of COX-2 in lymphangiogenesis and lymphatic metastasis is still poorly understood. In present study, we aimed to investigate the relationship between vascular endothelial growth factor-C (VEGF-C) and COX-2 in human breast cancer, and correlations with lymphangiogenesis and prognosis. METHODS: Tissue samples of primary tumors from 70 patients undergoing intentionally curative surgical resections for breast cancer were immunohistochemically examined for VEGF-C, COX-2, and D2-40 expressions. The association between COX-2 and VEGF-C expressions and clinicopathological parameters as well as prognosis were analysised. To demonstrate the presence of proliferating lymphatic endothelial cells, 10 random cases with high LVD counts were selected for D2-40/Ki-67 double immunostaining. RESULTS: A significant correlation was found between the expression of VEGF-C and COX-2 (r = 0.529, P < 0.001), and both elevated VEGF-C expression and elevated COX-2 expression were associated with higher lymph vessel density (LVD), lymph node metastasis and D2-40 positive lymphatic invasion (LVI) as well as worse disease free survival (DFS) and overall survival (OS) in a univariate analysis. In the double immunostain for the lymph vessel marker D2-40 and the proliferation marker Ki-67, the results confirmed Ki-67-positive nuclei in a proportion of lymph vessel endothelial cells. CONCLUSION: There is indeed lymphangiogenesis in breast cancer, the most compelling evidence being the presence of proliferating lymphatic endothelial cells. VEGF-C and COX-2 are coexpressed and significantly associated with lymphangiogenesis and prognosis in invasive breast cancer. Suggesting COX-2 may up-regulate VEGF-C expression and thus promote lymph node metastasis via lymphangiogenesis pathway in human breast cancer.

Simple instruments facilitating achievement of transanal total mesorectal excision in male patients.

AIM: To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS: A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform taTME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated. RESULTS: All 115 patients had successful sphincter preservation. The operative time in group B (240 min, range: 160-330 min) was significantly shorter than that in group A (280 min, range: 200-360 min; P = 0.000). Compared with group A, more complete distal mesorectum and total mesorectum were achieved in group B (100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo follow-up, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant (5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION: Retrograde taTME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors.

Overexpression of salusin-ß is associated with poor prognosis in ovarian cancer.

Ovarian cancer is recognized as one of the worst gynecologic malignancies associated with rapid metastasis and poor overall survival rate. The identified valuable molecular biomarkers criticize importance of timely diagnosis for ovarian cancer. Salusin-ß levels are dramatically increased in women with polycystic ovarian syndrome. However, the roles of salusin-ß in ovarian cancer have yet to be fully elucidated. A total of 57 paired ovarian cancer specimens and matched adjacent normal tissues were used to measure the salusin-ß levels. The prognostic value of salusin-ß for tumor progression and survival rate was investigated. The effects of salusin-ß on ovarian cancer cell proliferation and epithelial-mesenchymal transition were also explored. The expression of salusin-ß was significantly increased in ovarian cancer tissue specimens compared with matched normal adjacent tissue (P<0.05). The high salusin-ß level was closely related with FIGO stage and lymph node metastases. The ovarian cancer patients with high salusin-ß had a shorter overall survival (P<0.05). Salusin-ß obviously enhanced the proliferation and epithelial mesenchymal-transition of SKOV3 cells. Furthermore, salusin-ß substantially decreased the expression of p-GSK-3ß and GSK-3ß, but stimulated the ß-catenin expression and downstream genes of wnt/ß-catenin including cyclin D1 and C-myc. Our data demonstrated for the first time that upregulated salusin-ß may be a novel independent prognostic biomarker for overall survival of ovarian cancer. Salusin-ß accelerated the proliferation and epithelial mesenchymal transition of ovarian cancer cells at least partly via activation of Wnt/ß-catenin signaling pathway. Salusin-ß may be an important target for therapeutic intervention in ovarian cancer.