Objective To explore the expression of matrix metalloproteinase （MMP）-2 in patients with papillary thyroid cancer （PTC） recurrence or residuum and its value of clinical application. Methods The serums from 68 patients with thyroid disease underwent operation and 15 health examinations under stomachs empty from March 2009 to December2009 in this hospital were gathered. Sixty-eight patients with thyroid disease were divided into PTC with lymph node metastasis （LNM） group （n=19），PTC recurrence or residuum with LNM group （n=17），PTC without LNM group （n=10），and benign thyroid disease group （n=22） according to the postoperative pathological findings，15 health examinations as control group. The expression of MMP-2 of serum sample was detected by ELISA method. The difference of the expression of MMP-2 in each group was analyzed. Results The expressions of MMP-2 in the PTC recurrence or residuum with LNM group，PTC with LNM group，PTC without LNM group， benign thyroid disease group，and the control group were （1 724.00±762.24） ng/ml，（1 329.16±776.59） ng/ml，（1 489.61±546.53） ng/ml，（1 264.87±817.27） ng/ml，and （608.43±88.63） ng/ml，respectively. The expressions of MMP-2 in the PTC with LNM group and PTC recurrence or residuum with LNM group were significantly higher than those in the benign thyroid disease group （P＜0.05） and the control group （P＜0.05），respectively，which in the PTC without LNM group was significantly higher than that in the control group （P＜0.05）. There was no significant difference of MMP-2 expression of serum between the benign thyroid disease group and the control group （P＞0.05），which were no significant difference among the other threemalignant disease groups （P＞0.05）. The MMP-2 positive expression rates were 79%，76%，80%，41%，and 20% in the PTC with LNM，PTC recurrence or residue with LNM group，PTC without LNM group，benign thyroid disease group，and control group，respectively. The MMP-2 positive expressions rates of serums were not significantly different among three malignant disease groups （P＞0.05），but which were significantly higher than those of the benign thyroid disease group （P＜0.01） and control group （P＜0.01），respectively. Conclusions The MMP-2 level of serum can be used as an index to judge preoperative thyroid nodules，which can not be use to determine whether PTC metastasis or not.
Objective To investigate the expression of cerb B2 and CathepsinD in gastric carcinoma and its correlation with the biological behavior of gastric carcinoma (GC). MethodsThe expression was studied by immunohistochemical technique. The expression of cerb B2 and CathepsinD were analyzed with their relation to histologic types, depth of invasion, growth pattern, lymph node metastasis and prognosis of gastric carcinoma. ResultsThirtynine of the 102 gastric carcinoma specimens (38.24%) were positive for cerb B2 and correlated with depth of invasion (P＜0.05) and lymph node metastasis (P＜0.05); eightythree of the 102 gastric carcinoma specimens (81.37%) were positive for CathepsinD and correlated with depth of invasion (P＜0.05), growth pattern (P＜0.05), lymph node metastasis (P＜0.05) and blood vessels cancer embolus (P＜0.05). Prognosis of patients with gastric carcinoma with positive expression of cerb B2 or CathepsinD was poor. The 5year survival rate was significantly lower in gastric carcinoma patients with positive expression of cerb B2 or CathepsinD. Conclusion cerb B2 and CathepsinD are highly related to growth, invasion, metastasis and prognosis of gastric carcinoma.
Objective To explore the value of multidetector row helical CT （MDCT） in the diagnosis of lymph node metastasis in adenocarcinoma of esophaogastric junction （AEG）， and to study the pattern of lymph node metastasis of it. Methods The MDCT images of 60 patients with AEG who underwent operation in our hospital from Jan. 2011to Oct. 2012 were collected， in order to explore the value of MDCT in the diagnosis of lymph node metastasis in AEG， and to study the pattern of lymph node metastasis of it. Results With diameter upper 8 mm and the difference of the mean value of enhanced degree upper 70 Hu as the standard of lymph node metastasis， the Kappa value （0.819 and 0.718），sensitivity （83.1% and 91.8%）， and specificity （78.9% and 83.5%） were all optimal. The lymph node metastasis rate was significantly higher in serosa invasion group than those of non-invasion group （P＜0.05）. The metastatic area of lymphnodes mainly concentrated around cardia （No. 7， 8， and 9 group）， lesser curvature of the stomach， celiac axis， and hepato-gastric ligament （No. 10， 11， 12， and 14 group） with the metastasis rate of 83.8% and 82.3%， respectively. Conclusion MDCT is useful to confirm the features， location， and rules of lymph node metastasis in patients with AEG， which is helpful in accurately cleaning the lymph nodes.
ObjectiveTo investigate the value of diffusion weighted imaging (DWI) combined with three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma. MethodsFrom July 2009 to March 2011, DWI examination was performed in 37 patients with hilar cholangiocarcinoma, which was compared with 3D-VIBE sequences. The morphological characteristics and distribution were analyzed for metastatic and nonmetastatic lymph nodes. Signal intensity (SI) was measured on DWI images and apparent diffusion coefficient (ADC) was calculated for each lymph node. The SI of lymph nodes (SILN） and liver (SIliver) were also measured and the ratio of SI was calculated. The ADC and the ratio of SI were compared between metastatic and nonmetastatic lymph nodes. ResultsThere were fifty-nine groups of lymph nodes in 37 patients with hilar cholangiocarcinoma, fifty-one groups were revealed in both DWI and 3D-VIBE sequences, and eight groups were only demonstrated in one sequence (P=0.070). The short diameters were (1.05±0.42) cm and (0.78±0.22) cm on 3D-VIBE images for metastatic and nonmetastatic lymph nodes, respectively (P=0.030). The ADC value in metastatic lymph nodes was (1.64±0.3)×10-3 mm2/s, which was significantly lower than that in nonmetastatic lymph nodes 〔(2.28±0.79)×10-3 mm2/s〕 on DWI images (P=0.033). There were no significant differences in SILN/SIliver between metastatic and nonmetastatic lymph nodes on images of portal venous phase and 3 min delayed contrast-enhanced phase. ConclusionsDifferences of ADC and short diameter can provide valuable information to differentiate metastatic lymph nodes with nonmetastatic lymph nodes. When combined with 3D-VIBE sequence, DWI is more effective in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma.
Objective To study the expression of CD133 mRNA in peripheral blood mononuclear cells （PBMCs） of patients with gastric adenocarcinoma （GC） before operation or after operation and its clinical significance. To learn the relationship of CD133 expressions in PBMCs to primary lesion of GC. Methods Fifty patients with GC，10 patients with gastric ulcer （GU）， and 10 healthy volunteers were registered in this research. Expressions of CD133 mRNA in PBMCs and in primary lesion of GC by semi-quantitative RT-PCR and expression of CD133 protein in primary lesion of GC by immunohistochemical staining were detected. Correlations of CD133 mRNA expression with clinicopathologic parameters and postoperative survival rate were analyzed. Relation between CD133 mRNA level and CD133 protein expression or lymphatic metastasis were assessed too. Results The brightness scale value （ABSV） of CD133 mRNA in PBMCs of the patients with GC before operation （0.270±0.163） was higher than that in the healthy volunteers （0.029±0.060） or in the patients with GU （0.059±0.099） （P=0.000）. The ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related to poor cell differentiation （P=0.002）， lymph vessel invasion （P=0.028），deeper tumor invasion （P=0.041），later lymph node metastasis stage （P=0.010），later TNM stage （P=0.006），and positive expression of CD133 protein in the primary lesion （P=0.011）. Relative analysis revealed that the ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related positively to metastatic lymphatic nodes ratio （rs=0.422，P=0.002），metastatic lymph node number （rs=0.398，P=0.004），and ABSV of CD133 mRNA in the primary lesion of GC （rs=0.337，P=0.017）. The ABSV of CD133 mRNA in the PBMCs of patients with GC after operation obtained from blood sample at 1 week after curative resection was higher than that in the patients before operation （P=0.021）. Patients suffered from deeper invasion inclined to have a higher ABSV of CD133 mRNA after surgery （P=0.039）. Higher expression of CD133 mRNA in patients after operation demonstrated a much poorer survival rate （P=0.013）. Conclusions Higher expressive level of CD133 mRNA in GC before operation is associated to poor cell differentiation，lymph vessel invasion，deeper invasion，higher lymph node metastasis，later TNM stage，and positive expression of CD133 protein. It is also related positively to metastatic lymphatic nodes ratio，metastatic lymph node number，and ABSV of CD133 mRNA in primary lesion of GC. The level of CD133 mRNA in PBMCs of patients with GC is higher after operation as compared with before operation，which demonstrates deeper invasion and poorer survival.
Objective To explore the expression of chemokine receptor CCR7 in thyroid papillary microcarcinoma tissues and the relationship with clinicopathological features. Methods The CCR7 expressions in 31 cases of thyroid papillary microcarcinoma, 34 cases of thyroid papillary carcinoma which diameter＞1cm, 34 cases of nodular goiter, and 12 cases of thyroid papillary microcarcinoma contralateral normal thyroid tissues were detected by using immunohistochemistry S-P method. Results The expression positive rates of CCR7 in thyroid papillary microcarcinoma and papillary thyroid carcinoma which diameter＞ 1cm were both 100%, the difference had not statistically significant （P＞0.05）. In nodular goiter and normal thyroid tissues, the expression positive rate of CCR7 was 64.7% and 33.3%, respectively, and compared with thyroid papillary microcarcinoma, the difference had statistically significant （P＜0.05）. There were not relations between the expression of CCR7 and patient’s gender, age, capsule invasion, and lymph node metastasis （P＞0.05）. Conclusions The CCR7 in thyroid papillary microcarcinoma and thyroid papillary carcinoma which diameter＞ 1cm are both high expressions, and have the same bionomics, both prone to cervical lymph node meta-stasis, and the radical neck dissection （central area） are both need to take.
Objective To assess the applied significance of carbon nanoparticles in central compartment lymph node dissection in treatment of cN0 papillary thyroid carcinoma. Methods Sixty-eight patients with cN0 papillary thyroid carcinoma who were treated in Tongji Hospital of Tongji Medical College from May. to Oct. in 2012 were randomly allocated to the control group （n=32） and the carbon nanoparticles trace group （tracer group， n=36）， receiving non-carbon nanoparticles trace and carbon nanoparticles trace respectively. All patients were received total resection of thyroid plus the affected side and （or） contralateral side central compartment lymph node dissection. The lymph node-related indexes（including number of dissected lymph node at Ⅵarea and lymph node metastasis rate at Ⅵarea） and operative indexs （including operation time， blood loss， drainage time， complication， and hospital stay） were collected and compared between the 2 groups. Results There were 205 and 324 dissected lymph node at central compartment in control group and tracer group respectively. The results of postoperative pathology showed that the number of lymph node in central compartment of the tracer group was much more than those of control group （8.99±2.24 vs. 6.41±1.56， P＜0.001）. The metastasis rate of central compartment lymph node were 40.6% （13/32） in control group and 47.2% （17/36） in tracer group， but there was no significant difference between the 2 groups （P=0.762）. But in medial area of laryngeal recurrent nerve， the metastasis rate in the tracer group （38.9%， 14/36） was much higher than those of control group （12.5%， 4/32）， P=0.029. There were no significant differences in the operation time， blood loss， drainage time， hospital stay， and complication incidence such as bleeding， temporary hypocalcemia， and injury of superior laryngeal nerve between 2 groups （P＞0.05）. All the patients in 2 groups had followed-up for 6 months without death， recurrence， and metastasis.Conclusions The lymphatic tracer technique of carbon nanoparticles may improve the number of dissected lymph nodes in central region of cN0 papillary thyroid carcinoma， without increasing （or prolonging） operation time， intraoperative blood loss， and postoperative hospital stay， and can accurately represent the metastasis of lymph node， thus to make the staging of the tumor accurately and guide postoperative treatment.
Objective
To investigate the expression and prognostic value of vascular endothelial growth factor receptor 3 (VEGFR-3) in human breast cancer.
Methods
A tissue microarray containing cores was constructed from 173 female patients with primary breast cancers (experimental group) and 19 female patients with benign breast lesions (control group) between March 2004 and June 2007. HE staining was performed to determine the quality of tissue microarray and immunohistochemistry staining was used to detect VEGFR-3 expression in the tissue microarray. Statistical analysis was performed to show the association between VEGFR-3 expression and clinicopathologic parameters.
Results
Histological examination showed that the tissue microarray had good quality, which could represent the histological characteristics of breast cancer and benign breast lesions. VEGFR-3 was expressed in 55.5% (96/173) breast cancer patients of experimental group, while the expression was negative in lesions of control group. VEGFR-3 expression rate had no significant relation with age, estrogen receptor, and progesterone receptor (P gt; 0.05). VEGFR-3 expression rate correlated positively with tumor size and pathological staging compared to VEGFR-3 negative tumors (P lt; 0.05). The positive expression rate of VEGFR-3 in breast cancer with lymph node metastasis was significantly higher than that without lymph node metastasis (P lt; 0.05). Furthermore, VEGFR-3 positive staining correlated with human EGF receptor 2 expression (P lt; 0.05).
Conclusion
The expressions of VEGFR-3 in human breast cancer have close relations with lymph node metastasis. Thus, VEGFR-3 may be a potential prognostic indicator and a new anti-cancer target for breast cancer.
Objective To study the relationship between early gastric cancer and MiB-1 expression. Methods Resected early gastric cancer from 99 cases were studied by immunohistochemical method. Results MiB-1 proliferation index (MiB-1 PI) was related to patient ’s age, tumor size, location and depth of invasion. MiB-1 PI was higher in differentiated adenocarcinomas than in undifferentiated adenocarcinomas(P＜0.01). Cancers with lymphatic vessel invasion or lymph node metastasis had higher MiB-1 PI (P＜0.05). The postoperative survival was related to MiB-1 proliferation grade (MiB-1 PG), being higher in MiB-1 PG 1,2 grade than that in MiB-1 PG 3,4 grade. Conclusion Even in the early stage of gastric cancer, tumor proliferation activity was related to patients’ prognosis.
To investigate the relationship between clinicopathological features and lymph node metastasis in the primary gastric cancer and affer the basis for deciding appropriate extent of lymph node dissection, a total of 192 patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Result: The total rate of lymph node metastasis was 60.4%, with 28.9% of the resected lymph nodes involved. The lymph node metastasis of C, M, A region and the whole stomach were 64.6%, 57.7%, 59.1% and 90.9% respectively. The rates of the lymph node metastasis increased successively in carcinoma of early, middle and late stages (Ｐ＜0.05), the rate of the infiltrative tumor (Borr Ⅲ，Ⅳ) being 76.5% which was significantly higher than that of the circumscribed tumor (Borr Ⅰ，Ⅱ) (43.2%)。 Relating with the tumor size ＜4cm in diameter showed lesser rate, while 4-8 cm and ＞8cm in diameter showed increasingly higher metastaticrate (Ｐ＜0.01). As a result, we should decide the appropriate extent of lymph node dissection during the operation on the basis of clinicopathological stages, type of Borrmann’s, site and maximum diameter of gastric cancer along with the state of lymph node metastasis in carcinoma of different region of the stomach.
