ObjectiveTo explore the correlation between multiple clinicopathologic factors and perineural invasion in patients with pancreatic carcinoma.MethodsThe clinical data of 90 patients with pancreatic carcinoma in the Department of General Surgery of Shanghai Ninth People’s Hospital of Shanghai JiaoTong University School of Medicine from January 2012 to January 2020 were retrospectively collected. We collected clinical data such as patient medical records, surgical records, nursing records, examination reports, pathological reports, and studied the parameters that affect the occurrence of perineural invasion in patients with pancreatic carcinoma.ResultsAmong 90 patients with pancreatic carcinoma, 47 cases had perineural invasion and 43 cases had no perineural invasion. The univariate analysis results showed that perineural invasion was associated with abdominal pain and low back pain, levels of fasting blood glucose, glycosylated hemoglobin, CA19-9, carcinoembryonic antigen (CEA), and bilirubin, as well as tumor location, TNM stage, differentiation degree, lymph node metastasis, vascular cancer thrombus, peripheral invasion, and expression of p53 (P<0.05). Binary logistic regression analysis showed that abdominal or lower back pain, increased fasting blood glucose, tumor with invasion of surrounding tissues, and p53-positive expression were the independent risk factors for perineural invasion of pancreatic carcinoma (P<0.05).ConclusionPatients with pancreatic carcinoma have abdominal or lower back pain, elevated fasting blood glucose before surgery, tumor with surrounding tissue invasion, and p53-positive expression are independent risk factors for perineural invasion, which should be paid attention to.
Objective To systematically review the prognostic value of perineural invasion (PNI) for patients with early-stage cervical cancer. Methods We searched PubMed, EMbase, The Cochrane Library (Issue 10, 2016), CNKI, WanFang Data, CBM and VIP databases to collect case-control studies about prognostic value of PNI in cervical cancer from inception to October, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results Seven case-control studies from eight articles involving 1 218 patients were included. The results of meta-analysis showed that: (1) On Cox's model multivariate analysis, PNI was not identified as an independent risk factor for disease free survival (DFS) (HR=0.73, 95%CI 0.33 to 1.58,P=0.42) or overall survival (OS) (HR=0.89, 95%CI 0.41 to 1.94,P=0.77) with no significant difference; (2) On Kaplan-Meier-curves, DFS (HR=1.86, 95%CI 1.20 to 2.88,P=0.006) and OS (HR=2.43, 95%CI 1.63 to 3.62,P<0.000 1) were both significantly decreased in patients with PNI positive group. Conclusion PNI represents a decreasing disease-free survival and overall survival in patients with early-stage cervical cancer, and is one of the poor prognosis factors which be informed management decisions regarding adjuvant therapy. However, there is no evidence that PNI is an independent factor affecting the prognosis. In view of the limitation of the studies, a large sample prospective controlled trial is warranted to verify the above conclusion.
ObjectiveTo investigate relationship between galectin-1 (Gal-1) and invasion and metastasis of gastric cancer.MethodThe related literatures on the relationship between the Gal-1 and the invasion and metastasis of gastric cancer in recent years were reviewed.ResultsThe expression of Gal-1 in the gastric cancer tissue was closely related to the invasion, metastasis ability, immunosuppression, and angiogenesis of tumor cells, and played the important role in the progression and evolution of the gastric cancer. The expression of Gal-1 was higher, the malignancy of the tumor was higher, and the prognosis of the patient was worse.ConclusionExpression of Gal-1 can promote invasion and metastasis of gastric cancer, but further clinical trials need to be verified.
The article aims to explore the optimal concentration of arsenic trioxide (As2O3) on HepG2 of liver cancer cells, and the effect of As2O3 on the migration, invasion and apoptosis of HepG2 cells. In this study, the activity of HepG2 cells treated with 0, 1, 2, 4, 8, 16, 32 μmol/L As2O3 was tested by CCK-8 method, the semi-inhibitory concentration (IC50) was calculated, and the morphological changes of HepG2 cells were observed after the action of As2O3 at IC50 concentration for 12, 24, 48 h. The effect of As2O3 on cell migration and invasion ability was verified by wound healing experiment and Transwell invasion experiment. Western blot and qRT-PCR were used to detect the effects of As2O3 on the gene and protein expression levels related to cell migration, invasion and apoptosis. The results showed that, compared with the control group, the activity of HepG2 cells decreased with the increase of the concentration of As2O3 treatment, showing a dose-dependent effect, and its IC50 was 7.3 μmol/L. After 24 hours’ treatment with 8 μmol/L As2O3, HepG2 cells underwent significant apoptosis, and its migration and invasion abilities were significantly reduced. In addition, the protein expression levels of RhoA, Cdc42, Rac1 and matrix metalloproteinase-9 (MMP-9) were down-regulated, the protein and mRNA expression levels of anti-apoptotic gene Bcl-2 were significantly down-regulated, and the protein and mRNA expression levels of pro-apoptotic genes Bax and Caspase-3 were significantly up-regulated. The above results indicate that certain concentration of As2O3 can inhibit the migration and invasion of hepatocellular carcinoma cells and promote the apoptosis of hepatocellular carcinoma cells.
Objective To compare microsurgery lumbar discectomy (MSLD) via posterior approach with traditional open discectomy by fenestration for single-level lumbar disc protrusion in terms of methodology and therapeutic effect. Methods From January 2001 to January 2008, 230 patients with single-level lumbar disc protrusion were randomized into two groups. In group A, 114 patients underwent MSLD, including 77 males and 37 females aged 15-76 years old (average 41 years old); the duration of the disease ranged from 6 months to 28 years (average 51 months); the lumbar disc protrusion involved L4,5 level in 52 cases, and L5 - S1 level in 62 cases; there were 50 cases of lumbar disc protrusion on the left side, 54 onthe right side, and 10 of the central type; preoperative JOA score was 6-18 points (average 11.8 points). In group B, 116 patients underwent traditional posterior open discectomy by fenestration, including 78 males and 38 females aged 14-78 years old (average 42 years old); the duration of the disease ranged from 8 months to 26 years (average 52 months); the lumbar disc protrusion involved L4,5 level in 56 cases, and L5 - S1 level in 60 cases; there were 53 cases of lumbar disc protrusion on the left side, 52 on the right side, and 11 of the central type; preoperative JOA score was 5-19 points (average 12.3 points). No significant difference was evident between two groups in terms of general information (P gt; 0.01). Parameters of operative time, volume of blood loss during operation, length of operative incision, length of hospital stay after operation, and total medical cost of single disease were analyzed. Therapeutic effect was assessed by postoperative JOA score during follow-up period. Results The operative time was (40 ± 9) minutes in group A and (47 ± 11) minutes in group B. The volume of blood loss during operation was (26 ± 5) mL in group A and (60 ± 6) mL in group B. The length of operative incision was (2.6 ± 0.8) cm in group A and (5.6 ± 0.5) cm in group B. The length of hospital stay after operation was (4.0 ± 2.6) days in group A and (8.0 ± 2.9) days in group B. The total medical cost of single disease was (5 500 ± 1 800) ￥ in group A and (6 300 ± 1 500) ￥ in group B. Significant difference was evident between two groups in terms of the above parameters (P lt; 0.01). The incisions in two groups all healed by first intention.No compl ications such as wrong orientation, nerve root injury, cauda equina injury, and infection occurred. The follow-upperiod was 12-37 months (average 26 months) for 102 patients of group A and 12-35 months (average 24 months) for 98 patients of group B. The JOA score 12 months after operation was 21-28 points (average 24.8 points) in group A and 22-27 points (average 25.2 points) in group B, showing a significant difference when compared with preoperative score (P lt; 0.01), and no significant difference between two groups (P gt; 0.01). Conclusion Two methods have similar cl inical outcomes, but MSLD has merits of minimal invasion, less blood loss, shorter operative time, shorter length of hospital stay, and lower medical cost. It is one of ideal minimally invasive operations for single-level lumbar disc protrusion．
ObjectiveTo explore the mechanisms of perineural invasion (PNI) in pancreatic cancer so as to find a new treatment for pancreatic cancer. MethodsThe literatures on PNI, neurotropism, nerve-tumor microenvironment and nerve growth factor in pancreatic cancer were reviewed and the mechanisms of PNI were summarized. ResultsThe rich innervation of pancreatic tissue itself and the minute slits within perineural structure were the anatomic basis of PNI. Tumor cells expressed neural antigens were the pathological basis of PNI. Tumor-nerve microenvironment and nerve growth factor family and themselves receptors might play an important molecular role in PNI. However, tumor cells expressed neural antigens were not only closely related to the PNI, but also the interaction between tumor cells and nerves played an important role in PNI. ConclusionsThe detailed mechanisms of PNI are extremely complex and controversial up to today. However, it is possible to search a new therapeutic target in pancreatic cancer according to the mechanisms of PNI.
ObjectiveTo detect the expression of FXYD domain-containing ion transport regulator 6 (FXYD6) protein in hepatocellular carcinoma tissues and the corresponding paracancerous liver tissues, and to explore the clinical significance of FXYD6 protein expression in hepatocellular carcinoma.MethodsEighty hepatocellular carcinoma tissues and the corresponding 40 paracancerous tissues were retrospectively collected in Cangzhou Central Hospital from March 2012 to January 2018, and the expression of FXYD6 protein was examined in these tissues by strept avidin-biotin complex (SABC) immunohistochemistry. We analyzed the relationship between the expression of FXYD6 protein and clinicopathological characteristics of the patients with hepatocellular carcinoma, and the relationship between the expression of the protein and early recurrence or overall survival.ResultsThe positive expression rate of FXYD6 protein was statistically higher in hepatocellular carcinoma tissues than that in the corresponding paracancerous tissues [77.5% (62/80) vs. 40.0% (16/40), P<0.001]. Its expression in hepatocellular carcinoma was not related with gender, age, histological differentiation, tumor maximum diameter, tumor number, AFP concentration in serum, and HBV or HCV infection (P>0.05), but with integrity of tumor capsule, microvascular invasion, and tumor stage (P<0.05). The positive FXYD6 protein expression group had a significantly higher recurrence rate than that of the negative FXYD6 protein expression group [53.2% (33/62) vs. 16.7% (3/18), P=0.006]. However, multivariate analysis results showed that high FXYD6 protein expression was not a risk factor for early relapse (P=0.422). The positive FXYD6 protein expression group had a significantly shorter postoperative survival than the negative FXYD6 expression group ( P=0.043). However, multivariate analysis results showed high FXYD6 protein expression was not a risk factor for overall survival (P=0.754).ConclusionsFXYD6 protein was expressed abnormally in hepatocellular carcinoma tissues, which might be involved in the carcinogenesis and the progression of hepatocellular carcinoma. It might be a poor prognostic factor for patient with hepatocellular carcinoma.
This paper aims to study the effects of traditional Chinese medicine Euphorbia esula on multidrug resistant human gastric cancer cells in the cell proliferation, migration, invasion and apoptosis, and to study the apoptosis-inducing pathway. Different dilutions of Euphorbia esula extract were used to process human multidrug resistant gastric cancer SGC7901/ADR cells. Cell proliferation inhibition phenomenon was determined by MTT experiment. Nuclear morphological changes of apoptotic cells and apoptotic indexes were observed and determined by Hochest33528 staining followed with fluorescence microscope observing. Flow cytometry was used to detect cell apoptosis rate. Cell migration and invasion ability were observed and determined by Transwell method. Spectrophotometry was used to detect caspase-3 and caspase-9 enzyme activity. Western blotting was used to detect subcellular distribution of cytochrome c. The results showed that Euphorbia esula extract had obvious inhibition effect on proliferation of gastric cancer multidrug resistant SGC7901/ADR cells, which was time- and concentration-dependent. After processing multidrug resistant gastric cancer SGC7901/ADR cells with Euphorbia esula extract, the apoptotic index and apoptosis rate were significantly increased than those in the control group, which showed a time- and dose-dependent mode; but if a caspase inhibitor was added, apoptosis index was not obviously increased. Transwell method showed that migration and invasion ability of the Euphorbia esula extract-processed SGC7901/ADR cells dropped significantly. Spectrophotometry showed that in Euphorbia esula extract-processed SGC7901/ADR cells, caspase-3 and caspase-9 expression were increased, which had significant differences with the control group. Western blotting test showed that the distribution of cytochrome c decreased in mitochondria, while increased in the cytoplasm (i.e., cytochrome c escaped from mitochondria to the cytoplasm). In conclusion, Euphorbia esula extract could inhibit the proliferation, migration and invasion, and induce apoptosis in human gastric cancer multidrug resistant SGC7901/ADR cells; and cytochrome c, caspase-9 and caspase-3 might be involved in cell apoptosis induced by Euphorbia esula extract, suggesting endogenous or mitochondrial apoptotic pathway.
Objective To explore the feasibility and the effectiveness of the accurate placement of lumbar pedicle screws using three-dimensional (3D) printing navigational templates in Quadrant minimally invasive system. Methods The L1-5 spines of 12 adult cadavers were scanned using CT. The 3D models of the lumbar spines were established. The screw trajectory was designed to pass through the central axis of the pedicle by using Mimics software. The navigational template was designed and 3D-printed according to the bony surface where the soft tissues could be removed. The placed screws were scanned using CT to create the 3D model again after operation. The 3D models of the designed trajectory and the placed screws were registered to evaluate the placed screws coincidence rate. Between November 2014 and November 2015, 31 patients with lumbar instability accepted surgery assisted with 3D-printing navigation module under Quadrant minimally invasive system. There were 14 males and 17 females, aged from 42 to 60 years, with an average of 45.2 years. The disease duration was 6-13 months (mean, 8.8 months). Single segment was involved in 15 cases, two segments in 13 cases, and three segments in 3 cases. Preoperative visual analogue scale (VAS) was 7.59±1.04; Oswestry disability index (ODI) was 76.21±5.82; and the Japanese Orthopaedic Association (JOA) score was 9.21±1.64. Results A total of 120 screws were placed in 12 cadavers specimens. The coincidence rate of placed screw was 100%. A total of 162 screws were implanted in 31 patients. The operation time was 65-147 minutes (mean, 102.23 minutes); the intraoperative blood loss was 50-116 mL (mean, 78.20 mL); and the intraoperative radiation exposure time was 8-54 seconds (mean, 42 seconds). At 3-7 days after operation, CT showed that the coincidence rate of the placed screws was 98.15% (159/162). At 4 weeks after operation, VAS, ODI, and JOA score were 2.24±0.80, 29.17±2.50, and 23.43±1.14 respectively, showing significant differences when compared with preoperative ones (t=14.842,P=0.006;t=36.927,P=0.002;t=–36.031,P=0.001). Thirty-one patients were followed up 8-24 months (mean, 18.7 months). All incision healed by first intention, and no complication occurred. During the follow-up, X-ray film and CT showed that pedicle screw was accurately placed without loosening or breakage, and with good fusion of intervertebral bone graft. Conclusion 3D-printing navigational templates in Quadrant minimally invasive system can help lumbar surgery gain minimal invasion, less radiation, and accurate placement.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.
