ObjectiveTo study the clinicopathologic features, diagnosis and treatment of papillary cystic and solid tumor of the pancreas (PCSTP).MethodsOne case with PCSTP in our hospital and a review of 60 others from the literatures of the People’s Republic of China, a total of 61 cases were analyzed retrospectively.ResultsThe patients (57 women, 4 men) were of mean age 24.6 (range 9~59) years. The main manifestations included abdominal mass (n=52), pain (n=22) and discomfort (n=10). They were distributed in the head (n=29), neck and body (n=2), body (n=1), body and tail (n=5), tail (n=16) and capsule (n=2) of the pancreas. The other 6 cases occurred outside the pancreas. All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination, 7 of which were malignant (11.5%). The total 1, 3, 5year survival rate was 100%, 96.1% and 86.5% respectively.ConclusionIt is difficult to correctly diagnose the PCSTP before operation because PCSTP is often lack of typical clinical manifestations. The correct diagnosis should depend on histopathologic examination.Complete removal of the PCSTP is the most perfect treatment. PCSTP has a good prognosis.
ObjectiveTo investigate researches on pancreatic neoplasms and molecular imaging in recent five years and provide reference information for the majority of professionals in deep research. MethodsBibliographies from research literature of pancreatic neoplasms and molecular imaging in recent five years in PubMed database were downloaded. The publication years, journals, countries of publication, the first authors and the frequency of MJMEs were counted by Bicomb 2.0 software. The affiliations were analyzed artificially. MJMEs appeared no less than two times were intercepted as high frequency ones and the high frequency MJMEs co-occurrence matrix were formed. SPSS 22.0 statistical software were applied for clustering analysis with matrix, then to get the topic hotspots. ResultsA total of 28 literatures were screened out. The data of research trend, journals, research degree of countries were acquired. The number of high frequency MJMEs were 20 and among which 5 research hotspots were clustered. ConclusionsResearches on pancreatic neoplasms and molecular imaging are mainly in terms of therapy and genetics, diagnosis and metabolism, radionuclide imaging, pharmacology and pathology.
ObjectiveTo investigate the possible mechanism of cucurmosin on apoptosis in human pancreatic cancer cell line SW1990 in vitro. MethodsThe inhibition of cucurmosin on SW1990 cell was detected by MTT assay, the apoptosis was observed by transmission electron microscope, the apoptosis rate was analyzed by flow cytometry, and the protein level of caspase3 was determined by Western blot. ResultsAfter exposure to cucurmosin at 1.25, 2.50, 5.00, 10.00, 20.00, 40.00, and 80.00 μg/ml for 24, 48, and 72 h, the proliferation of SW1990 cell was inhibited in a time-and dose-dependent manner (Plt;0.05). At 72 h after 40.00 μg/ml cucurmosin treatment, the typical apoptosis changes and apoptotic bodies were observed by transmission electron microscope. After exposure to cucurmosin at 0, 2.50, 10.00, and 40.00 μg/ml for 72 h, the apoptosis rate increased gradually as (0.30±0.11)%, (18.93±1.06)%, (28.00±2.07)%, and (49.93±3.25)%, respectively (Plt;0.05). The expression of caspase-3 protein was elevated gradually (Plt;0.05). ConclusionCucurmosin may induce the apoptosis of pancreatic cancer cell through up-regulating the expression of caspase-3.
Objective To reveal the significance of D2-40/CK19 dual immunohistochemistry for micrometastasis of peripancreatic neural plexus in patients with pancreatic cancer. Methods Between January 2006 and January 2007, 44 patients with pancreatic duct adenocarcinoma underwent extended radical resection. Conventional hematoxylin/eosin staining and double immunohistochemical staining using CK19 and D2-40 were used to determine peripancreatic neural invasion and lymphatic vessel invasion (LVI) in peripancreatic neural plexus tissues. Results D2-40 immunohistochemistry showed brown-yellow tube-like lymph vessels. The lymph vessel of peripancreatic nerve plexus followed vascular and perineurium, and the lymph vessel adjacent to peripheral nerve fascicles owned tube-like structure. CK19 immunohistochemistry showed cytoplasm of pancreatic cancer cell was red. The LVI was observed in lymphatic capillaries. Peripancreatic neural plexus invasion was found in 30 cases (68.2%), tumor cell invading presented in lymph vessels of peripancreatic neural plexus in 21 patients (47.7%) with pancreatic cancer. The peripancreatic neural plexus invasion was associated with LVI (P=0.003). The plexus of pancreatic capitalis and celiac plexus were respectively confirmed to be the spot with the highest lymphatic vessel density and the maximal incidence of neural plexus invasion simultaneously. Conclusions Patients with pancreatic cancer should be given the opportunity of radical operation combining related peripancreatic neural plexus as far as possible. The dual immunohistochemical staining with anti-CK19 and anti-D2-40 monoclonal antibodies should be a new method in research of perineural invasion of pancreatic cancer, exhibiting both the pancreatic cancer cells and lymph vessels clearly and distinctly.
Objective To know the abnormal expression of the cell cycle-regulated proteins in pancreatic adenocarcinoma and their effect on tumor cell growth. Methods The expression of p16, p21, Rb and p53 protein in 47 cases were investigated by immunohistochemistry with wet autoclave pretreatment for antigen retriaval. Furthermore, tumor growth index were assessed by a novel anti-ki-67 antibody (ki-s5). Results All the expression of p53, p16, p21 and Rb protein were the nuclear stainning. The positive rates of p53, p16, p21 and Rb protein were 55%, 53%, 74% and 98% respectively. There was negative correlation between of p16, p21 or Rb protein expression and ki-67 growth index. No relation of p53 protein stainning and the expression of p21 protein was found. Conclusion In pancreatic adenocarcinoma, the negative expression of p16 protein and p21 protein may play an important role in tumor cell growth, but tumor proliferation caused by abnormality of Rb protein is rare. The expression of p21 protein was not associated with the expression of p53 protein.
目的 总结胰腺实性假乳头状瘤（solid-pseudopapillary tumor of pancreas, SPTP）的诊治经验。方法 回顾性分析我院1999年11月至2007年10月期间收治的6例SPTP患者的临床资料。结果 6例均为女性，其中4例为年轻女性； 术前均未确诊； 行胰腺体尾部切除2例，肿瘤局部切除4例，其中2例加脾切除，术后病理报告确诊为SPTP。 术后无严重并发症，随访1～95个月，无复发和转移。结论 SPTP多发于年轻女性，术中冰冻切片对术中处理提供参考，手术切除为首选治疗方法，预后良好。
目的 探讨胰腺囊腺瘤和囊腺癌的临床病理特点及其诊治。 方法 回顾性分析山东省菏泽市立医院及曹县人民医院1996年6月至2007年3月共收治的17例患者的临床病理资料。结果 本病临床表现无特征性。B超和CT检查能发现囊肿但不能确定类型。浆液性囊腺瘤7例均行肿瘤局部切除； 黏液性囊腺瘤6例，行胰十二指肠切除1例，胰体尾切除5例； 囊腺癌4例，行胰十二指肠切除加淋巴结清扫1例，胰体尾切除术2例，胰体尾加脾切除1例。光镜下浆液性囊腺瘤囊壁由扁平或立方上皮细胞组成； 黏液性囊腺瘤囊壁由高柱状上皮细胞组成，可见乳头状突起； 囊腺癌囊壁细胞核异形明显，可见核分裂象及间质浸润。15例获得B超随访，中位随访时间为42个月（1～129个月），除1例行胰体尾切除加脾切除的老年囊腺癌患者术后6个月死于营养衰竭和 1例胰十二指肠切除患者并发糖尿病外，其余患者生存满意，未见肿瘤复发。结论 B超和CT是本病的主要影像检查方法。加强对本病临床病理特征的认识是提高诊治率的关键。手术切除治疗本病疗效满意。
ObjectiveTo study the expression of HOX A9 mRNA and its clinicopathological significance in the benign and malignant lesions of pancreas. MethodsIn situ hybridization for HOX A9 mRNA was used on routine paraffinembedded sections. ResultsThe positive rate and scoring mean of HOX A9 mRNA expression was significanfly lower in pancreatic carcinoma (49%, 3.3±2.1) than that in chronic pancreatitis (95%, 5.4±0.8) and pericancerous tissues (80%, 4.6±1.2), the negative case of HOX A9 mRNA in chronic pancreatitis and pericancerous tissues showed middle or severelyatypical hyperplasis of the ductal epitheli. The positive rate and scoring mean of HOX A9 mRNA expression was significantly higher in the cases of welldifferentiation (63%, 4.0±2.2) or without metastasis (64%, 4.1±2.2) than that in the ones of poorlydifferentiation (32%, 2.6±2.3) or with metastasis (32%, 2.7±2.2). ConclusionThe expression of HOX A9 mRNA might be related the carcinogenesis, progress, biological behaviors, and prognosis of pancreatic carcinoma. The assay of HOX A9 mRNA expression in the benign lesions of pancreas might have important clinical values in the prevention and earlystage finding of the pancreatic carcinoma.
Objective To study the expression and clinic significance of nm23 gene (product of uncleoside ciphosphate kinase) in the pancreatic adenocarcinoma tissues. MethodsSP immunohistochemical method was used to examine the expression of nm23/NDPK in 40 pancreatic adenocarcinoma and 14 normal pancreas tissues.ResultsTwentysix of 40(65%) pancreatic adenocarcinoma showed b immunoreactivity for NDP kinase, whereas 4 of 14 (28.5%) normal pancreatic tissues showed weak immunoreactivity. Significant difference was found between the two groups (P＜0.05). The nm23/NDPK expression levels in pancreatic adenocarcinoma of lower differentiation was higher than those in pancreatic adenocarcinoma of higher differentiation (10/11，90.9%; 2/8, 25%; P＜0.05). Positive staining was associated with higher incidence of lymph node metastasis (10/14, 71.4%) than negative staining (6/19,31.5%, P＜0.05). These results suggested that nm23/NDPK expression was positively associated with lymph node metastasis and aggressiveness. They also suggested that nm23/NDPK expression had negative correlation with the extent of histologic differentiation. Conclusion nm23/NDPK can serve as a marker for malignant potentiality and indicate the prognosis of pancreatic adenocarcinoma.
ObjectiveTo investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in human pancreatic adenocarcinoma and their correlation with clinicobiological behavior.MethodsThe expression of COX-2 and VEGF in 51 cases of human pancreatic ductal adenocarcinoma were detected with immunohistochemistry of Envision.ResultsExpression of COX-2 and VEGF in pancreatic ductal adenocarcinoma were 74.5% and 68.6%, respectively; no expression of COX-2 and VEGF in adjacent normal tissue was detected. Both COX-2 and VEGF expression in clinical stage Ⅲ-Ⅳ were much higher than those in clinical stage Ⅰ-Ⅱ, and also higher in positive group of lymph node metastasis than in negative group as well (Plt;0.05). None of them had relation with histological grades, age, sex, tumor size and location. The expression of COX-2 was closely correlated with VEGF (r=0.411, Plt;0.01).ConclusionCOX-2 and VEGF may play a pivotal role in tumorigenesis and tumor progression in pancreatic cancer, they may provide new targets for therapy of pancreatic cancer.