Objective To study the relationship between blood metastasis of colorectal cancer and cancer metastasis related factors.MethodsCK20 mRNA in peripheral blood was investigated by reverse transcription polymerase chain reaction (RTPCR) and proteins of CD44v6 and p53 in cancer tissues were examined by immunohistochemical in 50 cases of colorectal neoplasm. ResultsThe results showed that the positive rates of peripheral blood micrometastasis of colorectal cancer were 68%. It escalated along with the rising of the Dukes stage, the rates in Dukes C and D stage were significantly higher than that in Dukes A and B stage. The positive rates of CD44v6,p53 expression in colorectal cancer were 74% and 62% respectively. The positive rates of CD44v6 and p53 in Dukes A and B stage were significantly lower than those in Dukes C and D stage,in peripheral blood and colorectal cancer micrometastasispositive group were significantly higher than that in the micrometastasisnegative group. CK20 mRNA was significantly correlated with expressions of CD44v6 and p53 in cancer tissues. Conclusion The detection of CK20 mRNA in blood before operation and after operation examination of CD44v6 and p53 in cancer tissues are helpful for prediction of blood metastasis of colorectal neoplasm and postoperative treatment.
ObjectiveTo study and analyse the correlation between biologic behavior and clinical factors in gastric cancer.MethodsClinical and pathological study of carcinoma of stomach were retrospectively made in 1034 patients. ResultsIn this series,148 of 1034 patients (14.3%) were early gastric cancer.The frequency of lymph nodes metastasis was higher in proximal gastric cancer than distal (P＜0.0001).Similar frequency can also be seen in the tumor of larger diameter (P＜0.01),deeper invasion (P＜0.0001) and poor differentiation (P=0.004).Some difference in ages and sex of patients may be found on the invasion (P=0.003),differentiation (P＜0.0001),site (P＜0.001) and frequency of lymph nodes metastasis of the tumor (P=0.01).In multifactorial multivariate linear regression analysis,the site of tumor (P=0.003),diameter of tumor (P＜0.0001),depth of tumor infiltration (P＜0.0001) and the cell differentiation showed significant association with lymph node metastasis,in which the female patient had more lymph node metastasis than male (P＜0.001).Depth of tumor infiltration was the most important factor in lymph node metastasis.Numbers of lymph nodes resected were much more in total and distal gastrectomies than that in proximal gastrectomy (P＜0.0001). ConclusionThe results of this study suggest that radical gastrectomy with lymphadenectomy is necessary even in all stages of gastric cancer.
Objective To investigate the related factors affecting the metastases to left gastric artery lymph nodes in patients of esophageal cancer, and evaluate the clinical significance of resection of left gastric artery. Methods One hundred and eighty-six patients with esophageal cancer undergone esophagectomy and esophagogastrostomy were involved in these case-control study. The left gastric artery, lymph nodes and fat tissue around it were removed in these patients. Patients were divided into 2 groups according to the occurrence of metastases to para left gastric artery lymph nodes. Chi-square test, rank sum test, t-test and the logistic regression were adopted to analyze the correlations between these related factors and the metastases to para left gastric artery lymph nodes. Results Thirty-three patients had para left gastric artery lymph nodes metastases （17. 74%）. Related factors that affect the metastases to para left gastric artery lymph nodes were showed by monovariate analysis as follows： TNM staging of tumor, the metastases to paraesophageal nodes, paracardial nodes and subcarinal nodes （P〈0.001, P=0.025, 0.047,0.038）. Multivariate analysis showed that location of tumor was the only independent factor that influences the metastases of para left gastric artery lymph nodes（P= 0. 002）. Skip metastasis was a distinct feature of esophageal cancer, with a frequency of 78.79%（26/33）. Conclusions This study suggests that the major correlative factor of para left gastric artery lymph node metastasis is location of tumor. Resection of left gastric artery as a routine procedure in radical operation of esophageal cancer should be considered.
Objective To summarize the role of the relationship between liver cancer and cellular immunological function, and the role of immune therapy in clinical application. Methods To analyze the relationship between liver cancer and cellular immunological function, and the present research situation of immune therapy for liver cancer in clinical application retrospectively via review the related domestic and foreign literatures. Results The cellular immune dysfunction existed in all liver cancer patients. The state of body’s cellular immunological function is closely related with the arising and development of liver cancer, and the lowness of cellular immunological function is an important factor of hepatocellular carcinoma hard to cure or recurrence and metastasis. Immune therapy plays an important role in the treatment of liver cancer by adjusting the body’s cellular immunological function. Conclusions Liver cancer is closely related with the body’s cellular immunological function. Immune therapy is expected to offer a new way for the treatment of liver cancer, which can also be used as an important auxiliary treatment way.
Objective To study the effect of Huaier granule on the recurrence and metastasis of hepatocellular carcinoma (HCC) and immune rejection in the postoperative patients with liver transplantation for HCC. Methods Twenty-eight patients of liver transplantation for HCC who had taken Huaier granule orally for more than 6 months from September 2001 to March 2007 in West China Hospital were included as treatment group, and other 56 patients of liver transplantation for HCC who didn’t take any Huaier granule in the same time were included as the control group according to the same stage of TNM, degree of tumor differentiation (Edmondson grading) respectively with the treatment group. The method of retrospective cohort study was used to compare the incidence of immune rejection and the 6-month, 1-year, and 2-year recurrence and metastasis of HCC, disease free survival rate, and survival rate between two groups after 2 years’ follow-up beginning from the date of surgery. Results The 6-month, 1-year, and 2-year tumor recurrence and metastasis incidences in treatment group were 14.3%, 32.1%, and 39.3% respectively, which were 23.2%, 32.1%, and 50.0% respectively in control group, and the 2-year tumor recurrence and metastasis incidence of the treatment group was lower than that of the control group. The 6-month, 1-year, and 2-year disease free survival rates in treatment group were 85.7%, 67.5%, and 60.0% respectively, which were 76.7%, 67.6%, and 49.3% respectively in control group, and the 2-year disease free survival rate of treatment group was higher than that of the control group. The 6-month, 1-year, 2-year survival rates in treatment group were 92.9%, 78.6%, and 67.9% respectively, which were 89.3%, 75.0%, and 62.5% respectively in control group. But the 2-year tumor recurrence and metastasis incidence (P=0.353), 2-year disease free survival curve (P=0.386), and 2-year survival curve (P=0.620) were not significantly different between two groups. The incidence of immune rejection was 14.29% in the treatment group and 16.07% in the control group, which was not significantly different between the two groups (P=0.831). Conclusions Huaier granule can increase the 2-year tumor-free survival rate and restrain the recurrence and metastasis of HCC, and does not increase the incidence of immune rejection. Huaier granule as a treatment of HCC in patients with liver transplantation is safe and effective.
Objective To summarize the advancement on Lewis-Selectin metastasis pathway and anti-tumor treatment of cimetidine in colorectal cancer.Methods Domestic and international publications involving Lewis-Selectin metastasis pathway and antitumor role of cimetidine in recent years were collected and reviewed. Results The expression of sialyl Lewis X (sLeX) was most significant in Lewis-Selectin metastasis pathway in colorectal cancer. Cancer cells could interact with E-selectin and P-selectin of activated vascular endothelial cells by sLeX ligand on the cell surface, thereby prompting invasion and metastasis. Cimetidine could inhibit the growth of tumor, improve immune response of the host to tumor cell, inhibit angiogenesis of tumor and metastasis. The curative effect of cimetidine on colorectal cancer patients with positive sLeX expression was better than that with negative sLeX expression. Conclusion Lewis-Selectin metastasis pathway is one of the important metastasis pathway in colorectal cancer. Cimetidine can prevent metastasis of colorectal cancer by blocking sLeX expression.
Objective To study the expression of p53 and vascular endothelial growth factor (VEGF) and its correlation with hematogenous metastasis in colorectal cancer. MethodsAvidinbiotin complex method was used to study the expression of p53 and VEGF in 79 cases of colorectal cancer.ResultsThe positive rates of p53 and VEGF were 48.1% and 58.2% respectively in 79 cases of colorectal cancer. p53 and VEGF expression were identical in 49 (62.0%) cases. There was significant association between p53 or VEGF expression and venous invasion or hematogenous metastasis (P＜0.05). The incidence of hematogenous metastasis in the p53（＋）/VEGF（＋） subgroup was 66.7% and was significantly higher than that in the p53（－）/VEGF（－） or p53（＋）/VEGF（－） subgroup （P＜0.01）. Neither synchronous nor metachronous hematogenous metastasis were found in the p53（－）/VEGF（－） subgroup.Conclusion The combination of p53 and VEGF expression is an important predictor for hematogenous metastasis in patients with colorectal cancer.
【Abstract】ObjectiveTo investigate the relationship between the expression of urokinase-type plasminogen activator (uPA) mRNA and breast cancer, lymph node metastasis. MethodsSixty patients with breast tumor were selected randomly and the expression of uPA mRNA was detected with RT-PCR. The patients were divided into benign group (18 cases) and malignant group (42 cases) which included 22 cases with lymph node metastasis and 20 cases without lymph node metastasis. The relationship between uPA mRNA expression and breast cancer, lymph node metastasis was analyzed. ResultsAmong these 18 benign tumors, low expression of uPA mRNA was found in 2 cases and the others were negative. While in 42 cases of malignant tumor, uPA mRNA were positive in 22 cases of lymph node metastasis, 16 of which were high expression, 5 of which were moderate expression, and 1 was low expression. uPA mRNA were positive in 18 of 20 cases of nonmetastatic lymph node, 1 of which was high expression, 5 of which were moderate expression and 12 of which were low expression, the other 2 were negative expression. The expression of uPA mRNA had significant difference between benign and malignant tumors (P＜0.05). The expression in lymph node metastasis was much higher than no lymph node metastasis (P＜0.05). ConclusionThe expression of uPA mRNA in malignant breast cancer is obviously higher than that in benign breast tumor. The expression tensity of uPA is highly relevant to lymph node metastasis in malignant breast cancer, which can provide evidence for clinical staging and therapy.
Objective To study the expressions of Wnt5a, MMP2, and MMP14 in the primary lesions of gastric cancer and the influences on clinicopathologic features. Methods The expressions of Wnt5a, MMP2, and MMP14 in the specimens of 106 patients with gastric cancer and 39 patients from the adjacent normal gastric tissues were detected by immunohistochemical staining, χ2 test and non-parametric test were used to analyze the relationships among them and between them and their influences on the clinicopathologic features. Results Extensive expressions of Wnt5a, MMP2, and MMP14 were demonstrated in the gastric cancer, which were significantly higher than those in the normal gastric tissues respectively (Plt;0.05). Positive expression of Wnt5a was associated with larger tumor diameter, deeper depth of invasion, higher degree of regional lymph node metastasis, later TNM stage, and higher rate of lymph node metastasis (Plt;0.05). In addition, Wnt5a expression was also associated with lymphatic infiltration and vascular infiltration (Plt;0.05). The expressions of MMP2 and MMP14 were associated with lymphatic infiltration, but not with vascular infiltration. Higher expressions of MMP2 and MMP14 were correlated with deeper tumor invasion, higher degree of regional lymph node metastasis, later TNM stage, and higher rate of lymph node metastasis (Plt;0.05). In addition, higher expression of MMP2 possesed greater tumor diameter (Plt;0.05). Spearman rank correlation analysis revealed the positive relation between Wnt5a and MMP2 （rs=0.240, P=0.014）, Wnt5a and MMP14 （rs=0.251, P=0.010）, as well as MMP2 and MMP14 （rs=0.444, P=0.000）. Conclusion Higher expressions of Wnt5a, MMP2, and MMP14 seem to promote invasion and metastasis of gastric cancer, and there are positive relations among their expressions.
ObjectiveTo study the expression of p27 in hepatocellular carcinoma (HCC) and its clinical significance.MethodsFortyfive specimens of HCC and 30 specimens of adjacent noncancerous lesions obtained from 45 patients who underwent surgery were examined for p27 expression by immunohistochemistry SABC method. The diameter of tumor ranged from 1 cm to 19 cm (d ≤5 cm, 9 samples; 5 cmlt;d≤10 cm, 19 samples; d＞10 cm, 17 samples). These tumors were graded according to the criteria described by EdmondsonSteiner: highdifferentiated HCC group (Grade Ⅰ＋Ⅱ), 26 samples; lowdifferentiated HCC group (Grade Ⅲ＋Ⅳ), 19 samples. According to the clinicopathological features: 19 samples were poorly encapsulated, 15 samples had portal invasion, 11 samples had extrahepatic metastasis, 12 samples had intrahepatic metastasis; all of the above were classified as the invasive and metastatic group, while the others were classified as the noninvasive and nonmetastatic group. ResultsThe average labeling index (LI) of p27 in HCC was significantly higher than that of adjacent noncancerous lesions (45.87±14.21 vs 33.77±12.92, Plt;0.001). The LI of p27 in lowdifferentiated HCC group (stage Ⅲ＋Ⅳ) was significantly lower than that of highdifferentiated group (stage Ⅰ＋Ⅱ), 34.46±12.29 vs 52.80±11.36 (Plt;0.001). The LI of p27 had significant difference between the large ones (d＞10 cm, 37.59±13.12) and the small ones (d≤5 cm, 53.28±15.17 or 5 cmlt;d≤10 cm, 49.50±10.96) (Plt;0.05). The LI of p27 in the invasive and metastatic group was significantly lower than that in the noninvasive and nonmetastatic group (41.42±12.86 vs 51.44±14.10, Plt;0.05).ConclusionThe expression of p27 is more frequently detected in HCC than in adjacent noncancerous lesions. It indicates that p27 might be a compensatory factor during HCC carcinogenesis. The LI of p27 significantly decreases in poor differentiation group, invasive and metastatic group. It indicates that p27 might be related with the differentiation, invasion and metastasis of HCC.