Objective The aim of the current study was to investigate the prognostic value of extracapsular lymph node spread in gastric cancer patients and to find correlations with clinicopathological parameters.Methods Clinicopathological data of 131 gastric cancer patients who underwent gastrectomy with lymphadenectomy were analyzed retrospectively. The number of metastatic lymph nodes with extracapsular spread were determined. Multivariate analysis was performed to find the clinical prognosis affecting extracapsular lymph node involvement. Results Seventy-eight patients (59.5%)had perigastric lymph node metastasis. Fortysix cases were detected extracapsular lymph node involvement. The 5-year cumulative survival rate for patients with extracapsular lymph node spread was 13. 5% , while 32 patients with lymph node metastasis but without extracapsular involvement had a 5-year survival rate of 39.3%. The survival rate decreased significantly with the increase of extracapsular lymph node involvement(P =0.001). Extracapsular lymph node involvement was significantly associated with the higher number of metastatic lymph nodes, the location of lymph node metastasis, tumor invasion depth and distant lymph node metastasis. In the multivariate analysis, extracapsular lymph node spread also remained as an independent prognostic factor(P =0.003). Conclusions Extracapsular lymph node involvement is a convenient and reliable prognostic index, and is an independent prognostic factor in gastric cancer patients. In future staging systems for gastric cancer, extracapsular lymph node involvement should be considered, be pathologically checked and reported in order to determine extracapsular spread status.

Objective To analyze the clinical and pathological characteristics and its surgical management strategy for colorectal high-grade intraepithelial neoplasia (HGIN).Methods Eighty-two cases with colorectal tumors diagnosed as colorectal HGIN based on colonoscopic biopsy between January 2005 and December 2012 were enrolled in the study.The clinicopathological data of all the patients was collected and analyzed.Of the 82 cases,71 cases had radical colorectal surgery,1 cases had Miles operation after previous transanal excisions,3 had transanal local excisions,8 cases had palliative surgery.The surgical specimens were all examined pathologically and compared with the preoperative diagnosis of colonoscopic biopsy of all the patients.Results Three cases (3.7％) were pathologically diagnosed as high-grade intraepithelial neoplasia,their average diameter was 1.5 cm.The other 79 (96.3％) cases were diagnosed as adenocarcinoma,with an average diameter of 4.7 cm.The difference in tumor size was statistically significant (P ＜ 0.01).Comparison of pre-and post-operative specimens showed poor consistency,the Kappa value was O.104.Significant analysis showed a correlation between cancerous change to tumor size and depth of invasion.In the 79 cases confirmed as adenocarcinoma,liver metastasis occurred in 8 cases,regional lymph nodes metastasis in 31 cases (39.2％).Of the 33 cases with rectal tumors,30 cases (90.9％) were pathologically diagnosed as adenocarcinoma after operation.Conclusions Much attention should be payed to the pathological diagnosis in colorectal intraepithelial neoplasia,especially in the HGIN.We have found that of the cases first diagnosed as HGIN,approximately 96.3％ already have invasion adenocarcinoma.Most cases had reginonal lymph nodes metastasis.Liver metastasis had been occurred.thus active surgical measures should be taken.If the location of the tumor was not involved to anal sphincter,or cases with tumors larger than 3 cm was diagnosed,in highly suspected cases with malignant potiential,radical surgery is recommended.For tumors located at the lower rectum,the final decision should be made only after repeated endoscopic or transanal biopsy.

Objective To investigate the role of lysyl oxidase (LOX) in synovitis and cartilage destruction by comparing the expression of LOX in synovial fluid and synovium of active rheumatoid arthritis (RA) and active osteoarthritis (OA).Methods LOX in the synovium was detected by immunohistochemistry from 14 patients with active RA,24 patients with active OA and 20 patients with knee injury (the control group).LOX in the synovial fluid was measured by enzyme linked immunosorbent assay (ELISA) from 14 patients with active RA and 24 patients with active OA.T-test was used for statistical analysis.Results The level of LOX expression in active RA synovium (0.012±0.007) was similar to that in active OA synovium (0.013±0.011,P＞0.05).But the expression of LOX in synovium of active RA and active OA was significantly higher than that in synovium of the control group (0.003±0.004,P＜0.01).The amount of LOX in the synovial fluid of active RA [(1.9±1.4) μg/ml] was significantly higher than that of active OA [(1.0±0.4) μg/ml,P＜0.05].Conclusion High expression of LOX in the synovial fluid and synovium of active RA and active OA suggest that LOX may be involved in chronic synovitis and cartilage destruction,and may be related with the extent of synovitis and cartilage destruction.

ObjectiveTo detect glucose-6-phosphate isomerase (GPI) in knee joint synovial fluid of active rheumatoid arthritis (RA) and explore the correlation between GPI and anti-cyclic citrulline peptide antibody (anti-CCP).MethodsGPI and anti-CCP in the synovial fluid were measured by enzyme linked immunosorbent assay(ELISA) from 22 patients with active RA and 37 patients with active osteoarthritis (OA).Student's t-test was used for intergroup comparison and Spearman's analysis was used for correlation analysis.ResultsThe level of GPI and anti-CCP in the synovial of active RA [ (9.6±8.4) μg/ml,( 14.61 ±18.64) U/ml] was significantly higher than that of active OA[ (0.9±1.8) μg/ml,(1.42±0.09) U/ml)].There was positive correlation between GPI and anti-CCP (r=0.447,P=0.037).ConclusionHigh expression of GPI is shown in active RA synovial fluid.It is suggested that GPI as an antigen that may participate in chronic synovitis,bone destruction and joint malformation.Both GPI and anti-CCP may be the laboratory markers for the diagnosis of RA.