Objective:To study the correlation of C(-938)A single nucleotide polymorphism (SNP) in the promoter of anti-apoptosis gene Bcl-2 with the clinical biological parameters of breast cancer patients in Hebei Province. Methods:Three genotypes(AA, AC, CC) of Bcl-2 C(-938)A from 113 samples of breast cancer patients were analyzed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, and the results were associated with clinical biological parameters. The distribution of genotype frequency was compared between different groups. Results:When stratified for axillary lymph node metastases, the frequency of AA genotype were 26.8%, 47.8% and 52.6% and the distribution of AC+CC genotypes were 73.2%, 52.2% and 47.4% in negative group, 1-3 metastasis group, and ≥4 metastasis group. The difference between the two groups was significant (χ~2=6.337, P=0.042). Compared with the AC+CC genotypes, the OR value of AA genotype in ≥4 metastasis group was 3.041 (95%CI=1.072-8.626). The frequency of AA genotype were 30.9% and 69.1% in gradeⅠ-Ⅱ group and grade Ⅲ group, and the frequency of AC+CC genotypes were 57.9% and 42.1%. The difference between the two groups was significant (χ~2=5.055; P=0.025). Compared with the AC+CC genotypes, the OR value of AA genotype in differentiated tumors(grade Ⅲ)was 3.082 (95%CI=1.122-8.465). Stratified for estrogen receptor (ER), progesterone receptor (PR) and C-erbB2, there was no difference between the distribution of AA genotype and AC+CC genotypes (χ~2=3.005, χ~2=1.504, χ~2=1.163, P>0.05). Conclusion:The AA genotype of Bcl-2 gene C(-938)A maybe correlated with high lymph node metastasis rate and poor differentiation.

OBJECTIVETo study the correlation between characteristics of lymph node metastases and prognosis in pancreatic cancer treated with pancreaticoduodenectomy.

METHODSThe clinicopathological data of consecutive series of 122 patients who underwent resection for adenocarcinoma of the pancreas with lymphadenectomy in our hospital were reviewed in this study. The number of metastatic lymph nodes, lymph node metastasis ratio, lymph node levels, and other clinocopathological factors were analyzed by Kaplan-Meier method and Cox proportional hazard model, and their correlation with prognosis was also analyzed.

RESULTS122 patients met the inclusion criteria and entered the study. There were 90 patients (73.8%) with lymph node metastases. Median (range) metastatic lymph node number was 7 (1-28) for the entire cohort, and median (range) metastatic lymph node ratio was 21.1% (3.6%-62.2%). The numbers of patients with lymph nodes metastases to levels 1, 2, 3 were 39 (43.3%), 40 (44.4%), and 11 (12.2%), respectively. Univariate analysis suggested that the maximum diameter of tumor, lymph node metastases, number, ratio, level, distant metastases and adjuvant chemotherapy were significantly related to survival in the entire cohort (P < 0.05). The maximum diameter of tumor, lymph node metastasis number, ratio, level, and adjuvant chemotherapy were significantly related to the survival in node-positive patients (P < 0.05). Multivariate analysis suggested that the diameter of tumor >2 cm, lymph node metastases, metastatic lymph node number >2, ratio >20%, level >1, and without adjuvant chemotherapy were independent risk factors of survival in the entire cohort (P < 0.05). The maximum diameter of tumor >2 cm, metastatic lymph node number >2, ratio >20%, level >1 and without adjuvant chemotherapy were independent risk factors of survival in node-positive patients (P < 0.05 for all).

CONCLUSIONSThe three indexes, metastatic number, ratio and extent of lymph nodal involvement are statistically significant prognostic factors in pancreatic cancer, which can complement the existing lymph node metastasis staging. The standardized pancreaticoduodenectomy combined with proper lymphodenectomy provides an important basis for a correct prognostic evaluation.

Adenocarcinoma ; Anastomosis, Surgical ; Chemotherapy, Adjuvant ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; diagnosis ; Multivariate Analysis ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; diagnosis ; surgery ; Pancreaticoduodenectomy ; Prognosis ; Proportional Hazards Models