AIM: To investigate the expression of midkine in bladder transitional cell carcinoma and to analyze its relationship with the features of clinical pathology and prognosis.METHODS: The expressions of midkine protein in 50 cases of bladder transitional cell carcinoma samples were detected by SP immunohistochemical method using polyclonal antibodies against human midkine.Survival time of 40 cases was recorded.RESULTS: The protein expression of midkine was found in cytoplasm of tumor cells.The overall positive rate of midkine in 50 cases of bladder carcinoma was 90%(45/50).The positive degree of midkine showed a trend of increasing in grade and stage.There was statistically significant difference among them(P0.05).Patients with high expression of MK predicted a poor clinical outcome.CONCLUSION: Midkine is overexpressed in bladder transitional cell carcinoma than that in normal bladder.MK expression in bladder cancer is higher in less differentiated and deeper invaded cases,but it has no correlation with age,sex,treatment,tumor number and size.Patients with higher MK expression have shorter survival time than those with lower MK expression.

Objective In this retrospective study, we analyzed the magnetic resonance imaging (MRI)and computed tomography(CT)scans of patients with prostate cancer to investigate the relationship between the apex of prostate and the anatomic structures visible in CT, and to provide evidence for localizing the prostatic apex in radiation treatment planning. Methods MRI and CT scans from 108 patients with prostate cancer were analyzed to measure the distance between the prostatic apex and the bottom of ischial tuberosities,the bottom of obturator foramen, the bottom of pubic symphysis and the bulb of the penis. The volume of prostate was calculated and the relationship between the size of the prostate and the localization of the prostatic apex was analyzed. Results The prostatic apex is located 13. 1 mm ±3. 3 mm superior to the bulb of the penis, 11.0 mm ± 5.4 mm superior to the bottom of obturator foramen, 31.3 mm ± 5.5 mm superior to the bottom of ischial tuberosities, and 7. 1 mm ± 4. 7 mm superior to the bottom of obturator foramen. There was no correlation between the size of prostate and the localization of the prostatic apex(R =0. 07、-0. 33, all P ＞ 0. 05). Conclusions Ninety-five percent of patients had a prostatic apex that is above the bulb of the penis 6 mm, and 100% of patients had a prostatic apex that is above the bottom of obturator foramen.

ObjectiveTo investigate the early diagnosis and treatment of pleuropulmonary blastoma in children. Meth-ods The progress of pleuropulmonary blastoma from type 1 to type 3 was retrospectively analyzed.Results The male infant had no obvious abnormality in chest X-ray at 18 days. At one year old, X-ray iflm of the chest showed cystic lesions near hilum of the left lung (about 5 cm × 4 cm × 4 cm). The congenital cystic adenomatoid malformation was considered and an operation resection was suggested. However, it had been rejected by his parents. At 3 years and 2 months old, chest X-ray and CT showed left lung had a solid cystic lesion, the volume was signiifcantly enlarged, the back side was solid and the upper part had a large gas cavity. Two months later, the patient had asthmatic suffocation. The chest CT showed the tumor was completely solid. Pleuropulmonary blastoma type 3 was considered. The patient received the conventional chemotherapy after operation excision, and was followed up for 1 year. No recurrence was observed after the treatment.Conclusions Type 1 pleuropulmonary blastoma and congenital cystic adenomatoid malformation are hard to be differentially diagnosed. Early diagnosis and treatment of type 1 pleuropulmo-nary blastoma can improve the prognosis.

Objective To evaluate the significance of the expression level of aldo-keto reductase family 1 member C3(AKR1C3) for esophageal carcinoma patients treated with radiotherapy.Methods The clinical data of 28 patients with locally advanced esophageal carcinoma treated with radiotherapy alone was retrospectively analyzed, and the expression level of AKR1C3 was detected by immunohistochemistry.Statistical analysis was performed using SAS 8 statistical software, P<0.05 was considered statistically significant difference.Results The expression level of AKR1C3 was different in esophageal carcinoma patients at different levels of differentiation.The level of AKR1C3 expression was negatively correlated with efficacy of radiotherapy (P=0.031, 95%CI 0.151-0.914).Conclusion AKR1C3 can serve as a promising biomarker of the efficacy of radiotherapy for esophageal cancer.

Objective To study the radiosensitizing effect of 2'-hydroxyflavanone (2'-HF) on prostate cancer cells,and to preliminarily investigate its mechanism.Methods Colony formation assay,tert-butylhydroperoxide (TBHP) oxidative stress assay,Hoechst staining,and apoptosis flow cytometry using Annexin V-FITC and propidium iodide (PI) were performed to measure the impact of 2'-HF on the radiosensitivity of VCaP prostate cancer cells.Western blot was used to determine the effects of 2'-HF on expression of AKT,phosphorylated AKT (p-AKT),and aldo-keto reductase 1 C3 (AKR1 C3) in VCaP cells and preliminarily investigate the mechanism.Data were analyzed by t test and factorial analysis of variance.Results The results of colony formation assay indicated that after exposure to radiation,VCaP cells treated with 2'-HF had a significantly lower proliferation level than cells in the control group (P=0.010),yielding a sensitization enhancement ratio of 1.19.The resuhs of TBHP oxidative stress assay suggested that VCaP cells treated with 2'-HF had significantly weaker anti-oxidative capacity than cells in the control group (P=0.015).Hoechst staining and apoptosis flow cytometry with Annexin V-FITC and PI indicated that 2'-HF treatment plus irradiation significantly enhanced apoptosis in VCaP cells (P=0.001.The results of Western blot suggested that 2'-HF treatment significantly inhibited the protein expression of p-AKT and AKR1C3 in VCaP cells (P=0.013 and P=0.016).Conclusions 2'-HF can enhance the radiosensitivity of prostate cancer cells,which is probably associated with its inhibitory effects on AKT pathway and AKR1C3 expression in prostate cancer cells.

Objective To evaluate the impact of gross tumor volume(GTV)on prognosis of three-dimensional conformal radiotherapy(3DCRT)in esophageal carcinoma.Methods From Jan.2004 to Oct.2007,131 stageⅠ-Ⅲb patients with unreseetable esophageal carcinomas who received 3DCRT with 60 Gy/ 30f/6w were analyzed retrospectively.The effectiveness of related prognostic factors on survival was evaluated by univariate and multivariate analyses.Results The following-up rate was 100%.By univariate analysis,the 1-,2-and 3-year local tumor control rates were 71%,64%and 60%for patients with GTV volume≤40 cm3,and 43%,32%and 28%for those with GTV volume>40 cm3(X2=13.16,P=0.000).respectively.The 1-,2-and 3-year local tumor control rates were 67%,59%,59%for T1+2 patients,62%,53%,50%for T3 patients,and 41%,28%,19%for T4 patients,respectively(X2=13.25,P=0.001).The 1-,2-and 3-year survival rates were 78%,53%,46%for patients of GTV volume≤40 cm3 and 45%.27%and 7%for patients of GTV volume>40 cm3(X2=21.55,P=0.000).The 1-,2-and 3-year survival rates were 71%,50%and 39%for patients with T1+2,68%,46%and 25%with T3,and 36%,18%and 15%with T4,repectively(X2=14.35,P=0.001).The 1-,2-and 3-year survival rates for patients with tumor length≤5 cm were 75%,50%and 44%,compared with 53%,35%and 18%with tumor length>5cm(X2=5.99,P=0.014).By multivariate analysis,GTV volume and T stage were likelv to be independent prognostic factors for local tumor control rates(X2=7.07,P=0.008;X2=6.63,P=0.036).Only the GTV volume was associated with the overall survival rate(X2=15.82,P=0.000).Conclusions GTV volume is independent prognostic factor.The larger the GTV volume is,the worse the prognosis will be.

Objective To examine the expression of MMP-2 gene and Survivin gene in subclinical microscopic tumor and its peripheral normal esophageal tissues,and study the radiation target in molecular level. Methods Esophageal squamous cancer and its peripheral tissue samples of 34 patients were cut into sequential sections.The expression of MMP-2 gene and Survivin gene then examined.The length of the peripheral esophageal tissue,positively expressing the two genes,was measured,and the relation among the experimental date,tumor stage and vertical length of tumor were analyzed. Results For tumor tissue,subclinical microscopic tumor and the peripheral differentiated normal tissue,the positive expression rate of MMP-2 was 85%,83%and 79%,respectively.The positive expression rate of Survivin was 76%,85%and 85%,respectively.The positive expression level of both MMP-2 and Survivin genes in subclinical microscopic tumor was significantly higher than that in the peripheral differentiated normal tissue(χ2=6.46,P=0.028 and χ2=16.15,P=0.001).The length was 17.2-70.4 mm and 15.0-82.4 mm of cancerous peripheral tissue with positive expression of MMP-2 gene upside and downside of the tumor.The length was＜70 mm in 97% of the samples.For Survivin gene.the length was 3.7-76.4 mm and 16.1-56.3 mm.and was＜70 mm in 96%of the samples.The length of cancerous peripheral esophageal tissue expressing the two genes increased significantly along with tumor stage or tumor length,and there was statistical correlation between the length of tumor and the positive expression ranges of Survivin gene. Conclusions Both MMP-2 gene and Survivin gene are positively expressed in esophageal cancerous peripheral tissue.The range positively expressing the two genes is＜70 mm in more than 96%of the samples,and the length is correlated with the tumor stage.More attention should be paid to the peripheral differentiated normal tissue with positive expression of MMP-2 gene and Survivin gene in esophageal squamous carcinoma.

Objective To evaluate the respiration-induced dosimetric variance in 3DCRT for midthoracic esophageal carcinoma, in order to guide the radiation oncologist to choose the expansion margin. Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CT simulator respectively in free breathing ( FB), breath-hold after normal inspiration and expiration ( IBH and EBH )with the same scanning range. Then the CT images of three series were transferred to the treatment planning system. The target volume was outlined following the same standard. Plan1 was designed in the images of FB and transported completely to the images of IBH and EBH as Plan2 and Plan3 respectively to observe the dosimetric variance in target volume. Results For GTV, there was a statistical difference only in V100 of the three plans ( H = 6.423, P = 0.040 ) and no significant difference was found in other indexes. For CTV, the V100 and V95 were better in Plan1 (F=3.992, P=0.030; H=9.920, P=0.007) and no significant difference was found in other indexes. While ()TV, the Dmin, V100 and V95 was better in Plan1 ( F = 3.677, P = 0.039; F = 4.539, P = 0.020; H = 6.846, P = 0.033 ) and no significant difference was found in other indexes. There were no significant differences in all the indexes for the spinal cord and lung in the three plans. Conclusions The change in dose distribution was not so much with the standard expansion. It can meet the needs of clinical treatment.

Objective To explore the relationship between esophageal carcinoma extensive infiltration and lesion length and 252 Cf intracavitary brachytherapy,and to evaluate its prognostic influence.Methods Thirty-two patients with esophageal carcinoma were treated by external beam and 252Cf intracavitary radiation.The patients were first treated with conventional fractionated radiation to a dose of 38 Gy over 4 weeks,with 5 daily fractions of 2 Gy per week,and then treated with external and intracavitary radiation concomitantly (4.0 Gy per fraction,once a week on every Saturday to 12 Gy in 3 fractions).The total dose of external irradiation was 50 Gy.Results The local control rate (LCR) at 1,3 and 5 years was 93.75％,76.70％ and 65.75％ in the patients with ≤5 cm lesion (NMT5 group),and 60.94％,27.08％ and 27.08％ in the patients with ＞5 cm lesion (MT5 group),respectively (x2 =7.01,P ＜ 0.05).The 1-,3-and 5-year survival rate (SR) was 93.75％,56.25％ and 43.75％ in the NMT5 group,and 75.00％,18.75％,12.50％ in the MT5 group,respectively (x2 =5.96,P ＜ 0.05).The LCR at 1,3 and 5 years was 92.31％,73.85％ and 61.54％ in the patients with ≤1.5 cm infiltration depth (NMT1.5 group),and 67.67％,35.45％ and 35.45％ in the patients with ＞ 1.5 cm infiltration depth (MT1.5 group),respectively (x2 =3.87,P ＜ 0.05).The 1-,3-and 5-year SR was 92.31％,61.54％ and 46.15％ in the NMT1.5 group,and 73.68％,21.05％ and 15.79％ in the MT1.5 group,respectively (x2 =6.24,P ＜ 0.05).LCR and SR in the patients with ≤5 cm lesion and ≤2 cm infiltration depth were significantly better than those with ＞ 5 cm lesion and ＞ 2 cm infiltration depth (x2 =10.09,7.97,P ＜ 0.05).Conclusions The patients with ≤5 cm lesion length or those with ≤ 1.5 cm infiltration depth,might become the most adaptable indication for 252 Cf intracavitary radiation.In addition,those patients with ≤2 cm infiltration depth and ≤5 cm lesion length were also suitable for 252Cf intracavitary radiation.

Objective To investigate the androgen-like effects of Cordyceps sinensis (CS) and its impact on the radiosensitivity of VCaP prostate cancer cells.Methods The hormone levels and weight index of reproductive organs in mice were determined after gavage with CS.Clonogenic assay was performed to determine the impact of CS on the radiosensitivity of VCaP cells.The 3-(4,5-dimethylthiazol-2-yl)-5 (3-carboxymethonyphenol)-2-(4-sulfophenyl)-2H-tetrazolium assay,flow cytometry,and tumor xenografts in nude mice were performed to determine the effects of CS on the proliferation of VCaP cells (androgen receptor-positive) and PC-3 cells (androgen receptor-negative) in vitro and in vivo.Serum prostate-specific antigen (PSA) levels in nude mice were evaluated.Data were analyzed by one-way analysis of variance or ttest.Results The testosterone level and weight of prostate in mice were significantly higher in the CS group than in the control group ((8.28± 1.94) vs.(2.08± 1.24) ng/ml,P=0.023;(0.53±0.04) vs.(0.31 ± 0.04) mg/g,P =0.006).The radiosensitivity enhancement ratio (ratio of D0 values) was 0.80.The viability of VCaP cells was significantly higher in the CS group than in the control group (1.32 ± 0.07 vs.0.66 ±0.02,P=0.000),and colony forming efficiency was significantly enhanced in the CS group than in the control group (57.0％ ± 1.9％ vs.47.0％ ± 0.6％,P =0.005).VCaP tumor xenografts in nude mice were inclined to grow faster in the CS group than in the control group,and the serum PSA level in the CS group was significantly higher than that in the control group ((0.66 ± 0.04) vs.(0.26 ±0.06) ng/ml,P =0.000).However,CS had no effect on PC-3 cells at the working concentration.Conclusions CS has the androgen-like effects.It may also promote the proliferation and reduce the radiosensitivity of androgen receptor-positive VCaP cells.