Objective Shh and Ptch have been known to play critical roles in the hedgehog pathway and the hedgehog pathway activation occurs in the gastrointestinal cancers. This study was to detect the expression of Shh and Ptch in gallbladder carcinoma, and explore their correlation to gallbladder carcinoma. Methods The expression of Shh and Patch protein in 41 specimens of primary gallbladder carcinoma, 20 specimens of normal gallbladder and 21 specimens of adenoma tissue were assessed by immunohistochemistry.Results The positive expression rate of Shh and Ptch in gallbladder carcinoma was 75.6% (31/41) and 78.0% (32/40) respectively, in normal gallbladder mucous was 5% ( 1/20 ) and 5% ( 1/20 ) respectively,in gallbladder adenoma was 4.7% ( 1/21 ) and 9.6% (2/21) respectively, and there was significant differenee between the three groups in Shh and Patch expression values(P ＜0.001 ). However, there was no significant difference between age group, histological grade group, histologic type group, Nevin stage group,lymph node or distal organ metastasis group, and gallstone presence group in Shh and Ptch expression value (P ＞ 0.05, respectively). The expression of Shh was positively correlated to Ptch (r = 0.72, P ＜ 0.01 ).Conclusion These data support our hypothesis that Hh signaling is dysregulated in human gallbladder carcinognesis.

Objective To study the expression of chemokine stromal cell-derived factor-1 and its receptor CXCR4 in gallbladder carcinoma and evaluate the relationship between the expression of SDF-1 and CXCR4 protein and the clinicopathology,and lymph node metastasis of gallbladder carcinoma.Methods The expression of SDF-1 and CXCR4 protein in 41 cases of gallbladder adenoma carcinoma was examined by immunohistochemical technique(SP),and the relation of SDF-1/CXCR4 biology axis to clinicopathological parameter was also analyzed.Results The positive expression rate of SDF-1 and CXCR4 in gallbladder carcinoma was 68.3%(28/41)and 51.2%(21/41)respectively,in normal gallbladder mucous was 5%(1/20)and 5%(1/20)respectively,in cholecystitis and gallstone was 6.7%(6/90)and 5.6%(5/90)respectively,and there is significantly different among the three groups in SDF-1 and CXCR4 expression values(P＜0.001,P＜0.001,respectively).There is significant difference among histological grade group,Nevin stage group,histological differentiation,lymph node or distal organ metastasis group in SDF-1 and CXCR4 expression value(P＜0.05,respectively).However,there is no significant difference among sex group,age group,tumor size group,and gallstone presence group in SDF-1 and CXCR4 expression value(P＞0.05,respectively).The expression of SDF-1 was positively correlated to CXCR4(r=0.68,P＜0.01).Conclusion Up-regulated SDF-1 and CXCR4 is associated with the carcinogenesis and metastasis of gallbladder carcinoma.

Objective To analyze the CT staging and evaluate its role in assessing the resectability of the gallbladder carcinoma.Methods The CT scans of 47 patients who had pathologically confirmed gallbladder carcinoma were retrospectively reviewed and the CT stages of gallbladder carcinoma were used to evaluate the resectability.Results Before operation,three patients were in stage Ⅰ(6.4%,3/47),14stageⅡ(29.8%,14/47),10 stageⅢ(21.7%,3/47),20 stage Ⅳ(42.6%,20/47),however,after operation,three patients were in stage Ⅰ(6.4%,3/47),14 stageⅡ(29.8%,14/47),8 stage Ⅲ(17.0%%,8/47),22 stage Ⅳ(42.6%,20/47).The accurate rate of CT staging confirmed by operation was 91.5%(43/47).The treatment procedures of gallbladder carcinomas included radical operation,palliative excision and exploratory laparotomy.For 47 patients with gallbladder carcinomas,radical operation was performed in 30 cases(3 stage Ⅰ,14 stageⅡ,7 stage Ⅲ,6 stage Ⅳ),palliative excision 15 cases(1 stage Ⅲ,14 stage Ⅳ),exploratory laporatory 2 eases(2 stage Ⅳ).Conclusion The staging of gallbladder carcinoma with CT may provide definite value in evaluating respectability of gallbladder carcinoma.

Primary carcinoma of the gallbladder (PCG)is the common malignant tumor in the biliary system.Because there is no specific clinical manifestation, patients diagnosed with PCG are mostlyin intermediate or advanced stages.Therefore, they lose the chance of radical resection of gallbladder carcinoma and have a poor prognosis.Radiotherapy and chemotherapy are not effective palliative measures.Immunotherapy has become an alternative strategy besides operation, chemotherapy and radiotherapy.Treatment with DCs vaccines, as a new method of immunotherapy, has become more and more important.Here we review treatment with DCs vaccines in primary carcinoma of gallbladder.

Indoleamine 2,3-dioxygenase(IDO)is the rate-limiting enzyme in the catabolism of trypto-phan along the kynurenine pathway.Over expression of IDO is one of the reasons which are responsible for immune tolerance of tumor.IDO also affects the effects of the vaccine of the dendritic cell in the tumor therapy.Lipopolysaccharide(LPS),cytokines and so on can regulate the expression of IDO via different regulating mechanisms.IDO participates in the local immune tolerance of tumor by three kinds of mechanisms.Further research on this immunological regulatory mechanism will be significant for tumor immunotherapy.

End stage liver disease is a serious threat to human health.Existing conventional therapies are far from ideal,and orthotopic liver transplantation is limited by the lack of donor liver.A new therapy,transplantation of hepatic stem cell,is a promising approach.Hepatic oval cells are hepatic stem/progenitor cells(HSC/HPC)during hepatic regeneration,and they are being referred to as hepatic precursor cells.It got its name because of its oval nucleus,high nuclear/cytoplasmic ratio and other morphological features.Research has shown increasingly importance in the knowledge of hepatic oval cells.There are many signaling pathways in hepatic oval cells activation and proliferation.As a branch of the Wnt signaling pathway,Wnt/β-catenin signaling pathway has a significant effect on hepatic oval cells activation and proliferation.However,the exact mechanisms of this process have not been completely elucidated.This review describes the role of Wnt/β-catenin signaling pathway in hepatic oval cell activation and proliferation.

Gastrointestinal cancer is the most prevalent cancer among malignant tumors,with a upward trend in incidence.Since there is absence of specific clinical manifestation as well as low diagnostic rate,patients diagnosed with cancer of digestive tract are mostly in intermediate or advanced stages.Therefore,they lose the best chance of surgery and have a poor prognosis. Metabonomics,a kind of high sensitivity research technology,shows great potential in the exploration of occurrence and development of malignant tumor.The aim of this study was to review the progress of application in gastrointestinal cancer by metabonomics.

ObjectiveTo evaluate the changes of Ag-NORs in patients with gallbladder carcinoma.MethodsAg-NORs in the peripheral blood lymphocytes,bile lymphocytes and the mucosa of gallbladder were detected by a cell image analysis of KL-2 in 20 normal volunteers,90 cholecystitis cases, and 20 gallbladder carcinomas. ResultsAg-NORs in peripheral blood lymphocytes (PBL) and bile lymphocytes (BL) in cholecystitis were lower than that in normal group(P

0.05). The positive expression rate of p21 and p53 in gallbladder carcinoma was 62.5%(25/40) and 65.0%(26/40) respectively. The expression values of p21 and p53 in chronic cholecystitis was 2.5%(1/40) and 5.0%(2/40) respectively, which was significantly different from that of gallbladder carcinoma ( P

Objective To investigate the expressions of indoleamine 2,3-dioxygenase (IDO) and transcription factor forkhead box P3(FOXP3)in gallbladder adenocarcinoma; and to evaluate the relationship between the expressions of IDO and FOXP3 protein,and clinicopathology and lymph node metastasis of gallbladder carcinoma.Methods The expressions of IDO and FOXP3 in 51 cases of primary gallbladder cancer,90 cases of chronic cholecystitis,and 20 cases of normal gallbladder tissues were studied by immunohistochemical staining. Results The positive expression rates of IDO and FOXP3 in gallbladder carcinoma were 72.5％ (37/51) and 60.8％ (31/51),in normal gallbladder mucosa were 5％ (1/20) and 20.0％ (4/20),in cholecystitis and gallstone were 11.1％ (10/90) and 32.2％ (29/90),respectively.There were significant differences among the three groups in IDO and FOXP3 expressions (P＜0.01).The positive expression rates of IDO and FOXP3 were 7.1％ and 14.3％ for simple hyperplasia,17.7％ and 35.3％ for atypical hyperplasia,40％ and 35％ for gallbladder carcinoma (stages Ⅰ-Ⅲ),and 77.4％ and 64.5％ for gallbladder carcinoma (stages Ⅳ-Ⅴ ).There were significant differences among the four groups in IDO and FOXP3 expressions (P＜0.01).There were significant differences among the Nevin stage groups,lymph node metastasis group and gallbladder stone in IDO and FOXP3 expressions.However,there were no significant differences among the sex groups and the age groups in IDO and FOXP3 expressions (P＞0.05).In gallbladder carcinoma,the expression of IDO had a positive correlation with FOXP3 expression in lymphocyte (γ=0.406,P=0.003).Conclusion In gallbladder cancer,a high-expression of IDO and an expression of FOXP3 in lymphocyte are closely related with immune tolerance of gallbladder carcinoma.The results provide a reference for clinical use of immunotherapy in gallbladder cancer.