Objective To investigate the expression and clinical significance of apoptosis inhibitory protein, Livin and Smac,in pancreatic carcinoma. Methods The expressions of Livin and Smac protein in 46 cases of pancreatic carcinoma tissues and 15 cases of insulinoma tissues and 14 cases of normal pancreatic tissues were examined by using immunohistochemical SP staining, and its relationship with clinicopathological parameters was analyzed. Results The positive expression rates of Llivin protein were 73.9％ ( 34/46),73.3％ (11/15) and 14.3％ (2/14) in pancreatic carcinoma, insulinoma and normal pancreatic tissue. Livin was highly expressed in pancreatic carcinoma and insulinoma, but there was no significant difference between the two groups, however, both were significantly higher than that in normal pancreatic tissues group ( P ＜ 0.05 ). The expression of Livin was significantly correlated with lymph node metastasis, histopathological grading and clinical staging (P ＜ 0.05 or P ＜0.01 ). The positive expression rates of Smac protein were 39.1％ (18/46), 100％ ( 15/15 ) and 92.9％ (13/14) in pancreatic carcinoma, insulinoma and normal pancreatic tissue. Smac was highly expressed in normal pancreatic tissues and insulinoma, but there was no significant difference between the two groups, however, both were significantly higher than that in pancreatic cancer group (P ＜ 0.05 ). The expression rote of Smac protein was significantly correlated with lymph node metastasis, histopathological grading, chnical staging and patients' age (P ＜0.05 or P ＜0.01 ).Conclusions Livin protein may play an important role in genesis and development of pancreatic carcinoma,but Smac protein may play a role in preventing the development of pancreatic carcinoma.

Objective To analyze survival and recurrence rates of patients with Masaoka stage Ⅲ thymoma and to explore the prognostic factors.Methods Between September 1965 and December 2010,a total of 111 patients with stage Ⅲ thymoma treated in our hospital were retrospectively analyzed.Sixty-eight patientsreceived comple te rescction ± radiotherapy,whilc 23 patients received incomplete resection ±radiotherapy and 20 patients received biopsy ± radiotherapy.Eighty-seven patients received postoperative radiotherapy (12 patients received preoperative radiotherapy) while 24 patients received surgery alone.Results The median follow-up time was 66 months (5-540) with a follow-up rate of 92.5％ (111/120).Compared with incomplete resection ± radiotherapy and biopsy ± radiotherapy,the 5-year overall survival (OS) (88％ vs.59％ and 57％,x2 =12.11,P =0.002),disease free survival (DFS) (74％ vs.40％ and 41％,x2 =11.49,P =0.003) and disease specific survival (DSS) (94％ vs.69％ and 60％,x2 =10.95,P =0.004) could be improved with complete resected ± radiotherapy.Compared with surgery alone,postoperative radiotherapy did not improve OS,DFS and DSS (55％ vs.77％ (x2 =1.01,P =0.316),61％vs.61％ (x2 =0.12,P =0.729) and 72％ vs.85％ (x2 =0.27,P =0.601),respectively).For the 68 patients received complete resection,radiotherapy after complete resection (56 patients) did not improve OS,DFS and DSS (82％ vs.89％ (x2 =0.31,P =0.576),72％ vs.81％ (x2 =0.05,P=0.819) and 89％vs.95 ％ (x2 =0.05,P =0.825),respectively) compared with surgery alone (8 patients).Conclusions Stage Ⅲ thymoma patients received complete resection had better outcome than patients received incomplete resection or biopsied only.The role of postoperative radiotherapy is still controversial for stage Ⅲ thymoma,randomized clinical trial is needed