Gastrointestinal stromal tumor (GIST) may be defined as mesenchymal tumors of the gastrointestinal tract,and the application of the tyrosine kinase inhibitor imatinib mesylate has changed the treatment style of the tumor.The surgical treatment is the only choice for the GIST patients before imatinib era,but now the individualized treatment combined with target therapy,surgery and laparoscope surery becomes the mainstay.The paper focus on the new development of preoperative biopsy,laparoscope surery,imatinib neoadjuvant and imatinib therapeutic effect evaluation in recent years.

With the progress of gastrointestinal stromal tumor(GIST), to prevent GIST's recurrence and metastasis is still a hot topic. The pre-operative pathological diagnosis of GIST is difficult to be made, and the biopsy has the chance to cause metastasis. Standard operative procedure is the key point to prevent GIST's recurrence and metastasis, which includes en-bloc resection, enough margin and so on. For the recurrence/metastasis GIST, the reoperation can be performed, but the effective therapy is to use the molecular targeted drug:imatinib.

The treatment of gastrointestinal stromal tumors (GIST) has been revolutionized by the molecular targeted therapy, but we still emphasize the importance of how to use surgical principle and skill to treat GIST. In this review, we describe the experience in the treatment of GIST located in esophagus, gastrointestinalinal tract and colorectum. During operation, the surgeon shouldi resect the tumor completely. If the tumor can not to be resected completely, treatment should be managed by imatinib mesylate(Gleevec). Because GISTs seldom appear lymph metastases, it is not necessary to perform lymph node dissection.

Synovial sarcoma(SS) is a common soft tissue tumor,which origin hasn’t been confirmed. With different morphology and various differentiation, SS is likely to be confused with other soft tissue tumors.Therefore,the rate of misdiagnosis is very high.It is very diffi cult to diagnose SS just relying on symptom,sign,imaging and so on. The article mainly reviews the advances on immunohistochemistry and genetical detection in diagnosis of SS.

Sentinel lymph node(SLN) is prevalently studied in breast cancer and malignant melanoma as well as being applied in clinical practice.Currently,the study on sentinel lymph node of gastric cancer has gradually been a vital component in the study of diagnosis and treatment of gastric cancer.Sentinel lymph node examination is feasibly applied in clinical T1N0M0 stage gastric cancer or early gastric cancer because of its high accuracy and sensibility.However,the sentinel lymph node examination is not suitable for advanced gastric cancer due to low sensibility and high false negative rate.The article mainly reviewed the advances on SLN tracer,application,micrometastasis,imaging system and so on in gastric cancer.

Targeted therapy has gradually become the focus in the treatment of tumor, with the emerge of more and more targeted drugs which has brought the treatment of tumor into a new era. Imatinib, the tyrosine kinase inhibitor, is one of the important types of targeted therapy, has become the standard of care in adjuvant therapy of gastrointestinal stromal tumor(GIST) with extraordinary effects. However, the questions are still on debate incluing the optimal way to evaluate treatment results, the treatment duration, whether it can be intermitted or not, second line therapy for imatinib-intolerance or -resistance and the combination with surgery.

Purpose: The purpose of this study was to assess the method of compartment resection and evaluate its application to patients with extremity soft tissue sarcomas. Methods: From 1997 to 2002, 10 cases of thigh sarcoma underwent this operation (7 cases of posterior compartment and 3 anterior compartment) while 2 cases with upper limb disease received similar resection. Results: All the limbs of this group with such tumors were preserved. We followed up the 12 patients in the range of 10 to 60 months, 10(82%) were alive without tumor recurrence or metastases. One patient local with recurrent tumor is receiving radiotherapy now and another died from distance metastases. Conclusions: This improvement in the rate of limb -preserving resection in our series has been the result of compartment resection.

Background and purpose:Blood vessel metastasis often occurs after the operation of rectal cancer of stage Ⅱ and Ⅲ,angiogenesis is an important step of the procedure.Cycloxygenase-2(COX-2) and vascular endothelial growth factor(VEGF-C) are correlated to angiogenesis. The purpose of this study is to investigate the expressions of Cycloxygenase 2(COX-2) and vascular endothelial growth factor(VEGF-C) in rectal cancer of stage Ⅱ and Ⅲ,to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis.Methods:The expressions of COX-2,VEGF-C and the microvessel density(MVD) were detected by immunohistochemical staining.Results:①The positive rates of COX-2 and VEGF-C expression in rectal cancer were 72.5%,higher than those in peritumoral normal tissue(P

Objective To summarize the clinical and pathological characteristics of gastrointestinal stromal tumors with hepatic metastasis, and to analyze its survival and explore its principles of diagnosis and treatment. Methods Among 99 patients diagnosed as gastrointestinal stromal tumors who had a completely case history in our hospital, we retrospectively analyzed the clinical data of 26 patients with hepatic metastatic and the factors influencing survival. Results The average age at diagnosis of primary and hepatic metastatic gastrointestinal stromal tumors was 50.8 and 51.8 years old respectively. Five cases were confirmed by pathological examination, 12 cases were diagnosed by the exploration during the operation and 14 patients had an imaging diagnosis only. Synchronous and metachronous hepatic metastasis happened in 8 and 18 patients respectively. The median interval between the primary tumor and the metachronous hepatic metastasis was 12 months. The primary sites of 12 cases were in stomach, 5 in colorectum, 6 in small intestine and 3 in extra-gastrointestinal tract.Four cases of the hepatic metastatic tumors were treated with surgical resections, 2 with injections of anhydrous alcohol, 3 with interven-tional therapies, 7 with systemic chemotherapies, 8 with imatinib and 2 without treatment. The median survival was 21 months after hepatic metastasis. The administration of imatinib was an important factor prolonging the survival after hepatic metastasis. Conclusions The most frequent primary site of hepatic metastatic stromal tumor is the stomach while small intestinal stromal tumors are most inclined to metastasize to the liver. Treatment with imatinib for more than 3 months can prolong the survival.

Objective Colonic short chain fatty acids(SCFA) may maintain colonocyte differentiation and oppose carcinogenesis, although its precise mechanisms remain unclear. The purpose of this study is to investigate SCFA regulation of intestinal epithelial phenotype by characterizing the effects of three kinds of SCFA on differentiation,proliferation,and migration of human colonic adenocarcinoma cell line Caco-2 and discuss its clinical value. Methods Differentiation was assessed by brush border enzyme expression, doubling time (proliferation) calculated directly from serial cell counts and logarithmic transformation method. Cell motility(migration) was quantitated by the expansion of a confluent Caco-2 monolayer(after release from a constraining fence) across bacteriologic plastic dishes precoated with saturating concentrations of type Ⅰ collagen. Results All three SCFA studied altered the Caco-2 phenotype. Treatment with 10 mmol/L SCFA significantly prolonged the cell doubling time, promoted brush border enzyme expression(cathepsin C), and inhibit the motility of the Caco-2 cells. Conclusion The SCFA butyrate, propionate, and acetate inhibit the proliferation and motility of a well-differentiated human colonic cancer cell line while promoting the expression of the differentiation marker cathepsin C. The SCFA produced by bacterial fermentation of dietary fiber may exert a protective effect against the development of colon cancer.