Animals ; Colorectal Neoplasms ; blood ; etiology ; Humans ; Hyperinsulinism ; blood ; complications ; Insulin ; blood ; Insulin Resistance ; Insulin-Like Growth Factor Binding Proteins ; blood ; Insulin-Like Growth Factor I ; metabolism ; Metabolic Syndrome ; blood ; complications ; Receptor, IGF Type 1 ; blood ; Receptor, Insulin ; blood

Digestive System Neoplasms ; classification ; pathology ; surgery ; Lymphoma ; classification ; pathology ; surgery ; Neoplasm Staging ; Pathology ; trends ; Pathology, Surgical ; trends ; Urogenital Neoplasms ; classification ; pathology ; surgery ; World Health Organization

Adenomatous Polyposis Coli ; genetics ; metabolism ; pathology ; Bone Morphogenetic Protein Receptors, Type I ; genetics ; metabolism ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; metabolism ; pathology ; Genes, APC ; Genetic Predisposition to Disease ; Hamartoma Syndrome, Multiple ; genetics ; metabolism ; pathology ; Humans ; Microsatellite Instability ; Mutation ; PTEN Phosphohydrolase ; genetics ; metabolism ; Peutz-Jeghers Syndrome ; genetics ; metabolism ; pathology ; Protein-Serine-Threonine Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins B-raf ; genetics ; metabolism

AIM: To observe the effect of Ahmed glaucoma valve implantation intravitreal bevacizumab in the treatment of neovascular glaucoma ( NVG) .
METHODS:Twenty-two cases (22 eyes) who presented with NVG were first treated with intravitreal bevacizumab 0. 1mL ( 2. 5mg ), then with Ahmed glaucoma valve implantation after regression of iris neovessels. Cases were followed - up for 6 - 36 ( mean 24 ) mo with observation on visual acuity, IOP control, regression of iris neovessels, and complications during or after surgery.
RESULTS: Iris neovessels was regressed in different degree after injection within 1wk in 22 eyes. At final follow-up, the IOP of 18 eyes were all less than 21mmHg without any drugs and of 3 eyes with 1-3 kinds of anti-glaucoma drugs after combined Ahmed glaucoma valve implantation. The IOP of one eye was controlled after cryotherapy. The mean IOP dropped from 45. 36 ±8.13mmHg preoperatively to 15. 59 ± 3. 21mmHg postoperatively. IOP reduction was statistically significance between preoperative and postoperative ( P<0. 05) at final follow-up. Visual acuity was improved in 9 eyes (41%) and was no changed in 13 eyes. No serious complications were observed during or after intravitreous bevacizumab injection and Ahmed glaucoma valve implantation.
CONCLUSION: Ahmed glaucoma valve implantation and intravitreal bevacizumab in the treatment of NVG is useful and safe. It improves the success rate of surgery and preserves visual function, furthermore its complications are less.

OBJECTIVETo construct a recombinant short hairpin RNA (shRNA) expression vector targeting EZH2 gene, and to determine its effect on the proliferation of colon adenocarcinoma SW480 cells.

METHODSThe DNA sequence with short hairpin structure was designed according to the EZH2 cDNA sequence and cloned into PGFP-V-RS vector to construct a recombinant expression vector silencing EZH2 gene. After identification, the shRNA-expressing vector was then transfected into SW480 cells. RT-PCR and Western blot were used to detect the inhibitory effect at both mRNA and protein levels. MTT was used to detect cell viability due to the alteration of EZH2 gene activity.

RESULTSAt 48 h after transfection, the expression of EZH2 mRNA in the gene silencing group and negative control group were 0.339 ± 0.013 and 1.968 ± 0.072, respectively. The expression of EZH2 protein in the gene silencing group and negative control group were 0.229 ± 0.008 and 1.168 ± 0.053, respectively. The expression of EZH2 in the gene silencing group was significantly lower than that in the negative control group (P < 0.01, P < 0.05). At 48 and 72 h after transfection, the inhibition rate of cell growth in the gene silencing group was 30.7% and 25.9%, respectively, indicating that the cell growth was significantly inhibited in comparison with that in the blank control group (P < 0.05).

CONCLUSIONSA recombinant shRNA expression vector targeting EZH2 gene has been successfully constructed in this study, with a significant inhibitory effect on the proliferation of SW480 cells. This lays an experimental foundation for further exploring the mechanism underlying the action of EZH2 gene on tumor biology.

Adenocarcinoma ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Colonic Neoplasms ; metabolism ; pathology ; Enhancer of Zeste Homolog 2 Protein ; Gene Silencing ; Gene Targeting ; Genetic Vectors ; Humans ; Plasmids ; Polycomb Repressive Complex 2 ; genetics ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Transfection

OBJECTIVETo evaluate the value of spiral computed tomography in the preoperative assessment of the degree of tumor infiltration in mesorectum and circumferential resection margin status of rectal cancer compared with large tissue slice technique.

METHODSFifty-seven patients with rectal cancer diagnosed by fiber colonoscopy and pathology from March 2007 to December 2007 underwent preoperative 64-layers spiral CT examination. The degree of tumor infiltration in mesorectum and circumferential resection margin status were evaluated. Large tissue slice technique was applied in the pathologic study after the total mesorectal excision of the rectum to determine the degree of tumor infiltration in mesorectum and the circumferential resection margin status. The spiral CT findings were compared with pathologic results. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the CT results were assessed respectively.

RESULTSThe overall spiral CT accuracy was 93.0% (53/57) for the degree of tumor infiltration in mesorectum, and it was 94.7%, 94.7% and 96.5% for degree I, II, III infiltration, respectively. Fifty-three cases (93.0%) were accurately predicated with the circumferential resection margin status. The sensitivity, specificity, PPV and NPV of spiral CT measurement was 80.0%, 97.6%, 92.3% and 93.2%, respectively, and was consistent well with the histopathological diagnosis.

CONCLUSIONSSpiral CT provides accurate preoperative assessment for the degree of tumor infiltration in mesorectum and circumferential resection margin status of rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Mesentery ; diagnostic imaging ; pathology ; Middle Aged ; Neoplasm Invasiveness ; diagnostic imaging ; Neoplasm Staging ; Predictive Value of Tests ; Rectal Neoplasms ; diagnostic imaging ; pathology ; Rectum ; diagnostic imaging ; pathology ; Sensitivity and Specificity ; Tomography, Spiral Computed

OBJECTIVETo identify the differentially expressed proteins or peptides and potential biomarkers of tumorigenesis for colorectal cancers.

METHODSImmobilized pH gradient two-dimensional gel electrophoresis (2-DE) was used to separate and obtain the differentially expressed protein spots between colorectal cancers and matched normal mucosa. Liquid chromatography/mass spectrometry (LC-MS/MS) was used to characterize these proteins. Selected candidate proteins were further studied by Western blot, semi-quantitative RT-PCR and immunohistochemical staining.

RESULTSThirty-five protein spots showed marked expression changes (more than 5-fold) in colorectal carcinoma compared to normal mucosa. Fifteen proteins were up regulated and 20 were down regulated. Fourteen of these proteins were identified by tandem mass spectrometry, among which secretagogin (SCGN) was down-regulated and glucose-related protein (GRP) 78 was up-regulated in the tumors. The SCGN down-regulation was further supported by Western blot and RT-PCR analyses. Immunohistochemistry revealed that SCGN was strongly expressed in neuroendocrine cells of the colonic crypts and 53 of 54 (98%) neuroendocrine tumors. At protein level, although GRP78 was up regulated in colorectal carcinoma, there was no difference in the mRNA expression level between the tumor and paired normal mucosa.

CONCLUSIONSThe 2-DE combined with MS is a powerful tool for screening potential tumor biomarkers. The differentially expressed candidate proteins identified by 2-DE may be of significance in understanding the tumorigenesis of the colon cancer. SCGN is a potential biomarker for neuroendocrinal differentiation. GRP78 up-regulation in colorectal carcinomas may be related to its post-translational modification.

Biomarkers, Tumor ; genetics ; metabolism ; Calcium-Binding Proteins ; genetics ; metabolism ; Colorectal Neoplasms ; metabolism ; Electrophoresis, Gel, Two-Dimensional ; Gene Expression Profiling ; methods ; Gene Expression Regulation, Neoplastic ; Heat-Shock Proteins ; genetics ; metabolism ; Humans ; Immunohistochemistry ; Molecular Chaperones ; genetics ; metabolism ; Neuroendocrine Cells ; metabolism ; Neuroendocrine Tumors ; metabolism ; Proteomics ; methods ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Secretagogins

OBJECTIVETo describe the fine needle aspiration cytology (FNAC) features of various salivary gland lesions and to analyze the respective diagnostic value and pitfalls.

METHODS113 FNAC specimens of salivary gland lesions were reviewed and correlated with clinical and histopathologic findings.

RESULTSThe FNAC diagnostic failure (2); non-neoplastic lesions (12); benign neoplasm (82) and malignant neoplasm (17). Cytologically, the distinction between cellular pleomorphic adenoma, adenoid cystic carcinoma and basal cell adenoma could be difficult due to their overlapping morphologic features. The cytologic patterns of primary lymphoepithelial carcinoma of the parotid were indistinguishable from those of metastatic nasopharyngeal undifferentiated carcinoma. The ultimate distinction relied on clinical correlation. The three inaccurately diagnosed cases of FNAC are, as follows: reactive lymphoid hyperplasia of lymph node mistaken as non-Hodgkin lymphoma, mucoepidermoid carcinoma diagnosed as "scanty atypical cells present" and primary lymphoepithelial carcinoma mistaken as benign lymphoepithelial lesion. On the basis of FNAC, 97.4% (110 /113) were correctly depicted as benign (95/96; 99.0%) or malignant (15/17; 88.2%). Furthermore, 90.3% (102 /113) (specificity = 91.9%; 102/111) were accurately diagnosed, including 91.7% (88/96) benign lesions (specificity = 92.6% ; 88/95) and 82.4% (14/17) malignant tumors (specificity = 87.5%; 14/16).

CONCLUSIONSFNAC is reliable in distinguishing benign and malignant salivary gland lesions. A specific cytologic diagnosis is often possible. On the other hand, due to the pitfalls in cytologic diagnosis of certain salivary gland tumors, tissue biopsy for histologic examination may be necessary.

Adenolymphoma ; pathology ; Adenoma ; pathology ; Adenoma, Pleomorphic ; pathology ; Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Adenoid Cystic ; pathology ; Carcinoma, Mucoepidermoid ; pathology ; Carcinoma, Squamous Cell ; pathology ; Child ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands ; pathology ; Submandibular Gland Neoplasms ; pathology

OBJECTIVEThe study aimed to evaluate the value of plasma NT-proBNP in diagnosing heart failure in patients with previous myocardial infarction.

METHODSPlasma concentration of NT-proBNP was measured in patients with previous myocardial infarction by ELISA method at admission. Patients were divided into non heart failure group (NYHA class I) and heart failure group (NYHA class II-IV). The NT-proBNP levels were compared between NYHA class I, II, III and IV, and between heart failure group and non heart failure group. ROC analyses were performed to evaluate the diagnosing value of plasma NT-proBNP for heart failure and to identify the optimal cut-off point for diagnosing heart failure patients.

RESULTSTotal 586 patients [aged from 25 - 83 (58 ± 11) years, 80% male] with previous myocardial infarction were enrolled in his study (n = 374 of NYHA class I, n = 99 of NYHA classes II, n = 82 of NYHA class III, n = 31 of NYHA class IV). Plasma NT-proBNP levels in these four NYHA classes were 484.7 (381.6, 647.8) pmol/L, 907.6 (516.6, 1290.3) pmol/L, 1420.2 (879.5, 2336.2) pmol/L, 2442.6 (1695.4, 3670.7) pmol/L, respectively (P < 0.01). The plasma NT-proBNP level in heart failure group was significantly higher than in non heart failure group [1148.2 (707.9, 2145.3) pmol/L vs. 484.7 (381.6, 647.8) pmol/L, P < 0.01]. Plasma NT-proBNP level in patients with age ≥ 60 years was significantly higher than patients with age < 60 years [702.3 (472.4, 1208.5) pmol/L vs. 526.6 (392.1, 855.6) pmol/L, P < 0.01]. ROC analysis showed that the area under the curve (AUC) for diagnosing heart failure was 0.844 (95%CI: 0.809 - 0.880, P < 0.01), the optimal plasma NT-proBNP cut-off point for diagnosing heart failure was 700 pmol/L with a sensitivity of 75.9%, a specificity of 79.9%, an accuracy of 78.3%, a positive predictive value of 67.9% and a negative predictive value of 85.3%. The optimal plasma NT-proBNP cut-off point was 600 pmol/L for patients ≥ 60 years old and 800 pmol/L for patients < 60 years old.

CONCLUSIONPlasma NT-proBNP level is a valuable parameter for diagnosing heart failure in patients with previous myocardial infarction.

Adult ; Aged ; Aged, 80 and over ; Female ; Heart Failure ; diagnosis ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVETo study the clinicopathologic features, immunophenotype, differential diagnosis and prognosis of uterine epithelioid trophoblastic tumor(ETT).

METHODSFrom 2000 to 2007, 5 ETTs cases were diagnosed in the affiliated Women's Hospital, School of Medicine, Zhejiang University. The pathologic characteristics and immunophenotype of the tumors were analyzed by histological examination and immunohistochemistry of CK18, p63, inhibin-alpha, HCG, HPL, PLAP and Ki-67. The clinical prognostic factors were evaluated based on a following-up data with a period of 11 - 50 months.

RESULTSThe overall prevalence of ETT was 0.48% among all the gestational trophoblastic diseases patients received in the same period. Five ETT patients were in the reproductive ages with a median of 33 years. Histologically, the tumor showed an invasive, nodular growth consisting of uniform mononuclear trophoblastic cells. There were zones of hyaline material in the tumour nests. Necrosis was commonly seen with a characteristic geographic pattern. Immunohistochemically, all cases displayed a diffuse CK18 and p63 positivity, to be either positive focally or negative for HCG, HPL and PLAP staining. Inhibin-alpha staining was positive or negative either in the 5 cases. Two patients died of the tumour relapse: one died after 1 year with the tumor having a high mitotic activity (averagely 15 mitotic figures per 10 high-power fields), and the other died of lung metastasis 2 years after the diagnosis.

CONCLUSIONSETT is a rare trophoblastic disease with distinct clinicopathological features and immunostaining patterns. A high mitotic index and lung metastasis are indicators for an unfavorable prognosis.

Adult ; Alkaline Phosphatase ; metabolism ; Chemotherapy, Adjuvant ; Chorionic Gonadotropin ; metabolism ; Epithelioid Cells ; pathology ; Female ; Follow-Up Studies ; GPI-Linked Proteins ; metabolism ; Humans ; Hysterectomy ; Inhibins ; metabolism ; Isoenzymes ; metabolism ; Keratin-18 ; metabolism ; Ki-67 Antigen ; metabolism ; Lung Neoplasms ; secondary ; Membrane Proteins ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Placental Lactogen ; metabolism ; Pregnancy ; Trophoblastic Neoplasms ; drug therapy ; metabolism ; pathology ; secondary ; surgery ; Uterine Neoplasms ; drug therapy ; metabolism ; pathology ; surgery