OBJECTIVETo explore the value of dynamic subtraction technique of magnetic resonance imaging MRI in preoperative TNM-staging assessment of gastric carcinoma.

METHODSMRI was performed in 39 patients with gastric carcinoma diagnosed by postoperative pathology.The results of MRI were prospectively analyzed by one professor and compared with the corresponding pathological findings.

RESULTSIn comparison with pathological results, the accuracy of MRI for T stage was 82.1%, for N stage was 71.8%, and for M stage was 84.6% respectively. The accuracy of MRI for TNM stage was 71.8%, which revealed concordance between the preoperative TNM-staging and postoperative pathological findings (Kappa= 0.671-0.763, P<0.05).

CONCLUSIONMRI plays an important role in the assessment of invasion depth of gastric carcinoma, lymph node and distant organ metastases,which has unique priority in preoperative TNM-staging assessment of gastric carcinoma.

Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Stomach Neoplasms ; pathology

OBJECTIVETo explore the CT criteria for evaluating lymph node (LN) metastasis and preoperative N-staging of gastric cancer through the comparison of CT signs and surgical pathology.

METHODSEighty-nine patients with gastric cancer underwent CT examinations before radical resections. A soft-reading method on PACS workstation was employed to evaluate the detection of LNs. The size and number of LNs were registered, and the accumulated size of LNs was calculated in every case. The pathological N-staging (pN(0-3)) was considered on the basis of pathological examination of excised specimens according to UICC TNM-staging system (6th edition, 2002). The relationships between LN metastases and CT findings were analyzed by SPSS using t test and one-way ANOVA analysis.

RESULTSThe distribution of maximal size, CT detection number and accumulated size were significantly different among different pN stages (P<0.01). All these 3 indicators were significantly different between LN metastasis group and non-metastasis group (P<0.01). There was no significant difference of maximal size among different pN stages in positive metastasis LNs (P>0.05), while significant difference could be found in CT detection number between pN1 and pN3 (P<0.01), pN2 and pN3 (P<0.01), and in accumulated size between pN1 and pN3 (P<0.01), pN1 and pN2 (P<0.01).

CONCLUSIONSThe involvement of LNs in gastric cancer and pN staging are associated with size, number, and accumulated size of CT detection. CT detection number is more valuable in the evaluation of N staging than LNs size. CT detection number combined with accumulated size of LNs can provide meaningful information for preoperative N-staging.

Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Stomach Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

OBJECTIVETo investigate the efficacy of the procedure for prolapse and hemorrhoids (PPH) combined with external hemorrhoids excision in the treatment of III or IV mixed hemorrhoids.

METHODSOne hundred and twelve patients with III or IV mixed hemorrhoids admitted for surgical treatment were randomly divided into three groups: PPH 1 group (34 cases), PPH2 group (36 cases), and Milligan-Morgan group (42 cases). PPH1 group received the standard PPH operation, PPH2 received PPH and external hemorrhoids excision, and Milligan-Morgan group received Milligan-Morgan hemorrhoidectomy. Postoperative 24 h-pain index, pain index when defecating, bleeding, anal discomfort feeling , wound edema, the ability of controlling feces, operating time, hospitalization time and charges were recorded. The change of anal dynamics was detected by anorectal manometry. All the patients were followed-up for 0.5-1 year.

RESULTSThere were no significant differences among the three groups in bleeding, anal discomfort feeling, the ability of controlling feces (P>0.05). The postoperative 24 h-pain index of PPH1 group was lower than those of the other two groups (P<0.05). PPH1 group and PPH2 group were better than Milligan-Morgan group in pain index when defecating, wound edema, operating time, and hospitalization time (P<0.05). Milligan-Morgan group was better than the other two groups in postoperative urinary retention and hospital charges (P<0.05). The change of anal duct pressure of Milligan-Morgan group was less than those of the other two groups (P<0.05). Within 0.5-1.0 year follow-up, 3 patients got thrombosed external hemorrhoid in PPH1 group, 2 patients recurred and 1 patient got thrombosed external hemorrhoid in Milligan-Morgan group, no recurred patients in PPH2 group.

CONCLUSIONPPH combined with external hemorrhoid excision is a safe and effective treatment for mixed hemorrhoids, which is suitable for mixed hemorrhoids with severe external hemorrhoids.

Adult ; Aged ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Hemorrhoids ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Prolapse ; Surgical Stapling

OBJECTIVETo investigate the expression of phosphatase of regeneration liver-3(PRL-3) protein and its relationship with tumor invasion and metastasis in human colorectal carcinoma,and elucidate prognostic value.

METHODSImmunohistochemistry method was applied to detect the PRL-3 expression in the primary tumor specimens and paired paratumor normal tissues from 46 colorectal carcinoma patients, the adenoma tissues from 6 patients with colorectal adenoma, all the metastatic lymph nodes from 29 cases and the metastatic liver lesions from 6 cases. The relationship between PRL-3 expression and clinicopathologic parameters was analyzed and a survival curve was achieved according to Kaplan-Meier method.

RESULTSNo or weak PRL-3 protein expression was detected in normal colorectal mucosa and colorectal adenoma. In colorectal carcinoma tissues, PRL-3 expression was confirmed in 26 of 46 cases (56.5%) of primary colorectal carcinomas (with lymph node metastasis 63.0%, without lymph node metastasis 37.0%, P=0.001), 26 of 29 (89.7%) lymph node metastases, and 5 of 6 liver metastases. The expression of PRL-3 was assembled in the cytoplasm of carcinoma cells and more intensively on the cell membrane.Analysis of the relationship between PRL-3 expression and the clinicopathologic features showed that PRL-3 expression was closely associated with tumor stage (P=0.019), lymph node metastasis (P=0.026), but no relationship with age, sex, tumor size, degree of differentiation was founded (P<0.05). The mean follow-up time was 41.4 months and results showed that patients with positive expression of PRL-3 had a significantly poorer prognosis than those with negative PRL-3 expression group(P=0.032).

CONCLUSIONSPRL-3 protein plays a novel role in tumor progression and metastasis of colorectal carcinoma. PRL-3 can be expected to be a potential predictive biomarker for identifying the prognosis in colorectal carcinoma patients.

Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Liver Neoplasms ; metabolism ; secondary ; Liver Regeneration ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Prognosis ; Protein Tyrosine Phosphatases ; metabolism

OBJECTIVETo investigate the expression of chemokine receptor CXCR4 in colorectal carcinoma and its relationship with the clinicopathological parameters, and to reveal the role of CXCL12/CXCR4 in the invasion and metastasis of colorectal carcinoma.

METHODSCXCR4 expression was studied in 53 colorectal cancer tissues and 27 normal tissues by immunohistochemistry. Its relationship with clinicopathological characteristics of colorectal cancer patients were analyzed. The CXCR4 expression in tumor and normal specimens and its metastatic sites were assessed by RT-PCR and Western blot.

RESULTSFifty-three colorectal cancer patients,collected from July 2005 to February 2007 in our hospital,were enrolled in this study. CXCR4 was positive in 39 cancer tissue specimens(73.6%) and its high expression rate (in > 50% of cells) was 45.3%. High CXCR4 expression rate was significantly higher in patients with lymph node metastases (N(1)+N(2): 65.4%) than that in those without metastases(N(0) 25.9%). There were also associations between the high CXCR4 expression and the vascular and lymphatic vessel invasions (P<0.01). Meanwhile, there was a rising trend of high expression rate according to American Joint Committee on Cancer (AJCC) stage and pathologic grade,but no significant difference was found(P>0.05). There were no significant correlation of CXCR4 expression with clinicopathological parameters such as tumor location, tumor size, depth of tumor invasion(P>0.05). In addition, the CXCR4 mRNA expression in primary tumor specimens (n=27) from AJCC stage IIII( patients was significantly higher than that in normal tissues. CXCR4 mRNA expression of liver metastasis specimens(n=5) was significantly higher as compared with the primary colorectal cancer specimens(P<0.01).

CONCLUSIONSChemokine receptor CXCR4 is associated with the progression of colorectal carcinoma. High CXCR4 expression is associated with metastasis. The CXCL12-CXCR4 signaling pathway may be a potential novel target of therapy for patients with colorectal cancer.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; genetics ; Receptors, CXCR4 ; metabolism

OBJECTIVETo explore the effects and associated mechanism of phosphatase of regenerating liver cell-3 (PRL-3) on the invasion of human colon cancer cell.

METHODSAfter colon cancer cell line HCT116 was transfected with PRL-3 small interfering RNA (siRNA), the mRNA and protein expression of PRL-3 and matrix metalloproteinase 2 (MMP-2) and MMP-9 were determined by real time RT-PCR and Western blot respectively. The anchorage-independent growth was examined using clone formation assay in soft agar, and invasion ability was evaluated by boyden chamber model. Then the transfected HCT116 cells were implanted into nude mice and the tumor growth was observed.

RESULTSPRL-3 siRNA could inhibit anchorage-independent growth of HCT116 cells in a dose-dependent manner in vitro. The mRNA and protein expression of MMP-2 and MMP-9 were down-regulated by PRL-3 siRNA. HCT116 cells invaded striated muscle and vessels in control nude mice but such phenomena were not found in transfected HCT116-implanted nude mice in vivo.

CONCLUSIONPRL-3 siRNA inhibit the invasion of colon cancer cells possibly through the down-regulation of MMP-2 and MMP-9.

Animals ; Colorectal Neoplasms ; genetics ; metabolism ; HCT116 Cells ; Hepatocytes ; enzymology ; physiology ; Humans ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Proteins ; genetics ; Protein Tyrosine Phosphatases ; genetics ; RNA Interference ; RNA, Messenger ; genetics ; RNA, Small Interfering ; Transfection

OBJECTIVETo study the precise cause and the specific procedure about gastric mucosal lesion in rats with water immersion-restraint stress(WRS).

METHODSOne hundred and forty-four Wistar rats were divided into 9 groups randomly: A, B, C, D, E, F, G, H and I group. There were 16 rats in each group. A, B and C groups underwent gastric emptying determination. Emptying rate of gastric fluid was determined with radiate nuclide (99m)Tc. D, E and F groups underwent gastric acid secretion determination after cleaning gastric contents and pylorus ligation. G, H and I groups underwent gastric acid secretion determination after pylorus ligation without cleaning gastric contents. Gastric mucosal lesion ulcer index(UI) was evaluated. The relationship between of gastric mucosal lesion and gastric emptying rate and gastric acid secretion were examined.

RESULTSGastric emptying rate decreased obviously when the WRS time was prolonged. There were significant differences among B (WRS 2 h), C group (WRS 4 h) and A group (controlled group) (P<0.01). There was also significant difference between B and C group (P<0.01).The rats' gastric acid secretion was inhibited significantly. The differences among E (WRS 2 h), F (WRS 4 h) and D groups (controlled group) were significant (P<0.01). There was no significant difference between F and E groups (P>0.05). The gastric mucosal lesions were aggravated with time of stress. Gastric contents cleaning could effectively prevent gastric mucosal lesions originated by stress .The operation had no influence on this test. There were significant gastric mucosal lesion UI in B and C groups compared with A group (P<0.01). The difference between B and C group was significant (P<0.01).There were no gastric mucosal lesions in A, D, E, F and G groups. However, There was significant difference between I and F group (P<0.01). No significant difference were found among A, D, E, F and G groups (P>0.05). There were significant difference between H and B group and also between I and C group (P<0.01).

CONCLUSIONSWRS can induce gastric emptying disturbance, reduce gastric acid secretion and cause gastric mucosal lesion. As a factor inducing gastric mucosal lesion, acid can damage gastric mucosa as long as it exists without necessary peracid. The prolongation of acid with gastric mucosa contact period and the decrease of gastric mucosa resistance are perhaps the major causes of gastric mucosal lesion. Besides anti-acid, giving facilitative gastric emptying drugs and gastric lavage during stress ulcer prevention and cure should be considered. Acid evacuation in time is also a major cure for gastritis and recurrent ulcer.

Animals ; Gastric Acid ; secretion ; Gastric Emptying ; Gastric Mucosa ; pathology ; Male ; Rats ; Rats, Wistar ; Stress, Physiological

OBJECTIVETo estimate the effect of the lymph duct ligation on systemic inflammatory factors and endotoxins during intestinal ischemia-reperfusion (I/R).

METHODSMale SD rats underwent occlusion of superior mesenteric artery for 60 min followed by reperfusion for 120 min plus lymph duct ligation or not. Forty rats were randomly divided into 4 groups: group A (blank); group B (sham); group C (intestinal I/R); group D (intestinal I/R plus lymph duct ligation). Mesenteric lymph nodes were harvested for standard bacteriologic cultures. The endotoxin, D-lactate, diamine oxidase (DAO), and cytokines in serum were detected.

RESULTSThe rates of bacterial translocation to mesenteric lymph nodes were 40% in group C and 20% in group D. No positive lymph node cultures were encountered in any of group A and B. The serum cytokines (except for sICAM-1) , D-lactate, DAO and endotoxin levels were lower in group D than those in group C (P<0.05), but both were higher than those in group A and B (P<0.05).

CONCLUSIONDuring intestinal I/R injury, blockage the lymph flow from gut into bloodstream decreases the levels of cytokines, and significantly attenuates the increase in intestinal permeability.

Animals ; Disease Models, Animal ; Inflammation ; Intestinal Diseases ; metabolism ; microbiology ; pathology ; Intestines ; blood supply ; pathology ; Ligation ; Lymph Nodes ; pathology ; Lymphatic System ; surgery ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; microbiology ; pathology

OBJECTIVETo investigate the expression differences of minichromosome maintenance 2 (MCM2) mRNA and protein among colon adenocarcinoma, colon adenoma and normal mucosa, and among different clinicopathological types of adenomas.

METHODSFifty specimens, including 33 colonic adenomas, 12 colonic adenocarcinomas and 5 normal colonic mucosa were selected. Each specimen was divided into two parts, one for immunohistochemistry and the other for real-time RT-PCR. Expression differences of MCM2 mRNA among the colonic adenocarcinoma, adenoma and normal colonic mucosa were evaluated by REST-XL software.

RESULTSThe expression of MCM2 was observed in the basal third to half of the colonic crypts in normal mucosa, while throughout the epithelium in the colonic adenocarcinomas and adenomas. However, the expression of MCM2 mRNA in the adenocarcinomas was significantly higher than that in the adenomas(P=0.001). The MCM2 mRNA expression was elevated in the adenoma with villous type, in the conditions of high-grade dysplasia, larger size, sessile morphology and in patients of older ages, but the difference was not significant by REST-XL (P>0.05).

CONCLUSIONThe difference of MCM2 expression between the adenoma and the adenocarcinoma indicates its potential value in the early diagnosis of colonic cancer.

Adenocarcinoma ; metabolism ; pathology ; Adenoma ; metabolism ; pathology ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Cell Cycle Proteins ; genetics ; metabolism ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Minichromosome Maintenance Complex Component 2 ; Nuclear Proteins ; genetics ; metabolism ; RNA, Messenger ; Young Adult

OBJECTIVETo compare the sensibility and specificity between single-stranded conformation polymorphism (SSCP) and denaturing high-performance liquid chromatography (DHPLC) in screening hMSH2 and hMLH1 gene mutations for the diagnosis of hereditary non-polyposis colorectal cancer (HNPCC).

METHODSSeven Chinese HNPCC kindreds were collected. PCR-SSCP and DHPLC were used to screen the coding regions of hMSH2 and hMLH1 genes and the abnormal profiles were sequenced by a 377 DNA sequencer.

RESULTSSeven gene sequence variations of hMSH2 or hMLH1 were found. Among them, 4 variations were not found by SSCP, but by DHPLC. The sensibility of SSCP and DHPLC were 51.6% and 100% respectively, and the specificity were 66.6% and 93.3% respectively.

CONCLUSIONDHPLC has better sensibility and specificity in screening hMSH2 and hMLH1 gene mutation as compared to SSCP. DHPLC is an ideal method in the diagnosis of HNPCC.

Adaptor Proteins, Signal Transducing ; genetics ; Chromatography, High Pressure Liquid ; methods ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; DNA Repair ; Humans ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; genetics ; Mutation ; Nuclear Proteins ; genetics ; Pedigree ; Polymorphism, Single-Stranded Conformational ; Sensitivity and Specificity ; Sequence Analysis, DNA