OBJECTIVETo evaluate the feasibility and utility of an ex vivo sentinel lymph node (SLN) identification and ultrastaging for colorectal cancer (CRC).

METHODSCRC patients undergoing resection of a primary colorectal cancer were considered for inclusion. Following resection, SLN identification was performed. The SLN was dissected from the mesentery and submitted separately for pathologic analysis. All lymph nodes were stained with HE. Blue lymph nodes, when negative by routine HE staining, were further analyzed.

RESULTSA total of 62 tumors from 60 patients with colorectal cancer were studied. 95.2% (59/62) specimens was successfully identified. In these 59 specimens, a total of 1114 (18.9 per specimens) lymph nodes were examined; of these, 157 (14.9%) were designated as SLNs. The number of blue-stained lymph nodes removed ranged from 1 to 9, with a mean of 2.7 blue nodes identified. The sensitivity of a blue-stained lymph node identifying metastatic disease was 39.1%. The false-negative was 23.7%. In 4 specimens micrometastases were detected only by immunohistochemistry with cytokeratin.

CONCLUSIONSEx vivo sentinel lymph nodes mapping in colorectal cancer is feasible and can identify the SLNs with a very high success rate. Ex vivo SLN mapping improves pathologic staging of patients with CRC. The SLN evaluation should not replace attempts to harvest large number of nodes for standard processing. SLN mapping can help improving the number of nodes for pathological examination.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Rosaniline Dyes ; Sentinel Lymph Node Biopsy ; methods

OBJECTIVETo investigate the effect of Qufeng Tongluo Recipe (QTR) on the expression of desmin and CD2-associated protein (CD2AP) in adriamycin-induced nephropathy rats.

METHODSThe adriamycin-induced nephropathy rat model was induced by a disposable intravenous injection of adriamycin. The model was successfully established after 3 weeks. Rats were then randomly divided into the blank control group (Group A, n =12), the model control group (Group B, n = 8), the small, medium, large dose QTR group (Group C, n = 8; Group D, n = 8; Group E, n = 8), and the positive control group (Group F, n = 8). From the fourth week normal saline was given to rats in Group A and Group B, QTR 1.0 g/mL, 2.1 g/mL, and 4.2 g/mL was respectively administered to those in Group C, D, and E. Prednisone 25 mg/kg was given to rats in Group F. All medication was performed by gastrogavage at 10 mL/kg, once daily, for 28 successive days. 24-h urinary protein excretion and sera biochemical indices were determined during medication. At the end of the experiment, ultrastructure was observed, mRNA expression of desmin, mRNA and protein of CD2AP were detected by Real-time PCR and Western blot.

RESULTS(1) Compared with Group B, 24-h urinary protein excretion significantly decreased in Group C, D, E, and F (P < 0.05). (2) Compared with Group B, Alb in Group C, D, and E increased (P < 0.05) and TC significantly decreased (P < 0.05). TG significantly increased in Group F (P < 0.05). (3) Results of electron microscope showed, compared with Group B, the morphology of foot cells was improved to various degrees in Groups D, E, and F, especially the foot process structure and the number of foot processes were significantly improved, which was more obviously shown in Group D and Group E. (4) mRNA expression of desmin, mRNA and protein of CD2AP increased in adriamycin-induced nephropathy rats (P < 0.05). After intervention, when compared with Group B, mRNA expression of desmin and CD2AP were significantly lower in Group C, D, E, and F (P < 0.05). (5) Compared with Group A, expression of desmin and CD2AP significantly increased (P < 0.05). Compared with Group B, the expression of desmin protein were obviously lower in Group C, D, E, and F, and the protein expression of desmin obviously decreased in Group D, E, and F (P < 0.05). The protein expression of desmin and CD2AP gradually decreased in Group C, D, and E (P < 0.05). Compared with Group F, the expression of CD2AP protein obviously increased in Group C and D (P < 0.05); the expression of CD2AP protein obviously decreased in Group E (P < 0.05); the expression of desmin protein was higher in Group C, D, and E (P < 0.05).

CONCLUSIONQTR's therapeutic effect on adriamycin-induced nephropathy rats might be achieved through altered expression of desmin and CD2AP.

Adaptor Proteins, Signal Transducing ; metabolism ; Animals ; Cytoskeletal Proteins ; metabolism ; Desmin ; metabolism ; Doxorubicin ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Kidney Diseases ; chemically induced ; drug therapy ; metabolism ; Male ; Phytotherapy ; Podocytes ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley

【Objective】Serum gamma-glutamyltransferase（GGT）has recently been implicated in the pathogenesis of atherosclerosis and coronary heart disease（CHD）. We aimed to evaluate the association between the serum GGT level and the 10-year risk score for CHD（Framingham Risk Score，FRS）in a Chinese population.【Methods】We conducted a population-based cross-sectional study in 9，544 Guangzhou residents aged 40 years and older. Participants were divided into four quartiles according to their GGT levels：Quartile 1 <15 U/L（n=2 407），Quartile 2 15~19.9 U/L（n=2 302）， Quartile 3 20~28.9 U/L（n=2 442），and Quartile 4 ≥29 U/L（n=2 393）. The multivariate logistic regression analysis was used to assess the incidence of intermediate and high risk of developing CHD at 10 years（FRS≥10%）in relation to each quartile increase of serum GGT level.【Results】The incidence of FRS≥10% increased with elevating serum GGT levels（P for trend<0.001）. Compared with the lowest quartile of serum GGT level ，the adjusted odds ratio in the highest quartile was 1.72（95% confidence interval 1.28 to 2.29）.【Conclusion】Serum GGT level is associated with the FRS for CHD ，and might be used as an adjuvant marker for identifying patients at increased risk of cardiovascular events and early intervention.

OBJECTIVETo investigate the outcome of surgical treatment for gastrointestinal stromal tumor(GIST) and the associated factors.

METHODSA total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University. The clinical data were retrospectively reviewed and the pathological examination was reviewed. Follow-up was performed.

RESULTSThere were 176 males and 101 females. The age ranged from 20 to 81 years old (median,57). Location of the tumor included colorectum (n=28),small bowel(n=76), stomach(n=173). All the patients had en bloc resection, including local excision in 98 patients, organ resection in 64, and extended resection in 115. The 5-year survival rates were 83.5%, 71.9%, and 61.9% in the three different procedures, respectively, and the difference was not statistically significant(P>0.05). Cox model showed that the tumor size, recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients(P<0.05).

CONCLUSIONSSurgery remains the major approach for gastrointestinal GIST. Complete resection is the principal treatment. Extensive resection or extended lymph nodes dissection is not associated with improved survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the treatment of postoperative chyle leak after surgery for digestive malignancies.

METHODSFrom December 2008 to February 2012, in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, clinical data of 19 patients with chyle leak after digestive system cancer surgery were retrospective analyzed.

RESULTSNineteen cases of chyle leak were all identified between the second and the fourth postoperative day and were all initially managed with conservative treatment including early fasting, parenteral nutrition(PN), 24-hour continuous infusion of somatostatin, and low pressure suction drainage. Eight patients were treated successfully for 6 to 10 days with a significant reduction of the daily drainage volume. Ten patients had enteral nutrition(EN) and their drain tubes were repeatedly washed with 30 ml of compound meglumine diatrizoate injection every day until the drainage volume decreased to 200 ml/day. The time to resolution of chyle leak in these ten patients ranged from 12 to 24 days. One patient had no significant decrease in fluid drainage and developed abdominal distension after one week of conservative treatment. Surgical closure of chyle leak was performed on the 11th postoperative day, abdominal cavity drainage tube was removed on the 4th postoperative day. The patient was discharged home in good condition.

CONCLUSIONMost postoperative chyle leak after surgery for digestive malignancies can be successfully managed with conservative treatment. Somatostatin and the drainage are the main therapeutic approaches. When chyle leak is not resolved with conservative treatment, surgical treatment should be considered to prevent serious complications.

Adult ; Aged ; Anastomotic Leak ; therapy ; Chyle ; Digestive System Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Retrospective Studies

Objective： This study was designed to explore the relationship between clinicobiological acting and expression of p21 protein and estrogen receptor(ER) in colorectal cancer. Methods： The intensity of expression of p21 protein and ER for 206 patients with colorectal cancers were determined by labeled-streptokinase avidin-biotin(LSAB) assay. Results： The expression of p21 protein is negatively correlated with that of ER in colorectal cancer(r=-0.6613, P<0.01). The intensity of expression of p21 protein and ER in colorectal cancers were not related with the patients age, sexuality, tumor position, pathological type, histological type, Dukes stage etc.(r< 0.4,P>0.05). Both the expressions were related to the prognosis of colorectal cancer(P<0.01). Higher the intensity of expression of p21 protein worse the patients prognosis, and higher the intensity of expression of ER better the patient s prognosis. Conclusions： The abnormal expression of p21 protein is related to the dysbolism of estrogen in colorectal cancer. The detection of p21 protein and ER are helpful for diagnosis and prognostic evaluation for colorectal cancer.

Objective：The aim of this study was to investigate the distribution of carcinoembryonic antigen (CEA) in colorectal cancerous tissue and to evaluate its clinicobiological significance, especially its prognostic value. Methods: Distribution of tissue CEA in 189 patients with colorectal cancer were detected with immunohistochemical method, and its relationship with many clinicopathological parameters was analyzed with SPSS software. Results: CEA distributed in both tumor tissue and normal mucosa but there was a significant difference between them. Staining positive rate of CEA in tumor tissue was 96.3％ , with 52.4％ strong and 36.5％ moderate. While in normal mucosa it was 17.4％ , with 16.2％ weak and 1.2％ moderate. There was a close relationship between tissue CEA and many clinicopathological parameters, such as differentiation, invasion depth, metastasis to regional lymph node, preoperative serum CEA level, postoperative tumor recurrence, metastasis, and postoperative survive. Conclusions: CEA overexpression in colorectal cancer tissue. Tissue CEA is a good prognostic indicator for colorectal cancer reflecting its clinicobiological features. Combining tissue CEA with serum CEA level should be better for predicting prognosis,and patient with both elevated preoperative serum CEA level and strong expression of CEA in tumor tissue indicates the worst prognosis.

AIM To evaluate anti-gastric cancer effects and benefits of the combination therapy of celastrol and curcumin in vitro and in vivo.METHODS Curcumin,celastrol and curcumin + celastrol applied to BGC823 gastric cancer cells had their impact on the cells growth and apoptosis in vitro checked by CCK-8 assay and flow cytometry of AnnexinV-FITC/PI;and their in vivo anti-tumor effect,systemic toxicity,and influence to the survival time evaluated by using BGC823-bearing gastric tumor mouse models induced by subcutaneous implantation.RESULTS IC50 of curcumin,celastrol and curcumin + celastrol on BGC823 cell were found to be at (57.47 ± 5.22),(2.11 ±0.07) and (0.22 ±0.01) μmol/L,respectively.Curcumin + celastrol achieved a most optimal BGC823 cell apoptosis rate of (73.07 ±3.82)％ at concentrations of (10 mol/L +2 mol/L);and they left a positive impact on the BGC823 gastric tumor-bearing mice,given a (64.87 ±4.16)％ inhibitory rate,and a 50.5-day median survival time.Additionally,the combination therapy demonstrated its less side effects in terms of the body weight,spleen and liver of the nude mice,and significantly improved serum concentrations of TNF-α and IL-6.CONCLUSION Combination of curcumin and celastrol shows significantly synergistic anti-gastric cancer effects in vitro and in vivo.

Objective：This study was designed to evaluate the genetic stability on chromosome 16q22 24 in primary nasopharyngeal carcinoma. Methods: Tissue samples from fifty patients with nasopharyngeal carcinoma (NPC) tumors were examined by loss of heterozygosity (LOH) and microsatellite instability (MSI) analysis with a panel of 8 microsatellite polymorphic markers distributed along the chromosome 16q22 24. Results: LOH was observed at one or more loci in 24 cases (48％ ) and the prevalence of MSI was detected in 9 cases (18％ ). But the genomic alterations scattered along the region, neither common deletion or instability region was found. Conclusions: The status of genetic stability in chromosome 16q22 24 suggests that the genomic alterations on chromosome 16q22 24 may be involved in the development of NPC.

Humans ; Thyroid Cancer, Papillary ; Carcinoma, Papillary/surgery* ; Thyroid Neoplasms/surgery*