Objective To investigate factors affecting the metastasis of lymph nodes around the root of inferior mesenteric artery(IMA) in rectal cancer,and the significance of root lymph nodes dissection of IMA in radical surgery for rectal cancer.Methods Clinicopathological data of 105 rectal cancer patients undergoing root lymph node dissection of IMA during radical resection in Peking University First Hospital from January 2005 to December 2008 were analyzed retrospectively.Rectal cancer patients without root lymph node dissection of IMA during the same period served as control.Results were compared between these two groups for survival and local recurrence rates.Results The rate of lymph node metastasis around the origin of IMA was 9.5％ (10/105).The five-year survival rate in patients with IMA root nodal dissection was 71.3％,and that without was 70.6％ (P =0.995),while the local recurrence was respectively 1.9％ and 7.4％ (P ＜ 0.05).In multivariate analyses,IMA root nodal metastasis occurred more frequently in patients with pT3 and pT4 tumor(Wald =5.764,P ＜ 0.05) and poorly differentiated tumor(Wald =7.818,P ＜ 0.05).Conclusions Root lymph nodes dissection of IMA could not increase five-year survival rate,but it could reduce local recurrence rate in patients with rectal cancer.In radical surgery of rectal cancer,lymphadenectomy of IMA root should be performed in patients with T3 and T4 tumor with poorly differentiated tumor,so as to reduce local recurrence rate.

Objective: To determine the relationships between apoptosis induced by transforming growth factor beta 1 (TGF-β1) and Smad in human hepatoma cell lines. Methods: Three human hepatic carcinoma cell lines, involving different status of the p53 gene respectively, were used in this study.TGF-β1-induced apoptosis in hepatic carcinoma cell lines was quantitated using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. For identification of the mechanism of apoptosis induced by TGF-β1, these cell lines were transfected with a TGF-β1-inducible luciferase reporter plasmid containing Smad binding elements (SBE) and luciferase gene using LF2000, then were treated with TGF-β1. Relative luciferase activity was assayed respectively. Results: Among three cell lines studied with TUNEL assay, addition of TGF-β1 induced apoptosis only in HepG2 cells (wild type p53). In contrast, Huh-7 ( mutant p53) and Hep3B ( deleted p53) cell lines lacked apoptosis. The detection of luciferase activity indicated that HepG2 cells dramatically increased the response to TGF-β1 induction, Huh-7 and Hep3B cell lines significantly lowered luciferase expression. Conclusion: HepG2cells were highly susceptible to TGF-β1-induced apoptosis compared with Hep3B and Huh-7 cell lines.Smad4 may be a central mediator of the TGF-β1 signaling transdution pathway.

Objective: To investigate the prediction value of prognosis of resectable gastric cancer patients based on texture features of preoperative enhanced CT images. Methods:: Data of 197 patients with gastric cancer confirmed by surgical pathology were retrospectively analyzed. The patients were randomly divided into training group (n=147) and validation group (n=50). A total of 90 3-dimensional quantitative features on portal venous phase images of preoperative enhanced CT were extracted of all patients, and intraclass correlation coefficient was used to select better repetitive features. LASSO COX regression analysis was used to reduce dimensionality and screen features related to patients' overall survival (OS). A image tag was built to classify patients in 2 groups. The patients were stratified into high-risk and low-risk groups according to the median of signature score, and the difference of OS was analyzed. A nomogram integrating image tag and pathological features was constructed after analyzing the relationship of clinical, pathological features or image texture labels and prognosis of gastric cancer patients, and the efficacy in predicting prognosis of gastric cancer patients was evaluated. Clinical decision curve was plotted to evaluate relative clinical value. Results: The image tag was established with 2 OS-related CT features. Statistical differences of OS were found between high-risk and low-risk patients in both training group (χ2=9.25) and validation group (χ2=8.49, both P<0.01). The image tag and TNM staging were independent risk factors of gastric cancer. For patients in training group and validation group, AUC of image tag predicting 3-year OS was 0.72 (P=0.02) and 0.67 (P=0.07), of nomogram integrated image tag and TNM staging was 0.78 and 0.81, respectively (both P<0.01). The decision curve analysis showed that the nomogram model had higher net benefit than image tag alone with the threshold probabilities of 0.13-0.59. Conclusion: Image labels based on texture features of enhanced CT image can be used for postoperative risk stratification of gastric cancer patients. Nomogram constructed with image tag combining pathological features can help to predict the prognosis of patient with resectable gastric cancer.

Objective To evaluate total pelvic exenteration (TPE) in the treatment of locally recurrent rectal cancer (LRRC). Methods Clinical data of 35 patients with LRRC who underwent TPE between 1989 and 2003 were analyzed retrospectively. Results Thirty patients underwent TPE, the remaining 2 did sphincter-preserving TPE, 2 with lower sacrectomy and 1 with hemipelvectomy, among them 80% cases received radical resection. Operative mortality rate was 3%, and morbidity rate was 51%. The overall post TPE tumor local recurrence rate was 48%. The 5-year survival rate was 16% in all cases and 19% in radical resection group. The 5-year survival rate in patients without lymph node metastasis was 24%, and 0 in patients with metastasis. Conclusion Effective TPE treatment lies in strict patient selection and radical resection.

OBJECTIVETo investigate the correlation between tissue factor (TF) expression and hepatic metastasis and prognosis in rectal cancer.

METHODSTF expression was retrospectively studied by immunohistochemical method in specimens of 40 rectal cancer, 3 hepatic metastasis and 6 benign adenoma with relation to their clinicopathologic data.

RESULTS1. TF expression was detected in 20 (50%) of the 40 primary rectal cancer specimens and all the 3 hepatic metastatic specimens, but not in the 6 benign adenoma or normal mucosa of rectum, 2. Significant correlation was observed between TF expression and synchronic hepatic metastasis (P = 0.002) and heterochronic hepatic metastasis (P = 0.001) and 3. TF was a risk factor for the prognosis of primary rectal cancer (P = 0.024).

CONCLUSIONTissue factor expression may play a role in the process of developing hepatic metastasis. It may be considered as a new clinical indicator for monitor of hepatic metastasis and prognosis of primary rectal cancer.

Adenoma ; metabolism ; pathology ; Humans ; Immunohistochemistry ; methods ; Liver Neoplasms ; metabolism ; secondary ; Logistic Models ; Predictive Value of Tests ; Proportional Hazards Models ; Rectal Neoplasms ; metabolism ; pathology ; Rectum ; metabolism ; Retrospective Studies ; Staining and Labeling ; methods ; Thromboplastin ; biosynthesis

To develop and validate a fat-suppressed (T2 weighted-magnetic resonance imaging, T2W-MRI) based radiomics signature to preoperatively evaluate the histologic grade (grade I/II VS. grade III) of invasive breast cancer.
 Methods: A total of 202 patients with MRI examination and pathologically confirmed invasive breast cancer from June 2011 to February 2017 were retrospectively enrolled. After retrieving fat-suppressed T2W images and tumor segmentation, radiomics features were extracted and valuable features were selected to build a radiomic signature with the least absolute shrinkage and selection operator (LASSO) method. Mann-Whitney U test was used to explore the correlation between radiomics signature and histologic grade. Receiver operating characteristics (ROC) curve was applied to determine the discriminative performance of the radiomics signature [area under curre (AUC), sensitivity, specificity, and accuracy]. An independent validation dataset was used to confirm the discriminatory power of radiomics signature. 
 Results: Eight radiomics features were selected to build a radiomics signature, which showed good performance for preoperatively evaluating histologic grade of invasive breast cancer, with an AUC of 0.802 (95% CI 0.729 to 0.875), sensitivity of 78.7%, specificity of 70.3% and accuracy of 73.7% in training dataset and AUC of 0.812 (95% CI 0.686 to 0.938), sensitivity of 80.0%, specificity of 73.3% and accuracy of 76.0% in the validation dataset.
 Conclusion: The fat-suppressed T2W-MRI based radiomics signature can be used to preoperatively evaluate the histologic grade of invasive breast cancer, which may assist clinical decision-maker.
Breast Neoplasms ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Preoperative Care ; ROC Curve ; Retrospective Studies