Objective To analyze the expression of activated T cell nuclear factor (NFAT) in hepatoeellular carcinoma (HCC) tissues and its correlation with clinicopathological factors.Methods Data of 105 patients including 87 males and 18 females,aged 55.1 ± 10.8 years old,diagnosed with HCC who underwent hepatectomy in hepatobiliary surgery department of the first central hospital of Tianjin from September 2014 to December 2016 were retrospectively analyzed,Immunohistochemical staining was used to detect the expression of NFAT subtypes in HCC tissues and adjacent normal liver tissues,and the differences in expression of NFAT subtypes and related factors were analyzed.Results HCC tissues had higher expression of NFAT4 and lower expression of NFAT1 compared to adjacent tissues (P＜0.05).NFAT1 positive group had higher HBV infected rate (93.1％ vs.78.7％) and lower microvascular invasion rate than that in NFAT1 negative group (24.1％ vs.46.8％) (P＜ 0.05).NFAT3 positive group had more younger patients (≤ 60 years old) (80.0％ vs.60.0％) and higher microvascular invasion rate (46.2％ vs.15.0％) (P＜0.05).NFAT4 positive group had higher microvascular invasion rate (43.3％ vs.22.2％) (P＜0.05).Conclusion HCC tissues had different expressions of NFATs.The expressions of NFAT1,NFAT3 and NFAT4 are related to microvascular invasion.

Objective To investigate the function of activated T cell nucleus factor 1 (NFATc1) in liver cancer tissues and the correlations between (NFATc1 and prognosis,and the effect of NFATc1 on liver cancer cell migration.Methods The hepatobiliary surgery department of Tianjin First Central Hospital collected 33 patients with hepatocellular carcinoma from January to June 2015,and studied the expression of NFATc1 in liver cancer and adjacent tissues and the prognosis of patients.HCC cell HepG2 were randomly divided into blank control group (without any intervention),interference group (infected with lentivirus interference sequence,down-regulated expression of NFATc1),and negative control group (infected with lentivirus negative control sequence).The relative expression of NFATc1 in the patients and the three groups were detected by real-time fluorescence quantitative polymerase chain reaction (rt-pcr),and the expressions of NFATc1,n-cadherin and e-cadherin in the three groups were detected by Western blot,and the migration of the cells was detected by Transwell.Results The mRNA level of NFATc1 in liver cancer tissues was higher than that in adjacent tissues,and the difference was statistically significant (P ＜ 0.05).According to the median expression of NFATc1,the 33 patients were divided into high-expression group (n =17) and low-expression group (n =16).The survival rate of the high-expression group was better than that of the low-expression group,and the difference was statistically significant (P ＜ 0.05).The mRNA level of NFATc1 in the interference group was lower than that in the negative control group and the blank control group,and the difference was statistically significant (P ＜0.05).The mRNA levels of NFATc1 and n-cadherin in the interference group were lower than those in the negative control group and the blank control group,while the mRNA levels of e-cadherin were higher than those in the negative control group and the blank control group,with statistically significant differences (P ＜ 0.05).The number of migrative cells in the interference group was (24.0 ± 5.6),which was lower than that in the blank control group [(69.0 ±4.0)] and the negative control group [(73.0 ±4.4)],and the difference was statistically significant (P ＜0.05).Conclusions The expression of NFATc1 is increased in liver cancer,and high level of NFATc1 indicated poor prognosis in liver cancer patients.Low expression of NFATc1 reduces the migration ability of liver cancer cells.

Objective To compare the characteristics of clinical pathology between patients with early recurrence and those with late recurrence of colorectal cancer.Methods Clinicopathological data of 391 recurrence patients after surgery from Changhai Hospital were recruited between Jan 2005 and Dec 2015.The clinical and pathological characteristics of primary cancer in early recurrence group (less than 2 years after surgery) and late recurrence group (2 year or more after surgery) were compared.Results 246 patients had early recurrence (62.9％) and 145 had late recurrence (37.1％).Liver,systemic metastases and peritoneum were the main sites of distant recurrence in the early recurrence group,whereas liver,lung and systemic metastases were the most frequent sites of metastases in the late recurrence group.Patients with the increased tumor perimeter,lymph node metastasis,increased CEA and CA19-9,without postoperative adjuvant treatment and microsatellite stability are more likely to have early recurrence.5-year overall survival rate for patients with early recurrence was significantly lower than those with late recurrence.Conclusions This study showed that clinical and pathological factors are significantly associated with recurrence of colorectal cancer.Two years after surgery is an important period for the recurrence of colorectal cancer.

OBJECTIVE: To investigate the surgical efficacy and prognostic factors of T3NxM0 middle-low rectal cancer without neoadjuvant therapy. METHODS: Clinical data of patients with middle-low rectal cancer undergoing TME surgery with T3NxM0 confirmed by postoperative pathology at Colorectal Surgery Department of Changhai Hospital from January 2008 to December 2010 were analyzed retrospectively. INCLUSION CRITERIA: (1)no preoperative neoadjuvant chemoradiotherapy (nCRT); (2) complete preoperative evaluation, including medical history, preoperative colonoscopy or digital examination, blood tumor marker examination, and imaging examination; (3) distance between tumor lower margin and anal verge was ≤ 10 cm; (4) negative circumferential resection margin (CRM-). Finally, a total of 331 patients were included in this study. According to the number of metastatic lymph node confirmed by postoperative pathology, the patients were divided into N0 group without regional lymph node metastasis (190 cases) and N+ group with regional lymph node metastasis (141 cases). The perioperative conditions, local recurrence, distant metastasis and prognostic factors were analyzed. RESULTS: Compared to N0 group in the perioperative data, N+ group had higher ratio of tumor deposit [29.8%(42/141) vs. 0, χ²=64.821, P<0.001] and vascular invasion [7.1%(10/141) vs. 0.5%(1/190),χ²=10.860, P<0.001]. There were no significant differences in tumor diameter, number of lymph nodes detected, positive nerve invasion, degree of tumor differentiation, morbidity of postoperative complication and postoperative adjuvant chemotherapy rate between the two groups (all P>0.05). The median follow-up period was 73.4 months. The merged 5-year local recurrence rate was 2.7%(9/331), 5-year distant metastasis rate was 23.3% (77/331), 5-year disease-free survival (DFS) rate was 73.4%, and 5-year overall survival (OS) rate was 77.2%. Multivariate analysis showed that lymph node metastasis (HR=3.120, 95%CI: 1.918 to 5.075, P<0.001), nerve invasion (HR=0.345, 95%CI: 0.156 to 0.760, P=0.008) and vascular invasion (HR=0.428, 95%CI: 0.189 to 0.972, P=0.043) were independent risk factors for DFS in patients with T3NxM0 rectal cancer after operation. Preoperative carcinoembryonic antigen level (HR=1.858, 95%CI:1.121 to 3.079, P=0.016), lymph node metastasis (HR=3.320, 95%CI: 1.985 to 5.553, P<0.001) and nerve invasion (HR=0.339, 95%CI: 0.156 to 0.738, P=0.006) were independent risk factors for OS in patients with T3NxM0 rectal cancer after operation. CONCLUSIONS Optimal local control rate of middle-low rectal cancer patients with T3NxM0 and CRM- can be achieved by standard TME surgery alone. For patients with preoperative elevated blood carcinoembryonic antigen level, regional lymph node metastasis, or neurovascular invasion confirmed by pathology after surgery, adjuvant chemoradiotherapy should be actively applied after surgery to improve prognosis.
Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Mesocolon ; surgery ; Neoadjuvant Therapy ; Neoplasm Staging ; Proctectomy ; methods ; Prognosis ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies

Liver cancer stem cells have the abilities of infinite proliferation,self-renewal,chemoradiation tolerance,high tumorigenicity and stem cell characteristics.The proportion of liver cancer stem cells is positively correlated with the malignancy of the tumor.MicroRNAs (miRNA) can regulate the expression of many genes by degrading mRNA or inhibiting mRNA translation.MicroRNAs also play an important role in a series of life activities such as embryogenesis,tissue and organ development,cell growth and differentiation,apoptosis,disease development.In-depth study of specific miRNA in the occurrence and development of liver cancer and its role in LCSCs,it may provide a new target for prevention and treatment of recurrence and metastasis of liver cancer.

OBJECTIVETo compare the clinicopathological features and prognosis between left-sided colon cancer (LC) and right-sided colon cancer (RC).

METHODSClinicopathological and follow-up data of 2 174 colon carcinoma cases undergoing resection at Shanghai Changhai Hospital of The Second Military Medical University from January 2000 to December 2010 were retrospectively analyzed. Patients with transverse colon cancer, overlapping position, unknown location, recurrent cancer, multiple primary cancer, concomitant malignant tumors, preoperative chemotherapy, local resection, incomplete clinical data and missed follow up were excluded. Finally, a total of 1 036 patients, whose primary tumors were radically removed, were enrolled, with 563 patients in LC group (including carcinoma in cecum, ascending colon and hepatic flexure) and 473 in RC group (including carcinoma in splenic flexure, descending colon and sigmoid colon). The clinicopathological features and survival, including median overall survival, 5-year overall survival rate, tumor specific median overall survival, cancer specific 5-year overall survival rate, were compared between LC and RC groups. Tumor specific overall survival was defined as the period between operation date to the date of death caused by cancer progression. Multivariate Cox regression analysis was used to analyze the influencing factors of survival. Propensity score matching was carried out to balance the clinicopathological factors between the two groups with the SAS 9.3, taking the following parameters into consideration (age, gender, gross appearance, tumor diameter, invasion depth, lymph node metastasis, distant metastasis, TNM stages, differentiation, CEA and CA199-9). Patients in RC group and LC group were matched according to the propensity scores and the clinicopathological characteristics and prognosis of two groups were compared again.

RESULTSNo significant differences were identified between the two groups in age, distant metastasis and serum CEA level. Compared with RC group, LC group had more male patients [60.9%(343/563) vs. 51.0%(241/473), P=0.001], more ulcerative tumors [71.9% (405/563) vs. 65.3%(309/473), P=0.006], better differentiation [well/moderately differentiated: 87.5%(493/563) vs. 73.8%(349/473), P=0.000], lower infiltration depth [T1-2: 17.1%(96/563) vs. 10.1%(48/473), P=0.001], higher lymph node metastasis rate [N0: 53.3%(300/563) vs. 62.4%(295/473), P=0.013], lower TNM stage [stage I(: 13.3%(75/563) vs. 7.8%(37/473), P=0.000], lower serum CA199 level [<37 kU/L: 68.4% (385/563) vs. 62.6% (296/473), P=0.022] and smaller tumor diameter [<5.0 cm: 55.1%(310/563) vs. 38.3%(181/473), P=0.000]. The median overall survival was 82 months and 76 months in LC and RC groups, respectively, and the 5-year overall survival rate was 58.3% and 50.9%(P=0.038). The median tumor specific survival was 84 months and 78 months in LC and RC groups, respectively, and the 5-year tumor specific overall survival rate was 60.6% and 52.9% (P=0.031). Multivariate Cox regression analysis showed that tumor location (LC vs. RC) was not associated with overall survival (P=0.106) and tumor specific survival (P=0.091). After propensity score matching, no significant difference was found in clinicopathological factors and propensity score (0.458±0.129 vs. 0.459±0.129, P=0.622) between LC and RC group. After matching, there was no significant difference in overall survival rate (54.0% vs. 51.7%, P=0.982) and tumor specific overall survival rate(56.4% vs. 53.1%, P=0.819) between two groups.

CONCLUSIONSignificant difference exists between RC and LC in clinicopathological factors, but not in survival.

Objective To investigate the common initial clinical presentations of primary Sj(o)gren's syndrome (pSS) with pulmonary complications,and to explore the differences between patients with extraglandular manifestations at disease onset (EGM) and those with glandular manifestations at disease onset (GM).Methods A total of 1 341 hospitalized SS patients from 2003 to 2012 were retrospectively reviewed.Of them,102 hospitalized patients with pSS'associated lung disease were analyzed and included.Case control study was performed to explore the differences between the EGM group and the GM group.Results Fifty-one percent of patients were presented with EGM at onset,with significantly shorter disease duration [36 (12,156) m vs 102 (48,159) m,x2=-2.41,P=0.016].Although the mean diagnose time was similiar,only 4％ of the EGM group could be confirmed the pSS diagnose at onset,which was significantly less frequently than that of the GM group (34％,22=15.29,P＜0.01).Case control study revealed that hyperglobulinemia,elevated RF titers and anti-SSA and/or anti-SSB test positive were less predominant in the EGM group [IgG 16(12,21) g/L vs 21 (15,28) g/L,x2=-2.15,P=0.032;22 (20,171) U/ml vs 104 (20,238) U/ml,x2=-l.98,P=0.048;33％ vs 72％,x2=15.78,P＜0.01].The predicted value of TLC and FVC were lower [(87±23)％ vs (97±20)％,x2=-1.96,P=0.050;(8±28)％ vs (100±27)％,x2=-1.70,P=0.089] and HRCT score was higher in EMG group [12(88,15) vs 8(5,13),x2=-1.82,P=0.070].Conclusion EMG at onset is the common initial manifestation of pSS'associated lung involvement.Pulmonary complication is more progressively and severe than those with MG at onset.Anti'SSA positive,elevated RF titer and hyperglobulinemia are not predominant for patients with EMG at onset.

Objective To investigate the clinical characteristics and prognosis of primary diffuse large B-cell lymphoma of central nervous system ( PCNS DLBCL). Methods The data of 70 patients with PCNS DLBCL confirmed by pathology were retrospectively analyzed. Survival and prognostic analyses were further conducted in the 66 follow-up patients. Results Median age at diagnosis was 57 years old. The ratio of male and female was 1.3∶1. The time from having symptoms to seeking medical advice was less than 2 months in 54 (77.1%) patients. 44 (62.9 %) patients had increased intracranial pressure, and 26 (37.1 %) patients had limb weakness or hemiplegia symptoms. 37 (52.9%) patients were multiple lesions, 59 (84.3%) cases were supratentorial, and 46 (65.7%) cases showed involvement of deep-brain tissues. Among 66 follow-up patients 7 cases received supportive and palliative care, 27 cases received surgery, 6 cases received radiotherapy, 9 cases received chemotherapy alone, and 21 cases received radiotherapy in addition to chemotherapy. The median overall survival (OS) was 9 months (95 % CI 1-16 months), and the 2-year survival rate was 36.1 %. The median OSs of the supportive and palliative therapy group and the surgery group were 2 months and 3 months, respectively. The median OS of the chemotherapy, radiotherapy or combination group was 33 months (95%CI 22-43 months) and the 2-year OS rate was 56.9 %. The Cox multivariate regression analysis showed that the involvement of deep-brain tissues (P=0.04) and not receiving radiotherapy or chemotherapy (P=0.00) were related to poor prognosis. Conclusions PCNS DLBCL is a highly aggressive and malignant tumor. Patients undergoing only surgery have poor effect and short survival. The patients with involvement of deep brain tissues have a poor prognosis. The chemotherapy, radiotherapy or combination of them may improve the prognosis.

Objective To investigate the expression level of collagen triple helix repeat containing 1 ( CTHRC1) in human gastric carcinoma and the relationship with the clinicopathological characteristics of gastric cancer?Methods The expression of CTHRC1 in human gastric carcinoma and normal gastric mucosa were detected by immunohistochemistry ( S?P method ) , and the correlation with various clinical characteristics, including gender,age,tumor diameter,degree of differentiation,depth of invasion,lymph node metastasis,TNM stage,was analyzed?Results ( 1 ) CTHRC1 expressed positive for 41 cases ( positive rate=53?95%) in 76 gastric carcinoma specimens, but only 1 case ( positive rate=3?33%) expressed positive in 30 normal gastric mucosa,the difference was statistically significant (χ2 =23?0332, P=0?000 )? ( 2 ) In early stage of gastric carcinoma,CTHRC1 was predominantly positive in the nucleus,but with the progression of the tumor,CTHRC1 expressed predominantly in cytoplasm?( 3) The expression of CTHRC1 was correlated with the depth of invasion (P=0?000),lymph node metastasis(P=0?009) and TNM?stage(P=0?007),but not with age,gender,size of the tumor and differentiated degree ( P>0?05 )?Conclusion CTHRC1 might play important roles in the occurrence,invasion and metastasis in human gastric carcinoma,and may be new therapy targets.