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ABSTRACT: It is not clear if sentinel lymph node (SLN) mapping can improve outcomes in patients with colorectal cancers. The purpose of this study was to determine the prognostic values of ex vivo sentinel lymph node (SLN) mapping and immunohistochemical (IHC) detection of SLN micrometastasis in colorectal cancers.
Colorectal cancer specimens were obtained during radical resections and the SLN was identified by injecting a 1% isosulfan blue solution submucosally and circumferentially around the tumor within 30 min after surgery. The first node to stain blue was defined as the SLN. SLNs negative by hematoxylin and eosin (HE) staining were further examined for micrometastasis using cytokeratin IHC.
A total of 54 patients between 25 and 82 years of age were enrolled, including 32 males and 22 females. More than 70% of patients were T3 or above, about 86% of patients were stage II or III, and approximately 90% of patients had lesions grade II or above. Sentinel lymph nodes were detected in all 54 patients. There were 32 patients in whom no lymph node micrometastasis were detected by HE staining and 22 patients with positive lymph nodes micrometastasis detected by HE staining in non-SLNs. In contrast only 7 SLNs stained positive with HE. Using HE examination as the standard, the sensitivity, non-detection rate, and accuracy rate of SLN micrometastasis detection were 31.8% (7/22), 68.2% (15/22), and 72.2%, respectively. Micrometastasis were identified by ICH in 4 of the 32 patients with HE-negative stained lymph nodes, resulting in an upstaging rate 12.5% (4/32). The 4 patients who were upstaged consisted of 2 stage I patients and 2 stage II patients who were upstaged to stage III. Those without lymph node metastasis by HE staining who were upstaged by IHC detection of micrometastasis had a significantly poorer disease-free survival (p = 0.001) and overall survival (p = 0.004).
Ex vivo localization and immunohistochemical detection of sentinel lymph node micrometastasis in patients with colorectal cancer can upgrade tumor staging, and may become a factor affecting prognosis and guiding treatment. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1350200526694475.
Diagnostic Pathology 06/2012; 7:71. · 1.64 Impact Factor
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ABSTRACT: To determine the distal intramural spread (DIS) margin of rectal cancer.
Sixty-one p53-positive specimens of rectal cancer were used. After conventional hematoxylin and eosin (H&E) staining, the DIS margin of rectal cancer in large specimens was examined by immunohistochemistry. The patients were divided into A, B, C, and D groups. After a long-term follow-up, the survival curves of the four groups were estimated using the life table.
Fifty-one of the sixty-one cases (83.6%) had DIS. The extent of DIS ranged 0.11-3.5 cm; meanwhile the mean of DIS measured by H&E staining was 0.13 cm. The significant difference was found between the means (t=5.622, P<0.0001). Only 1 of 51 patients had DIS greater than 3 cm. The DIS was less than 1.0 cm in most rectal cancer patients. The long-term results indicated that the survival rate of the patients whose DIS was greater than 1.0 cm was lower than that of the patients whose DIS was less than 0.5 cm.
Rectal cancer patients with DIS greater than 1.0 cm have poor prognosis.
World Journal of Gastroenterology 03/2006; 12(10):1626-9. · 2.47 Impact Factor
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ABSTRACT: To evaluate the feasibility and utility of an ex vivo sentinel lymph node (SLN) identification and ultrastaging for colorectal cancer (CRC).
CRC 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.
A 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.
Ex 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.
Zhonghua wai ke za zhi [Chinese journal of surgery] 09/2005; 43(15):994-7.
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ABSTRACT: The optimal distal molecular clearance margin of rectal cancer hasn't been confirmed. This study was designed to explore the molecular margin of distal intramural spread (DIS)in rectal cancer, and its prognostic value, and to further clarify the required distal margin of radical surgery for rectal cancer.
Sixty-one P53 positive specimens,resected from patients with rectal cancer from Aug.1996 to Oct. 1997, were collected. Microscopic DIS was examined by P53-immunohistochemistry (P53-IHC),comparing with conventional hematoxylineosin (HE)staining in consecutive large slice. Tissue shrinkage ratio,comparing the distal clearance margin measured in fresh specimens to that measured in large slice after fixed in each case,was used to convert macroscopically measured extent of distal spread to its actual extent. After long-term follow-up, the survival curves of 4 DIS groups were estimated by Life-table method.
With P53-IHC,DIS was observed in 50 cases (82.0%), DIS extents were 0.11-3.50 cm with the mean of 0.59 cm, DIS extent of > 3.00 cm was detected in 1 case only. Meanwhile,DIS was observed in 29 cases (47.5%)by HE staining, DIS extents were 0.10-1.39 cm with the mean of 0.13 cm. There was significant difference between the 2 means (P< 0.0001). The long-term result indicated that the survival rate of DIS extent of >1.00 cm group was lower than those of non-DIS group,and DIS extent of < 0.50 cm group (P< 0.05).
DIS was more exactly detected by P53-IHC than by HE. Most of DIS extents were less than 1 cm in rectal cancer. For over 95% cases, 3 cm distal to the rectal cancers was relatively safe in radical operations. The poor prognosis can be predicted in cases with DIS extent of >1 cm.
Ai zheng = Aizheng = Chinese journal of cancer 11/2004; 23(10):1199-202.
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ABSTRACT: To compare the effect of 5-fluorouracil (5-FU) portal vein infusion (PVI) for 7 days after radical resection, with intraluminal chemotherapy during operation for eliminating liver metastasis and elevating long-term prognosis in colorectal cancer.
162 colorectal cancer patients with radical resection were divided into portal vein chemotherapy group (group A, 82 cases) and intraluminal chemotherapy group (group B, 80 cases) randomly. In group A, 5-fluorouracil were infused with 1g per day constantly for 7 days after operation through portal vein catheters, which placed into greater omental vein and fixed on the abdominal wall. In group B, intraluminal chemotherapy was given and 5-fluorouracil 0.5 g was injected into the greater omental vein during operation.
The short-term complications and long-term effect in the two groups were compared by statistical software SPSS 8.0. Group A had more operative complications, and no statistical differences was found in hospital time and survival rate of the two groups. The 5-year survival rate is 76.7% (group A: 74.3%, group B: 79.2%), and the liver metastasis rate is 19.8%. There is no significant difference between the two group-survival curves. Multiple variable analysis suggested that Dukes' stage was the prognosis factor (P < 0.05).
The present study demonstrated that the two chemotherapy methods play an important role in preventing liver metastasis and improving the survival rate, and the intraluminal chemotherapy would be easier and simpler. The result should be further improved by using combined chemotherapy.
Zhonghua wai ke za zhi [Chinese journal of surgery] 08/2004; 42(15):918-21.
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ABSTRACT: To construct a cycle peptide library composed of 16 random amino acids with yeast two-hybrid system.
Random oligonucleotides encoding 16-mer peptides were designed and synthesized artificially, and then were amplified by PCR. The amplified products were digested with BamH I and EcoR I and cloned into yeast expression plasmid pGADT(7) GH to construct the cycle library plasmids pGADT(7) GH-RP Then the number of different recombinants and the randomness of the library were tested, and the cycle peptide library plasmids were amplified, extracted and purified.
A random cycle peptide library with 1.28 x10(7) different recombinant clones was obtained. No significant difference was found between amino acid distribution in the cycle peptide library and the expected frequency.
The random cycle peptide library has been successfully constructed. And a lot of cycle peptide library plasmids with high purity were obtained.
Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology 10/2003; 19(5):437-9.
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ABSTRACT: To investigate the effect of activator protein-1 (AP-1) decoy-oligodeoxynucleotides (Decoy-ODNs) on the expression of fibroblast alpha2 type I collagen, so as to explore the gene therapy of pathologic scar.
Decoy-ODNs targeting AP-1 were designed and synthesized. NIH3T3 cells were transfected by cationic liposomes. The distribution of Decoy-ODNs in the cells was investigated. The inhibiting effects of Decoy-ODNs on AP-1 were determined by electrophoretic mobility shift assay (EMSA). And the effects of Decoy-ODNs on the collagen synthesis in the cells were analyzed by RT-PCR.
AP-1 Decoy-ODNs could competitively inhibit the AP-1 in vitro activity. Cationic liposomes could play roles by effectively transfecting Decoy-ODNs into the plasma and nucleus. The mRNA expression of fibroblast alpha2 type I collagen decreased evidently after 24 hours of Decoy-ODNs action.
Decoy-ODNs could inhibit the mRNA expression of fibroblast alpha2 type I collagen by antagonizing AP-1.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 07/2003; 19(3):175-8.
