Qiang Li

Tianjin Medical University, T’ien-ching-shih, Tianjin Shi, China

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Publications (57)82.49 Total impact

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    ABSTRACT: Wnt5a, p-JNK and p-paxillin proteins have been shown to be associated with the development of several types of cancer. Here we studied the role of Wnt5a, p-JNK and p-paxillin protein expressions and functions in the further development of pancreatic adenocarcinoma. Fresh tissue samples from adjacent and malignant portions were obtained after operation from 58 patients with pancreatic adenocarcinoma. Wnt5a, p-JNK1, JNK1, paxillin and p-paxillin were detected with immunohistochemical staining. The expressions of Wnt5a, p-JNK1 and p-paxillin were higher in malignant tissues than in adjacent portions (p < 0.01), where JNK1 and paxillin were absent (p > 0.05). The expression levels of Wnt5a, p-JNK1 and p-paxillin in tumor tissues were correlated with each other (r = 0.564, 0.586 and 0.737, respectively). The expression of Wnt5a in tumor tissue could independently predict the occurrence of lymph node involvement [odds ratio (OR) 8.19, 95 % confidence interval (CI) 2.47-27.19]. The expression of p-JNK1 in tumor tissue was an independent predictor of peritoneal metastasis (OR 4.01, 95 % CI 1.32-12.17). Wnt5a/JNK signaling might be activated in pancreatic cancer. Wnt5a is the specific predictor for lymph node involvement.
    International Journal of Clinical Oncology 12/2013; · 1.41 Impact Factor
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    ABSTRACT: Non-parasitic hepatic cysts with biliary communication are rare. The clinical symptoms involved are not specific to this condition, thereby making diagnosis difficult and treatment controversial. Here, we report a case of 70-year-old woman complaining of abdominal satiety, combined with non-specific pain in the right upper quadrant. The abdominal contrast-enhanced MRI-scan revealed a large and thick-walled septus cystic lesion in the liver. During operation, the biliary fistula was confirmed in the cyst cavity. A silica gel tube was inserted via the cystic duct for cholangiography, which demonstrated communication between the cyst and biliary tract. We performed wide-scale cyst wall resection; the biliary fistula was completely repaired by the closure of communicated bile ducts. The postoperative course was uneventful, and the patient was discharged with no sign of cholangitis or any other symptoms. The novel surgical management via wide resection of the cyst wall and closure of biliary communication proved to be an adequate and effective procedure for treating nonparasitic hepatic cysts with biliary communication.
    Cancer biology & medicine. 06/2013; 10(2):110-3.
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    ABSTRACT: Obesity is rapidly becoming pandemic and is associated with increased carcinogenesis, especially hepatocellular carcinoma (HCC). Adipose tissue is considered as an endocrine organ because of its capacity to secrete a variety of adipokines, such as leptin, adiponectin and resistin. Recently, adipokines have been demonstrated to be associated with kinds of chronic liver diseases including fibrosis, cirrhosis and carcinogenesis. Direct evidence is accumulating rapidly supporting the inhibitory and/or activating role of adipokines in the process of carcinogenesis and progression of human HCC. This review aims to provide important insight into the potential mechanisms of adipokines in the development of HCC.
    International Journal of Cancer 02/2013; · 6.20 Impact Factor
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    ABSTRACT: Objective: This work aimed to investigate the correlations of tumor-associated macrophages (TAMs) and their subtypes M1 and M2 with liver metastasis of colorectal cancer, and provide useful references for seeking predictors of liver metastasis and studying mechanisms. Methods: 120 patients with colorectal cancer from 2000 to 2009 were divided into low, middle and high liver metastasis groups (group A, B and C, respectively). S-P immunohistochemical staining and microscopic observation were conducted to compare expression in CD68- positive cells (TAMs), CD80-positive cells (M1) and CD163-positive cells (M2) in three groups. Correlations of TAMs, M1, M2, and M2/M1 ratio with clinical and pathological parameters were analyzed. Results: With increase of liver metastatic ability, the number of TAMs decreased gradually, with no significant difference between any two of the three groups (P > 0.05), while the numbers of M1 and M2 were significantly decreased and increased, respectively, with significant difference between any two of three groups (P < 0.05 or P < 0.01). In addition, the M2/M1 ratio increased with increase of liver metastatic ability (P < 0.01). There was no statistical significance of correlation of TAMs with each clinical and pathological parameter. M1 was negatively related with lymphatic metastasis and liver metastatic ability. M2 was positively correlated with preoperative CEA level, lymphatic metastasis, tumor differentiation degree and liver metastatic ability. The same was the case for the M2/M1 ratio. Conclusions: Effects of TAMs on liver metastasis of colorectal cancer do not depend on the total number of TAMs, but on the number and proportion of functional subtypes M1 and M2. M2 number and M2/ M1 ratio are more accurate predictors for liver metastasis of colorectal cancer.
    Asian Pacific journal of cancer prevention: APJCP 01/2013; 14(2):1003-7. · 1.50 Impact Factor
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    ABSTRACT: OBJECTIVES: The aim of this study was to determine if there has been improvement in survival for patients with gallbladder cancer treated with surgical procedures. METHODS: A retrospective review of all patients with gallbladder cancer admitted during the past 11 years was conducted. The patients were categorized into two periods: period 1, from 1 January 2000 to 31 December 2005 (group 1, n = 77); and period 2, from 1 January 2006 to 31 December 2010 (group 2, n = 131). RESULTS: The two groups have similar age, sex distribution, and symptoms. There were more patients with advanced stage in group 2 (P = 0.001). And patients in group 2 were treated with more aggressive surgical procedures compared with group 1. Patients of group 2 had a better surgical outcomes and longer 5-year overall survival (9 % vs. 19 %, P = 0.040) and disease-free survival (P = 0.017). Median survival in group 1 was 14.7 months, while in group 2 it was 22.3 months. Patients underwent R0 resection in group 2 had better survival than that in group 1 (P = 0.009), while they had similar survival for those who underwent non-R0 resection in both periods (P = 0.108). CONCLUSIONS: A significant improvement of disease-free survival and long-term survival results was observed in the past decade.
    Journal of Gastrointestinal Surgery 10/2012; · 2.36 Impact Factor
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    ABSTRACT: To explore the efficacy of hepatic resection (HR) in a relatively unselected group of patients with ovarian cancer liver metastases (OCLM). A study was conducted between September 2000 and September 2011 on 60 ovarian cancer patients with hepatic metastases (24 solitary and 36 multiple), 40 of whom had extrahepatic metastases. HR was done in all patients provided that curative hepatic resection was feasible, and extrahepatic disease was controlled with medical and/or surgical therapy. Most patients (n=54; 90.0%) had a negative hepatic margin (R0), whereas 6 patients (10.0%) had microscopic disease at the margin (R1). The prognostic value of each study variable was assessed using log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis. The result was a median survival of 39 months and 5-year overall survival rate of 30%. Univariate analysis showed that surgery result (P=0.001), disease free interval (P=0.018) and the number of hepatic lesions (P=0.018) were significantly related to survival. Furthermore, the surgery result (P=0.004) remained significant for prognosis in multivariate analysis. For patients with OCLM, HR is safe and may provide a significant survival benefit compared with medical therapy alone. A long interval time, the number of hepatic lesions, and surgery results are key prognostic factors. Favorable outcomes can be achieved even in patients with medically controlled or surgically resectable extrahepatic disease, indicating that surgery should be considered more frequently in the multidisciplinary care of patients with OCLM.
    Cancer biology & medicine. 09/2012; 9(3):182-187.
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    ABSTRACT: BACKGROUND & AIMS: Antiangiogenic agents can sometimes promote tumor invasiveness and metastasis, but little is known about the effects of the antiangiogenic drug sorafenib on progression of hepatocellular carcinoma (HCC). METHODS: Sorafenib was administered orally (30 mg · kg(-1) · day(-1)) to mice with orthotopic tumors grown from HCC-LM3, SMMC7721, or HepG2-wt cells. We analyzed survival times of mice, along with tumor growth, metastasis within liver and to lung, and induction of the epithelial-mesenchymal transition. Polymerase chain reaction arrays were used to determine the effects of sorafenib on gene expression patterns in HCC cells. We analyzed regulation of HIV-1 Tat interactive protein 2 (HTATIP2) by sorafenib and compared levels of this protein in tumor samples from 75 patients with HCC (21 who received sorafenib after resection and 54 who did not). RESULTS: Sorafenib promoted invasiveness and the metastatic potential of orthotopic tumors grown from SMMC7721 and HCC-LM3 cells but not from HepG2 cells. In gene expression analysis, HTATIP2 was down-regulated by sorafenib. HCC-LM3 cells that expressed small hairpin RNAs against HTATIP2 (knockdown) formed less invasive tumors in mice following administration of sorafenib than HCC-LM3 without HTATIP2 knockdown. Alternatively, HepG2 cells that expressed transgenic HTATIP2 formed more invasive tumors in mice following administration of sorafenib. Sorafenib induced the epithelial-mesenchymal transition in HCC cell lines, which was associated with expression of HTATIP2. Sorafenib regulated expression of HTATIP2 via Jun-activated kinase (JAK) and signal transducer and activator of transcription (STAT)3 signaling. Sorafenib therapy prolonged recurrence-free survival in patients who expressed lower levels of HTATIP2 compared with higher levels. CONCLUSIONS: Sorafenib promotes invasiveness and the metastatic potential of orthotopic tumors from HCC cells in mice, down-regulating expression of HTATIP2 via JAK-STAT3 signaling.
    Gastroenterology 08/2012; · 12.82 Impact Factor
  • Xiao Feng Duan, Qiang Li
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    ABSTRACT: The aim of this study was to define the clinical features and surgical treatment outcomes of patients with primary hepatic angiosarcoma. Data of the 6 patients diagnosed with primary hepatic angiosarcoma in Tianjin Medical University Cancer Institute and Hospital from January 1999 to December 2005 were retrospectively reviewed. The median age of the patients was 49 years (range 45-78 years) with a male predominance. Laboratory tests showed a mild elevation of α-fetoprotein in 2 patients, and 2 had both hepatitis B and C. Liver resection was performed in all patients. For the 5 patients who received curative liver resection, the median follow-up duration was 41 months (range 23-84 months) and the overall 1-year, 3-year and 5-year survival rates were 100.0%, 80.0% and 40.0%, respectively. One patient who underwent a palliative operation died of tumor progression a month after operation. Early diagnosis is necessary and complete surgical resection is the key to improve prognosis.
    Journal of Digestive Diseases 07/2012; 13(7):381-5. · 1.85 Impact Factor
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    ABSTRACT: PURPOSE: To evaluate clinical outcomes associated with single-session, whole-liver radioembolization with Yttrium-90 (90Y)-labeled resin microspheres in patients with nonresectable liver metastases from breast cancer that were refractory to other treatments. METHODS: A retrospective analysis of consecutive patients who were treated between January 2002 and October 2008 was performed. Fifty-eight patients with unresectable liver metastases from breast cancer who had a good performance status and a low burden of extrahepatic disease were eligible for RE. Patients had undergone polychemotherapy regimens including at least anthracyclines and taxanes, hormonal therapy, and trastuzumab were applicable. RESULTS: A median activity of 1.93 GBq of 90Y was delivered. Follow-up at a median of 4.2 months demonstrated complete response, partial response, stable disease, and progressive disease in 5, 52, 31, and 12 % of patients, respectively. With respect to tumor diameters, imaging revealed a maximum and minimum response of -57.6 to +25.8 %, respectively. The median overall survival was 12.3 months. The median survival of responders and nonresponders was 20.9 and 6.3 months, respectively, and the median survival of patients with and patients without extrahepatic disease was 8.3 and 16.2 months, respectively. Clinically significant toxicities with the appearance of increasing transaminase level, increasing bilirubin level, nausea and vomiting, gastric ulcers, and ascites. CONCLUSIONS: Single-session, whole-liver 90Y radioembolization can be performed with an acceptable toxicity profile in patients with liver metastases from breast cancer.
    Journal of Cancer Research and Clinical Oncology 06/2012; 138(10):1779. · 2.91 Impact Factor
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    ABSTRACT: To analyze our experience and the surgical and survival outcomes of patients with pancreatic carcinoma who underwent pancreaticoduodenectomy (PD) by analysis of a retrospective cohort of 205 patients over a 10 years period. The patients were categorized into two 5-year periods: period 1, from 2000 January 1 to 2004 December 31(group 1, n = 48) and period 2, from 2005 January 1 to 2009 December 31(group 2, n = 157). We analysis the data using statistical software and find the improvement of surgical and survival outcomes of PD for pancreatic cancer in the past 10 years. The two groups have similar age, sex distribution, comorbidity, preoperative serum tumor markers, patients number of preoperative biliary drainage and postoperative chemotherapy. More patients in group 2 underwent lymph nodes dissection (P = 0.031). And patients of group 2 had a better surgical outcomes and longer 5-year overall survival (8% vs. 19%, P = 0.036). The blood loss volume, transfusion volume, and the number of patients need blood transfusion were significantly fewer (P < 0.001) for the patients in group 2, however, the operation time was obviously lengthened (P = 0.002). Patients in Group 1 suffered more postoperative complications than those of the patients in group 2 (P = 0.021). A significant difference was reached for survival between the two group (P = 0.036). A significant improvement of surgical and survival outcomes after PD for pancreatic cancer patients was achieved in the past 10 years. PD remains the only treatment option that potentially provides a cure for pancreatic head cancer, and postoperative chemotherapy may produce survival benefit.
    Pancreatology 05/2012; 12(3):206-10. · 2.04 Impact Factor
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    ABSTRACT: Astragalus polysaccharides (APS), the main active extract from Astragalus membranaceus (a traditional Chinese medicinal herb), is associated with a variety of immunomodulatory activities. The purpose of the present study was to examine the effect of APS on the function of Treg cells in the tumor microenvironment of human hepatocellular carcinoma (HCC) and to identify the pharmacologic mechanism of APS responsible for the anti-chemotactic activity in CD4+CD25highTreg cells in tumor site of HCC. The prevalence of Treg in fresh tissue samples from 31 patients with HCC after radicalhepatectomy was detected. CD4, CD25 and CD127 were selected as Treg cell makers to phenotype cell populations. The expression of FOXp3 mRNA was also analyzed. The migration and proliferation of Treg cells were observed. Interleukin (IL)-4, IL-10, IFN-γ and SDF-1 in cell supernatant were detected. For all tests, functions of Treg cells were evaluated after treatment with APS. APS can inhibit the growth and proliferation of CD4+CD25+Treg cells in vitro in a dose- and time-dependent manner. APS may inhibit CD4+CD25+Treg cells through restoring the cytokine imbalance and reducing the expression of FOXp3 in local HCC microenvironments. SDF-1 played an important role in there recruitment of Treg cells into the tumor microenvironment of HCC. APS might have inhibiting effects on Treg cell migration by blocking SDF-1 or its receptor through the CXCR4/CXCL12 pathway. The increase in numbers of tumor associated Treg cells might play a role in modulation of the immune response against HCC. APS can restore the cytokine balance in the tumor micro environment and suppress the expression of FOXp3 mRNA to inhibit the immune suppressive effects of Treg cells. The application of APS in the tumor microenvironment might act to enhance the anti-tumor effects of the immunotherapy-based methods, and consequently to increase the survival rate in HCC.
    Chinese medical journal 03/2012; 125(5):786-93. · 0.90 Impact Factor
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    ABSTRACT: Aim:  To compare the surgical treatment outcomes between patients with colorectal liver metastases (CLM) and non-colorectal liver metastases (NCLM). Methods:  The study population consisted of 132 patients undergoing hepatectomy at Tianjin Medical University Cancer Hospital between January 1996 and December 2008. Survival analyses were used to assess the differences in prognosis and survival between groups. Results:  The primary tumor site was colorectal in 60 (45.5%), breast in 16 (12.1%), lung in 14 (10.6%), non-colorectal gastrointestinal in 12 (9.1%), genitourinary in 10 (7.6%), pancreatobiliary tumor (n = 8, 6.1%) and others in 12 (9.1%). A curative liver resection was performed in all patients by pathological findings. After a median follow-up of 32 months, the overall 3- and 5-year survival rate was 44.7 and 29.5% in all patients, respectively. The 3- and 5-year survival rates were 53.3 and 36.7% for liver metastases from colorectal tumors, 62.5 and 43.8% from breast, 60.0 and 40.0% from genitourinary neoplasm, 41.7 and 25.0% from non-colorectal gastrointestinal cancer, 28.5 and 15.0% from lung, 12.5 and 0% from pancreatobiliary malignancies, and 41.7 and 8.3% from other sites, respectively. Conclusions:  Hepatic resection is an effective and safe treatment for liver metastases mainly depending on primary tumor sites. Hepatic metastases from non-colorectal gastrointestinal cancer, pulmonary and pancreatobiliary malignancies have the worst prognosis; those from breast and genitourinary neoplasm show the best prognosis.
    Hepatology Research 12/2011; 42(3):296-303. · 2.07 Impact Factor
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    ABSTRACT: Histone deacetylases (HDACs) remove acetyl groups from lysine residues of histones and the deacetylation allows for tighter electrostatic interactions between DNA and histones, leading to a more compact chromatin conformation with limited access for transactivators and the suppression of transcription. HDAC mRNA and protein overexpression was observed in endometrial and ovarian cancers. Numerous in vitro studies have shown that HDAC inhibitors, through their actions on histone and nonhistone proteins, are able to reactivate the tumor suppressor genes, inhibit cell cycle progression and induce cell apoptosis in endometrial and ovarian cancer cell cultures. Results from mouse xenograft models also demonstrated the potency of HDAC inhibitors as anticancer reagents when used as single agent or in combination with classical chemotherapy drugs.
    Future Oncology 12/2011; 7(12):1415-28. · 3.20 Impact Factor
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    ABSTRACT: BACKGROUND: To determine whether the inferior outcome noted with triple-negative breast cancer (TNBC) reflects a higher risk population among patients with breast cancer liver metastases. METHODS: A total of 123 patients with breast cancer liver metastases diagnosed at Tianjin Medical University Cancer Hospital were included in this study. Breast cancer subtype was assigned using immunohistochemistry or fluorescence in situ hybridization: hormone receptor (HR) positive (+)/human epidermal growth factor receptor 2 (HER2) negative (-), HR+/HER2+, HR-/HER2+ and triple-negative subtype. Clinical features and survival were evaluated in different subtypes. RESULTS: The median age at breast cancer diagnosis was 47 years (range, 23-67 years). Breast cancer subtype was confirmed in all patients (39.8% with HR+/HER2-, 24.4% with HR+/HER2+, 15.3% with HR-/HER2+ and 20.3% with TNBC). The median overall survival after liver metastases was 29 months (range, 4-89 months), and the overall 1-, 2- and 3-year survival rate was 68.3, 48.0 and 34.1%, respectively. Survival was found to be impacted by breast cancer subtype (P = 0.001), and was shortest for patients with TNBC. Time to liver metastases (TTLM) less than 24 months and liver metastasis lesions ≥3 were found to be important predictors of poor survival after liver metastases (P = 0.009 and 0.001, respectively). CONCLUSIONS: The results indicate that clinical breast cancer subtype remains an independent prognostic predictor among patients with breast cancer liver metastases. Liver metastases arising from TNBC confers the worst prognosis, and novel agents capable of controlling intrahepatic and extrahepatic TNBC are needed.
    International Journal of Clinical Oncology 10/2011; · 1.41 Impact Factor
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    ABSTRACT: To explore the relationships among differentiation degree, contrast-enhanced ultrasound and the expression of EphB4/EphrinB2 in primary hepatocarcinoma. Forty one patients that were diagnosed with hepatocarcinoma by contrast-enhanced ultrasound before operation and then confirmed to have primary hepatocarcinoma by postoperative pathology were enrolled in our study. The expression of EphB4/EphrinB2 in tumor specimens were detected by immunohistochemical assay and compared with the result of contrast-enhanced ultrasound. Differentiation degree was related to EphrinB2 expression and contrast-enhanced ultrasound in primary hepatocarcinoma. EphrinB2 expression was significantly higher in poorly differentiated hepatocarcinoma (88.9%, 16/18) then in moderately and well differentiated hepatocarcinoma (34.8%, 8/23) (?2=12.17, p<0.001). The 'fast-in' in arterial phase displayed by contrast-enhanced ultrasound was also significantly higher in poorly differentiated hepatocarcinoma (100%) than in moderately and well differentiated hepatocarcinoma (60.9%, 14/23) (?2=9.02, p=0.003). EphrinB2 is an important indicator of poorly differentiated hepatocarcinoma. There is a good correlation of EphrinB2 expression with vascular perfusion pattern and morphology in arterial phase displayed by contrast-enhanced ultrasound, so contrast-enhanced ultrasound has a certain value in evaluating differentiation degree of primary hepatocarcinoma before operation.
    Hepato-gastroenterology 10/2011; 59(116):1164-7. · 0.77 Impact Factor
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    ABSTRACT: To evaluate the efficiency of combined treatment of transcatheter arterial chemoembolization (TACE) and systemic chemotherapy (SC) for liver-only metastases from breast cancer after mastectomy. We compared the outcomes of 44 patients who underwent combined treatment of TACE and systemic chemotherapy (TSC) with those of 43 patients who underwent systemic chemotherapy (SC). The median follow-up from the diagnosis of liver metastases was 29 months (range, 0-89 months). Response rates were 59.1% and 34.9% for TSC group and SC group (P < 0.05), respectively. The 1-, 2- and 3-year survival rates for TSC group were 76.2, 66.7 and 47.6%, and those for SC group were 48.1, 29.6 and 7.4% (P = 0.027), respectively. Estrogen receptor (ER)-negative status of primary tumor, disease-free interval from mastectomy to liver metastases (DFI) less than 24 months and patients who received systemic chemotherapy only were independently associated with poor prognosis (P = 0.009; P = 0.023; P = 0.030). The combined treatment of TACE and systemic chemotherapy may prolong survival for liver metastases in breast cancer after mastectomy.
    Journal of Cancer Research and Clinical Oncology 09/2011; 137(9):1363-70. · 2.91 Impact Factor
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    ABSTRACT: Hilar cholangiocarcinoma (HC) is the most common location for bile duct cancer. It represents a significant technical challenge for surgical operation due to the close proximity to major vascular structures and to the liver and arborization of the right and left biliary tree. The objective of this study was to assess the therapeutic strategies and prognostic factors that could influence the clinical outcome of HC. From January 1990 to December 2009, a total of 215 HC patients undergoing resection were included in this study. Survival and follow-up were calculated from the date of initial histologic diagnosis to the dates of first recurrence or death and last contact, respectively. Uni- and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence. 215 patients underwent resection: 141 (65.6%) had an R0 resection (negative histologic margins), 46 (21.4%) had an R1 resection (positive histologic margins), 28 (13.0%) had an R2 resection. The 1-, 3- and 5-year cumulative survival rates (%) of the patients were 60.3, 37.2 and 29.7%. The median survival time after R0 resection was 47.1 months, 17.2 months after R1 resection, and 12.1 months after R2 resection. The results from univariate analyses suggest that poor histopathological grade (p = 0.004), lymph node metastasis (p = 0.000), vascular invasion (p = 0.005), neuroinvasion (p = 0.044), R1 resection (p = 0.000) and T2 or T3 stage (p = 0.009) were significant predictors for poor survival rates. By multivariate analysis, only the lymph node metastasis (RR = 2.450, 95% CI 1.677-3.579) and R1 resection (RR = 0.283, 95% CI 0.183-0.437) were significantly associated with poor survival rates. Negative histologic margins were associated with improved outcome after all HC resections. Complete resection remains the only therapy that offers the possibility of long-term survival, and hepatic resection is a critical component of the surgical approach.
    Digestive surgery 01/2011; 28(3):226-31. · 1.37 Impact Factor
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    ABSTRACT: Resection + radiofrequency ablation (RFA) + hepatic artery infusion (HAI) + systemic chemotherapy for patients with unresectable synchronous liver-only metastases from colorectal cancer was rarely used previously. We compared the outcomes of 42 patients underwent resection + RFA + HAI + systemic chemotherapy (RRHS) with that of 43 patients underwent resection + RFA + systemic chemotherapy (RRS). The overall survival, the survival free of hepatic recurrence and the median survival in the RRHS group were all significantly higher than those in RRS group at 4 years. While the rates of adverse effects were similar in the two groups. For patients with unresectable synchronous liver-only metastases from colorectal cancer, RRHS not only decreases but also postpones hepatic recurrence and therefore improves overall survival at 4 years, as compared with RRS.
    Journal of Gastrointestinal Surgery 10/2010; 15(2):285-93. · 2.36 Impact Factor
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    ABSTRACT: To review the clinical data of a group of patients with pancreatic neuroendocrine tumors (pNETs) and to investigate the role of surgery in the treatment for pNETs by analyzing clinical manifestations and postoperative course of this rare disease. A total of 112 patients (aged 21-76 years; 45 males) who underwent treatment between 1980 and 2003 were recruited in this study. Patients' data related to demographics and characteristics, diagnostic studies, surgical and tumor characteristics and survival were retrospectively reviewed. Forty-six patients (41.1%) had a well-differentiated neuroendocrine tumor (WDT), 44 (48.2%) a well-differentiated neuroendocrine carcinoma (WD-Ca) and 12 (10.7%) a poorly differentiated neuroendocrine carcinoma (PD-Ca). Nonfunctional tumors were seen in 65 (58.0%) patients, whereas functional tumors were found in 47 (42.0%) patients, including 26 insulinomas, 17 gastrinomas, 2 VIPomas, 1 glucagonoma, and 1 ACTHoma. The sensitivity of computed tomography was 87.1%. Surgical resection was performed in 99 (88.4%) patients. Thirty-eight (33.9%) patients underwent partial pancreaticoduodenectomy, 32 (28.6%) had distal pancreatectomy and 29 (25.9%) underwent enucleation. No surgery-related death occurred. The common postoperative complications were pancreatic fistula (15.2%), wound infection (13.4%) and delayed gastric emptying (6.3%). Three (5%) patients had reoperation due to intra-abdominal abscess and postoperative hemorrhage. Twenty-six (55.3%) of the 47 functional tumors were malignant, whereas 40 (61.5%) of the 65 nonfunctional tumors were malignant. Survival was significantly related to the type of neuroendocrine tumor (p = 0.001). The overall 5-year actual survival rate of patients with WD-Ca (n = 54) was 56%, significantly less than that of patients with WDT (n = 46, 91%, p = 0.001). All the patients of PD-Ca (n = 12) group died in 5 years. The 5-year survival rate differed significantly between patients with tumor node metastasis (TNM) stage I and II disease and those with stage III and IV tumors (p = 0.011). Patients with stage III had better prognosis than those with stage IV tumors (p = 0.007). Patients' long-term survival was closely correlated with vascular invasion (p = 0.008) and resection margin (p = 0.004). PNETs can be safely resected. Microscopic vascular invasion and positive resection margin are helpful for predicting patient survival. Malignant cases should be treated with aggressive radical surgery to achieve complete tumor resection and potential for long-term survival.
    Digestive surgery 08/2010; 27(3):197-204. · 1.37 Impact Factor
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    ABSTRACT: Few detailed studies about the correlations among the expanded prevalence, elevated function of Treg cells in tumor microenvironment of hepatocellular carcinoma (HCC), and different clinical tumor stage were reported. The purpose of the present study was to examine the presence and functions of CD4(+)CD25(high) regulatory T cell (Treg cell) in tumor microenvironment from early and late stages and reveal the potential underlying mechanisms that may be responsible. The prevalence of Treg in peripheral blood and fresh tissue samples from 31 patients with HCC after radical hepatectomy and 9 controls was detected. CD127 was selected as a Treg cell maker to test the cell populations and compared its expressions with ICOS. The expressions of FOXP3 mRNA were analyzed. The migration, proliferation, and suppression functions of Treg cell were observed. IFN-γ., IL-10, TGF-ß, CCL-17, CCL-22, and SDF-1 in cell supernatant were detected. Among all of the tests, the relations among the different TNM tumor stages, populations, and functions of Treg cells were evaluated. The prevalence of Treg cell was significantly higher in the peripheral blood and in tumor tissue compared with those in normal donors. Increased numbers of Treg cell were showed in peripheral blood as well as in tumor tissue. High levels of IL-10 and TGF-ß, but little IFN-γ, were detected in the tumor microenvironment. Treg cells potently suppressed the functions and proliferation of CD4(+)CD25(-) T cells. High levels of SDF-1 were detected in malignant biopsies compared with those in benign regions, significantly increased in stage III. Plasma from the same patient was able to chemoattract Treg cell but that was lesser extent than those in tumor supernatant. Also, supernatant in advanced stage tumors exhibited powerful chemoattractic activity. SDF-1 played an important role in the recruited functions of Treg cell into tumor microenvironment of early and advanced stages. The expressions of Foxp3 mRNA increased in different TNM stages. The increased prevalence and expanded function of Treg cells in the tumor microenvironment of HCC were correlated with the cancer stage. The increase in frequency of Treg cells might play a role in modulation of the immune response against HCC in different TNM stages. The substance secreted in tumor microenvironment recruited CD4(+)CD25(+) Treg cells to tumor sites to contribute to the prosperity and growth of the tumors. The performance of Treg cells in different TNM stages of tumor microenvironment might be acted as the route to evaluate the immunotherapy-based methods, promote therapy effect, and consequently to increase the survival rate in HCC.
    Journal of Cancer Research and Clinical Oncology 03/2010; 136(11):1745-54. · 2.91 Impact Factor

Publication Stats

196 Citations
82.49 Total Impact Points

Institutions

  • 2005–2012
    • Tianjin Medical University
      T’ien-ching-shih, Tianjin Shi, China
  • 2000–2012
    • Tianjin Medical University Cancer Institute and Hospital
      T’ien-ching-shih, Tianjin Shi, China
  • 2010
    • Nankai University
      T’ien-ching-shih, Tianjin Shi, China
  • 2009
    • Tianjin University
      • School of Pharmaceutical Science and Technology
      Tianjin, Tianjin Shi, China
  • 2007
    • Memorial University of Newfoundland
      St. John's, Newfoundland and Labrador, Canada
  • 2002
    • Fuda Cancer Hospital
      Shengcheng, Guangdong, China