Jipeng Li

Fourth Military Medical University, Xi’an, Liaoning, China

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Publications (24)75.11 Total impact

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    ABSTRACT: Background The aim of this study was to compare surgical outcomes and oncologic efficacy of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy(OG) for advanced gastric cancer. Methods For this study, eighty-seven consecutive AGC patients underwent LAG with D2 lymph node dissection between April 2005 to October 2009 were enrolled, compared with eighty-seven AGC patients underwent OG during the same period. Results Operative procedure and surgical margin were similar between two groups. The operative time was significantly longer in LAG group than OG group, while the estimated blood loss was significantly less in LAG group. There were no significant differences in postoperative complications and in the number of lymph nodes retrieved. The use of analgesic drugs was significantly less after LAG. Length of postoperative stay was significantly shorter in LAG group. The 5-year overall survival rate and recurrence-free survival rate were comparative between two groups. Conclusions This 5-year case-control study presented that laparoscopy-assisted gastrectomy may be a safe and acceptable procedure in terms of long-term results for advanced gastric cancer.
    American journal of surgery 09/2014; · 2.36 Impact Factor
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    ABSTRACT: MicroRNAs are noncoding RNAs that regulate multiple cellular processes during cancer progression. Among various microRNAs, miR-630 has recently been identified to be implicated in many critical processes in human malignancies. We investigated the expression pattern and prognostic value of miR-630 in human colorectal cancer by utilizing cancer and adjacent normal specimens from 206 patients. Quantitative real-time PCR assay was used to detect the expression of miR-630, and appropriate statistical analysis was used to evaluate the association of miR-630 with overall survival. It was found that miR-630 expression was significantly increased in colorectal cancer specimens compared with that in adjacent normal specimens. It was also proved that miR-630 expression in colorectal cancer was associated with tumor invasion, lymph node metastasis, distant metastasis, and tumor-node-metastasis (TNM) stage. The Kaplan-Meier survival analysis proved that increased miR-630 expression was associated with poor overall survival of patients with colorectal cancer. Multivariate analysis proved that miR-630 was an independent prognostic marker after adjusted for known prognostic factors. These results confirmed the overexpression of miR-630 in human colorectal cancer and its association with tumor progression. It also suggested that miR-630 expression might serve as a prognostic biomarker for patients with colorectal cancer.
    Tumor Biology 07/2014; · 2.84 Impact Factor
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    ABSTRACT: CD147 is correlated with tumor aggressiveness in various human malignancies. Here, we investigated CD147 protein expression in 223 patients with gastric cancer by immunohistochemistry and analyzed its association with disease-free and overall survival. CD147 was increased in gastric cancer compared to normal tissues. Additionally, CD147 expression was associated with gastric cancer invasion, metastasis and TNM stage, whereas it was not related to age, sex, differentiation status, tumor site or Lauren classification. Kaplan-Meier analysis confirmed that CD147 was associated with disease-free and overall survival in patients with gastric cancer; i.e., patients with positive CD147 staining tend to have worse disease-free and overall survival. Moreover, Cox's proportional hazards analysis demonstrated that CD147 was an independent marker of disease-free and overall survival for patients with gastric cancer. These results confirm the association of CD147 with gastric cancer invasion and metastasis and prove that CD147 might be an indicator of tumor recurrence and prognosis in gastric cancer.
    PLoS ONE 06/2014; 9(6):e101027. · 3.53 Impact Factor
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    ABSTRACT: Human leukocyte antigen G (HLA-G) is a non-classical HLA class I molecule thought to play a key role in maternal-fetal tolerance and cancer immune evasion. This study aimed to investigate the HLA-G expression in lesion sections and plasma sHLA-G levels of primary esophageal squamous cell carcinoma (ESCC) patients and its clinical significance in diagnosis and prognosis of ESCC. 60 ESCC patients and 28 healthy controls were recruited, and the positive expression of HLA-G in ESCC lesions and adjacent normal tissues were 70% (42/60) and 8.6% (5/60) (P<0.05), respectively, while no expression was found in normal controls. HLA-G1 and HLA-G5 were determined to be dominating isoforms measured by RT-PCR. There was a significant difference in plasma sHLA-G levels between patients with ESCC (15.04U/ml, range 4.33-250.00U/ml) and healthy controls (6.81U/ml, range 0-29.27U/ml) (P<0.01). The plasma IL-10 level was higher in ESCC patients than the controls (23.86pg/ml vs. 12.81pg/ml, P<0.01). HLA-G expression in lesion tissues was correlated with cancer cell differentiation (P=0.033), lymph node metastasis (P=0.035) of ESCC. However, no obvious correlations were demonstrated between the plasma sHLA-G levels and the clinicopathological parameters. There was a significant correlation between sHLA-G and IL-10 expression (r=0.353, P=0.006) in patients with Esophageal squamous cell carcinoma. HLA-G positive expression showed poorer prognosis of ESCC. HLA-G positive expression might serve as a potential marker in the diagnosis or prediction of ESCC.
    Immunology letters 04/2014; · 2.91 Impact Factor
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    ABSTRACT: MicroRNAs are noncoding RNAs that regulate multiple cellular processes during cancer progression. Among various microRNAs, MiR-630 has recently been identified to be implicated in many critical processes in human malignancies. We aimed to investigate the significance and prognostic value of miR-630 in human gastric cancer. Gastric cancer and adjacent normal specimens from 236 patients from who had not received neoadjuvant chemotherapy were collected. The expression of miR-630 was investigated by quantitative real-time PCR assay and its association with overall survival of patients was analyzed by statistical analysis. MiR-630 expression level was significantly elevated in gastric cancer in comparison to adjacent normal specimens. It is also proved that miR-630 expression was to be associated with gastric cancer invasion, lymph node metastasis, distant metastasis and TNM stage. In addition, survival analysis proved that elevated miR-630 expression was associated with poor overall survival of patients. Multivariate survival analysis also proved that miR-630 was an independent prognostic marker after adjusted for known prognostic factors. The present study proved the over-expression of miR-630 and its association with tumor progression in human gastric cancer. It also provided the first evidence that miR-630 expression was an independent prognostic factor for patients with gastric cancer, which might be a potential valuable biomarker for gastric cancer.
    PLoS ONE 03/2014; 9(3):e90526. · 3.53 Impact Factor
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    ABSTRACT: An increasing amount of evidence demonstrated that the neurotrophic receptor tropomyosin-related kinase B (TrkB) plays a critical role in the development and progression of multiple types of cancer. However, its underlying mechanism in distant metastasis through the circulatory and lymphatic systems in colorectal cancer (CRC) is still unclear. Here we showed that downregulation of TrkB using short hairpin RNA obviously increased anoikis (detachment-induced apoptosis resulting from loss of cell-matrix interactions) sensitivity of CRC cells in vitro. Furthermore, using tail vein injection model, we confirmed that silencing TrkB significantly inhibited metastasis of CRC cells in vivo. Conversely, overexpression of TrkB obviously protected CRC cells from anoikis in vitro. Both loss- and gain-of-functional experiments indicated that TrkB could be a functional molecule in anti-anoikis of CRC cells. Mechanistically, we found that protein kinase B (PKB, also known as Akt) signaling pathway was a functional link in TrkB-induced anoikis suppression in CRC cells. Phosphorylation levels of Akt are closely related with the expression pattern of TrkB in CRC cells and inhibition of Akt activation robustly induces anoikis of CRC cells in vitro. In addition, our clinical investigation showed that high TrkB expression levels in CRC patients were associated with lymph node metastasis, distant metastasis and unfavourable prognosis. Thus, based on our results, this study suggests that an important function of TrkB is to protect CRC cells from anoikis in the circulatory and lymphatic systems, and that TrkB could be a promising candidate in CRC therapy, especially in the inhibition of cancer metastasis.
    Apoptosis 02/2014; · 3.61 Impact Factor
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    ABSTRACT: BACKGROUND: Matrix metalloproteinase-14 (MMP-14) has been considered to play an important role in invasion and metastasis of human solid tumor. AIM: The present study aimed to investigate the association of MMP-14 with overall survival in human gastric cancer. METHODS: Gastric cancer and adjacent normal specimens were collected from 205 patients who had not received neoadjuvant chemotherapy. MMP-14 expression was investigated by immunohistochemistry assay and staining evaluation results were analyzed statistically in relation to overall survival of patients. RESULTS: MMP-14 expression proved to be increased in gastric cancer compared with that in normal tissues. It was also proved that MMP-14 expression was associated with tumor invasion, metastasis, and TNM stage while no correlations were detected between MMP-14 expression and age, sex, differentiation status, or Lauren's classification. Moreover, patients with gastric cancer of MMP-14-positive expression tend to have worse overall survival compared with those with MMP-14 negative expression. CONCLUSIONS: The present study confirmed the over-expression of MMP-14 in human gastric cancer and its association with tumor progression. It also provided the first evidence that MMP-14 expression in gastric cancer was an independent negative prognostic factor of patients.
    Digestive Diseases and Sciences 01/2013; 58(5). · 2.26 Impact Factor
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    ABSTRACT: Background After laparoscopic total gastrectomy, the optimal method for esophagojejunostomy remains to be established. Study Design Between June 2009 and December 2012, 52 patients with gastric cancer underwent consecutive laparoscopic total gastrectomy with a new self-pulling and holding purse-string suture technique using a circular stapler for intracorporeal circular-stapled esophagojejunostomy in our hospital. Hand suture of purse-string is performed with assistance of constant self-pulling and holding of uncut the right esophagus on transected esophageal end after subtotal circumferential transaction (90%) of distal esophagus. needle insertion from the serosal side or the mucosal side of esophageal lumen is chosen depending on the difficulty of laparoscopic suturing to avoid backhand stitch. Results No procedures were converted to open or other laparoscopic anastomosis techniques in 52 cases. The mean operating time was 297.1 ± 53.0 min, and the time of both for the purse-string suture and anvil placement was 18.3 ±6.1 min. Negative tumor margin involved in all of 52 cases, and the mean proximal esophageal margin was 5.3 ± 1.7cm. There were 3 major postoperative complications: one patient for anastomotic bleeding on postoperative day 1 recovered in the conservative precedure, two patients for intestinal obstruction due to the adhesion and angulation at the jejunojejunal anastomosis recovered after enterolysis. Total morbidity rate was 21.2% , and there was no mortality. There were no postoperative anastomotic leakage, stenosis and duodenal stump leakage observed during the median follow-up period of 17 months ( range 7-43months ). Conclusions We believe that this method is feasible and reliable, and it could be applied in most laparoscopic total gastrectomy procedures. However, further follow-up is necessary to confirm long-term outcomes.
    Journal of the American College of Surgeons 01/2013; · 4.45 Impact Factor
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    ABSTRACT: Acute lung injury (ALI) is still a leading cause of morbidity and mortality in critically ill patients. Recently, our and other studies have found that hydrogen gas (H₂) treatment can ameliorate the lung injury induced by sepsis, ventilator, hyperoxia, and ischemia-reperfusion. However, the molecular mechanisms by which H₂ ameliorates lung injury remain unclear. In the current study, we investigated whether H₂ or hydrogen-rich saline (HS) could exert protective effects in a mouse model of ALI induced by intratracheal administration of lipopolysaccharide (LPS) via inhibiting the nuclear factor κB (NF-κB) signaling pathway-mediated inflammation and apoptosis. Two percent of H₂ was inhaled for 1 h beginning at 1 and 6 h after LPS administration, respectively. We found that LPS-challenged mice exhibited significant lung injury characterized by the deterioration of histopathology and histologic scores, wet-to-dry weight ratio, and oxygenation index (PaO₂/FIO₂), as well as total protein in the bronchoalveolar lavage fluid (BALF), which was attenuated by H₂ treatment. Hydrogen gas treatment inhibited LPS-induced pulmonary early and late NF-κB activation. Moreover, H₂ treatment dramatically prevented the LPS-induced pulmonary cell apoptosis in LPS-challenged mice, as reflected by the decrease in TUNEL (deoxynucleotidyl transferase dUTP nick end labeling) staining-positive cells and caspase 3 activity. Furthermore, H₂ treatment markedly attenuated LPS-induced lung neutrophil recruitment and inflammation, as evidenced by downregulation of lung myeloperoxidase activity, total cells, and polymorphonuclear neutrophils in BALF, as well as proinflammatory cytokines (tumor necrosis factor α, interleukin 1β, interleukin 6, and high-mobility group box 1) and chemokines (keratinocyte-derived chemokine, macrophage inflammatory protein [MIP] 1α, MIP-2, and monocyte chemoattractant protein 1) in BALF. In addition, i.p. injection of 10 mL/kg hydrogen-rich saline also significantly attenuated the LPS-induced ALI. Collectively, these results demonstrate that molecular hydrogen treatment ameliorates LPS-induced ALI through reducing lung inflammation and apoptosis, which may be associated with the decreased NF-κB activity. Hydrogen gas may be useful as a novel therapy to treat ALI. munosorbent assay; H₂-hydrogen gas; HMGB1-high-mobility group box 1; HS-hydrogen-rich saline; i.t.-intratracheal; KC-keratinocyte-derived chemokine; LPS-lipopolysaccharide; MCP-1-monocyte chemoattractant protein 1; MIP-1α-macrophage inflammatory protein 1α; MIP-2-macrophage inflammatory protein 2; MPO-myeloperoxidase; PBS-phosphate-buffered saline; PMNs-polymorphonuclear neutrophils; TUNEL-deoxynucleotidyl transferase dUTP nick end labeling; W/D-wet-to-dry.
    Shock (Augusta, Ga.) 05/2012; 37(5):548-55. · 2.87 Impact Factor
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    ABSTRACT: Totally laparoscopic gastrectomy represents the evolution of laparoscopy-assisted gastrectomy. Most surgeons prefer laparoscopy-assisted gastrectomy rather than totally laparoscopic procedures because of technical difficulties of intracorporeal anastomosis. We created one novel stapling anastomosis without hand-sewn technique in totally laparoscopic Billroth II gastrectomy. The feasibility and early surgical outcomes of totally laparoscopic Billroth II gastrectomy with stapling anastomosis and with hand-sewn anastomosis were introduced in this study. We retrospectively analyzed early surgical outcomes in 70 patients who underwent totally laparoscopic Billroth II distal gastrectomy for gastric cancer between January 2010 and July 2011. The patients were divided into hand-sewn and device groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 36) or only stapling devices (n = 34). In the device group, the gastrojejunostomy was performed using a circular stapler, and an additional side-to-side jejunojejunostomy was made at the site of jejunal enterotomy. There was no difference in the mean number of lymph nodes retrieved in both groups. The blood loss (hand-sewn group 205.8 ± 37.4 vs. device group 201.2 ± 51.2 ml, p > 0.05) and hospital stay (hand-sewn group 6.5 ± 3.7 vs. device group 5.9 ± 4.1 days, p > 0.05) were similar in both groups. We found that intracorporeal anastomosis by totally stapling devices was associated with decreased operative time (hand-sewn group 239.0 ± 40.1 vs. device group 203.6 ± 27.9 min, p < 0.05). We suggest that intracorporeal anastomosis using only stapling devices in the described method was as safe and feasible as by hand-sewn technique. Moreover, it is a simple and time-saving method without any difficult hand-sewn procedures.
    Journal of Gastrointestinal Surgery 12/2011; 16(4):738-43. · 2.36 Impact Factor
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    ABSTRACT: Notch1 has been proven to be aberrantly expressed in colorectal cancer and related to tumor differentiation status. However, few previous studies concentrated on the predictive role of Notch1 expression on the overall survival of patients with colorectal cancer. This study explored expression of Notch1 and its relationship with p65 and prognosis in colorectal cancer. Two independent study cohorts were involved in the present study. Clinical specimens from 941 eligible patients were constructed into tissue microarrays. The expression of Notch1 and p65 protein was investigated by immunohistochemistry. Statistically significant positive correlations were found between protein expression of Notch1 and p65 in both retrospective and prospective study cohorts. Patients with higher Notch1 expression showed a trend of having shorter survival time, whereas patients with lower Notch1 expression had better survival in both study cohorts. In multivariate analysis, Notch1 expression was proven to be an independent predictor of prognosis. Moreover, the prognostic value of Notch1 might differ according to p65 status. Notch1 is an independent predictor of prognosis for patients with colorectal cancer. In addition, the predictive role of Notch1 on clinical outcome might be modified by p65 status, suggesting that targeting Notch1 and nuclear factor κB (NF-κB) might be a promising strategy for colorectal cancer treatment.
    Clinical Cancer Research 08/2011; 17(17):5686-94. · 8.19 Impact Factor
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    ABSTRACT: Matrix metalloproteinase-21 (MMP-21) is a member of the MMP family, which is overexpressed in some solid tumors and is thought to enhance the tumor invasion and metastasis ability. The aim of the present study is to examine the MMP-21 expression in human colorectal cancer and normal colorectal tissue using tissue microarray technique and to determine its association with clinicopathological characteristics and prognostic value. Four array blocks including 256 cases of colorectal cancer and adjacent normal tissues were investigated by immunohistochemistry assay. Staining evaluation results were analyzed statistically in relation to various clinicopathological characters and overall survival. High level of MMP-21 expression was detected in colorectal cancer, significantly more than in normal colorectal epithelial cells. In colorectal cancer, MMP-21 was significantly positively correlated with depth of invasion, lymph node metastasis, and distant metastasis. The overall survival rate was significantly lower for patients with MMP-21 positive than those with MMP-21 negative tumors. However, no correlations between MMP-21 expression and patients' age, sex tumor location, or differentiation status were detected. Our findings emphasize the important role of MMP-21 in the invasion and metastasis process in human colorectal cancer. It might also serve as a novel prognostic marker that is independent of, and additive to, the TNM staging system.
    Journal of Gastrointestinal Surgery 07/2011; 15(7):1188-94. · 2.36 Impact Factor
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    ABSTRACT: The expression of matrix metalloproteinase-21 (MMP-21) has been shown to be elevated in some solid tumor and thought to enhance tumor invasion and metastasis ability. In the present study, we investigated the expression of MMP-21 and its association with prognosis in stage II and III colorectal cancer. MMP-21 expression was investigated in 286 cases of colorectal cancer by immunohistochemistry assay. Statistical analysis was utilized to evaluate the association of MMP-21 expression with clinicopathological characters and overall survival of patients with stage II and III colorectal cancer. MMP-21 expression was significantly higher in colorectal cancer, compared with that in normal epithelial tissue. And it also correlated with tumor invasion, lymph node metastasis, and distant metastasis of colorectal cancer. MMP-21 was also proved to be an independent prognostic factor in patients with stage II as well as stage III colorectal cancer. However, no correlations between MMP-21 expression and patients' age, sex, tumor location, or differentiation status were detected. These results suggested the potential role of MMP-21 in the invasion and metastasis process of human colorectal cancer. It could also be a novel molecular marker to predict prognosis of patients with stage II and stage III colorectal cancer.
    Journal of Surgical Oncology 06/2011; 104(7):787-91. · 2.84 Impact Factor
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    ABSTRACT: Matrix metalloproteinase-9 is a member of the MMP family, which is overexpressed in some solid tumors and is thought to enhance tumor invasion and metastasis ability. The present study aims to examine MMP-9 expression in human colorectal cancer and to determine its association with clinicopathological characteristics and prognosis. Colorectal cancer and adjacent normal tissues from 192 patients were investigated by immunohistochemical assay. Staining evaluation results were analyzed statistically in relation to various clinicopathological characters, disease-free survival, and overall survival. High level of MMP-9 expression was detected in colorectal cancer, significantly more than in normal colorectal epithelial cells. In colorectal cancer, MMP-9 was significantly positively correlated with depth of invasion, lymph node metastasis, and distant metastasis. However, no correlations between MMP-9 expression and patient age, sex, tumor location or differentiation status were detected. Disease-free and overall survival were significantly poorer for patients with positive MMP-9 staining than for those with MMP-9-negative tumors. Our findings emphasize the important role of MMP-9 in the invasion and metastasis process in human colorectal cancer. It could also serve as a novel prognostic marker that is independent of, and additive to, the tumor-node-metastasis (TNM) staging system.
    Annals of Surgical Oncology 04/2011; 19(1):318-25. · 3.94 Impact Factor
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    ABSTRACT: INTRODUCTION: Angiogenesis has become an appealing target in cancer therapy due to its fundamental role in cancer growth and metastasis. A number of angiogenesis-related molecules are under investigation, with some already in clinical practice with various results. The effort to present and discuss the current status of the research on the angiogenesis-related molecular targets will lead to improved clinical strategies and outcomes for patients with esophageal cancer (EC). AREAS COVERED: This review summarizes the recent advances in angiogenesis-related targets in EC, and also analyzes the clinical and therapeutic applications they provide. We envisage future developments towards the anti-angiogenic strategy of molecular targets and their potential applications to cancer treatment. EXPERT OPINION: Angiogenesis-related targets can be used as a useful therapeutic tool for EC. More investigations should be performed to promote the success of anti-angiogenic therapy in clinical trials.
    Expert Opinion on Investigational Drugs 03/2011; 20(5):637-44. · 4.74 Impact Factor
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    ABSTRACT: Recently, hydrogen gas (H₂) is reported to be a new therapeutic agent in organ damage induced by ischemia-reperfusion (I/R). The present study was designed to investigate the beneficial effects of H₂ against spinal cord I/R injury and its associated mechanisms. Spinal cord ischemia was induced by infrarenal aortic occlusion for 20 min in male New Zealand white rabbits. Treatment with 1%, 2% or 4% H₂ inhalation was given from 10 min before reperfusion to 60 min after reperfusion (total 70 min). Here, we found that I/R-challenged animals showed significant spinal cord damage characterized by the decreased numbers of normal motor neurons and hind-limb motor dysfunction, which was significantly improved by 2% and 4 % H₂ treatment. Furthermore, we found that the beneficial effects of H₂ treatment against spinal cord I/R injury were associated with the decreased levels of oxidative products [8-iso-prostaglandin F2α (8-iso-PGF2α) and malondialdehyde (MDA)] and pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and high-mobility group box 1 (HMGB1)], as well as increased activities of antioxidant enzymes [superoxide dismutase (SOD) and catalase (CAT)] in serum and spinal cord. In addition, H₂ treatment reduced motor neuron apoptosis in the spinal cord of this model. Thus, H₂ inhalation may be an effective therapeutic strategy for spinal cord I/R damage.
    Brain research 03/2011; 1378:125-36. · 2.83 Impact Factor
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    ABSTRACT: Here, we have first investigated the roles of ZNRD1 in angiogenesis of leukaemia. The leukaemia cell line K562 was transfected with the vector that included the full-length cDNA of ZNRD1, then the growth and angiogenesis of cells were detected. Up-regulation of ZNRD1 could significantly inhibit the growth of cells, reduce tumour microvessel densities and inhibit the VEGF (vascular endothelial growth factor) production. The results of human miRNA array and real-time PCR showed that ZNRD1 could significantly up-regulate the expression of miR-214 and down-regulate the expression of miR-296. Taken together, ZNRD1 might inhibit tumour angiogenesis and could be considered as a target for leukaemia therapy.
    Cell Biology International 11/2010; 35(4):321-4. · 1.64 Impact Factor
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    ABSTRACT: The application of laparoscopy-assisted gastric surgery has been increasing rapidly for the treatment of early gastric cancer. However, there were few reports of laparoscopic surgery in the management of advanced gastric cancer (AGC), especially with T3 depth of invasion. The aim of this study was to compare the technical feasibility and oncologic efficacy of laparoscopy-assisted distal gastrectomy (LADG) versus open distal gastrectomy (ODG) for advanced gastric cancer. A retrospective case-control study was performed comparing LADG and ODG for AGC. Thirty-five consecutive patients with AGC undergoing LADG between August 2005 and December 2007 were enrolled and these patients were compared with 35 AGC patients undergoing ODG during the same period. Forty-two (60.0%) patients were T3 in terms of depth of invasion. Tumor location and histology were similar between the two groups. Operation time was significantly longer in the LADG group than in the ODG group. Estimated blood loss was significantly less in the LADG group. Hospital length of stay after LADG was significantly shorter than in the open group. Postoperative pain was significantly lower for laparoscopic patients. There were no significant differences in postoperative early and late complication and in the number of lymph nodes retrieved between the two groups, and the cumulative survival of the two groups was similar. Our data indicate that LADG for AGC, mostly with T3 depth of invasion, yields good oncologic outcomes including the similar early and late complication and the cumulative survival between the two groups after 50 months of follow-up. To be accepted as a choice treatment for advanced distal gastric cancer, well-designed prospective trial to assess long-term outcomes is necessary.
    Journal of Gastrointestinal Surgery 10/2010; 15(1):57-62. · 2.36 Impact Factor
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    ABSTRACT: Notch1 regulates cell proliferation, development, and apoptosis. Aberrant expression of Notch1 has been discovered in many types of tumors. We examined Notch1 expression in colorectal cancer to assess its role as a prognostic indicator. Notch1 protein expression was examined by immunohistochemistry in 223 surgically resected specimens of colorectal cancer and adjacent tissues. The relationship between various clinicopathological features and overall patient survival rate was analyzed. The association of Notch1 expression with the colorectal cancer survival rate was assessed by Kaplan-Meier and Cox proportional-hazards regression. Significantly high Notch1 expression was found in colorectal cancer cells compared with that of normal colorectal epithelial cells. Notch1 was positively correlated with depth of invasion (P = 0.005), lymph node metastases (P = 0.03), and tumor-node-metastasis (TNM) stage (P < 0.001). Consistently, the overall survival rate was significantly lower for patients with Notch1-positive than those with Notch1-negative tumors. However, no correlation between Notch1 expression and patient age, sex or tumor location was found. Notch1 might serve as a novel prognostic marker that is independent of, and additive to, the TNM staging system.
    Annals of Surgical Oncology 05/2010; 17(5):1337-42. · 3.94 Impact Factor
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    ABSTRACT: As a result of increased surgeon's experience and the improvement in laparoscopic techniques, laparoscopic gastrectomy has been widely accepted for the management of early stage gastric cancer. Sufficient evidence has demonstrated the feasibility of laparoscopy-assisted distal gastrectomy for early gastric cancer. Radical laparoscopic treatment of more advanced gastric cancer is controversial. The purpose of the current study was to determine feasibility and advantage of laparoscopy-assisted total gastrectomy (LTG) versus open total gastrectomy (OTG) with D2 dissection of lymph nodes in patients with advanced gastric cancer. Between Nov 2005 and May 2009 in our single institute, 176 patients with advanced gastric cancer underwent total gastrectomy with D2 dissection of lymph nodes. 82 of these patients underwent LTG, 94 underwent OTG. Clinical data of the both procedures were compared. Disease-free survival was studied to assess short-term outcome differences between the groups. None of 82 patients was converted to laparotomy and no operative mortality was observed in LTG. Postoperative complication rate was 9.8% (8/82) in LTG, compared with 24.5% (23/94) in OTG. No major complications occurred among the all patients who underwent LTG. There were 2 deaths (2/94) due to myocardial infarction in 3 days after OTG. In comparison to OTG, LTG had the longer operating time (275 +/- 78 versus 212 +/- 51 min; p < 0.001), similar number of lymph nodes (34.2 +/- 13.5 versus 36.4 +/- 19.1; p = 0.331), less operative blood loss (156 +/- 112 ml versus 339 +/- 162 ml; p < 0.001), earlier recovery of bowel activity, earlier ambulation and reduced postoperative pain after surgery (p < 0.001). Tumor- free margins were obtained in all patients who underwent LTG. In a mean follow-up period of 22.5 months, local recurrence and metastasis were observed in 19 of 82 patients in LTG, 23 of 94 patients in OTG respectively. Laparoscopically assisted total gastrectomy for middle and upper gastric cancer is considered to be a safe and feasible procedure. Short-term oncological outcomes for laparoscopic total gastrectomy with extended lymph nodes were the same as in open surgery.
    Hepato-gastroenterology 01/2010; 57(104):1589-94. · 0.91 Impact Factor