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ABSTRACT: To evaluate the clinical characteristics and survival factors of patients with duodenal gastrointestinal stromal tumors (GIST).
The clinical data of 41 patients with duodenal GIST were analyzed retrospectively at Cancer Hospital and Institute, Chinese Academy of Medical Sciences from June 1996 to August 2011. Kaplan-Meier method was used to calculate the recurrence-free survival rate and the Cox proportional hazard regression model employed for the recurrence-free survival analysis.
The lesions of duodenal GIST were predominantly located in the descending (n = 26, 63.4%) and transverse portions (n = 10, 24.4%). Most duodenal GIST presented commonly with upper gastrointestinal bleeding (n = 18, 43.9%) and 12 cases (29.3%) were incidentally detected by physical examinations. Eight patients underwent pancreatoduodenectomy and 27 limited resection. The tumor size varied from 0.6 cm to 30.0 cm (mean: 8.4 cm). The recurrence-free survival rates analyzed by Kaplan-Meier method at 1, 2 and 5-year were 94.1%, 77.5% and 65.0% respectively. The results of Cox proportional hazards regression model indicated that the patients with >10/50 HP mitotic count showed a worse recurrence-free survival than those with ≤ 10/50 HP (HR = 3.7, 95%CI 1.0 - 13.7, P = 0.049). After adjusting other confounding factors, mitotic activity was one significant prognostic factor of recurrence (P = 0.024). There was no significant association between the risk of recurrence and other prognostic factors, including diagnostic age, tumor size, type of operation and the risk of aggressive behaviors (all P > 0.05).
Mitotic activity is one prognostic factor of duodenal GIST. And R(0) resection should be regarded as an optional treatment for duodenal GIST.
Zhonghua yi xue za zhi 06/2012; 92(24):1694-7.
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ABSTRACT: ObjectiveTo analyze the pathological features and prognosis factors of gastrointestinal stromal tumor (GIST) after primary resection.
MethodsMedical records of the diagnosis, surgery, and follow-up of 327 patients with GISTs who underwent surgery between 1988 and
2007 were retrospectively reviewed. The predictive factors for the survival of these patients were identified using multivariate
analysis.
ResultsIn the 327 tumors, 152 (46.5%) were located in the stomach, 89 (27.2%) in the small intestine, 33 (10.1%) in the colon and
rectum, and 43 (13.1%) in other sites including the omentum and mesentery. The 3-year and 5-year overall survival rates of
the 327 GIST patients were 74.4% and 62.7%, respectively, and univariate survival analysis demonstrated that factors, such
as tumor size, mitotic index, NIH categories, Ki-67 index, tumor location, surgical margins, tumor bleeding, and tumor necrosis
have significant effect on survival of the patients (P < 0.05). Multivariate analysis demonstrated that the NIH categories, surgical margins, and Ki-67 index were independent prognostic
factors for the survival rate. In the group of patients with postoperative recurrence or metastasis, the median survival time
of patients who did not receive imatinib treatment was 30 months and that of patients who received imatinib treatment was
59 months. Their 5-year survival rates were 16.4% and 39.4%, respectively, and the difference was statistically significant
(P = 0.017).
ConclusionComplete resection is the first choice of treatment for GISTs. It is reasonable to evaluate the prognosis of resectable GISTs
and guide the adjunctive therapy with NIH categories and Ki-67 index. Imatinib treatment can significantly increase the survival
rate of patients with recurrent and metastatic GISTs.
Key Wordsgastrointestinal stromal tumors-prognostic factors-surgical management-survival-adjuvant therapy
Clinical Oncology and Cancer Research 04/2012; 7(3):175-180.
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ABSTRACT: Fourier transform infrared spectroscopy (FT-IR) combined with chemometrics discriminant analysis technology could improve diagnosis. The present study aimed to evaluate the effects of FT-IR on malignant colon tissue samples in diagnosis of colon cancer.
Principal component analysis (PCA) and support vector machine classification were used to discriminate FT-IR spectra from malignant and normal tissue. Colon tissues samples from 85 patients were used to demonstrate the procedure.
For this set of colon spectral data, the sensitivity and specificity of the support vector machine (SVM) classification were found both higher than 90%.
FT-IR provided important information about cancerous tissue, which could be used to discriminate malignant from normal tissues. The combination of PCA and SVM classification indicated that FT-IR has a potential clinical application in diagnosis of colon cancer.
Chinese medical journal 08/2011; 124(16):2517-21. · 0.86 Impact Factor
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ABSTRACT: To present the experience and outcomes of the surgical treatment for the patients with anorectal melanoma from the Cancer Hospital, Chinese Academy of Medical Sciences.
Medical records of the diagnosis, surgery, and follow-up of 56 patients with anorectal melanoma who underwent surgery between 1975 and 2008 were retrospectively reviewed. The factors predictive for the survival rate of these patients were identified using multivariate analysis.
The 5-year survival rate of the 56 patients with anorectal melanoma was 20%, 36 patients underwent abdominoperineal resection (APR) and 20 patients underwent wide local excision (WLE). The rates of local recurrence of the APR and WLE groups were 16.13% (5/36) and 68.75% (13/20), (P = 0.001), and the median survival time was 22 mo and 21 mo, respectively (P = 0.481). Univariate survival analysis demonstrated that the number of tumor and the depth of invasion had significant effects on the survival (P < 0.05). Multivariate analysis showed that the number of tumor [P = 0.017, 95% confidence interval (CI) = 1.273-11.075] and the depth of invasion (P = 0.015, 95% CI = 1.249-7.591) were independent prognostic factors influencing the survival rate.
Complete or R0 resection is the first choice of treatment for anorectal melanoma, prognosis is poor regardless of surgical approach, and early diagnosis is the key to improved survival rate for patients with anorectal melanoma.
World Journal of Gastroenterology 01/2011; 17(4):534-9. · 2.47 Impact Factor
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ABSTRACT: To assess the value of intraoperative radiotherapy (IORT) in the combined treatment of locally advanced pancreatic cancer.
All patients with locally advanced pancreatic cancer at our hospital from January 2007 to December 2009, judged as unresectable and confirmed by histology or cytology, were recruited into this prospective study. They were randomly assigned into the IORT group (n=31) and control group (n=34). The IORT group received IORT plus internal drainage or laparotomy. The control group had internal drainage or laparotomy only. The evaluation of adverse results of two groups included: intraoperative and postoperative adverse events, recent post-operative side effects, analgesic effect, the level of tumor marker such as CA19-9 and the long-term survival.
There was no difference in operation duration, intraoperative hemorrhage and postoperative recovery. Significant differences were found in hematotoxicology, analgesic effect, tumor marker decreasing and long-term survival.
IORT is a safe, reliable and easy-to-master technique without any obvious side effect. Its analgesic effect is better than the control group. Also IORT can retard the tumor growth and improve the patient survival.
Zhonghua yi xue za zhi 01/2011; 91(4):243-6.
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ABSTRACT: To compare the difference of clinicopathological characteristics between colorectal signet-ring cell carcinoma and mucinous adenocarcinoma.
The clinicopathological and survival data of 65 patients with colorectal signet-ring carcinoma and 166 with mucinous adenocarcinoma were retrospectively analyzed.
Such clinical characteristics as gender, gross anatomical classification, preoperative carcinoembryonic antigen level and hepatic metastasis or not had no significant difference between two groups (P > 0.05) while the difference of such characteristics as age, location of tumor, vascular tumor embolus, N stage, T stage, AJCC stage, preoperative obstruction and the ratio of radical resection between them was significant (P < 0.05). The overall 3, 5-year survival of the whole group was 56.7% and 31.6% respectively. The 3, 5-year survival and median survival time (MST) in the signet-ring cell carcinoma and the mucinous adenocarcinoma groups were 33.1%, 14.8%, 24.0 months and 64.1%, 36.6%, 41.5 months respectively. The pathological type of signet-ring cell carcinoma was an independent risk factor of survival in the whole group.
Compared to colorectal mucinous adenocarcinoma, signet-ring cell carcinoma has a higher degree of malignancy and the patients have a worse survival.
Zhonghua yi xue za zhi 11/2010; 90(44):3124-6.
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ABSTRACT: To study the role of slow-release 5-fluorouracil implantation in treatment of unresectable pancreatic cancer.
85 cases of untreated patients with locally advanced pancreatic cancer (LAPC) were randomized into two groups: Trial group: slow-release 5-fluorouracil implantation (50 patients) and control group (35 patients). Observing the objective tumor response, clinical benefit response, toxicity, complications and survival of patients of the two groups.
In the trial group the overall response rate (PR + NC) was 76.0%, and the clinical benefit response rate was 52.0%. No toxicity was observed. Pancreatic fistula occurred in 2 patients. The median survival time of the two groups was 9.0 months and 4.0 months, respectively. The survival rates of 6- and 12-month were 56.8% vs. 31.4% and 22.9% vs. 2.9% in the two groups, respectively (P = 0.012).
Slow-release 5-fluorouracil implantation is a simple, safe and effective method in treatment of LAPC.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 09/2010; 32(9):706-8.
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ABSTRACT: To improve the diagnosis and treatment of non-ductal pancreatic adenocarcinoma-occupying lesions.
A retrospective analysis was made for 114 cases of pancreatic non-ductal adenocarcinoma-occupying pathologically confirmed lesions.
(1) There were 36 males (31.6%) and 78 females (68.42%); (2) presenting symptoms and signs were abdominal pain (n = 56, 49.1%), back pain (n = 24, 21.1%), weight loss (n = 18, 15.8%) and obstructive jaundice (n = 8, 0.07%); (3) the positive rates of CA19-9, CA242 and CEA were 21.1%, 19.7% and 5.6% respectively; (4) pancreaticoduodenectomy was performed in 26 patients, distal pancreatectomy in 53, tumor enucleation in 15, segmental pancreatectomy in 9, partial resection in 3, duodenum-preserving pancreatic head resection in 1 and palliative surgery (either cholecystojejunostomy anastomosis or gastrojejunostomy) in 7; (5) pathologic analysis revealed 35 solid pseudopapillary neoplasm of pancreas, 28 pancreatic endocrine tumors, 18 focal chronic pancreatitis, 11 serous cystic neoplasms, 9 mucinous cystic neoplasms, 4 pancreatic cysts, 3 acinar cell carcinomas, 2 pancreatic cavernous hemangiomas, 1 sarcoma of pancreas, 1 sarcomatoid carcinoma of pancreas, 1 pancreatic schwannoma and 1 pancreatic neuroblastoma.
The non-ductal pancreatic adenocarcinoma-occupying lesions have no specific clinical presentation or serum tumor marker. An understanding of the natural history of these lesions is important for optimal management.
Zhonghua yi xue za zhi 04/2010; 90(16):1089-92.
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Cheng-feng Wang,
Ping Zhao,
Ye-xiong Li,
Yi Shan,
Dong-bing Zhao,
Yan-tao Tian,
Yue-min Sun,
Xiao-feng Bai,
Xu Che,
Hui Qu,
Yi-bin Xie,
Rong Zheng,
Chun-wu Zhou
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ABSTRACT: To study the role of (125)I seed implantation in the treatment of unresectable pancreatic cancer.
From April 2004 to march 2006, 66 untreated patients with locally advanced pancreatic cancer (LAPC) were randomized into two groups: Group A: (125)I seeds implantation (n = 31) and Group B: control (n = 34). The objective tumor response, clinical benefit response, toxicity, complications and survival of two groups were observed.
In Group A, the overall response rate (PR + NC) was 80.6%. Clinical benefit response rate was 54.8%. No toxicity was observed. Gastrointestinal hemorrhage and pancreatic fistula occurred in 1 patient respectively in Group A. The survival rates of 6 and 12 months were 56.0% vs 31.4% and 16.8% vs 2.9% respectively in two groups (P < 0.05). The median survival time of two groups was 8.0 months vs 4.0 months (P < 0.05).
(125)I seed implantation is a simple, safe and effective method in the treatment of locally advanced pancreatic cancer.
Zhonghua yi xue za zhi 01/2010; 90(2):92-5.
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ABSTRACT: To investigate the surgical treatment and prognosis of primary retroperitoneal malignant tumor.
A total of 191 patients with primary retroperitoneal malignant tumor treated from January 1996 to December 2007 at our hospital were retrospectively analyzed. SPSS 13.0 was used to analyze the follow-up data.
The clinical manifestations included abdominal mass [122 (63.9%)], abdominal pain [77 (40.3%)] and abdominal distension [48 (25.1%)]. Liposarcoma [75 (39.3%)] was more frequently encountered than other tumors. Among these patients, 142 underwent complete resection, 35 palliative resection and 14 exploratory operation. The median survival time of complete resection, palliative resection and exploratory operation were 56, 33 and 11 months respectively. The difference was of statistical significance.
Surgical resection is an effective therapeutic method for primary retroperitoneal malignant tumor. Complete resection prolongs the survival time and it is effective in control of recurrent tumors.
Zhonghua yi xue za zhi 10/2009; 89(38):2699-701.
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Yi-Ran Cai,
Li Gong,
Xiao-Ying Teng,
Hong-Tu Zhang, Cheng-Feng Wang,
Guo-Lian Wei,
Lei Guo,
Fang Ding,
Zhi-Hua Liu,
Qin-Jing Pan,
Qin Su
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ABSTRACT: To identify clonality and genetic alterations in focal nodular hyperplasia (FNH) and the nodules derived from it.
Twelve FNH lesions were examined. Twelve hepatocellular adenomas (HCAs) and 22 hepatocellular carcinomas (HCCs) were used as references. Nodules of different types were identified and isolated from FNH by microdissection. An X-chromosome inactivation assay was employed to describe their clonality status. Loss of heterozygosity (LOH) was detected, using 57 markers, for genetic alterations.
Nodules of altered hepatocytes (NAH), the putative precursors of HCA and HCC, were found in all the FNH lesions. Polyclonality was revealed in 10 FNH lesions from female patients, and LOH was not detected in any of the six FNH lesions examined, the results apparently showing their polyclonal nature. In contrast, monoclonality was demonstrated in all the eight HCAs and in four of the HCCs from females, and allelic imbalances were found in the HCAs (9/9) and HCCs (15/18), with chromosomal arms 11p, 13q and 17p affected in the former, and 6q, 8p, 11p, 16q and 17p affected in the latter lesions in high frequencies (> or = 30%). Monoclonality was revealed in 21 (40%) of the 52 microdissected NAH, but was not found in any of the five ordinary nodules. LOH was found in all of the 13 NAH tested, being highly frequent at six loci on 8p, 11p, 13q and 17p.
FNH, as a whole, is polyclonal, but some of the NAH lesions derived from it are already neoplastic and harbor similar allelic imbalances as HCAs.
World Journal of Gastroenterology 10/2009; 15(37):4695-708. · 2.47 Impact Factor
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ABSTRACT: To analyze the value of combined therapy in pancreatic cancer with a poor prognosis.
The prognostic factors of pancreatic cancer with different clinicopathological characteristics and treatment modalities were analyzed retrospectively and the cumulative curve was plotted using the Kaplan-Meier method.
(1) From January 2001 to December 2005, 233 patients with pathological and cytological diagnosis of pancreatic cancer were analyzed. The median survival of all patients was 8.67 months, the 1-year survival rate 29.6% and the 5-year survival rate 4.5%. (2) Weightloss cases had a median survival of 7.7 months versus 10.0 months for cases without weightloss (P = 0.003). Back pain cases had a median survival of 6.5 months versus 9.0 months for cases without back pain (P = 0.015). Cases with normal CA19-9 levels (< or = 37 U/ml) had a median survival of 11.0 months versus 8.0 months for cases with CA19-9 > 37 U/ml levels (P = 0.000). Stages III and IV disease cases had a median survival of 8.7 and 6.3 months versus 16.0 months for cases of Stages I + II (P = 0.000). In the present study, patients suffering from weightloss or back pain or whose CA19-9 was above 37 U/ml or whose TNM stage was III/IV were defined as cases with a poor prognosis. (3) Patients were grouped as pancreatectomy group, cancer-directed treatment group (including intraoperative iodine-125 seed interstitial brachytherapy, 5-FU interstitial chemotherapy, radiotherapy, chemotherapy and transcatheter arterial infusion chemotherapy) and no cancer-directed treatment group (including cases receiving biopsies or bypass). Median survival of three groups were 14.0, 8.3 and 6.6 months respectively. And the 1-year survival rates were 53.5%, 22.5% and 11.8% respectively while the 5-year survival rate 5.8%, 0 and 0 respectively. (4) Median survival of poor prognostic cases (who suffered from weightloss or back pain or whose CA19-9 was above 37 U/ml or whose TNM stage was III/IV) treated with pancreatectomy were 12.0, 11.0, 12.0 and 7.0 months respectively. Median survival of poor prognostic cases treated with cancer-directed therapy were 7.7, 7.5, 8.6 and 8.0 months respectively. Median survival of poor prognostic cases treated with no cancer-directed therapy were 4.0, 3.0, 4.0 and 4.6 months respectively.
Optimized combined therapy is recommended for pancreatic cancer patients with poor prognostic factors.
Zhonghua yi xue za zhi 09/2009; 89(34):2381-5.
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Zhonghua zhong liu za zhi [Chinese journal of oncology] 06/2009; 31(6):401-4.
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ABSTRACT: To investigate the method and value of tru-cut biopsy (TCB) combined with fine needle aspiration biopsy (FNAB) in the pathological diagnosis of pancreatic carcinoma during operation.
From April 2007 to October 2008, 22 cases who were suspected to suffer from pancreatic carcinoma were enrolled into this prospective study. All of them underwent a tru-cut biopsy combined with fine needle aspiration biopsy for the pathological diagnosis during operation.
Of the 22 patients, 20 were finally diagnosed as having pancreatic carcinoma, while 2 having pancreatitis. The diagnosis of pancreatic carcinoma was confirmed in 19 by tru-cut biopsy combined with fine needle aspiration biopsy, while other 3 cases were not confirmed as pancreatic carcinoma. Among those 3 cases, one was diagnosed as having pancreatic carcinoma with hepatic metastasis by liver nodular biopsy, one as suffering from autoimmune pancreatitis, and another case as having chronic pancreatitis confirmed by follow-up for 9 months without any changes after the operation. The accuracy of FNA, TCB and FNA combined with TCB in the diagnosis for suspected pancreatic cancer were 86.4%, 90.9%, and 95.5%, respectively. No pancreatic fistula and bleeding developed after operation.
Tru-cut biopsy is more accurate in diagnosis for the suspected pancreatic cancer than fine needle aspiration biopsy during operation. Tru-cut biopsy combined with fine needle aspiration biopsy can improve the accuracy of diagnosis, and is a safe and effective diagnostic method.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 06/2009; 31(6):478-80.
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ABSTRACT: To discuss the significance of a positive ductal margin and evaluate the prognostic factors related to surgical resection for middle and distal bile duct carcinoma.
A retrospective clinicopathological analysis of 79 patients who had undergone surgical resection for middle or distal bile ductal cancer between January 1990 and December 2006 was conducted. The surgical procedures consisted of pancreatoduodenectomy in 46 patients, bile duct resection in 25 patients, bile duct resection plus hepatectomy in 6 patients, and bile duct resection with partial resection of portal vein in 2 patients. In 74 patients, 5 patients were excluded because they died after surgery without being discharged from the hospital, 15 clinicopathologic factors were evaluated using univariate and multivariate analysis.
The overall 5-year survival rate and the median survival time was 30.7% and 36 months, respectively. Sixteen of 74 patients (20.3%) were determined to have positive ductal margins on the final pathological examination. As a result, hepatic-side ductal margin, duodenal-side ductal margin and both was found to be positive in 6, 3 and 2 patients, respectively. Five patients had positive radial margins. The 5-year survival rate was 34.4% in 58 patients without microscopic residual disease (R0), and 15.5% in 16 patients with microscopic residual tumor (R1). The ductal recurrence rate of 16 patients with R1 resection was higher than 58 patients with R0 resection (62.5% vs. 17.2%, chi(2) = 13.024, P < 0.01). The 1-, 3-, and 5-year survival rates were better in the patients with R0 (92.5%, 56.7%, and 34.4%, respectively) than those in the patients with R1 resection (75.0%, 23.2%, and 15.5%, respectively) (P < 0.05). Twelve patients received postoperative adjuvant therapy. The 5-year survival rate was not significantly different between patients with postoperative adjuvant therapy and those without (18.2% vs. 31.8%, P = 0.221). The preoperative serum level of hemoglobin, pathological differentiation grade, the depth of neoplastic invasion, lymph node metastasis, R1 resection, and TNM stage were significant prognostic factors on the univariate analysis. Multivariate analysis revealed that lymph node metastasis and R1 resection were the independent prognostic factors.
In the treatment of middle and distal bile duct cancer, radical resection should be made to obtain a tumor-free margin. An aggressive surgical approach may improve the survival for middle bile duct cancer. Adjuvant therapy needs to be further developed.
Zhonghua wai ke za zhi [Chinese journal of surgery] 06/2009; 47(9):677-80.
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ABSTRACT: To investigate the effect of adjuvant therapy on the treatment of carcinoma of the body and tail of pancreas.
The clinical data of 137 patients with carcinoma of the body and tail of pancreas, 91 males and 46 females, aged 58.9 (24 - 76), of which 38 underwent radical resection, 24 underwent palliative resection, and 75 did not undergo resection, and 58 of which underwent adjuvant therapy, were analyzed.
The overall 3-year survival rate was 10.7% for the whole group, 27.3% for the radical resection group, 4.2% for the palliative resection, and 4.5% for the no resection group. The median survival time (MST) was 8 months for the whole group, 15 months for the radical resection group, 8 months for the palliative resection group, and 6 months for the no resection group. The 3-year survival rate was 13.9% for the patients undergoing adjuvant therapy and 7.2% for those without adjuvant therapy, and the MST was 11 months for those undergoing adjuvant therapy, and 5 months for those without adjuvant therapy. Intra-arterial therapy and radiation therapy were protective factors for those whose cancerous tissues were not radically resected (OR = 1.56, 95% CI: 1.04 - 2.35, P = 0.033).
Adjuvant therapy significantly improves the survival of the patients with pancreatic carcinoma of the body and tail. The clinical effect of intra-arterial therapy is better than those of radiation therapy and chemotherapy.
Zhonghua yi xue za zhi 05/2009; 89(14):951-4.
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ABSTRACT: To investigate the clinicopathological characteristics, diagnostic methods and prognosis of small pancreatic cancer.
From May 2000 to January 2007, 89 patients with pancreatic cancer underwent surgery in our hospital. Of those, 14 had a tumor < or = 2 cm in diameter (small tumor group), and the other 75 had a tumor >2 cm in diameter (controlled group). The clinicopathological data of all the cases were retrospectively reviewed and analyzed.
In the small pancreatic cancer group, CT and MRI detected 66.7% (8/12) and 77.8% (7/9) of the tumors, respectively. Serosal infiltration was found in 2 cases, lymph node involvement in 3 cases, and retroperitoneal infiltration in 3 cases. The follow-up duration of this group was 4-86 months. The overall 3- and 5-year survival rates were 42.8% and 31.7%, while in the control group, the overall 3- and 5-year survival rates were 29.7% and 22.5%, respectively. The multivariate analysis showed that the lymph node involvement, serosal infiltration and retroperitoneal infiltration were independent risk factors (P<0.05). However, the tumor size was not shown to be an independent risk factor (OR value = 1.45, P = 0.971).
CT and MRI are valuable in detecting small pancreatic cancer. Small pancreatic cancers are likely to have a better prognosis when compared with larger ones. Lymph node metastasis and local infiltration are independent predictors of prognosis but not tumor size.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 05/2009; 31(5):375-9.
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ABSTRACT: To investigate the clinicopathological features, surgical treatment and prognosis of primary carcinoma of the duodenum.
The clinicopathological data of 86 patients with primary duodenal carcinoma from January 1996 to June 2007 were retrospectively reviewed and analyzed by SPSS 13.0.
The clinical manifestation includes upper abdominal pain, jaundice, anemia, gastrointestinal obstruction, melena and weight loss. Four patients had a tumor located in the first portion of the duodenum, 66 in the second portion, 12 in the third portion and 4 in the fourth portion. The preoperative correct diagnostic rate by BUS was 41.7%, by CT 69.4%, by MRI 75.0%, by duodenal endoscopy 84.0%, and by air barium double radiography 80.9%. Complete resection of the tumors was achieved in 38 patients, palliative resection in 45 cases, and exploration alone in 3 cases. The median survival time of the group with complete resection was 42 months versus 13 months in the group with palliative resection, with a significant difference between the two groups (P < 0.05).
Primary carcinoma of the duodenum has no specific symptoms. Early diagnosis and complete resection are effective to improve prognosis.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 04/2009; 31(3):233-5.
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ABSTRACT: To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer, and to examine the therapeutic efficacy and surgical indications for this procedure.
Clinical data, obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005, were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier method, statistical comparisons were performed using the log-rank test, and multivariate analysis was performed using the Cox proportional hazards model.
Transanal, transsacral, and transvaginal excisions were performed in 92, 12, and 2 cases, respectively. The rate of complication, local recurrence, and 5-year survival was 6.6%, 17.0%, and 86.7%, respectively. Univariate analysis showed that T stage, vascular invasion, and local recurrence were related to the prognosis of the cases (P < 0.05). Multivariate analysis showed that T stage [P = 0.011, 95% confidence interval (CI) = 1.194-3.878] and local recurrence (P = 0.022, 95% CI = 1.194-10.160) were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer.
Local rectal cancer excision is associated with few complications, and suitable for stages Tis and T1 rectal cancer. Prevention of local recurrence, active postoperative follow-up, and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.
World Journal of Gastroenterology 03/2009; 15(10):1242-5. · 2.47 Impact Factor
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ABSTRACT: To further explore the effect of annexin I on the tumor growth of human pancreatic cancer in nude mice.
To knock down the expression of annexin I in pancreatic carcinoma cells by RNAi. A nude mouse model of human pancreatic cancer was established by subcutaneous inoculation of human pancreatic cancer cell line Suit-II cells. The effect of annexin I on tumor growth was assessed by tumor growth curve and tumor weight records, and Westen blot and flow cytometry were used to examine the expression of annexin I after annexin I-knocking down.
The results of Western blot revealed that the expression of annexin I was significantly decreased in Suit-II cells transfected with pSilencer-annexin I-siRNA1, and almost completely inhibited in the cells transfected with pSilencer-annexin I-siRNA2 and pSilencer-annexin I-siRNA3. The growth of tumors transfected with annexin I-siRNA2 and annexin I-siRNA3 was inhibited by 76.6% and 68.4%, respectively, in comparison with that of tumor from the parent Suit-II cells. At 44 days after tumor cell inoculation, the tumor weight was 0.8987 g (transfected with annexin I-siRNA2) and 0.8992 g (transfected with annexin I-siRNA3), significantly lower (P < 0.001) than that of tumor from parent Suit-II cells (2.5866 g) and transfected with annexin I-siRNAN (2.4070 g).
annexin I promotes the growth and proliferation of pancreatic carcinoma cells in vivo and increases the ability of tumor formation in nude mice. The results of this study support that annexin I may become a potential target in gene therapy for this disease.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 01/2009; 30(12):897-900.
