Surgical considerations for ‘intrinsic＇ brainstem gliomas： proposal of a modification in classification

BACKGROUND： Brainstem gliomas are highly heterogeneous tumors both in their clinical manifestation and in their pathology. Despite significant advances in the surgery for brainstem gliomas many aspects of this pathology are still unelear. OBJECTIVE： To evaluate the clinical, radiological and surgical outcome of 40 focal ＂intrinsic＂ brainstem gliomas and propose a surgical strategyoriented classification. MATERIALS AND METHODS： A total of 40 focal ‘intrinsie’ （＂expanding variety＂） tumors have been operated over a period of 8.5-years （January 1998-June 2007）. Our criteria included patients with （1） well-defined gadolinium enhancing tumor, （2） relatively long duration of symptoms （〉 six months） and （3） good neurological functional status and independent for all activities of davy living. The cutoff size of 2 cm was not rigidly adhered to. RESULTS： The ＂intrinsic＂ brainstem tumors were classified into three types： Expanding, diffuse infiltrative and pure ventral varieties.     

Clinical Studies on Primary Central Nervous System Lymphoma： A Report of 31 Cases

OBJECTIVE To analyze the clinical manifestations, neuroimaging and pathological characteristics of primary central nervous system lymphoma （PCNSL） with a normal immunity, and to explore the methods of treatment and diagnosis. METHODS The clinical, laboratory, imaging data and pathological findings and therapeutic efficacy of 31 cases with pathologically proved PCNSL, during a period from July 1995 to June 2006, were analyzed retrospectively. The method of surgery, used in combination with chemotherapy and radiotherapy, was evaluated in 18 cases versus a simple surgical procedure used in 5. Among the total cases, a CHOP regimen was employed in 11 and Teniposide （VM26） plus Semustine （me-CCUN） was used in 7 cases. RESULTS PCNSL had a variety of clinical features, so that its misdiagnosis rate was high. The main clinical findings of PCNSL included intracranial hypertension and （focal） neurologic impairment. No positive result was found in the CSF cellular examination. All of the 31 cases were B-cell lymphoma. Twenty-four of the 31 cases were followed-up, with a follow-up period from 6 to 98 months. The median period of survival of the group who underwent surgery in combination with chemotherapy and radiotherapy was 20 months, while the group with simple surgical therapy was 10 months. CONCLUSION Specific clinical manifestations were usually absent in the patients with PCNSL, giving an uncertain preoperative diagnosis and a poor prognosis. Pathological examination is the only reliable method for a final diagnosis of the disease. The main objective of surgical therapy is to relieve the intracranial hypertension caused by the tumor. Recurrence may occur in a short period following the simple operation. Therefore combined therapy, i.e. surgery plus additional radiotherapy and chemotherapy, should be adopted. This is the key point for extending survival time and improving the quality of life.     

Value of contrast-enhanced ultrasound in diagnosis ot focal liver lesions

Objective： By observing the pattern of the focal liver lesions （FLL） in different phases by real time contrast-enhanced ultrasound （CEUS）, compared to enhanced CT, investigate the value of CEUS in diagnosing focal liver lesions. Meth. ods： 35 patients with unconfirmed focal liver lesions were studied by contrast agent SonoVue and Technos DU 8 produced by Esaote company. Results： Among the 14 cases of hepatocellular carcinoma （HCC）, 10 were typical, presented with early artery enhancement and immediate wash-out. The enhancement patterns of 6 livers metastasis were diverse, including peripheral or entire degree enhancement. The wash-out time in malignant tumors was eadier than other focal liver lesions （P 〈 0.05）, appeared as hypoechoic in the portal phase or parenchyma phase. The 6 cases of hemangioma were enhanced centripetally nodular in artery phase and washed out after several minutes. The patterns of different lesions were similar compared to contrast-enhanced CT, without significant statistic differences. Conclusion： The contrast enhanced ultrasound technique can significantly improved the value of diagnosing focal liver lesions.     

The significance of minimally invasive core needle biopsy and immunohistochemistry analysis in 235 cases with breast lesions

OBJECTIVE To evaluate core needle biopsy （CNB） as a minimally invasive method to examine breast lesions and discuss the clinical significance of subsequent immunohistochemistry （IHC） analysis. METHODS The clinical data and pathological results of 235 patients with breast lesions, who received CNB before surgery, were analyzed and compared. Based on the results of CNB done before surgery; 87 out of 204 patients diagnosed as invasive carcinoma were subjected to immunodetection for p53, c-erbB-2, ER and PR. The morphological change of cancer tissues in response to chemo- therapy was also evaluated. RESULTS In total of 235 cases receiving CNB examination, 204 were diagnosed as invasive carcinoma, reaching a 100% consistent rate with the surgical diagnosis. Sixty percent of the cases diagnosed as non-invasive carcinoma by CNB was identified to have the presence of invading elements in surgical specimens, and similarly, 50% of the cases diagnosed as atypical ductal hyperplasia by CNB was confirmed to be carcinoma by the subsequent result of excision biopsy. There was no significant difference between the CNB biopsy and regular surgical samples in positive rate of immunohistochemistry analysis （p53, c-erbB-2, ER and PR; P 〉 0.05）. However, there was significant difference in the expression rate of p53 and c-erbB-2 between the cases with and without morphological change in response to chemotherapy （P 〈 0.05）. In most cases with p53 and c-erbB-2 positive, there was no obvious morphological change after chemotherapy. CONCLUSION CNB is a cost-effective diagnostic method with minimal invasion for breast lesions, although it still has some limitations. Immunodetection on CNB tissue is expected to have great significance in clinical applications.     

Endoscopic transnasal craniotomy and the resection of craniopharyngioma

OBJECTIVES/HYPOTHESIS： To describe the utility of a large transnasal craniotomy and its reconstruction in the surgical management of patients with craniopharyngioma. STUDY DESIGN： Observational, retrospective cohort study. METHODS： Retrospective review of patients treated in an academic neurosurgery/rhinology practice between 2000 and 2007. Patient characteristics （age, sex, follow-up）, tumor factors （size, position extension, previous surgery）, type of repair （pedicled mucosal flaps, free mucosal grafts）, and outcomes （visual, endocrine, and surgical morbidity） were defined and sought in patients who had an entirely endoscopic resection of extensive craniopharyngioma （defined as requiring removal of the planum sphenoidale in addition to sella exposure in the approach）.     

Study on the protein expression and amplification of HER2 gene in gastric cancer

Objective： The aim of the study was to investigate the human epidermal growth factor receptor 2 （HER2） gene amplification and protein expression and interpretation points in the stomach mixed carcinomas. Methods： Immunohistochemistry （IHC） and fluorescence in situ hybridization （FISH） technique were used to detect HER2 gene amplification and expression of HER2 protein in 442 cases of gastric mixed carcinoma. Results： The expression rate of HER2 protein was 41.2% （182/442）： the HER2 protein expression IHC 3＋ extensive type in 18 cases, partial type in 21 cases, focal type in 8 cases, accounting for 10.6% （47/442）; the HER2 protein expression IHC 2＋ extensive type in 23 cases, partial type in 28 cases, focal type in 11 cases, accounting for 14.0% （62/442）; the HER2 protein expression IHC 1＋ extensive type in 27 cases, partial type in 31 cases, focal type in 15 cases, accounting for 16.5% （73/442）. HER2 gene amplification rate of 442 cases was 16.1% （71/442）. In 182 cases of HER2 protein positive expression, the HER2 gene cluster amplification rate was 14.8% （27/182）, large granular amplification rate 11.0% （20/182）, punctate amplification rate 6.0% （11/182） and high polysomy 7.1% （13/182）. In 71 cases of HER2 gene amplification, there was 42 cases of HER2 protein expression IHC 3＋, 22 cases of HER2 protein expression IHC 2＋, and 7 cases of IHC 1＋. Conclusion： HER2 detection of gastric mixed carcinoma has great heterogeneity, HER2 protein positive expression is divided into extensive type, partial type and focal type, and HER2 gene positive amplification is divided into cluster amplification, large granular amplification, punctate amplification and high polysomy. These typing of HER2 protein expression and HER2 gene amplification provide reference index to quantify for targeted therapeutic effect of anticancer drugs.     

Argyrophilic nucleolar organizer region in MIB-1 positive cells in non-small cell lung cancer： clinicopathological significance and survival

Objective： To evaluate the relation between argyrophilic nucleolar organizer region （AgNOR）-associated proteins and clinicopathological parameters and survival in non-small-cell lung cancer （NSCLC）. Methods： A total of 207 surgical specimens diagnosed as NSCLC were included in this study. Double-staining procedures were performed using antigen Ki-67 （clone MIB-1） and silver nitrate by immunohistochemical and AgNOR-staining methods. Results： The AgNOR area in MIB-l-positive cells of NSCLC is related to clinicopathological parameters under the TNM （tumor, node, and metastasis） system. The survival of patients with small AgNOR area in MIB-1-positive cells is better than that of patients with large AgNOR area. Molecular, biological （AgNOR area in MIB-l-positive cells）, and clinicopathological （greatest tumor dimension, metastases to regional lymph nodes, histology, and differentiation） parameters are independent prognostic factors of NSCLC.Conclusion： The AgNOR area in MIB- 1-positive cells is related to clinicopathological parameters and survival in NSCLC.     

Maximum standardized uptake value on PET/CT in preoperative assessment of lymph node metastasis from thoracic esophageal squamous cell carcinoma

The presence of lymph node metastasis is an important prognostic factor for patients with esophageal cancer. Accurate assessment of lymph nodes in thoracic esophageal carcinoma is essential for selecting appropriate treatment and forecasting disease progression. Positron emission tomography combined with computed tomography （PET/CT） is becoming an important tool in the workup of esophageal carcinoma. Here, we evaluated the effectiveness of the maximum standardized uptake value （SUVmax） in assessing lymph node metastasis in esophageal squamous cell carcinoma （ESCC） prior to surgery. Fifty-nine surgical patients with pathologically confirmed thoracic ESCC were retrospectively studied. These patients underwent radical esophagectomy with pathologic evaluation of lymph nodes. They all had 18F-FDG PET/CT scans in their preoperative staging procedures. None had a prior history of cancer. The pathologic status and PET/CT SUVmax of lymph nodes were collected to calculate the receiver operating characteristic （ROC） curve and to determine the best cutoff value of the PET/CT SUVmax to distinguish benign from malignant lymph nodes. Lymph node data from 27 others were used for the validation. A total of 323 lymph nodes including 39 metastatic lymph nodes were evaluated in the training cohort, and 117 lymph nodes including 32 metastatic lymph nodes were evaluated in the validation cohort. The cutoff point of the SUVmax for lymph nodes was 4.1, as calculated by ROC curve （sensitivity, 80%; specificity, 92%; accuracy, 90%）. When this cutoff value was applied to the validation cohort, a sensitivity, a specificity, and an accuracy of 81%, 88%, and 86%, respectively, were obtained. These results suggest that the SUVmax of lymph nodes predicts malignancy. Indeed, when an SUVmax of 4.1 was used instead of 2.5, FDG-PET/ CT was more accurate in assessing nodal metastasis.     

Early post-operative MRI： correlation with progression-free survival and overall survival time in malignant gliomas

Forty-seven patients with Glioblastoma （42） and Anaplastic Astrocytoma （5） were studied with MR 24 hrs after surgery. In order to evaluate the role of early MR in defining the extent of surgical resection and its relation with the prognosis of malignant glioma patients, three categories of surgical resection were considered： gross total, sub-total and partial resection. The results were correlated with progression-free survival （PFS） and overall survival （ST）. As demonstrated by early-MR, gross total resection was performed in 17 patients, sub-total and partial resection in 19 and 11 patients, respectively. The PFS was 6 months in gross total resection, 6 and 3 months in sub-total and in partial resection, respectively. The median survival time was 16 months in total resection patients, 13 months and 7 months in sub-total resection and partial resection patients, respectively.     

非小细胞肺癌患者体外诱导的肿瘤细胞老化与化疗客观疗效关系的研究

Objective： To investigate the relationship between the objective response to combination chemotherapy of taxanes plus cisplatin in non-small cell lung cancer （NSCLC） and docetaxel plus cisplatin （DC regime） induced senescence of tumor cells in vitro. And its relation to mutant P53 protein （m-P53） was also to be evaluated. Methods： Sixty-seven specimen obtained from NSCLC patients from January 1, 2003 to June 30, 2006. The patients consisted of 48 males and 19 females, ranging in age from 54 to 82 years （mean, 67.5 years）, 41 cases were diagnosed as pathological stage Ⅲb, 26 cases were diagnosed as stage Ⅳ. Thirty-nine tumors were confirmed to be adenocarcinomas, 28 were confirmed to be squamous cell carcinomas. All patients accepted 2-6 cycles combination chemotherapy of Taxanes （docetaxel 40 mg/m^2, d1; d8, or paclitaxel 175 mg/m^2, d1） plus cisplatin （CDDP, 25 mg/m^2, d2-4）. Patients were divided into chemoresponsive （CR ＋ PR） and chemoresistant （SD ＋ PD） groups according to objective response status which was evaluated by RECIST system. Tumor cells from specimens of bronchoscopic, surgical biopsy and pleural effusion cell collection had been cultured and treated with DC in vitro. The m-P53 of culture supernatant was measured by ABC-ELISA kit before DC treatment. The telomerase activity was determined by the telomeric repeat amplification protocol （TRAP） based PCR-ELISA kit and apoptosis was determined by TdT-mediated d-UTP-X nick-end labeling （TUNEL） assay. Data represent as both actual detected and positive value. The senescence of tumor cells defined as that, apoptosis rate increased more than 50% to control, and telomerase activity decreased less than 50% to control. Results： There was no significant difference between clinical treatment response and sex, pathological type, specimen origin, or m-P53 status in cultured cell supernatant. Telomerase activity and apoptosis rate was positive in 61.1% （41/67） and 25.4%（17/67） of all samples respectively. A significant difference of senescence of tumor cells treated by DC, was existed between chemoresponsive and chemoresistant patients groups （P 〈 0.05）. Multinomial logistic regression analyses shew that telomerase activity decreased less than 50% in vitro may be an indicator of clinical response for taxanes plus cisplatin chemotherapy. Odds ratio was 4.226, P 〈 0.05. Conclusion： For NSCLC, DC induce lung cancer tumor cells senesce in vitro may be a promising predicator for clinical response, but the relationship between objective response by chemotherapy and detectable m-P53 or DC induced apoptosis is still obscure.     

不同淋巴结清扫范围的胃癌根治手术对机体的侵袭

Objective： To evaluate the effects of surgical trauma of open surgery on the patients with gastric carcinoma who underwent different lymph node dissection. Methods： Total 30 patients with gastric carcinoma were divided into three groups （D1, D2, and D3） according to the extent of lymph node dissection. Peripheral blood samples were taken to measure the levels of interleukin-6 （IL-6）, interleukin-8 （IL-8）, C-reactive protein （CRP） and polymorphonuclear elastase （PMNE）. Ad- ditionally, leucocytes and lymphocytes counts in peripheral serum were also detected. Results： All the three groups showed a significant increase of the levels of IL-6, IL-8, CRP and PMNE after operation. There was no significant difference between D1 and D2 groups. When the comparison was made between D3 group and the other two groups, it showed higher concentration of IL-6, IL-8, CRP and PMNE in serum of D3 group. Leucocytes count showed no difference among the three groups. After operation, the patients in three groups had transient lymphocytes decrease on the second and third postoperative days, the lymphocytes count in D3 group was still lower while those in D1 and D2 groups began to increase. Conclusion： IL-6, IL-8, CRP and PMNE can be used to monitor surgical stress. Using these parameters, we found that extended lymph node dissection of D3 group led to more postoperative stress than D1 and D2 groups.     

74例隆突型皮肤纤维肉瘤的治疗与预后分析

Objective： To study treatment and prognostic factor in 74 patients with dermatofibrosarcoma protuberans. Methods： From August 1990 to November 1999, 74 patients with dermatofibrosarcoma protuberans （DFSP） confirmed by pathology were treated in Cancer Hospital of Sun Yat-sen University. 72 cases were given wide excision and 2 cases were given local excision. All of 74 cases, 52 cases had surgical resection alone, and 22 cases had surgical resection combined with radiotherapy. Total dose of radiotherapy was 50-70 Gy. Results： The rate of recurrence was 36.1% for all patients. The 5-year recurrence-free survival （RFS） rate was 66%. The 5-year recurrence-free survival rates for resection alone and combined with radiotherapy were 58% and 90%, respectively （P=-0.0187）. The 5-year recurrence-free survival rates for positive microscopic margins and negative microscopic margins were 57% and 75%, respectively （P=0.0468）. Conclusion： Post-operation radiotherapy is an effective treatment to decrease the recurrence rate for the patients with positive microscope, or the patients without suitable surgical treatment.     

Diffusion-weighted images(DWI) without ADC values in assessment of small focal nodules in cirrhotic liver简

Objective： To assess if diffusion-weighted magnetic resonance （MR） imaging without apparent diffusion coefficient （ADC） values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver. Methods： Two observers retrospectively and independently analyzed 86 nodules （_〈3 em） certified pathologically in 33 patients with liver cirrhosis, including 48 hepatocellular carcinoma （HCC） nodules, 13 high-grade dysplastic nodules （HDN）, 10 low-grade dysplastic nodules （LDNs） and 15 other benign nodules. All these focal nodules were evaluated with conventional MR images （Tl-weighted, T2-weighted and dynamic gadolinium-enhanced images） and breath-hold diffusion-weighted images （DWI） （b=500 s/mm2）. The nodules were classified by using a scale of 1-3 （1, not seen; 3, well seen） on DWI for qualitative assessment. These small nodules were characterized by two radiologists. ADC values weren＇t measured. The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic （ROC） curves. The area under the curves （Az）, sensitivity and specificity values for characterizing different small nodules were also calculated. Results： Among 48 HCC nodules, 33 （68.8%） were graded as 3 （well seen）, 6 （12.5%） were graded as 2 （partially obscured）, and 9 weren＇t seen on DWI. Among 13 HDNs, there were 3 （23.1%） and 4 （30.8%） graded as 3 and 2 respectively. Five （50%） of 10 benign nodules were partially obscured and slightly hyperintense. For 86 nodules, the average diagnostic accuracy of combined DWI-conventional images was 82.56%, which was increased significantly compared with conventional MR images with 76.17%. For HCC and HDN, the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07 %. Conclusions： Diffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC, and it may not be helpful for LDN and regenerative nodule （RN） in cirrhotic liver.     

局部晚期肝门部胆管癌根治术后放射治疗

Objective： To evaluate the outcome of radiotherapy （RT） in locally advanced hepatic hilar cholangiocarcinoma. Methods： During March 1992 to December 1997, 47 patients who had positive microscopic surgical margins after surgery were treated by postoperative radiotherapy （S＋RT, 28 patients, with a median dose of 50 Gy, 45-62 Gy） and surgery alone （S, 19 patients）. The median follow-up was 30 months （4-113 months）. Results： The overall 5-year survival rate was 28%, with a median survival length of 19.6 months while 5-year survival rates of S＋RT group and S group were 34% and 14%, with median survival lengths of 29 and 10 months respectively （P=0.015）. The occurrence rate of complications was 11% in either group. Conclusion： Postoperative radiotherapy significantly prolongs survival lengths in patients with hepatic hilar cholangiocarcinoma who had positive microscopic surgical margins. Radiation toxicities are tolerable.     

Clinicopathologic characteristics and surgical outcome of gastric cancer in patients younger than 36 years of age

OBJECTIVE This study was designed to determine the clinicopathologic features of young patients who underwent gastrectomy for gastric cancer and to improve the clinical management of this disease. METHODS From 1981 to 2000, among 1,830 gastric cancer patients were admitted in our hospital for surgical treatment, 66 of them were 〈 36 years of age. The clinicopathologic data of these young patients were collected and reviewed. RESULTS The male ： female ratio was 1.2 ： 1. Most tumors were located in the lower third of the stomach （63.1%）. The overall 5-year survival rate of 66 cases was 28.7%. The 5-year survival rates in the patients with early stages and with advanced stages of gastric carcinoma were 77.8% （7/9） and 21.1% （12/57）, respectively. Unfavorable prognostic factors associated with poor 5-year survival included the degree of the invasion in the gastric wall （P 〈 0.05）, and curability of resection （non-curative vs. curative; P 〈 0.05）. CONCLUSION Gastric cancer in young adults tends to be more advanced presentation when diagnosed. However, young patients with early gastric cancer can tolerate radical treatments well. It is important to promptly make a precise diagnosis for gastric carcinoma in young patients and to treat it in early stage.     

甲状腺髓样癌降钙素及其基因相关肽检测的临床意义--附88例报告

Objective： To investigate the changes of calcitonin （CT） and calcitonin gene-related peptide （CGRP） in patients with medullary thyroid carcinoma （MTC）. Methods： Fifty-eight cases of MTC were selected and the relationship between the CT levels and metastasis was investigated. The immunohistochemical method was used to detect the expression of CT and CGRP in the 58 samples of MTC tissues. The CT and CGRP in 30 newly diagnosed MTC inpatients were measured before operation and in the first few days after operation using a radioimmunoassy. Results： （1） The rate of residual tumor had a significant difference between the normal serum CT group one month after operation and the elevated group at the same period （P〈0.01）. （2） Immunohistochemical study revealed the positive rate of CT was about 98%, and that of the CGRP was 87.8%. （3） Part of the patients had an elevated CGRP levels while CT levels was normal. （4） The serum CT levels were decreased to a stable range one week after operation. Conclusion： CT is a useful index to evaluate the efficacy of surgical treatment. The measurement of serum CGRP is helpful in the diagnosis of MTC, especially for those whose preoperative CT levels are normal.     

Lung Cancer Survival Improvement through Surgical Intervention in PUMCH Hospital

Objective： To investigate and evaluate improvement of lung cancer survival after surgical intervention in PUMC hospital during the last 15 years. Methods： From January 1989 to December 2003, 1574 lung cancer cases underwent surgical treatment and followed up. All cases in this series were divided into two groups according to time period： group A （1999-2003） and group B （1989-1998）. The difference in the survival rate between groups A and B was compared. Results： The morbidity and mortality in group A was decreased significantly in comparison to group B （11.2% vs. 19.2%, 1.06% vs. 1.93%, respectively）. However, the 3-year and 5-year survival rate was increased from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively. A significant improvement in survival was observed in patients with stage Ⅰ, Ⅱ and ⅢA, but not in those with stage ⅢB and Ⅳ. Also, patients with lobectomy had more satisfactory results than those receiving exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection. Conclusion： Lobectomy plus systematic mediastinal lymph nodes dissection has become the standard mode for resectable lung cancer. Combination of complete resection along with lymph nodal dissection, and postoperative adjuvant chemotherapy based on platinum/3^rd generation chemotherapy medicine, has preliminarily been justified, proving an important approach for effective improvement in long-term survival of non-small cell lung carcinoma.     

胰腺癌:CT、MRI诊断学

Introduction The introduction of modem imaging and fast imaging processing has tremendously improved detection and staging of pancreatic cancer. Besides progress in surgical techniques and handling the advances of both computerized tomography （CT） and magnetic resonance imaging （MRI） have remarkably contributed to higher resection rates, better patient selection and clinical management.     

ASSOCIATION OF pIgR POLYMORPHISMS WITH NASOPHARYNGEAL CARCINOMA

Objective： Epstein-Barr virus （EBV） associated nasopharyngeal carcinoma （NPC） is an important squamous cell cancer endemic in southern China and Southeast Asia. pIgR （polymeric immunoglobulin receptor） gene plays central roles during immune responses and EBV inflammatory and therefore is a good candidate susceptibility gene for NPC. This study is to evaluated potential associations between pIgR gene and NPC susceptibility. Methods： Sequencing was used to identify multiple single nucleotide polymorphisms （SNPs） within the exon regions of pIgR in Guangdong population. Four SNPs were genotyped in 528 NPC patients and 408 normal individuals to perform case-control study. Results： There was no statistical difference in the allele frequencies of each SNP （P〉0.05）. After categorized into 2 groups by age of 45 y, in the group of age below 45 the minor allele T frequency of C888oT was 7%, whereas 4% in controls, with significant difference （P〈0.05）. The Odds Ratio （OR=1.84） also showed higher risk of NPC with individuals carried the minor alleles. Conclusion： The result has proved that SNP C8880T is associated with NPC susceptibility and pIgR gene might play a certain role in oncogenesis and development of NPC.     

结直肠癌趋化因子MCP-1的表达及其与巨噬细胞浸润的关系

Objective： To study the expression of MCP-1 in colorectal carcinoma and its relationship to the infiltration of the macrophage and to the biological behaviour of infiltration and metastasis of colorectal carcinoma. Methods： The expression of the MCP-1 mRNA was assessed in colorectal carcinoma collected freshly from surgical specimen by RT-PCR and the expression of the MCP-1 protein was assessed in colorectal carcinoma collected from surgical specimen by immunohistochemistry. The tumor infiltrating cell and macrophage were also investigated by immunohistochemistry. Results： All the 12 specimens of colorectal carcinoma detected by RT-PCR expressed the MCP-1 mRNA; MCP-1 protein was detected in 90% （36/40） cases of the tumor; The expression of the MCP-1 protein in colorectal carcinoma correlated negatively with its state of metastasis and the Dukes＇ stage. But a postive correlation was found between the expression of MCP-1 and the infiltrated macrophage. The stronger expression of MCP-1, the more number of the infiltrated macrophage. Conclusion： The expression of chemokine MCP-1 in colorectal carcinoma may influence its biological behaviour of infiltration and metastasis, and can attract the immuno-cell to the local of the tumor, such as Macrophage.