Impact of tumor infiltration pattern into the surrounding tissue on prognosis of the subserosal gastric cancer (pT2b)

Background

The aim of this study was to clarify the impact of infiltration pattern on prognosis in patients with gastric carcinoma invading subserosa.

Methods

Clinicopathologic findings in patients with ssγ pattern (n = 144) were compared with those in patients with ssα/ssβ cancers (n = 222). Prognostic factors of pT2b patients were analyzed by univariate and multivariate analysis.

Results

Compared with the ssα/β group, ssγ gastric cancer exhibited more frequent undifferentiated histology, disseminated lymph node metastasis and perineural invasion. Frequency of postoperative peritoneal recurrence was significantly higher in ssγ gastric cancer (P < 0.05). The 5-year survival rate for patients with ssγ gastric cancer was significantly lower compared with ssα/β group (63.2% vs. 74.8%, respectively; P < 0.05). Lymph node metastasis, vein invasion and infiltrative pattern (ssγ) were significant independent prognostic factors affecting survival in pT2b patients.

Conclusion

In patients with gastric cancer invading the subserosa, infiltrative type growth pattern is closely related to carcinomatosis and poorer prognosis.     

Human sodium iodide symporter added to multidrug resistance 1 small hairpin RNA in a single gene construct enhances the therapeutic effects of radioiodine in a nude mouse model of multidrug resistant colon cancer

The objective of this study was to investigate the therapeutic potential of 131I added to doxorubicin therapy in multidrug resistance (MDR) mouse colon cancer coexpressing the MDR1 small hairpin RNA (shRNA) and human sodium iodide symporter (hNIS) gene in a single gene construct and to visualize the antitumor effects using molecular nuclear imaging. HCT-15 coexpressing shRNA for MDR1 gene (MDR1 shRNA) and hNIS gene with a single construct was established (referred to as MN61 cell). Inhibition of P-gp function by MDR1 shRNA and functional activity of hNIS gene was assessed using a ??(m)Tc sestamibi uptake and 12?I uptake, respectively. Cytotoxic effects by a combination of doxorubicin and 131I were determined in parental (HCT-15) or MN61 cells using an in vitro clonogenic assay. Therapeutic effect of either combination therapy (doxorubicin and 131I) or single therapy (doxorubicin or 131I alone) was evaluated by tumor volume measurement. ??(m)Tc-sestamibi, 123I, and ??(m)Tc-pertechnetate images of mice were acquired to evaluate functional assessment in vivo. Cellular uptake of ??(m)Tc-sestamibi and 12?I was approximately 2-fold and 100-fold higher in MN61 cells than in parental cells, respectively. Combination of 131I and doxorubicin resulted in higher cytotoxcity in MN61 cells as compared with parental cells. Scintigraphic imaging showed higher uptake of ??(m)Tc-sestamibi and 123I in MN61 tumor as compared with parental tumor. In mice treated with doxorubicin, there was a slight delay in tumor growth in the MN61 tumor but not in the parental tumor. Cancer treatment with 131I or doxorubicin induced a rapid reduction of tumor volume in the MN61 tumor but not in the parental tumor. Combination therapy further generated a rapid reduction of tumor volume as compared with 131I therapy alone (p?相似文献   

First‐line therapy with doxycycline in ocular adnexal mucosa‐associated lymphoid tissue lymphoma: A retrospective analysis of clinical predictors

This retrospective study was launched to evaluate the efficacy of doxycycline and to find independent predictors of a clinical response in patients with ocular adnexal lymphoma of mucosa‐associated lymphoid tissue (OAML). Thirty‐eight patients with newly diagnosed, localized OAML received doxycycline for 3 weeks (12 patients) or 6 weeks (26 patients). Clinical factors including absolute lymphocyte count (ALC) and neutrophil count (ANC) were compared between responders and non‐responders. After a median follow‐up of 26.4 months, doxycycline resulted in an overall response rate of 47% and a 3‐year time‐to‐treatment failure (TTF) rate of 84%. Patients treated with doxycycline for 6 weeks versus 3 weeks tended to have a higher response rate (54%vs 33%). Absolute lymphocytosis (ALC > 3.01 × 10⁹/L) and absolute neutrophilia (ANC > 1.92 × 10⁹/L) were defined based on the median value of each count. Patients with (19 patients) versus without absolute lymphocytosis had significantly shorter 2‐year TTF (70%vs 100%, P = 0.021) and a lower response rate (32%vs 63%, P = 0.051). Absolute lymphocytosis (odds ratio [OR] = 4.7; 95% confidence interval [CI], 1.1–20.8; P = 0.043) and non‐conjunctival tumor (OR = 11.8; 95% CI, 1.1–122.5; P = 0.038) were negative predictors for response by multivariate analysis. Front‐line doxycycline is effective particularly in localized OAML patients without absolute lymphocytosis but with conjunctival involvement. (Cancer Sci 2010; 101: 1199–1203)     

MicroRNAs in lung cancer

MicroRNAs have become recognized as key players in the development of cancer. They are a family of small non-coding RNAs that can negatively regulate the expression of cancer-related genes by sequence-selective targeting of mRNAs, leading to either mRNA degradation or translational repression. Lung cancer is the leading cause of cancer-related death worldwide with a substantially low survival rate. MicroRNAs have been confirmed to play roles in lung cancer development, epithelial-mesenchymal transition and response to therapy. They are also being studied for their future use as diagnostic and prognostic biomarkers and as potential therapeutic targets. In this review we focus on the role of dysregulated microRNA expression in lung tumorigenesis. We also discuss the role of microRNAs in therapeutic resistance and as biomarkers. We further look into the progress made and challenges remaining in using microRNAs for therapy in lung cancer.     

Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett’s esophagus

AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×80.The magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s classification.Then,a 0.5%solution of methylene blue(MB)was sprayed over columnar mucosa.The patterns of the magnified image and MB staining were analyzed.Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.RESULTS:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have SIM.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.     

Improvement of type 2 diabetes mellitus after gastric cancer surgery:Short-term outcome analysis after gastrectomy

AIM:To evaluate the effect of gastrectomy on diabetes control in patients with type 2 diabetes mellitus and early gastric cancer.METHODS:Data from 64 patients with early gastric cancer and type 2 diabetes mellitus were prospectively collected.All patients underwent curative gastrectomy(36 subtotal gastrectomy with gastroduodenostomy,16subtotal gastrectomy with gastrojejunostomy,12 total gastrectomy)and their physical and laboratory data were evaluated before and 3,6 and 12 mo after surgery.RESULTS:Fasting blood glucose(FBS),HbA1c,insulin,C-peptide,and homeostasis model assessment-estimated insulin resistance were significantly improved 3mo after surgery,regardless of operation type,and the significant improvement in all measured values,except HbA1c,was sustained up to 12 mo postoperatively.Approximately 3.1%of patients stopped diabetes medication and had HbA1c<6.0%and FBS<126 mg/dL.54.7%of patients decreased their medication,and had reduced FBS or HbA1c.In multivariate analysis,good diabetic control was not associated with operation type,but was associated with diabetes duration.CONCLUSION:Diabetes improved in more than 50%of patients during the first year after gastric cancer surgery.The degree of diabetes control was related to diabetes duration.     

Molecular classification of colorectal carcinomas:The genotype-to-phenotype relation

Colorectal carcinomas(CRCs)are frequently found in industrialized countries and lead to a high incidence of malignancy-related mortality.Defined by histomorphological features,CRCs and their pre-invasive lesions are quite heterogeneous.The underlying molecular mechanisms include genomic instability,genomic mutation of tumor suppressor genes or oncogenes,epigenetic changes,and the microRNA network.The molecular mechanisms are guided by repeated clonal selections.The genotype-to-phenotype relation is assumed to be the great challenge of cancer research and the development of effective targeted therapies.At present a strong genotype-to-phenotype relation is characterized only for a minority of CRCs.Consequently,the molecular characterization of CRCs is essential to interpret histological patterns and to identify prognostic groups as well as patients for targeted therapy.