To investigate the natural history of renal cell carcinoma (RCC) with delayed treatment and to immunohistochemically analyze the correlation between some biomarkers and the growth rate of RCC.We reviewed our institutional databases to identify renal tumors which were confirmed to be RCC by delayed surgical treatment after at least 12 months of active surveillance (AS). Growth rate was defined as the average growth rate of the maximal diameter on computed tomography or magnetic resonance imaging. The clinicopathological characteristics and immunohistochemical biomarkers (Ki-67, p53, bcl-2, and vascular endothelial growth factor) were analyzed the correlation with the growth rate of RCC.We identified 45 RCCs from 45 patients. The mean patient age was 54 years (range, 26-78 years). The mean tumor size increased from 2.39 cm (range, 0.10-6.70 cm) at presentation to 4.54 cm (range, 1.40-11.80 cm) after a mean time of 45.4 months (range, 12-155 months) of AS. The mean growth rate was 0.79 cm/y (range, 0.10-4.74 cm), and 36 (80.0%) tumors presented a growth rate ≤ 1.00 cm/y. Clear cell RCC had a trend of growing faster than other histological subtypes. Pathological grade was significantly correlated with the growth rate of RCC (p = 0.043). High positive ratio of Ki-67 (r = 0.351, p = 0.018) and being p53 positive (p = 0.019) were significantly correlated to the fast growth rate of RCC.In general, RCCs under AS are slow growing with a wide variation of growth rate, with a portion of RCCs presenting rapid growth kinetics. RCC with rapid growth during AS is characterized by a high histological grade, high positive ratio of Ki-67, and being p53 positive.
Objective
To explore the expression of protease activated receptor 3 (PAR3) and protease activated receptor 4 (PAR4) in the progression from colorectal polyps to cancer.
Methods
In this study, five groups of specimens were researched: primary colorectal cancer group (n=30), matched normal colorectal tissues group (taken 5 cm away from the tumour) (n=30), tubular adenoma group (n=30), villous adenoma group (n=20), and adenoma mixed group (n=30). The protein and mRNA levels of PAR3 and PAR4 were detected by immunohistochemistry and real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) respectively.
Results
The positive expression rate of PAR3 protein in normal colorectal mucosa, colorectal adenoma and colorectal carcinoma tissues was 73.3%, 50.0% and 6.7% respectively, with significant differences among them (P=0.009). The positive expression rate of PAR4 protein in these groups was 6.7%, 35.0% and 70.0% respectively. FQ-PCR showed that the expression of PAR3 mRNA in normal colorectal mucosa, tubular adenoma, mixed pattern of adenoma, villous adenoma and colorectal carcinoma was 0.787±0.040, 0.453±0.023, 0.410±0.050, 0.368±0.032 and 0.259±0.017, P=0.011; and that of PAR4 mRNA in these groups was 0.370±0.301, 10.384±1.474, 20.892±4.485, 36.311±7.953, 52.083±12.550 (F=43.342, P=0.009, respectively).
Conclusion
These results suggested PAR3 and PAR4 may play a role in the development of colorectal cancer.
Key words:
Protease activated receptor 3; Protease activated receptor 4; Colorectal cancer; Colorectal adenoma
To evaluate the efficacy and safety of raltitrexed plus oxaliplatin-based transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). A total of 123 patients with unresectable HCC were recruited into the prospective cohort study. Raltitrexed plus oxaliplatin-based TACE was performed according to the traditional method at monthly intervals and was repeated for up to 4 cycles if no disease progression or intolerable toxicity occurred. The primary efficacy endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS) and tumor response rate. The Cox proportional-hazards regression model was used to assess the independent prognostic factors of OS. Adverse events were also observed. The median OS time and PFS were 623 days (95% CI: 461, 785) and 338 days (95% CI: 302, 704), respectively. The disease control rate was 95.5% (118/123). The Cox proportional-hazards regression model indicated that age, ECOG performance status and response to TACE as independent prognostic factors of OS. No treatment-related mortality occurred within 30 days of treatment procedure. The most common complications included postembolization syndrome, liver dysfunction and hematological toxicity. Grade 3 pain, transglutaminase abnormality and thrombocytopenia were observed in 16 (13%), 15 (12.2%) and 3 (2.4%) patients, respectively. No grade 4 adverse events were observed. Raltitrexed plus oxaliplatin-based TACE led to high tumor response rate and promising PFS and OS, and was considered safe and tolerable in patients with unresectable HCC.
Objective:To explore the relationship between the expressions of MCM5 and E2F-1 with the genesis,clinicopathological parameters of gastric carcinoma.Methods:Immunohistochemistry SP method was used to detect the expressions of MCM5 and E2F-1 in gastric car- cinoma tissues of 57 cases and in normal gastric mucosa of 20 cases.The correlation between expressions of MCM5 and E2F-1 and clinicopathological parameters of gastric carcinoma was analysed. Results:The positive expression rate of MCM5 in cancer tissues was 71.9%(41/57),while in normal mucosa it was 0(0/20).The difference between the two groups was statistically significant (P0.001).The positive rates of E2F-1 in normal and gastric carcinoma tissues were 35%(7/20)and 66.7%(38/57),denoted a significant diference(P0.05).The expressions of MCM5 and E2F-1 in cancer tissues were not correlated with sex,age,the cell differentiation,the depth of invasion,lymph node metastases,distant metastases and TNM stage(P0.05).The correlation between MCM5 and E2F-1 expressions in gastric carcinoma was highly significant positive(r=0.635,P=0.000).Conclusion: Overexpression of MCM5 and E2F-1 corelates with occurence and development of gastric carcinoma.MCM5 and E2F-1 may work in the early phase in carcinogenesis of gastric carcinoma.
Clinical and basic research increasingly suggests a correlation between migraine and irritable bowel syndrome (IBS). In this study, we aimed to explore the clinical features and risk factors for IBS in migraine patients.This was a retrospective, cross-sectional study. A total of 1,112 consecutive patients from the internal medicine and emergency departments of three hospitals from June 2014 through 2016. A comprehensive interviewer-administered questionnaire was designed based on the International Classification of Headache Disorders, 3rd edition (beta version).The response rate was 94.6%. Among 1,052 participants, 287 suffered from migraine (27.3%) and 312 suffered from IBS (29.7%). A total of 79 patients suffered from both migraine and IBS (comorbidity rate: 7.5%). The migraine cohort exhibited a higher frequency of IBS than did the comparison cohort at baseline (P<0.05). Migraine patients with higher headache frequency, longer length of headache history, and anxiety disorders were more likely to also suffer from IBS (P=0.015). There were no significant differences between the two groups in age, sex, family history, duration of headache attack, migraine aura, headache intensity, or depression disorders (P>0.05). Multiple regression analysis indicated length of headache history and headache frequency were associated with IBS.Migraine patients with a long headache history, recurrent episodic headache attacks, and anxiety were more likely to have IBS.
Traditional Chinese Medicine Jianpijiedu decoction (JPJD) could improve the general status of liver cancer patients in clinics, especially the symptoms of decreased food intake and diarrhea. In this study, our results showed that the survival rate of the liver cancer with food restriction and diarrhea (FRD-LC) rats was lower than the liver cancer (LC) rats, and the tumor volume of the FRD-LC rats was higher than the LC rats. It was also shown that the high dose of JPJD significantly improved the survival rate, weight, and organ weight when compared with FRD-LC-induced rats. Moreover, JPJD administration upregulated the mRNA and protein levels of ABCC2 and downregulated the mRNA and protein levels of OATP1B2 in liver tissues. However, opposite results were observed in the cancer tissues. In conclusion, the study indicated that the Chinese Medicine JPJD could contribute to the rats with liver cancer which were pretreated with food restriction and diarrhea by regulating the expression of ABCC2 and OATP1B2 in liver tissues and cancer tissues.
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