BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficul...BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.展开更多
BACKGROUND As a novel endogenous anti-angiogenic molecule, vasohibin 1(VASH1) is not only expressed in tumor stroma, but also in tumor tissue. Moreover, studies have shown that VASH1 may be a prognostic marker in colo...BACKGROUND As a novel endogenous anti-angiogenic molecule, vasohibin 1(VASH1) is not only expressed in tumor stroma, but also in tumor tissue. Moreover, studies have shown that VASH1 may be a prognostic marker in colorectal cancer(CRC). Knockdown of VASH1 enhanced transforming growth factor-β1(TGF-β1)/Smad3 pathway activity and type Ⅰ/Ⅲ collagen production. Our previous findings suggest that ELL-associated factor 2(EAF2) may play a tumor suppressor and protective role in the development and progression of CRC by regulating signal transducer and activator of transcription 3(STAT3)/TGF-β1 signaling pathway. However, the functional role and mechanism of VASH1-mediated TGF-β1 related pathway in CRC has not been elucidated.AIM To investigate the expression of VASH1 in CRC and its correlation with the expression of EAF2. Furthermore, we studied the functional role and mechanism of VASH1 involved in the regulation and protection of EAF2 in CRC cells in vitro.METHODS We collected colorectal adenocarcinoma and corresponding adjacent tissues to investigate the clinical expression of EAF2 protein and VASH1 protein in patients with advanced CRC. Following, we investigated the effect and mechanism of EAF2 and VASH1 on the invasion, migration and angiogenesis of CRC cells in vitro using plasmid transfection.RESULTS Our findings indicated that EAF2 was down-regulated and VASH1 was upregulated in advanced CRC tissue compared to normal colorectal tissue. KaplanMeier survival analysis showed that the higher EAF2 Level group and the lower VASH1 Level group had a higher survival rate. Overexpression of EAF2 might inhibit the activity of STAT3/TGF-β1 pathway by up-regulating the expression of VASH1, and then weaken the invasion, migration and angiogenesis of CRC cells.CONCLUSION This study suggests that EAF2 and VASH1 may serve as new diagnostic and prognostic markers for CRC, and provide a clinical basis for exploring new biomarkers for CRC. This study complements the mechanism of EAF2 in CRC cells, enriches the role and mechanism of CRC cellderived VASH1, and provides a new possible subtype of CRC as a therapeutic target of STAT3/TGF-β1 pathway.展开更多
BACKGROUND Esophageal carcinoma is a highly aggressive digestive cancer responsible for a notable proportion of cancer-related deaths worldwide.Its elevated metastatic rate contributes to a poor prognosis in affected ...BACKGROUND Esophageal carcinoma is a highly aggressive digestive cancer responsible for a notable proportion of cancer-related deaths worldwide.Its elevated metastatic rate contributes to a poor prognosis in affected patients.In this case review,we aim to summarize the metastatic characteristics of intramural gastric metastasis(IGM)in mucosal esophageal squamous carcinoma.CASE SUMMARY A 56-year-old man was admitted to our hospital because of a dry cough with an esophageal sensation for one year.Endoscopic examination revealed a 2.0 cm 1.0 cm,superficial esophageal squamous cell carcinoma,and the patient underwent endoscopic submucosal dissection(ESD).Fifteen months after ESD,positron emission tomography/computed tomography revealed that the metabolism of the stomach cardia wall had increased slightly.However,the mucosa of the gastric cardia was smooth under gastroendoscopy.Two years after ESD,endoscopic examination revealed a giant gastric cardia carcinoma,while the esophageal mucosa was smooth,and no advanced cancer was found.A biopsy of the gastric cardia indicated squamous-cell carcinoma.The patient received immunochemotherapy and radiotherapy for esophageal cancer for 8 mo and is currently under follow-up.CONCLUSION Early-stage esophageal carcinoma with IGM is rare.Despite the ESD of the primary lesion,IGM may still occur and should be closely monitored after ESD.展开更多
AIM:To compare the effect of endoscopic variceal ligation(EVL)with that of endoscopic injection sclerotherapy(EIS)in the treatment of patients withesophageal variceal bleeding.METHODS:We performed a systematic literat...AIM:To compare the effect of endoscopic variceal ligation(EVL)with that of endoscopic injection sclerotherapy(EIS)in the treatment of patients withesophageal variceal bleeding.METHODS:We performed a systematic literature search of multiple online electronic databases.Metaanalysis was conducted to evaluate risk ratio(RR)and95%confidence interval(CI)of combined studies for the treatment of patients with esophageal variceal bleeding between EVL and EIS.RESULTS:Fourteen studies comprising 1236 patients were included in the meta-analysis.The rebleeding rate in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group(RR=0.68,95%CI:0.57-0.81).The variceal eradication rate in actively bleeding varices patients in the EVL group was significantly higher than that in the EIS group(RR=1.06,95%CI:1.01-1.12).There was no significant difference about mortality rate between the EVL group and EIS group(RR=0.95,95%CI:0.77-1.17).The rate of complications in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group(RR=0.28,95%CI:0.13-0.58).CONCLUSION:Our meta-analysis has found that EVL is better than EIS in terms of the lower rates of rebleeding,complications,and the higher rate of variceal eradication.Therefore,EVL is the first choice for esophageal variceal bleeding.展开更多
BACKGROUND In recent years,the incidence of gastrointestinal(GI)cancer in China has increased annually.Early detection and appropriate therapy are considered to be the key to treat GI cancer.DNMT1 takes an active part...BACKGROUND In recent years,the incidence of gastrointestinal(GI)cancer in China has increased annually.Early detection and appropriate therapy are considered to be the key to treat GI cancer.DNMT1 takes an active part in the advancement of GI cancer,which will change as the disease progresses.But its expression characteristics in the dynamic variations of GI carcinogenesis are still unclear.AIM To investigate the expression characteristics of DNMT1 in different GI diseases.METHODS We detected the expression of DNMT1 in 650 cases of different GI diseases by immunohistochemistry,including 90 cases of chronic superficial gastritis(CSG),72 cases of atrophic gastritis with intestinal metaplasia(AG/GIM),54 cases of low-grade intraepithelial neoplasia(GLIN),66 cases of high-grade intraepithelial neoplasia(GHIN),71 cases of early gastric cancer(EGC),90 cases of normal intestinal mucosa(NIM),54 cases of intestinal low-grade intraepithelial neoplasia(ILIN),71 cases of intestinal high-grade intraepithelial neoplasia(IHIN),and 82 cases of early colorectal cancer(ECRC).RESULTS In the CSG group,all cases showed weakly positive or negative expression of DNMT1.However,in other four groups(AG/GIM,GLIN,GHIN,and EGC),the positive expression rate gradually increased with the severity of the diseases;the negative or weakly positive cases accounted for 55.56%(40/72),38.89%(21/54),1.52%(1/66),and 1.41%(1/71),respectively.Besides,the moderately positive cases were 44.44%(32/72),57.41%(31/54),80.30%(53/66),and 43.66%(31/71),respectively.The strongly positive cases only existed in the GLIN(3.70%,2/54),GHIN(18.18%,12/66),and EGC(54.93%,39/71)groups.The differences between any two groups were statistically significant(P<0.05).Similarly,in the NIM group,cases with weakly positive expression of DNMT1 were predominant(91.11%,82/90),and the rest were moderately positive cases(8.89%,8/90).In the ILIN,IHIN,and ECRC groups,the rates of cases with weak or negative expression of DNMT1 were 46.30%(25/54),12.68%(9/71),and 4.88%(4/82),respectively;with moderately positive expression were 53.70%(29/54),71.83%(51/71),and 34.15%(28/82),respectively;and with strongly positive expression were 0.00%(0/54),15.49%(11/71),and 60.98%(50/82),respectively.The differences between any two groups were also statistically significant(P<0.05).CONCLUSION The overexpression of DNMT1 protein could effectively predict early GI cancers and severe precancerous lesions,which may have potential clinical application value.展开更多
AIM:To investigate the expression and prognostic role of pyruvate dehydrogenase(PDH) in gastric cancer(GC).METHODS:This study included 265 patients(194 male,71 female,mean age 59 years(range,29-81 years) with GC who u...AIM:To investigate the expression and prognostic role of pyruvate dehydrogenase(PDH) in gastric cancer(GC).METHODS:This study included 265 patients(194 male,71 female,mean age 59 years(range,29-81 years) with GC who underwent curative surgery at the First Affiliated Hospital of China Medical University from January 2006 to May 2007.All patients were followed up for more than 5 years.Patient-derived paraffin embedded GC specimens were collected for tissue microarrays(TMAs).We examined PDH expression by immunohistochemistry in TMAs containing tumor tissue and matched nonneoplastic mucosa.Immunoreactivity was evaluated independently by two researchers.Overall survival(OS) rates were determined using the Kaplan-Meier estimator.Correlations with other clinicopathologic factors were evaluated by two-tailed χ2 tests or a two-tailed t-test.The Cox proportional-hazard model was used in univariate analysis and multivariate analysis to identify factors significantly correlated with prognosis.RESULTS:Immunohistochemistry showed that 35.47% of total cancer tissue specimens had cytoplasmic PDH staining.PDH expression was much higher in normal mucosa specimens(75.09%;P = 0.001).PDH expression was correlated with Lauren grade(70.77% in intestinal type vs 40.0% in diffuse type;P = 0.001),lymph node metastasis(65.43% with no metastasis vs 51.09% with metastasis;P = 0.033),lymphatic invasion(61.62% with no invasion vs 38.81% with invasion;P = 0.002),histologic subtypes(70.77% in intestinal type vs 40.0% in diffuse type;P = 0.001) and tumor-node-metastasis(TNM) stage(39% in poorly differentiated vs 65.91% in well differentiated and 67.11% in moderately differentiated;P = 0.001) in GC.PDH expression in cancer tissue was significantly associated with higher OS(P < 0.001).The multivariate analysis adjusted for age,Lauren classification,TNM stage,lymph node metastasis,histological type,tumor size,depth of invasion and lymphatic invasion showed that the PDH expression in GC was an independent prognostic factor for higher OS(HR = 0.608,95%CI:0.504-0.734,P < 0.001).CONCLUSION:Our study indicated that PDH expression is an independent prognostic factor in GC patients and that positive expression of PDH may be predictive of favorable outcomes.展开更多
BACKGROUND A nomogram is a diagram that aggregates various predictive factors through multivariate regression analysis,which can be used to predict patient outcomes intuitively.Lymph node(LN)metastasis and tumor depos...BACKGROUND A nomogram is a diagram that aggregates various predictive factors through multivariate regression analysis,which can be used to predict patient outcomes intuitively.Lymph node(LN)metastasis and tumor deposit(TD)conditions are two critical factors that affect the prognosis of patients with colorectal cancer(CRC)after surgery.At present,few effective tools have been established to predict the overall survival(OS)of CRC patients after surgery.AIM To screen out suitable risk factors and to develop a nomogram that predicts the postoperative OS of CRC patients.METHODS Data from a total of 3139 patients diagnosed with CRC who underwent surgical removal of tumors and LN resection from 2010 to 2015 were collected from the Surveillance,Epidemiology,and End Results program.The data were divided into a training set(n=2092)and a validation set(n=1047)at random.The Harrell concordance index(C-index),Akaike information criterion(AIC),and area under the curve(AUC)were used to assess the predictive performance of the N stage from the American Joint Committee Cancer tumor-node-metastasis classification,LN ratio(LNR),and log odds of positive lymph nodes(LODDS).Univariate and multivariate analyses were utilized to screen out the risk factors significantly correlating with OS.The construction of the nomogram was based on Cox regression analysis.The C-index,receiver operating characteristic(ROC)curve,and calibration curve were employed to evaluate the discrimination and prediction abilities of the model.The likelihood ratio test was used to compare the sensitivity and specificity of the final model to the model with the N stage alone to evaluate LN metastasis.RESULTS The predictive efficacy of the LODDS was better than that of the LNR based on the C-index,AIC values,and AUC values of the ROC curve.Seven independent predictive factors,namely,race,age at diagnosis,T stage,M stage,LODDS,TD condition,and serum carcinoembryonic antigen level,were included in the nomogram.The C-index of the nomogram for OS prediction was 0.8002(95%CI:0.7839-0.8165)in the training set and 0.7864(95%CI:0.7604-0.8124)in the validation set.The AUC values of the ROC curve predicting the 1-,3-,and 5-year OS were 0.846,0.841,and 0.825,respectively,in the training set and 0.823,0.817,and 0.835,respectively,in the validation test.Great consistency between the predicted and actual observed OS for the 1-,3-,and 5-year OS in the training set and validation set was shown in the calibration curves.The final nomogram showed a better sensitivity and specificity than the nomogram with N stage alone for evaluating LN metastasis in both the training set(-4668.0 vs-4688.3,P<0.001)and the validation set(-1919.5 vs-1919.8,P<0.001)through the likelihood ratio test.CONCLUSION The nomogram incorporating LODDS,TD,and other risk factors showed great predictive accuracy and better sensitivity and specificity and represents a potential tool for therapeutic decision-making.展开更多
BACKGROUND Drugs targeting mitochondria can induce mitophagy and restrain proliferation in colorectal cancer(CRC)cells.Phosphoglycerate mutase family member 5(PGAM5)activates serine/threonine PTEN-induced putative kin...BACKGROUND Drugs targeting mitochondria can induce mitophagy and restrain proliferation in colorectal cancer(CRC)cells.Phosphoglycerate mutase family member 5(PGAM5)activates serine/threonine PTEN-induced putative kinase 1/Parkin pathway-mediated mitophagy.However,there are few studies on the clinical and prognostic significance of expression of PGAM5 protein and mitophagy-related protein Parkin in patients.AIM To assess the clinical significance of PGAM5 and Parkin proteins,as biomarkers for diagnosis and prognosis of CRC,by studying their expression in advanced CRC tissues and their association with clinicopathological parameters.METHODS The expression of PGAM5 and Parkin in CRC tissues from 100 patients was determined by immunohistochemistry.Each case was evaluated by using a combined scoring method based on signal intensity staining(scored 0-3)and the proportion of positively stained cancer cells(scored 0-4).The final staining score was calculated as the intensity score multiplied by the proportion score.Specimens were categorized as either high or low expression according to the Youden index,and the association between the expression of PGAM5 or Parkin and clinicopathological factors was ascertained.Additionally,we employed western blot to measure PGAM5 and Parkin protein expression in six matched pairs of CRC and adjacent non-tumor tissues.RESULTS Immunohistochemical and western blot findings showed that both PGAM5 and Parkin protein expression in tumor tissues was significantly higher than that in the adjacent tissues:PGAM5 and Parkin were mainly expressed in the cytoplasm of colonic epithelial cells.PGAM5 and Parkin protein levels were significantly positively correlated in advanced CRC tissues.Moreover,reduced Parkin protein expression was an independent prognostic factor for overall survival and progression-free survival in CRC patients as evinced by multivariate analysis.CONCLUSION The expression of PGAM5 protein and mitophagy-related protein Parkin has diagnostic significance for CRC and may become new biomarkers.Parkin may be a potential marker for the survival of CRC patients.展开更多
BACKGROUND The androgen responsive gene,ELL-associated factor 2(EAF2),expressed in benign prostate tissues,has been shown to play an important role in tumor suppression in a variety of malignant tumors.In addition,som...BACKGROUND The androgen responsive gene,ELL-associated factor 2(EAF2),expressed in benign prostate tissues,has been shown to play an important role in tumor suppression in a variety of malignant tumors.In addition,some scholars found that EAF2 frameshift mutations are associated with intratumor heterogeneity in colorectal cancer(CRC)and inactivation of EAF2 in microsatellite instability-high CRC.However,the molecular mechanism by which EAF2 is involved in CRC invasion and metastasis remains unclear.AIM To determine the clinical value of expression of EAF2 protein in CRC,and to study the effects of EAF2 on the invasion,migration,and angiogenesis of CRC cells in vitro.METHODS In this study,we collected colorectal adenocarcinoma and corresponding adjacent tissues to investigate the clinical expression of EAF2 protein in patients with advanced CRC.Subsequently,we investigated the effect of EAF2 on the invasion,migration,and angiogenesis of CRC cells in vitro using plasmid transfection.RESULTS EAF2 protein was lowly expressed in cancer tissues of patients with advanced CRC.Kaplan-Meier survival analysis showed that the survival rate of the high EAF2 level group was higher than that of the low EAF2 level group.CONCLUSION Our results demonstrated that EAF2,as a tumor suppressor,may inhibit the invasion,metastasis,and angiogenesis of CRC cells by regulating the signal transducer and activator of transcription 3/transforming growth factor-β1 crosstalk pathway,and play a cancer suppressive and protective role in the occurrence and development of CRC.Our findings are of great significance to provide a new idea and theoretical basis for the targeted diagnosis and treatment of CRC.展开更多
AIM: To evaluate the possible association between alcohol consumption and Barrett's esophagus(BE).METHODS: We performed a systematic literature search of multiple online electronic databases.Inclusion criteria ent...AIM: To evaluate the possible association between alcohol consumption and Barrett's esophagus(BE).METHODS: We performed a systematic literature search of multiple online electronic databases.Inclusion criteria entailed studies about alcohol and BE.Metaanalysis was conducted to evaluate odds ratio(OR) and95%CIs for the association between alcohol consumption and BE.RESULTS: Twenty studies comprising 4758 patients with BE were included in the meta-analysis.The risk of BE in patients with alcohol consumption was increasedcompared with control groups(OR = 1.01; 95%CI: 1.00-1.02),especially in case-control and cohort,European and Asian,and hospital studies,but there was a decreased risk of BE associated with alcohol consumption from American studies(OR = 0.86; 95%CI: 0.77-0.96).At the same time,there was no significant association between BE and alcohol consumption in community studies(OR = 0.97; 95%CI: 0.84-1.12) and the type of alcohol(wine,beer and liquor) studies.CONCLUSION: Our meta-analysis found that alcohol consumption was associated with an increased risk of BE,especially for European and Asian drinkers.展开更多
Additive manufacturing of aluminum alloys has received significant attention in the aerospace industry;however,achieving sufficient high strength,especially at elevated temperatures,remains challenging.Here,a crack-fr...Additive manufacturing of aluminum alloys has received significant attention in the aerospace industry;however,achieving sufficient high strength,especially at elevated temperatures,remains challenging.Here,a crack-free and near-full dense Al-1Fe-0.6Cu-1.3Zr alloy was fabricated by the laser powder bed fusion(LPBF)technique.The Al-Fe-Cu-Zr alloy exhibits heterogeneous microstructures with two distinct zones.One is the so-called coarse-grain zones(CGZs)with an average grain size of 0.95μm,where(Al,Cu)Fe_(3) nanoparticles precipitate in the Al matrix and Fe and Cu cosegregate at the grain boundaries(GBs).The other is fine-grain zones(FGZs)with an average grain size of 0.45μm,where an Al 3 Zr nanoparti-cle precipitates in each of theα-Al grains(serves as the nuclei),and Fe-rich nanoprecipitates and Fe/Cu cosegregation appear at the GBs.As a result,the LPBF Al-Fe-Cu-Zr alloy,with these unique heteroge-neous structures,displays high strength at both room temperature and elevated temperatures,e.g.,with high yield strengths of 500 MPa at room temperature,and 163 MPa at 573 K,both are higher than those of additive manufactured Al-based alloys reported thus far.It is suggested that the high strength over a wide temperature range of the current LPBF Al alloy is mainly attributed to the combination of the precipitation strengthening mechanism and grain-boundary strengthening mechanism.展开更多
嗜酸粒细胞性胰腺炎(EP)是一种非常罕见的疾病,单纯由胰腺嗜酸性粒细胞浸润引起。EP容易被误诊为胰腺癌,给患者造成不必要的经济负担和身体伤害。2017年至今,我们报告了3例EP病例,均通过类固醇治愈,未出现复发。我们回顾性分析了3例患...嗜酸粒细胞性胰腺炎(EP)是一种非常罕见的疾病,单纯由胰腺嗜酸性粒细胞浸润引起。EP容易被误诊为胰腺癌,给患者造成不必要的经济负担和身体伤害。2017年至今,我们报告了3例EP病例,均通过类固醇治愈,未出现复发。我们回顾性分析了3例患者的临床表现、血清学表现、影像学特点(超声、CT和MRI)、病理诊断及治疗,并对其进行了电话随访。此外,在Web of Science和PubMed数据库上使用与EP相关的关键词进行了文献检索,并纳入了不受出版日期或语言限制的病例报告。我们对最终共纳入的19例病例进行了分析,并明确了EP的诊断标准。我们提出的EP诊断流程可以很好地对EP进行诊断。希望我们的诊断标准和诊断流程能够降低EP误诊率,以提高临床诊治水平。同时,我们也期望通过更多的EP病例来检验我们提出的诊断标准,并设计出一个更为系统的诊断流程图。展开更多
基金Natural Science Foundation of Liaoning Province,China,No.2022-YGJC-71
文摘BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.
基金the Natural Science Foundation of Liaoning Province,No.2023-MS-149.
文摘BACKGROUND As a novel endogenous anti-angiogenic molecule, vasohibin 1(VASH1) is not only expressed in tumor stroma, but also in tumor tissue. Moreover, studies have shown that VASH1 may be a prognostic marker in colorectal cancer(CRC). Knockdown of VASH1 enhanced transforming growth factor-β1(TGF-β1)/Smad3 pathway activity and type Ⅰ/Ⅲ collagen production. Our previous findings suggest that ELL-associated factor 2(EAF2) may play a tumor suppressor and protective role in the development and progression of CRC by regulating signal transducer and activator of transcription 3(STAT3)/TGF-β1 signaling pathway. However, the functional role and mechanism of VASH1-mediated TGF-β1 related pathway in CRC has not been elucidated.AIM To investigate the expression of VASH1 in CRC and its correlation with the expression of EAF2. Furthermore, we studied the functional role and mechanism of VASH1 involved in the regulation and protection of EAF2 in CRC cells in vitro.METHODS We collected colorectal adenocarcinoma and corresponding adjacent tissues to investigate the clinical expression of EAF2 protein and VASH1 protein in patients with advanced CRC. Following, we investigated the effect and mechanism of EAF2 and VASH1 on the invasion, migration and angiogenesis of CRC cells in vitro using plasmid transfection.RESULTS Our findings indicated that EAF2 was down-regulated and VASH1 was upregulated in advanced CRC tissue compared to normal colorectal tissue. KaplanMeier survival analysis showed that the higher EAF2 Level group and the lower VASH1 Level group had a higher survival rate. Overexpression of EAF2 might inhibit the activity of STAT3/TGF-β1 pathway by up-regulating the expression of VASH1, and then weaken the invasion, migration and angiogenesis of CRC cells.CONCLUSION This study suggests that EAF2 and VASH1 may serve as new diagnostic and prognostic markers for CRC, and provide a clinical basis for exploring new biomarkers for CRC. This study complements the mechanism of EAF2 in CRC cells, enriches the role and mechanism of CRC cellderived VASH1, and provides a new possible subtype of CRC as a therapeutic target of STAT3/TGF-β1 pathway.
基金Supported by Natural Science Foundation of Liaoning Science,No.2022-YGJC-71.
文摘BACKGROUND Esophageal carcinoma is a highly aggressive digestive cancer responsible for a notable proportion of cancer-related deaths worldwide.Its elevated metastatic rate contributes to a poor prognosis in affected patients.In this case review,we aim to summarize the metastatic characteristics of intramural gastric metastasis(IGM)in mucosal esophageal squamous carcinoma.CASE SUMMARY A 56-year-old man was admitted to our hospital because of a dry cough with an esophageal sensation for one year.Endoscopic examination revealed a 2.0 cm 1.0 cm,superficial esophageal squamous cell carcinoma,and the patient underwent endoscopic submucosal dissection(ESD).Fifteen months after ESD,positron emission tomography/computed tomography revealed that the metabolism of the stomach cardia wall had increased slightly.However,the mucosa of the gastric cardia was smooth under gastroendoscopy.Two years after ESD,endoscopic examination revealed a giant gastric cardia carcinoma,while the esophageal mucosa was smooth,and no advanced cancer was found.A biopsy of the gastric cardia indicated squamous-cell carcinoma.The patient received immunochemotherapy and radiotherapy for esophageal cancer for 8 mo and is currently under follow-up.CONCLUSION Early-stage esophageal carcinoma with IGM is rare.Despite the ESD of the primary lesion,IGM may still occur and should be closely monitored after ESD.
基金Supported by National Natural Science Foundation of China,No.81300273
文摘AIM:To compare the effect of endoscopic variceal ligation(EVL)with that of endoscopic injection sclerotherapy(EIS)in the treatment of patients withesophageal variceal bleeding.METHODS:We performed a systematic literature search of multiple online electronic databases.Metaanalysis was conducted to evaluate risk ratio(RR)and95%confidence interval(CI)of combined studies for the treatment of patients with esophageal variceal bleeding between EVL and EIS.RESULTS:Fourteen studies comprising 1236 patients were included in the meta-analysis.The rebleeding rate in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group(RR=0.68,95%CI:0.57-0.81).The variceal eradication rate in actively bleeding varices patients in the EVL group was significantly higher than that in the EIS group(RR=1.06,95%CI:1.01-1.12).There was no significant difference about mortality rate between the EVL group and EIS group(RR=0.95,95%CI:0.77-1.17).The rate of complications in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group(RR=0.28,95%CI:0.13-0.58).CONCLUSION:Our meta-analysis has found that EVL is better than EIS in terms of the lower rates of rebleeding,complications,and the higher rate of variceal eradication.Therefore,EVL is the first choice for esophageal variceal bleeding.
文摘BACKGROUND In recent years,the incidence of gastrointestinal(GI)cancer in China has increased annually.Early detection and appropriate therapy are considered to be the key to treat GI cancer.DNMT1 takes an active part in the advancement of GI cancer,which will change as the disease progresses.But its expression characteristics in the dynamic variations of GI carcinogenesis are still unclear.AIM To investigate the expression characteristics of DNMT1 in different GI diseases.METHODS We detected the expression of DNMT1 in 650 cases of different GI diseases by immunohistochemistry,including 90 cases of chronic superficial gastritis(CSG),72 cases of atrophic gastritis with intestinal metaplasia(AG/GIM),54 cases of low-grade intraepithelial neoplasia(GLIN),66 cases of high-grade intraepithelial neoplasia(GHIN),71 cases of early gastric cancer(EGC),90 cases of normal intestinal mucosa(NIM),54 cases of intestinal low-grade intraepithelial neoplasia(ILIN),71 cases of intestinal high-grade intraepithelial neoplasia(IHIN),and 82 cases of early colorectal cancer(ECRC).RESULTS In the CSG group,all cases showed weakly positive or negative expression of DNMT1.However,in other four groups(AG/GIM,GLIN,GHIN,and EGC),the positive expression rate gradually increased with the severity of the diseases;the negative or weakly positive cases accounted for 55.56%(40/72),38.89%(21/54),1.52%(1/66),and 1.41%(1/71),respectively.Besides,the moderately positive cases were 44.44%(32/72),57.41%(31/54),80.30%(53/66),and 43.66%(31/71),respectively.The strongly positive cases only existed in the GLIN(3.70%,2/54),GHIN(18.18%,12/66),and EGC(54.93%,39/71)groups.The differences between any two groups were statistically significant(P<0.05).Similarly,in the NIM group,cases with weakly positive expression of DNMT1 were predominant(91.11%,82/90),and the rest were moderately positive cases(8.89%,8/90).In the ILIN,IHIN,and ECRC groups,the rates of cases with weak or negative expression of DNMT1 were 46.30%(25/54),12.68%(9/71),and 4.88%(4/82),respectively;with moderately positive expression were 53.70%(29/54),71.83%(51/71),and 34.15%(28/82),respectively;and with strongly positive expression were 0.00%(0/54),15.49%(11/71),and 60.98%(50/82),respectively.The differences between any two groups were also statistically significant(P<0.05).CONCLUSION The overexpression of DNMT1 protein could effectively predict early GI cancers and severe precancerous lesions,which may have potential clinical application value.
基金Grants from the research projects in Liaoning Province Science and Technology Department,No.2007225017,No.2009225011-2 and No.2011415052Science and Technology projects in Shenyang City,No.F11-264-1-19
文摘AIM:To investigate the expression and prognostic role of pyruvate dehydrogenase(PDH) in gastric cancer(GC).METHODS:This study included 265 patients(194 male,71 female,mean age 59 years(range,29-81 years) with GC who underwent curative surgery at the First Affiliated Hospital of China Medical University from January 2006 to May 2007.All patients were followed up for more than 5 years.Patient-derived paraffin embedded GC specimens were collected for tissue microarrays(TMAs).We examined PDH expression by immunohistochemistry in TMAs containing tumor tissue and matched nonneoplastic mucosa.Immunoreactivity was evaluated independently by two researchers.Overall survival(OS) rates were determined using the Kaplan-Meier estimator.Correlations with other clinicopathologic factors were evaluated by two-tailed χ2 tests or a two-tailed t-test.The Cox proportional-hazard model was used in univariate analysis and multivariate analysis to identify factors significantly correlated with prognosis.RESULTS:Immunohistochemistry showed that 35.47% of total cancer tissue specimens had cytoplasmic PDH staining.PDH expression was much higher in normal mucosa specimens(75.09%;P = 0.001).PDH expression was correlated with Lauren grade(70.77% in intestinal type vs 40.0% in diffuse type;P = 0.001),lymph node metastasis(65.43% with no metastasis vs 51.09% with metastasis;P = 0.033),lymphatic invasion(61.62% with no invasion vs 38.81% with invasion;P = 0.002),histologic subtypes(70.77% in intestinal type vs 40.0% in diffuse type;P = 0.001) and tumor-node-metastasis(TNM) stage(39% in poorly differentiated vs 65.91% in well differentiated and 67.11% in moderately differentiated;P = 0.001) in GC.PDH expression in cancer tissue was significantly associated with higher OS(P < 0.001).The multivariate analysis adjusted for age,Lauren classification,TNM stage,lymph node metastasis,histological type,tumor size,depth of invasion and lymphatic invasion showed that the PDH expression in GC was an independent prognostic factor for higher OS(HR = 0.608,95%CI:0.504-0.734,P < 0.001).CONCLUSION:Our study indicated that PDH expression is an independent prognostic factor in GC patients and that positive expression of PDH may be predictive of favorable outcomes.
基金Supported by Science and Technology Support Program of Shenyang,No.20-205-4-094.
文摘BACKGROUND A nomogram is a diagram that aggregates various predictive factors through multivariate regression analysis,which can be used to predict patient outcomes intuitively.Lymph node(LN)metastasis and tumor deposit(TD)conditions are two critical factors that affect the prognosis of patients with colorectal cancer(CRC)after surgery.At present,few effective tools have been established to predict the overall survival(OS)of CRC patients after surgery.AIM To screen out suitable risk factors and to develop a nomogram that predicts the postoperative OS of CRC patients.METHODS Data from a total of 3139 patients diagnosed with CRC who underwent surgical removal of tumors and LN resection from 2010 to 2015 were collected from the Surveillance,Epidemiology,and End Results program.The data were divided into a training set(n=2092)and a validation set(n=1047)at random.The Harrell concordance index(C-index),Akaike information criterion(AIC),and area under the curve(AUC)were used to assess the predictive performance of the N stage from the American Joint Committee Cancer tumor-node-metastasis classification,LN ratio(LNR),and log odds of positive lymph nodes(LODDS).Univariate and multivariate analyses were utilized to screen out the risk factors significantly correlating with OS.The construction of the nomogram was based on Cox regression analysis.The C-index,receiver operating characteristic(ROC)curve,and calibration curve were employed to evaluate the discrimination and prediction abilities of the model.The likelihood ratio test was used to compare the sensitivity and specificity of the final model to the model with the N stage alone to evaluate LN metastasis.RESULTS The predictive efficacy of the LODDS was better than that of the LNR based on the C-index,AIC values,and AUC values of the ROC curve.Seven independent predictive factors,namely,race,age at diagnosis,T stage,M stage,LODDS,TD condition,and serum carcinoembryonic antigen level,were included in the nomogram.The C-index of the nomogram for OS prediction was 0.8002(95%CI:0.7839-0.8165)in the training set and 0.7864(95%CI:0.7604-0.8124)in the validation set.The AUC values of the ROC curve predicting the 1-,3-,and 5-year OS were 0.846,0.841,and 0.825,respectively,in the training set and 0.823,0.817,and 0.835,respectively,in the validation test.Great consistency between the predicted and actual observed OS for the 1-,3-,and 5-year OS in the training set and validation set was shown in the calibration curves.The final nomogram showed a better sensitivity and specificity than the nomogram with N stage alone for evaluating LN metastasis in both the training set(-4668.0 vs-4688.3,P<0.001)and the validation set(-1919.5 vs-1919.8,P<0.001)through the likelihood ratio test.CONCLUSION The nomogram incorporating LODDS,TD,and other risk factors showed great predictive accuracy and better sensitivity and specificity and represents a potential tool for therapeutic decision-making.
基金Supported by the Natural Science Foundation of Liaoning Province,No.2019-BS-279.
文摘BACKGROUND Drugs targeting mitochondria can induce mitophagy and restrain proliferation in colorectal cancer(CRC)cells.Phosphoglycerate mutase family member 5(PGAM5)activates serine/threonine PTEN-induced putative kinase 1/Parkin pathway-mediated mitophagy.However,there are few studies on the clinical and prognostic significance of expression of PGAM5 protein and mitophagy-related protein Parkin in patients.AIM To assess the clinical significance of PGAM5 and Parkin proteins,as biomarkers for diagnosis and prognosis of CRC,by studying their expression in advanced CRC tissues and their association with clinicopathological parameters.METHODS The expression of PGAM5 and Parkin in CRC tissues from 100 patients was determined by immunohistochemistry.Each case was evaluated by using a combined scoring method based on signal intensity staining(scored 0-3)and the proportion of positively stained cancer cells(scored 0-4).The final staining score was calculated as the intensity score multiplied by the proportion score.Specimens were categorized as either high or low expression according to the Youden index,and the association between the expression of PGAM5 or Parkin and clinicopathological factors was ascertained.Additionally,we employed western blot to measure PGAM5 and Parkin protein expression in six matched pairs of CRC and adjacent non-tumor tissues.RESULTS Immunohistochemical and western blot findings showed that both PGAM5 and Parkin protein expression in tumor tissues was significantly higher than that in the adjacent tissues:PGAM5 and Parkin were mainly expressed in the cytoplasm of colonic epithelial cells.PGAM5 and Parkin protein levels were significantly positively correlated in advanced CRC tissues.Moreover,reduced Parkin protein expression was an independent prognostic factor for overall survival and progression-free survival in CRC patients as evinced by multivariate analysis.CONCLUSION The expression of PGAM5 protein and mitophagy-related protein Parkin has diagnostic significance for CRC and may become new biomarkers.Parkin may be a potential marker for the survival of CRC patients.
基金Supported by the Natural Science Foundation of Liaoning Province,No.2019-BS-279.
文摘BACKGROUND The androgen responsive gene,ELL-associated factor 2(EAF2),expressed in benign prostate tissues,has been shown to play an important role in tumor suppression in a variety of malignant tumors.In addition,some scholars found that EAF2 frameshift mutations are associated with intratumor heterogeneity in colorectal cancer(CRC)and inactivation of EAF2 in microsatellite instability-high CRC.However,the molecular mechanism by which EAF2 is involved in CRC invasion and metastasis remains unclear.AIM To determine the clinical value of expression of EAF2 protein in CRC,and to study the effects of EAF2 on the invasion,migration,and angiogenesis of CRC cells in vitro.METHODS In this study,we collected colorectal adenocarcinoma and corresponding adjacent tissues to investigate the clinical expression of EAF2 protein in patients with advanced CRC.Subsequently,we investigated the effect of EAF2 on the invasion,migration,and angiogenesis of CRC cells in vitro using plasmid transfection.RESULTS EAF2 protein was lowly expressed in cancer tissues of patients with advanced CRC.Kaplan-Meier survival analysis showed that the survival rate of the high EAF2 level group was higher than that of the low EAF2 level group.CONCLUSION Our results demonstrated that EAF2,as a tumor suppressor,may inhibit the invasion,metastasis,and angiogenesis of CRC cells by regulating the signal transducer and activator of transcription 3/transforming growth factor-β1 crosstalk pathway,and play a cancer suppressive and protective role in the occurrence and development of CRC.Our findings are of great significance to provide a new idea and theoretical basis for the targeted diagnosis and treatment of CRC.
基金Supported by National Natural Science Foundation of China,No.81300273 and 81300130
文摘AIM: To evaluate the possible association between alcohol consumption and Barrett's esophagus(BE).METHODS: We performed a systematic literature search of multiple online electronic databases.Inclusion criteria entailed studies about alcohol and BE.Metaanalysis was conducted to evaluate odds ratio(OR) and95%CIs for the association between alcohol consumption and BE.RESULTS: Twenty studies comprising 4758 patients with BE were included in the meta-analysis.The risk of BE in patients with alcohol consumption was increasedcompared with control groups(OR = 1.01; 95%CI: 1.00-1.02),especially in case-control and cohort,European and Asian,and hospital studies,but there was a decreased risk of BE associated with alcohol consumption from American studies(OR = 0.86; 95%CI: 0.77-0.96).At the same time,there was no significant association between BE and alcohol consumption in community studies(OR = 0.97; 95%CI: 0.84-1.12) and the type of alcohol(wine,beer and liquor) studies.CONCLUSION: Our meta-analysis found that alcohol consumption was associated with an increased risk of BE,especially for European and Asian drinkers.
基金This work was financially supported by the National Natural Science Foundation of China(Nos.52061160483 and 92166130)the Hubei Science Fund for Distinguished Young Scholars(No.2020CFA086).The authors are also grateful to the Analytical and Testing Center,Huazhong University of Science and Technology for technical assistance.
文摘Additive manufacturing of aluminum alloys has received significant attention in the aerospace industry;however,achieving sufficient high strength,especially at elevated temperatures,remains challenging.Here,a crack-free and near-full dense Al-1Fe-0.6Cu-1.3Zr alloy was fabricated by the laser powder bed fusion(LPBF)technique.The Al-Fe-Cu-Zr alloy exhibits heterogeneous microstructures with two distinct zones.One is the so-called coarse-grain zones(CGZs)with an average grain size of 0.95μm,where(Al,Cu)Fe_(3) nanoparticles precipitate in the Al matrix and Fe and Cu cosegregate at the grain boundaries(GBs).The other is fine-grain zones(FGZs)with an average grain size of 0.45μm,where an Al 3 Zr nanoparti-cle precipitates in each of theα-Al grains(serves as the nuclei),and Fe-rich nanoprecipitates and Fe/Cu cosegregation appear at the GBs.As a result,the LPBF Al-Fe-Cu-Zr alloy,with these unique heteroge-neous structures,displays high strength at both room temperature and elevated temperatures,e.g.,with high yield strengths of 500 MPa at room temperature,and 163 MPa at 573 K,both are higher than those of additive manufactured Al-based alloys reported thus far.It is suggested that the high strength over a wide temperature range of the current LPBF Al alloy is mainly attributed to the combination of the precipitation strengthening mechanism and grain-boundary strengthening mechanism.
基金Support Program for Young and Middle-Aged Science and Technology Innovation Talents of Shenyang [No.RC170446].
文摘嗜酸粒细胞性胰腺炎(EP)是一种非常罕见的疾病,单纯由胰腺嗜酸性粒细胞浸润引起。EP容易被误诊为胰腺癌,给患者造成不必要的经济负担和身体伤害。2017年至今,我们报告了3例EP病例,均通过类固醇治愈,未出现复发。我们回顾性分析了3例患者的临床表现、血清学表现、影像学特点(超声、CT和MRI)、病理诊断及治疗,并对其进行了电话随访。此外,在Web of Science和PubMed数据库上使用与EP相关的关键词进行了文献检索,并纳入了不受出版日期或语言限制的病例报告。我们对最终共纳入的19例病例进行了分析,并明确了EP的诊断标准。我们提出的EP诊断流程可以很好地对EP进行诊断。希望我们的诊断标准和诊断流程能够降低EP误诊率,以提高临床诊治水平。同时,我们也期望通过更多的EP病例来检验我们提出的诊断标准,并设计出一个更为系统的诊断流程图。
