ObjectiveTo systematically review the expression and clinical significance of CD133 in gastric cancer. MethodsSearches in the databases such as PubMed, EMbase, Web of Knowledge, The Cochrane Library (Issue 10, 2013), CBM, VIP, CNKI and WanFang Data were performed to collect case-control studies about the association between the CD133 expression and gastric cancer up to October 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then RevMan 5.2 software was used for meta-analysis. ResultsNine case-control studies involving 623 patients were included. The results of the meta-analyses showed that, there were significant differences of CD133 expression in the following comparisons:gastric cancer tissues vs. normal esophageal tissues (OR=3.89, 95%CI 1.87 to 8.11, P=0.000 3), lymph node metastasis vs. non-lymph node metastasis (OR=2.75, 95%CI 1.99 to 3.81, P < 0.000 01), clinical stages Ⅲ-Ⅳ vs. clinical stages Ⅰ-Ⅱ (OR=2.83, 95%CI 2.13 to 3.76, P < 0.000 01), as well as distant metastasis vs. non-distant metastasis (OR=2.38, 95%CI 1.47 to 3.85, P=0.000 4). While no significant difference was found between the cell differentiation G1-G2 vs. cell differentiation G3 (OR=1.70, 95%CI 0.90 to 3.21, P=0.10). ConclusionOver-expression of CD133 is associated with lymph node metastasis, distant metastasis and poor TNM stage, which suggests that CD133 may participate in the carcinogenesis of gastric cancer. However, due to the limitations of the included studies, more large-sample high-quality case-control studies are still needed to verify these results.
Objective To summarize the multi disciplinary team (MDT) discussion in the treatment of intrahepatic cholangiocarcinoma (ICC) involving inferior vena cava (IVC). Method The clinical data of a difficult ICC patient diagnosed and treated in Gansu Provincial Hospital in September 2020 were analyzed retrospectively, and the clinical features, diagnosis, treatment decision and prognosis of ICC were summarized. Results The patient was initially diagnosed as liver malignant tumor, which invaded the right adrenal gland and inferior vena cava. After MDT discussion, the patient decided to undergo surgical treatment, and successfully underwent radical resection of liver tumor combined with right adrenal gland and partial inferior vena cava and vascular reconstruction. The operation lasted 300 minutes, and the intraoperative bleeding was about 600 mL. The results of postoperative pathological examination indicated that it conformed to ICC, and carcinomatous tissues involvement could be seen in inferior vena cava and adrenal gland. The patient had no complication after operation and was discharged from hospital at 2 weeks after operation. The patient had been followed up for half a year and had been regularly treated with gemcitabine combined with platinum for 6 phases. No tumor recurrence or metastasis had been found. Conclusions The onset of ICC is concealed and its invasiveness is strong. The preliminary diagnosis can be determined by imaging examination combined with detection of tumor markers. Radical surgery is the main treatment. After MDT discussion, the formulation of a comprehensive treatment plan, including surgical strategy, local treatment and systemic treatment, can improve the prognosis and prolong the survival time of patients.