Objective To explore the clinical comprehensive therapy of Peutz-Jeghers syndrome. Methods From January 2000 to December 2010，71 cases of Peutz-Jeghers syndrome underwent endoscopic polyp resection firstly，and those with unresectable lesions or with severe complications underwent rescue laparotomy. After endoscopic or surgical treatment，the patients took Celecoxib capsules voluntarily for 6 to 9 months under informed consents. All cases were followed up from 6 months to 8 years. Results Twenty-nine patients had familial history of Peutz-Jeghers syndrome among the 71 patients （41 males and 30 females）. Sixty-two cases underwent 94 surgeries and intussusception was the most common cause of laparotomy. Sixty-five patients underwent 169 double-balloon endoscopy （DBE） therapies，and a total of 1 714 polyps were resected by DBE polypectomy. The largest major axis of small-bowel polyp was 8 cm. No severe complications occurred after DBE polypectomy except for 3 cases of intestinal perforation. Eight patients took Celecoxib capsule，3 of them were treated more than 6 months，and DBE examination showed the gastrointestinal polyps reduced in number and size. Conclusion The comprehensive treatment （including of endoscopic therapy，operation，and drug intervention） is a safe and effective clinical model to treat Peutz-Jeghers syndrome．
ObjectiveTo detect the expression of hMLH1, hMSH2 or hMSH6 protein in sporadic colorectal carcinoma (SCRC) and analyze the relationship of its expression to clinicopathologic parameters of patients with SCRC. MethodsTwo hundred and sixty-three patients with SCRC were studied, who underwent surgery in the Department of General Surgery, the Air Force General Hospital; and the Department of Colorectal Surgery, Beijing Cancer Hospital from March 2008 to March 2012. All the patients were diagnosed by histological examination without chemoradiotherapy before operation. Immunohistochemistry was used to detect the hMLH1, hMSH2 or hMSH6 protein expression in the tumor tissues from 263 cases of SCRC. The relationship of its expression to clinicopathologic parameters was analyzed. ResultsThe loss rates of hMLH1, hMSH2, and hMSH6 expressions in the tumor tissues from 263 patients with SCRC were 13.3% (35/263), 12.2% (32/263), and 28.9% (76/263), respectively. The loss rates of hMLH1/hMSH2, hMLH1/ hMSH6, hMSH2/hMSH6, and hMLH1/hMSH2/hMSH6 expressions were 3.4% (9/263), 10.2% (27/263), 6.8% (18/263), and 3.4% (9/263) corresponding. The loss rate of hMLH1 expression in the high differentiated adenocarcinoma tissues was significantly higher than that of the moderate to low differentiated adenocarcinoma or mucous carcinomas tissues (P < 0.01). The loss rate of hMLH2 expression in the tissues of tumor size more than 5 cm was significantly higher than that in the tissues of tumor size less than 5 cm (P < 0.05). The loss rate of hMSH6 expression in the male patient was significantly higher than that of the female patient (P < 0.01) and which in the tumor tissues of less lymph node metastasis was significantly higher than that in the tissues of the more lymph node metastasis (P < 0.01). ConclusionsThe hMLH1, hMSH2, or hMSH6 gene expression deletion is common in SCRC and the relation with the clinical pathology of SCRC is obviously different from Lynch syndrome. Therefore, the effects of hMLH1, hMSH2, and hMSH6 expressions on the development, invasion, and metastasis of SCRC are different from Lynch syndrome too.
Objective To detect the characteristic of multidrug resistance gene products expressions in gastric cancer tissues, including glutathione-s-transferase π (GST-π), P-glycoprotein (P-gp), topoisomerase Ⅱ (Topo-Ⅱ), thymidylate synthase (TS), and multidrug resistance related protein (MRP), and analyze their clinical significance for the therapy of gastric cancer. Methods SP immunohistochemical stain was used to detect GST-π, P-gp, Topo-Ⅱ, TS and MRP expressions in sample of 48 gastric cancer tissues and 10 normal gastric mucosa. And their corresponding clinical data were comprehensive analyzed. Results The expressions of GST-π, P-gp, Topo-Ⅱ, TS and MRP had notable differences between the gastric cancer tissues and normal gastric mucosa (GST-π： P＜0.01； P-gp： P＜0.01； Topo-Ⅱ： P＜0.01； TS： P＜0.05； MRP： P＜0.05). Positive expression rates of GST-π, P-gp, Topo-Ⅱ, TS and MRP in gastric cancer tissues were 72.9% (35/48), 56.3% (27/48), 83.3% (40/48), 41.7% (20/48) and 39.6% (19/48), and positive expression rates of them in normal gastric mucosa were 10.0% (1/10), 0 (0/10), 0 (0/10), 0 (0/10) and 0 (0/10) corresponding. Their positive expression rates were closely relevant to the degree of differentiation (P＜0.01), but not to the patients’ sex, age, tumour site, size of tumour, invasive depth and lymph node metastasis (Pgt;0.05). Conclusions The expressions of GST-π, P-gp, Topo-Ⅱ, TS and MRP in gastric cancer tissues exist obvious heterogeneity. Their overexpression underlie the multidrug resistance of gastric cancer. The joint detection of GST-π, P-gp, Topo-Ⅱ, TS and MRP can be looked as an important symbol for guiding its chemotherapy.
Objective To detect the expressions of epidermal growth factor receptor (EGFR), epidermal growth factor receptor-2 (C-erbB-2), vascular endothelial growth factor (VEGF) and cyclooxgenase-2 (COX-2) in gastric cancer tissues, and to analyze the relationship among them and the clinicopathologic factors of gastric cancer. Methods The SP immunohistochemical stain was used to detect EGFR, C-erbB-2, VEGF and COX-2 protein expressions in sample of 68 gastric cancer tissues. And their corresponding clinical data were analyzed retrospectively. Results The expression rates of EGFR, C-erbB-2, VEGF and COX-2 protein in gastric cancer tissue were 38.2% (26/68), 42.6% (29/68), 52.9% (36/68) and 60.3% (41/68) corresponding. An obvious increasing tendency as the differentiation of the cancer degraded, invasion depth deepened, lymphatic metastasis occurred and TNM stage upgraded was showed by the positive expression rates of them （P＜0.05，P＜0.01）; but there was no correlation with the patient’s sex, age, tumour site and size （Pgt;0.05）. There was a stable positive correlation among EGFR, C-erbB-2, VEGF and COX-2 expressions in gastric cancer tissue, respectively （P＜0.05）. Conclusion EGFR, C-erbB-2, VEGF and COX-2 expressions participate in the development, invasion and metastasis process of gastric cancer. Joint detection of them can be looked as an important symbol for judging the prognosis of gastric cancer and screening the high-risk metastasis patients, and guiding the molecular targeting therapy of gastric cancer.