The molecular mechanisms underlying the dysregulation of microRNAs (miRs) have been previously documented in breast cancer. miR-198 has been reported to be deregulated in several human cancers. However, the detailed effects of miR-198 on breast cancer progression remain unclear. Using quantitative polymerase chain reaction analysis, we demonstrated in the present study that miR-198 was downregulated in breast cancer tissues and cell lines, and that downregulation of miR-198 was significantly correlated with lymph node metastasis. Functional studies revealed that miR-198 inhibited cell proliferation and migration and promoted cell adhesion in aggressive breast cancer cells in vitro. In addition, we observed that CUB domain-containing protein 1 (CDCP1) was a direct target of miR-198, and that knockdown of CDCP1 inhibited cell proliferation and migration, and promoted cell adhesion, which was similar to the effects of overexpression of miR-198. Taken together, we provide evidence to characterize the role of miR-198/CDCP1 interaction in breast cancer, which may be useful in breast cancer therapy.

典型案例：胸内一科门诊来了一位老大爷，自述半年前淋雨受凉出现喷嚏咳嗽，自觉感冒了，到药店买了点药，几天后喷嚏好了，但咳嗽没完全好，自服氨苄青霉素，咳嗽有所好转，以为感冒引起的咳嗽，过段时间会全好。可断断续续的半声干咳半年，近期更是频繁，明显加重，前天还咳出了血丝痰。儿女赶紧带老人在当地医院拍片显示，右肺上出现一肿块，左肺上还有小结节。经湖南省肿瘤医院诊断为晚期肺癌。

The endothelin (ET)-1/endothelin A receptor (ETAR) axis is reportedly involved in tumor cell invasion, survival, and metastasis. However, the role of ETAR in colon cancer metastasis and the underlying mechanisms have not been defined. In the present study, we assessed the role of ETAR in colon cancer metastasis in vitro and in vivo. Overexpression and knockdown of ETAR were respectively performed in SW480 and SW620 human colon cancer cells. Overexpression of ETAR in SW480 cells significantly increased cell survival against cisplatin, cell invasion, and matrix metalloproteinase (MMP)-2 expression, which was strengthened by exogenous ET-1 and abolished by selective ETAR antagonist BQ123 and phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002. Knockdown of ETAR in SW620 cells markedly decreased cell survival against cisplatin, cell invasion, and MMP-2 expression, which was strengthened by BQ123 and LY294002, and partially rescued by exogenous ET-1. In a colon cancer liver metastasis mouse model, while ETAR overexpression promoted colon cancer liver metastases, ETAR knockdown markedly decreased liver metastases. In conclusion, our in vitro data demonstrate that ETAR mediates the promoting effects of ET-1 on colon cancer cell survival, invasion and MMP-2 expression by a PI3K-mediated mechanism. Our in vivo data indicate that ETAR markedly promotes colon cancer liver metastasis. This study provides direct evidence for a critical role of ETAR in colon cancer metastasis, which suggests that ETAR antagonism could benefit patients with metastatic colon cancer.

Discoidin domain receptors1 (DDR1) is associated with tumor progression, and its dysregulated expression has been observed in many cancers.

目的 探讨Trocar悬吊式免气腹腹腔镜下直肠癌根治术的可行性及特点.方法 分析22例在全麻下应用腹壁悬吊装置实施Trocar悬吊式免气腹腹腔镜直肠癌根治术(其中Dixon18例,Miles术4例)治疗的直肠癌患者的临床资料.所有患者术前均根据MRI分期,其中T1 5例,T212例,T35例;均为N0M0.结果 22例患者均手术成功,平均总手术时间为(140.2±12.4) min,腹腔镜下操作时间为(109.3±6.4)min,术后未出现并发症.平均住院时间(9.8±1.2)d,术后病理:切缘均无癌残留,平均淋巴结清扫数目为(15.2±2.8)枚.随访8 ～ 20个月未出现肿瘤复发及转移.结论 Trocar悬吊式免气腹腹腔镜下直肠癌根治术在技术上是可行的、安全的,可避免气腹对人体的影响,值得临床推广.

[目的]探讨结肠癌行右半结肠切除时十二指肠壁损伤的处理方法.[方法]比较造瘘与直接修补两组病人康复情况及并发症发生率的差异.[结果]造瘘组的并发症少于直接修补组,康复情况优于直接修补方法.[结论]十二指肠造瘘是右半结肠切除时十二指肠缺损的处理安全有效的方法之一.

[目的]探讨胃癌术后胃肠吻合口瘘的治疗方法与效果.[方法]对2例胃癌术后胃肠吻合口瘘患者的临床资料进行分析.[结果]2例患者均经通畅引流、抗炎补液、营养支持等措施治愈出院.[结论]对胃癌术后胃肠吻合口瘘患者,应根据患者具体情况实施个体化治疗方案治疗,效果可靠.

大肠癌早期常见粪便隐血 近年来,结直肠癌在我国的发病率和死亡率不断上升,每年新发病例已超过17万,死亡近10万,大多数临床就诊属中晚期病例.患者由于错过最佳治疗时机,5年生存率较低.美国目前人群结直肠癌5年生存率为64％,早期的达90％.以上海为例,结直肠癌的5年生存率仅44％. 结肠癌和直肠癌统称为大肠癌,是指大肠黏膜上皮,在环境或遗传等多种致癌因素作用下发生的恶性病变,预后不良,死亡率较高,是全世界最常见的恶性肿瘤之一.

Objective:To investigate the methods of surgical treatment for large primary liver cancer(LPLC).Methods:The clinical data of 180 patients with large LPLC admitted to our hospital from January 2002 to December 2009 were retrospectively reviewed.The presence of cirrhosis,tumor size,lesion location,clinical stage and comorbidities were analyzed.Results:All the 180 patients underwent surgical treatment,of whom 170 cases were hepatocellular carcinoma,7 cases were cholangiocarcinoma and 3 cases were mixed hepatic carcinoma.The average size(maximum diameter) of the tumors was 9(5.3-26.3) cm and 150 cases were accompanied with cirrhosis.Of the patients,anatomic hepatectomy was performed in 112 cases and non-anatomic hepatectomy was performed in 68 cases;the procedures were performed with pringle maneuver in 88 cases,selective hemihepatic vascular clamping in 62 cases,total hepatic vascular exclusion in 10 cases and without hepatic vascular occlusion in 20 cases,respectively.The incidence of postoperative complications was 13.89%(25/180) and the mortality was rate 1.61%(3/180).The 1-3-and 5-year overall survival rate of these patients was 76.11%,48.89% and 30.0%,respectively.Conclusion:Surgical resection-based comprehensive therapy is the main treatment method for large LPLC,and second-stage resection should be strived for after transcatheter arterial chemoembolization(TACE) for those presenting with formidable large LPLC.The rational choice of hepatic blood flow occlusion is a key to ensure operative success and smooth postoperative recovery.

Objective To prepare the mB7.1-GPI-surface-modified CMT93 colon cancer cell vaccine and investigate its anti-tumor effects. Methods mB7.1-GPI fusion protein was anchored on the membrane of colon cancer cells to prepare the mB7.1-GPI-anchored colon cancer cell vaccine, and the anchoring effect of this protein was detected through flow cytometry. C57BL/6 mice models of colon cancer cell were established to observe the immunotherapeutic effects of mB7.1-GPI-anchored colon cancer cell vaccine on mice bearing tumor. Results mB7.1-GPI fusion protein was stably anchored on the membrane of CMT93 colon cancer cells and effectively induced the proliferation of spleen cells as well as the secretion of IL-2 and IFN-γ. The mB7.1-GPI-surface-modified CMT93 colon cancer cell vaccine was capable of significantly inhibiting the growth of tumors in mice bearing tumor and prolonging their survival durations. Conclusion The tumor vaccine prepared by mB7.1-GPI fusion protein has effective anti-tumor effects. It may be used as a new type of cell vaccine in the prevention and treatment of colon cancer.

Objective To evaluate the clinical application of free grafting with the deep inferior epigastric perforator(DIEP) flap on one-stage breast reconstruction following adenomammectomy.Method Clinical results were retrospectively analyzed in 17 sufferers of breast cancer underwent free grafting with DIEP flap one-stage breast reconstruction following radical or modified radical adenomammectomy.Results All flaps survived,and all the reconstructions appeared good outline and good elasticity without fat liquefaction,contractural change,ventral hernia or bulge of abdominal wall.In the 15 cases who were followed up for 1 to 5 years,1 patient died of multiple metastases after 2 years and another patient abandoned treatment because of chest wall recurrence.Conclusions It is demonstrated that mammaplasty through DIEP flaps has much merits such as satisfactory outline,few complications in belly donor site,fine blood supply and abdominal wall reshaping simultaneously.It may be an ideal method of mammaplasty,and chemo or radiotherapy shows no impacts on the growth of flaps.

OBJECTIVE:To explore and evaluate the therapeutic efficacy of surgical treatment for cancer of the pancreatic head.METHODS:The clinical data of 96 patients with cancer of the pancreatic head admitted in our hospital from January 2002 to December 2009 were retrospectively analyzed. pancreatoduodenectomy was performed in 48 cases, extended pancreatoduodenectomy in 30 cases, and Roux-Y cholangiojejunostomy in 18 cases.RESULTS:The 1, 2 and 3-year survival rates were 59.2%, 41.8% and 13.2%, respectively, in the patients treated with pancreatoduodenectomy, and 73.2%, 58.2% and 24.1%, respectively, in the patients treated with extended pancreatoduodenectomy. The 1, 2 and 3-year survival rates were 36.8%, 15.8% and 5.3%, respectively, in the patients with unresectable tumor who received radiotherapy and (or) chemotherapy in Roux-Y cholangiojejunostomy. The postoperative morbidity was 29.2%, 30.0% and 27.8% in the patients treated with pancreatoduodenectomy, extended pancreatoduodenectomy and Roux-Y cholangiojejunostomy, respectively.CONCLUSIONS:Pancreatoduodenectomy is the most effective treatment. Extended pancreatoduodenectomy can improve the surgical resection rate, reduce the recurrence rate and improve the survival rate. Internal drainage is an important palliative measure.

Objective To explore the clinical value of celiac branch of vagus nerve-preserving radical gastrectomy.Methods A total of 128 gastric cancer patients were randomly divided into observation group(n=64) receiving celiac branch of vagus nerve-preserving radical gastrectomy and control group(n=64) receiving traditional classic radical resection.The two groups were compared gastro-intestinal dynamics and hormone levels.Results The first exhaust time and the first bowel movement were better in the observation group than the control group(P<0.05),while the number of lymph node dissection had no significant difference(P>0.05).The basis levels of observed serum gastrin and gastric acid secretion were significantly lower in the observation group than those in the control group(P<0.05).There was no significant difference of the fasting serum insulin levels(P>0.05).The fasting plasma pancreatic polypeptide levels was significantly higher in the observation group than the control group(P<0.05).Conclusion Abdominal vagus nerve branch retention of the radical surgery for gastric cancer patients can accelerate the recovery of gastrointestinal function and get better nutrient absorption.

Objective Comparing young and old patients the clinical and pathological features of gastric cancer.Methods Retrospective analysis of 680 cases of our hospital on clinical data,the study group of young patients,in elderly patients in the control group to compare the two groups were gender,family history of gastric cancer,clinical symptom,diagnosis time,lesions,Borrmann type,histological type,stage,metastasis,treatment method,such as differences in survival.Results 680 cases of 64 cases of young patients with gastric cancer incidence 9.41% of women in the two groups over the observation group,a high proportion of gastric cancer family history,clinical manifestation is not specifi c,confi rmed a long time,Borrmann Ⅲ,Ⅳ type mainly to low-undifferentiated adenocarcinoma,Ⅲ-Ⅳ of the majority,transfer rate,multi-choice surgical treatment(P>0.05);the two groups showed no difference in survival(P>0.05).Conclusion Higher incidence of gastric cancer in young,clinical lack of specifi city,the specifi c infi ltration capacity,a vicious high,with rapid,high rate of missed diagnosis,early metastasis,etc,that should be promptly diagnosed,early underwent endoscopy,surgery is still the most effective treatment.

大部分附睾肿瘤是良性肿瘤,恶性肿瘤少见.原发性附睾平滑肌肉瘤临床更是罕见,文献报道少.本院收治1例,结合国内外文献复习报告如下.

Objective To evaluate the therapeutic effects of the surgical treatment for primary retroperitoneal malignant tumor.Methods The clinical data of 120 primary retroperitoneal malignant patients were analyzed retrospectively.All the cases were examined by ultrasound,CT/MRI,and 8 cases of DSA,28 cases of IVP.The surgical treatments were achieved in 88 cases of radical excision,18 of palliated excision,and 14 of biopsy only.Results The 1-,3-,and 5-year overall survival rates of 88 cases with curative resection were 100.0%,91.2% and 25.1% respectively,and the 1-,3-,and 5-year overall survival rates of 18 cases with palliative resection were 34.1%,27.7% and 7.2% respectively.There were significant differences between the two groups(P0.05).Conclusions It is important of B-ultrasonography,CT,MRI and DSA for the preoperative evaluation in primary retroperitoneal malignant tumor.Surgical resection is an effective way for primary retroperitoneal malignant tumor,and multiple organs combined resection increases the success rate of tumor resection.Excellent surgical technique is the key to improve the tumor resection rate.

目的 探讨放射性膀胱炎出血的治疗方案.方法 本组41例放射性膀胱炎出血的患者.采用膀胱灌注甲醛,经尿道电凝,高压氧治疗.结果 41例患者经过不同的方法 出血均得到治愈.结论 放射性膀胱炎根据病情特点不同采用膀胱灌注甲醛,经尿道电凝,高压氧治疗可取得满意的效果.

Objective To investigate the effect of surgical treatment for liver metastasis from rectal cancer.Methods Clinical data of 186 cases with hepatic metastasis from rectal cancer were analyzed retrospectively with regard to surgical methods and survival rates.There were 96 cases of hepatectomy group received radical resection of rectal carcinoma and hepatectomy simultaneouly,in whom 83 received FOLFOX chemotherapy or TPVCE interventional therapy.There were 90 cases of non-hepatectomy group underwent radical resection of rectal carcinoma only,and 58 cases were treated by FOLFOX chemotherapy or TPVCE interventional therapy,20 by combined anhydrous alcoho intratumoral injection,and 12 by combined radiotherapy.Results The 1-and 3-year overall survival rate of the hepatectomy group was 79.8% and 44.2% respectively.The 1-and 3-year overall survival rate of the non-hepatectomy group was 55.1% and 20.1% respectively.The meso-survival time was 19(5～38) months and 14(3～37) months respectively in the hepatectomy group and the non-hepatectomy group.The survival rates and the meso-survival time between the two groups had significant differences(P0.05).Conclusion Hepatectomy can achieve best therapeutic effect for hepatic metastasis from rectal cancer.The surgical treatment combined with the chemotherapy can improve the survival rate and prevent the tumor recurrence.

[目的]探讨S100P在膀胱移行细胞癌(BTCC)组织中的表达与意义.[方法]应用免疫印迹法检测45例BTCC及15例正常膀胱组织中S100P的表达.[结果]膀胱肿瘤中S100P蛋白表达高于正常膀胱组织中S100P的表达(P＜0.05);在中低分化膀胱肿瘤组中S100P的表达高于高分化膀胱肿瘤组中S100P的表达(P＜0.05);在浸润性膀胱肿瘤组中S100P的表达高于浅表性膀胱肿瘤组中S100P的表达(P＜0.05).[结论]S100P在BTCC的发生、发展中起重要作用.

【Objective】To observe the expressions of transforming growth factor beta Ⅰgene(TGF-β1),P-glycoprotein(P-gp) and glutathione S-transferase-π(GSTπ) in pericancerous colorectal mucosa tissues and colorectal cancer tissue and to investigate the correlation of the expressions of P-gp,GST-π and TGF-β1 with clinical pathological parameters and recurrence or metastasis in colorectal cancer.【Methods】 The expressions of TGF-β1,P-gp and GST-π were detected in forty eight cases of colorectal cancer tissue and forty five cases of pericancerous colorectal mucosa tissues by immunohistochemistry.The correlations of P-gp,GST-π and TGF-β1 expression with clinical pathological parameters,recurrence or metastasis in colorectal carcinoma were analyzed,and the correlation of P-gp,GST-π and TGF-β1 expression were analyzed as well.【Results】 The expression levels of TGF-β1,P-gp and GST-π in colorectal cancer tissue were significantly higher than those of pericancerous mucosa tissues.The expressions of P-gp and GST-π in colorectal carcinoma were not associated with patients' age,sex,tumor size,histological grade,infiltration depth,Dukes staging and lymph node metastasis.The expression of TGF-β1 in colorectal carcinoma was not associated with patients' age,sex,histological grade,but associated with tumor size,Dukes staging.The expressions of P-gp,GST-π and TGF-β1 in colorectal cancer tissue with recurrence or metastasis were significantly higher than those without recurrence or metastasis.The expression of P-gp in colorectal cancer tissue was well correlated with that of GSTπ,but it was well correlated with that of TGF-β1.There was no correlation between the expression of GST-π and TGF-β1.【Conclusion】 Detecting the expressions of TGF-β1 and P-gp,GST-π in colorectal carcinoma may be helpful to predict prognosis and choice of chemotherapy.