简介：Objective:Toexploretheclinicopathologicalfeatures,surgicaltreatmenttechniques,andprognosticriskfactorsofintrahepaticcholangiocarcinoma(ICC).Methods:Atotalof104ICCcaseswerecollectedfromJanuary2008toDecember2013atTianjinMedicalUniversityCancerInstituteandHospitalanddividedintothehepatichilumlymphadenectomy(HLL,21cases),extendedhepatichilumlymphadenectomy(EHLL,12cases),andnon-lymphadenectomy(NL,71cases)groups.Theclinicaldataofthepatientswereretrospectivelyanalyzed,andtheprognosticdifferenceswerecomparedamongdifferentgroups.Results:The1-,2-,and3-yearoverallsurvival(OS)ratesofallcaseswere72.1%,56.1%,and43.7%,respectively.Themediansurvivaldurationwas34months.The1-,2-,and3-yearOSratesoftheHLLgroup(42.9%,28.6%,and28.6%,respectively)weresignificantlylowerthanthoseoftheNLgroup(78.9%,62.5%,and47.8%,respectively).Meanwhile,the1-,2-,and3-yearOSratesoftheEHLLgroup(75.0%,56.1%,and33.3%,respectively)werenotsignificantlydifferentfromthoseoftheothertwogroups.Univariateanalysisshowedthatage,gender,AmericanJointCommitteeonCancer(AJCC)stage,differentiation,ferritin(Fer),carbohydrateantigen19-9(CA19-9)andcarcinoembryonicantigen(CEA)levels,lymphnodemetastasis(LNM),andlymphnodedissection(LND)wereprognosticfactorsforthelong-termsurvivalofICC.Meanwhile,multivariateanalysisrevealedthatage,AJCCstage,differentiation,Ferlevels,andLNMwereindependentriskfactorsforsurvival.Conclusions:ICCpatientswillnotbenefitfromlymphadenectomyintheabsenceofLNM.However,systematiclymphadenectomymayimproveICCoutcomesifthelocationoflymphaticmetastasisisknown.Age,AJCCstage,differentiation,Ferlevel,andLNMareindependentriskfactorsforsurvivalinICC.

简介：瞄准：与积极浆液a-fetoprotein(法新社)在病人探索肝内cholangiocarcinoma(国际计算中心)的临床病理特征。方法：为病理地证实的国际计算中心经历了外科的解剖的一百和三十一个病人被划分成一个积极法新社(>20ng/mL)组(n=32)并且一个否定法新社组(n=99)，特征其临床病理被分析并且比较。结果：HBsAg的积极的率和积极法新社组的肝肝硬化比否定法新社组的高，当时CA19-9的积极的率(>37U/mL)并且淋巴节点转移率更低。结论：有积极法新社的国际计算中心病人与肝细胞癌分享许多临床病理类似。

简介：AIM:Todeterminetheclinicalvalueofdiffusion-weight-edimaging(DWI)forthediagnosisofextrahepaticcholangiocarcinoma(EHCC)bycomparingthediagnosticsensitivityofDWIandmagneticresonancecholan-giopancreatography(MRCP).METHODS:Magneticresonanceimagingexaminationwasperformedin56patientswithsuspectedEHCC.T1-weightedimaging,T2-weightedimaging,MRCPandDWIsequence,DWIusingsingle-shotspin-echoechoplanarimagingsequencewithdifferentbvalues(100,300,500,800and1000s/mm2),wereperformed.Allcaseswerefurtherconfirmedbysurgeryorhistopathologicaldiagnosis.TworadiologistsjointlyperformedtheanalysisoftheDWIandMRCPimages.Apparentdiffusioncoefficient(ADC)valueandsignal-noiseratiowerecalculatedforEHCC.Sensitivity,specificity,accuracy,positivepredictivevalueandnegativepredictivevalueweretestedusingDWIwithabvalueof500s/mm2andMRCPimages,respectively.RESULTS:Histopathologicaldiagnosisconfirmedthatamongthe56cases,35wereEHCC(20hilarand15distalextrahepatic),16werecholangitis,and5werecal-culusofbileduct.Thirty-threeoutofthe35EHCCcasesweredetectedbyDWI.EHCCexhibiteddifferentiallevelsofhighsignalintensityinDWIandlowsignalintensityintheADCmap.ThemeanvalueforADCwas(1.31±0.29)×10-3mm2/s.ThedetectionrateofEHCCwassignificantlyhigherbyDWI(94.3%)thanbyMRCP(74.3%)(P<0.05).Therewasasignificantdifferenceinsensitivity(94.3%vs74.3%),specificity(100%vs71.4%),accu-racy(96.4%vs73.2%),positivepredictivevalue(100%vs81.3%),andnegativepredictivevalue(91.3%vs62.5%)betweenDWIandMRCPindiagnosingEHCC.CONCLUSION:DWIhasahighsensitivityforthedetectionofEHCCasitshowstheEHCClesionmoreunambiguouslythanMRCPdoes.DWIcanalsoprovideadditionalclinicallyimportantinformationinEHCCpatientswhenaddedtoroutinebileductMRimagingprotocols.

简介：AIM:NitrativeandoxidativeDNAdamagesuchas8-nitroguanineand8-oxo-7,8-dihydro-2'-deoxyguanosine(8-oxodG)formationhasbeenimplicatedininitiationand/orpromotionofinflammation-mediatedcarcinogenesis.TheaimofthisstudyistoclarifywhethertheseDNAlesionsparticipateintheprogressionofintrahepaticcholangiocarcinoma.METHODS:Weinvestigatedtherelationoftheformationof8-nitroguanineand8-oxodGandtheexpressionofhypoxia-induciblefactor-1α(HIF-1α)withtumorinvasionin37patientswithintra-hepaticcholangiocarcinoma.RESULTS:Immunohistochemicalanalysesrevealedthat8-nitroguanineand8-oxodGformationoccurredtoamuchgreaterextentincanceroustissuesthaninnon-canceroustissues.HIF-1αcouldbedetectedincanceroustissuesinallpatients,suggestinglowoxygentensioninthetumors.HIF-1αexpressionwascorrelatedwithinduciblenitricoxidesynthase(iNOS)expression(r=0.369andP=0.025)and8-oxodGformation(r=0.398andP=0.015).DoubleimmunofluorescencestudyrevealedthatiNOSandHIF-1αco-localizedincanceroustissues.Notably,theformationof8-oxodGwascorrelatedsignificantlywithlymphaticinvasion(r=0.386andP=0.018).Moreover,8-nitroguanineand8-oxodGinnon-canceroustissueswereassociatedsignificantlywithneuralinvasion(P=0.042andP=0.026,respectively).TheseresultssuggestthatreciprocalactivationbetweenHIF-1αandiNOSmediatespersistentDNAdamage,whichinducestumorinvasivenessviamutations,resultinginpoorprognosis.CONCLUSION:Theformationof8-nitroguanineand8-oxodGplaysanimportantroleinmultiplestepsofgeneticchangesleadingtotumorprogression,includinginvasiveness.

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