Primary pancreatic lymphoma: A population-based analysis using the Surveillance, Epidemiology and End Results database

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Background: Primary pancreatic lymphoma (PPL) is a rare disease, accounting for only 0.5% of all pancreatic masses. The clinical presentation of PPL is similar to that of pancreatic adenocarcinoma and the two are difficult to distinguish radiographically. A paucity of literature exists on the epidemiology and outcomes of PPL. Given the limited case reports published on PPL, a comparison of the different treatment modalities has previously not been possible. Here, we present a series of 523 cases of PPL obtained from the Surveillance, Epidemiology, and End Results (SEER) database to investigate the tumor characteristics and compare the different treatment modalities.

Methods: Patients diagnosed with a primary pancreatic lymphoma from 1973-2007 were identified. Data on patient and tumor characteristics as well as initial treatment with surgery or radiation was extracted. Chemotherapy information is not available through SEER. Overall survival was calculated using the Kaplan-Meier method. A multivariate analysis was performed to determine independent prognostic factors predicting for survival using a Cox proportional hazards model.

Results: Fifty-eight percent of patients identified were male. The median age range at diagnosis was 65-69 years (range, 10-14 years – greater than 85 years). The most common histologic subtype in the present series was diffuse large B-cell lymphoma (DLBCL), which accounted for 71% of all patients. The 5-year overall survival for the group was 47%. Multivariate analysis indicates that age >60 and a marital status of single were predictive of a decreased cause-specific and overall-survival specific survival (p<0.05). Radiation therapy, but not surgery, was predictive of an improved overall survival (p<0.05).

Conclusions: PPL is a rare form of extra-nodal NHLs of the GI tract. Adjuvant radiation therapy for patients with a PPL should be strongly considered and a surgical treatment should be avoided if an early diagnosis is established. A prospective study evaluating this patient population will be difficult given the rarity PPL. We hope that this case series will provide a context in evaluating and treating patients with PPL.

No significant financial relationships to disclose.

Abstract P3-10-41: Quantitative Immunohistochemical Analysis and Prognostic Significance of TRPS-1, a New GATA Transcription Factor Family Member, in Breast Cancer

The Trichorhinophalangeal Syndrome-1 gene (TRPS-1) is a novel GATA transcription factor family member expressed in &gt;90% of human breast cancers. In this study, we developed a new quantitative IHC (qIHC) method to study TRPS-1 as a possible indicator ofprognosis in BC. Using this method, a quantitative parameter for TRPS-1 expression called a Quick Score (QS) was derived from the measured Labeling Index (LI) and Mean Optical Density (MOD) after IHC and applied to a set of 152 Stage II/III BC patients from 1993-2006 who did not receive preoperative chemotherapy. Although highly prevalent in BC, a wide range of TRPS-1 QS was found among the sample set with higher TRPS-1 QS significantly associated with tumor ER-alpha (p= 0.023 for QS, and p= 0.028 for Allred score), PR (p= 0.009), GATA-3 (P&lt;0.0001), and E-cadherin (p&lt; 0.001). TRPS-1 QS was also positively associated with HER2 status (p=0.026). Analysis of different ductal structures revealed that TRPS-1 was expressed at low levels in normal ducts and in usual ductal hyperplasia, but showed a marked increase in DCIS and invasive carcinoma lesions. An analysis of TRPS-1 expression in association with overall survival revealed that TRPS-1 QS (≥4.0) was significantly associated with improved survival (p=0.0165). Patients with TRPS-1 QS &lt;4 had a hazard ratio of 2 (p=0.019) after univariate Cox proportional hazards analysis. Further analysis of the patient samples revealed an ER-/lo, HER2+ (amplified) BC subset in which TRPS-1 expression above a critical quantitative threshold was predictive of greatly improved survival (median survival not reached after 10 years), while patients in this subset with TRPS-1 expression below this threshold having a median survival of less than 5 years. In summary, this new qIHC approach revealed critical differences in TRPS-1 expression in primary BC samples and found that this new GATA family member may be a promising positive prognostic marker that may regulate BC progression. In addition, TRPS-1 may also be a relevant new marker in a luminal ER-/low, HER2+ BC subset.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-41.

The indication and surgical results of local excision following radiotherapy for low rectal cancer

AIM

Radical surgery of rectal cancer is associated with significant morbidity, and some patients with low-lying lesions must accept a permanent colostomy. The objective of this study was to evaluate the outcome of local excision followed by adjuvant radiotherapy for rectal cancer for curative purposes.

METHOD

One hundred and seven patients with rectal carcinoma performed with local excision were analysed retrospectively.

RESULTS

The procedures of local excision were trans-anal resection in 83 patients, trans-sacral resection in 16, trans-sphincteric local resection in five, and trans-vaginal resection in three. The overall disease-free survival rate was 80.4% (86/107), including 90.0% (54/60) for T1 and 72.3% (34/47) for T2 tumours, respectively. Eighty-two of 107 patients underwent adjuvant postoperative radiotherapy after local excision, and 25 did not, and the DFS rates between radiation and nonradiation group were significantly different for T2 [81.6% (31/38) vs 33.3% (3/9), P < 0.05], but not for T1 tumours (90.9%vs 87.5%, P > 0.05). The rates of local recurrence and distant metastasis were 13.1% (14/107) and 4.7% (5/106), respectively, and the median time to relapse was 15 months (range: 10-53) for local recurrence and 30 months (21-65) for distant recurrence. The risk factors for local recurrence were large tumour (≥3 cm), poorly differentiated adenocarcinoma and T2 tumour.

CONCLUSIONS

Local excision followed adjuvant radiotherapy is an alternative and feasible technique for small T1 rectal cancer in selected cases.

Waist-to-height ratio, an optimal predictor for obesity and metabolic syndrome in Chinese adults

OBJECTIVE

Anthropometric indices to obesity were evaluated as predictors of metabolic syndrome risk factors. Our purpose was to explore an optimal or more reliable anthropometric indicator and optimal cut-off points for obesity on metabolic syndrome in Chinese adults.

PARTICIPANTS AND METHODS

The survey was conducted involving 2947 participants, aged 20 or above with cross-sectional study of population. The predictive validity and optimal cut-off values were analyzed by receiver operating characteristic (ROC) curves, area under curve (AUC) and the largest Youden's index (sensitivity + specificity - 1) by gender group, respectively. Kappa value showed diagnostic consistency.

RESULTS

According to the criteria of CDS 2004, IDF 2005 and AHA/NHLBI 2005, the prevalence of metabolic syndrome was 10.32%, 9.64% and 16.12% respectively, which indicated that the prevalence was higher in men than in women and increased with age (P < 0.05). The BMI, WC, WHR and WHtR in metabolic syndrome patients were greater than those in healthy volunteers and the indices in men were higher than those in women. With adjusted age and gender, the partial correlation coefficient for BMI-WC, BMI-WHR and BMI-WHtR was 0.7991, 0.5278 and 0.8196, respectively (P < 0.05). The area under curves (AUCs) of receiver operating characteristic (ROC) curves for WHtR was larger (P < 0.05) than that for WC and WHR. The cut-point of WHtR was approximately 0.5 in both genders with a satisfactory balance between sensitivity and specificity, where the Kappa (k) value for WHtR-BMI was higher than that for WHtR-WHR, and WHtR-WC.

CONCLUSIONS

The results indicated that WHtR might be an optimal anthropometric predictor of metabolic syndrome risk factors and the cut-point of WHtR was approximately 0.50 in both genders of Chinese adults.

Effects of the thyroid hormone responsive spot 14alpha gene on chicken growth and fat traits

The thyroid hormone responsive spot 14alpha (THRSPalpha) gene plays important roles in chicken growth and fat deposition. The aim of this study was to identify new variations in the gene to determine their effects on growth and fat traits in chicken and to observe the effects of the THRSPalpha gene on chicken lipid profile and lipoprotein and glucose and triiodothyronine effects on the THRSPalpha expression in liver and fat cells. Two new variations, namely A197835978G and G197836086A, and a reported 9-bp insertion-deletion (indel) of the THRSPalpha gene were genotyped by single-stranded conformational polymorphism in a Xinghua x White Recessive Rock F(2) full-sib resource population. The results showed that the A197835978G was significantly associated with hatch weight and BW at 28 d of age and breast muscle weight at 90 d of age in chickens (P < 0.05). The G197836086A was significantly associated with cingular fat width (P = 0.0349) and breast muscle crude fat content (P = 0.0349). The indel was significantly associated with abdominal fat weight (P = 0.0445). The above new THRSPalpha polymorphisms were also significantly associated with the total cholesterol and low-density lipoprotein, in which the THRSPalpha GA/AG genotype was associated with lipid and lipoprotein and the THRSPalpha BB indel genotype was significantly associated with liver weight in chicken breeds. The mRNA expression analysis in vivo and in vitro culture studies suggested that the THRSPalpha gene is more responsive to glucose than triiodothyronine. In conclusion, the 3 variations of the chicken THRSPalpha gene were associated with both growth and fat traits in this study. Such effects of the THRSPalpha gene were further supported from the data of observations in association analysis of the gene with phenotypic records and plasma lipid profiles, in the THRSPalpha gene expression in chicken development, and in vivo and in vitro cell culture observation of liver and abdominal fat tissues.

The clinicopathological behaviour and surgical treatment of abdominal Castleman's disease

INTRODUCTION

Castleman's disease, a rare atypical lymphoproliferative disorder of the lymphoid tissue with unknown cause, remains a diagnostic challenge. This study was conducted to analyse the clinicopathological behaviour and reasonable surgical treatment for patients with abdominal Castleman's disease.

METHODS

The medical records of seven patients with abdominal Castleman's disease were reviewed.

RESULTS

The patients comprised two men and five women, and their median age was 42.3 (range 29-53) years. The main clinical manifestation was an abdominal mass or an enlargement of the retroperitoneal lymph node. Other clinical manifestations included anaemia, loss of body weight and hypoalbuminaemia. The mean size of the tumour was 5.5 (range 4.0-8.0) cm. Postoperatively, all the patients were diagnosed with a hyaline vascular type of the disease, and had localised manifestations of the disease. All seven patients underwent complete surgical resection, two of whom also received adjuvant irregular chemotherapy (CHOP) and steroids postoperatively. All the patients survived, with no evidence of recurrence. One patient had survived for more than two years, four patients for more than three years, and two patients for more than five years.

CONCLUSION

Abdominal Castleman's disease is difficult to diagnose preoperatively, and surgical excision remains the treatment of choice, especially for localised disease.

Associations of ATGL gene polymorphisms with chicken growth and fat traits

Adipose triglyceride lipase (ATGL) catalyses the initial step in triglyceride hydrolysis, so the ATGL gene is a candidate for growth and fat traits in chickens. Nine reported single-nucleotide polymorphisms (SNPs) located in 3 exons of the chicken ATGL gene were chosen for genotyping an F2 population. Only 5 SNPs were confirmed for polymorphisms and used for association analyses. The results show that c.531G>A (p.E177Syn) was not associated with any growth and fat traits (P > 0.05), but c.782G>A (p.S261N) was associated with body weight (BW) on days 14, 21, 35, 63, 70, 77, cingulated fat width and abdominal fat pad weight (P < 0.05), and significantly associated with BW on days 42, 49, and 56 (P < 0.01). Significant associations of c.903C>T (p.F301Syn) with BW on days 49 and 77 days and crude protein content of breast muscle (P < 0.05), and c.1164G>A (p.K388Syn) with BW on day 7 (P < 0.05) were also detected. Additionally, c.1069T>C (p.L357Syn) was associated with breast muscle colour (P < 0.05), and significantly associated with crude fat (ether extract) content of breast muscle (P < 0.01). Thus the missense SNP of c.782G>A (p.S261N) was significantly associated with the largest number of chicken growth and fat traits in this study.

Evaluation of a school-based HIV/AIDS peer-led prevention programme: the first intervention trial for children of migrant workers in China

The effectiveness of a peer-led education intervention in HIV/AIDS prevention was assessed in the Chinese children of migrant workers. A prospective study was conducted in 12 junior high schools for migrant children. Among the intervention group, a peer-education-based HIV/AIDS prevention was implemented for three months. The results during the baseline survey indicated that the level of knowledge on HIV/AIDS was lower in children of migrant workers. After three months of peer-led intervention, compared with the control group, students in the intervention group positively increased their HIV/AIDS-related knowledge, modified their attitude and improved their protection self-efficacy. Compared with attitude, intervention was more effective in the improvement of knowledge and protection self-efficacy, especially knowledge. The findings suggest that peer-led education was an effective method in improving knowledge, attitude and protection self-efficacy in Chinese children of migrant workers. Heightened concerns targeting the group students were particularly necessary, given their lower level of related knowledge and vulnerability to HIV infection.

Skin and soft tissue infections caused by community-associated methicillin-resistant staphylococcus aureus among children in China

AIM

To investigate the characteristic of community-associated methicillin-resistant staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) among children in China.

METHODS

Forty-seven children with CA-MRSA SSTIs were enrolled in this study. Clinical information was collected and analysed. The strains from the children were analysed by multilocus sequence typing (MLST), staphylococcus cassette chromosome mec (SCCmec) typing and spa typing. The Panton-Valentine leukocidin (PVL) gene was also detected.

RESULTS

The majority of the 47 cases were impetigo (20; 42.6%) and abscesses (14; 29.8%). The rest was cellulites, infected wounds, omphalitis, paronychia and conjunctivitis combined folliculitis. Thirty-two of the isolates (68.1%) were PVL-positive, and the abscesses infected with PVL-positive strains usually required incision and drainage (87.5% vs. 16.7%, p = 0.026). Most of the isolates belonged to ST type 59, which accounted for 46.8%, followed by ST1 (7/47, 14.9%) and ST910 (5/47, 10.6%). The clone of ST59-MRSA-IV with t437 was the most prevalent one. The multiresistant rate of these strains was 93.6%.

CONCLUSION

The most common disease of CA-MRSA SSTIs was impetigo, and PVL-positive abscess was associated with incision and drainage. ST59-MRSA-IV with t437 was the most prevalent clone, and the multiresistant rate was high in Chinese children.

Graph-theory based parcellation of functional subunits in the brain from resting-state fMRI data

Resting-state fMRI provides a method to examine the functional network of the brain under spontaneous fluctuations. A number of studies have proposed using resting-state BOLD data to parcellate the brain into functional subunits. In this work, we present two state-of-the-art graph-based partitioning approaches, and investigate their application to the problem of brain network segmentation using resting-state fMRI. The two approaches, the normalized cut (Ncut) and the modularity detection algorithm, are also compared to the Gaussian mixture model (GMM) approach. We show that the Ncut approach performs consistently better than the modularity detection approach, and it also outperforms the GMM approach for in vivo fMRI data. Resting-state fMRI data were acquired from 43 healthy subjects, and the Ncut algorithm was used to parcellate several different cortical regions of interest. The group-wise delineation of the functional subunits based on resting-state fMRI was highly consistent with the parcellation results from two task-based fMRI studies (one with 18 subjects and the other with 20 subjects). The findings suggest that whole-brain parcellation of the cortex using resting-state fMRI is feasible, and that the Ncut algorithm provides the appropriate technique for this task.

Adaptive regularization using the entire solution surface

Several sparseness penalties have been suggested for delivery of good predictive performance in automatic variable selection within the framework of regularization. All assume that the true model is sparse. We propose a penalty, a convex combination of the L₁- and L_∞-norms, that adapts to a variety of situations including sparseness and nonsparseness, grouping and nongrouping. The proposed penalty performs grouping and adaptive regularization. In addition, we introduce a novel homotopy algorithm utilizing subgradients for developing regularization solution surfaces involving multiple regularizers. This permits efficient computation and adaptive tuning. Numerical experiments are conducted using simulation. In simulated and real examples, the proposed penalty compares well against popular alternatives.

The transcriptional network controlling pluripotency in ES cells

Embryonic stem (ES) cells are capable of continuous self-renewal and pluripotential differentiation. A "core" set of transcription factors, Oct4, Sox2, and Nanog, maintains the ES cell state, whereas various combinations of factors, invariably including Oct4 and Sox2, reprogram somatic cells to pluripotency. We have sought to define the transcriptional network controlling pluripotency in mouse ES cells through combined proteomic and genomic approaches. We constructed a protein interaction network surrounding Nanog and determined gene targets of the core and reprogramming factors, plus others. The expanded transcriptional network we have constructed forms the basis for further studies of directed differentiation and lineage reprogramming, and a paradigm for comprehensive elucidation of regulatory pathways in other stem cells.

HIV/AIDS-related knowledge, sources and perceived need among senior high school students: a cross-sectional study in China

This study aimed to assess HIV/AIDS-related knowledge, sources and perceived need among senior high school students in China. A total of 2668 senior high school students aged 15.17–23.42 years participated in the survey. A self-administered questionnaire was used to collect information on HIV/sexually transmitted infection-related knowledge, sources and perceived information need. The results showed that levels of HIV/AIDS knowledge were distributed as follows: low for 6.8%, moderate for 29.6% and high for 63.7%. The most important information sources were, in rank order, TV/photographic recording (72.1%), school heath education curriculum (51.8%) and reading materials (45.7%). About half of the students, 46.3%, confirmed a need for more information and 87.8% of the sampled senior high school students communicated with others if he/she had problems related to HIV/AIDS. Strengthening and improving information sources, particularly its accuracy and comprehensiveness, would help in ensuring that adolescents obtained the HIV/AIDS health information they needed.

Factors associated with bed and room sharing in Chinese school-aged children

BACKGROUND AND OBJECTIVES

Co-sleeping (bed or room sharing) has potential implications for children's development. Previous studies showed that co-sleeping was more prevalent in non-Western countries than in Western countries, which demonstrated that co-sleeping was marked with ethnic and socio-cultural background characteristics. The purpose of this study was to survey the prevalence of bed and room sharing and to examine related factors among school-aged children in an Asian country - China.

METHODS

A cross-sectional questionnaire survey was conducted in 10 districts of Shanghai, China from November to December 2005. A total of 4108 elementary school children, 49.2% boys and 50.8% girls with a mean age of 8.79 years, participated. Parent-administered questionnaires were used to collect information about children's sleeping arrangements and socio-demographic characteristics.

RESULTS

The prevalence of routine bed sharing, room sharing and sleeping alone in Chinese school-aged children was 21.0%, 19.1% and 47.7%, respectively. Bed and room sharing didn't show significant gender difference but gradually decreased with increasing age. Multivariate logistic regression identified those factors associated with bed and room sharing: younger age, large family, children without their own bedroom and parents' approval of a co-sleeping arrangement.

CONCLUSION

Co-sleeping arrangement was a common practice in Chinese school-aged children. Associated factors were characterized by intrinsic socio-cultural values and socio-economic status in China.

Assessment of mitral valve volume by quantitative three-dimensional echocardiography in patients with rheumatic mitral valve stenosis

BACKGROUND

Thickening of mitral leaflets in rheumatic mitral valve stenosis is well described in necropsy studies; however, volume computation of the thickening mitral leaflets has not been attempted. 4trial fibrillation is one of the complications of rheumatic mitral stenosis. Quantitative assessment of thickened mitral valve and its relation to clinical complications is clinically desirable.

HYPOTHESIS

The study was undertaken to compare measurement of mitral valve volume in normal subjects and in patients with rheumatic mitral valve stenosis.

METHODS

An HP Sonos 2500 echocardiographic system with 5 MHz multiplane transesophageal transducer was used for data acquisition, and TomTec Echoscan computer setup was used to off-line volume computation. Study subjects included 10 normal subjects (mean age 44.8 years) and 36 patients with rheumatic mitral valve stenosis (22 female, 14 male) with an age range of 25 to 69 years (mean age 47 +/- 9.6 years). Mitral valve volumes were compared between the normal subjects and patients with mitral valve stenosis, and further comparison was made between the sinus rhythm (SR) and atrial fibrillation (AF) groups in patients with mitral valve stenosis. In all study subjects, the mitral valve area (MVA) was determined by two-dimensional echocardiography.

RESULTS

Quantitative three-dimensional (3-D) echocardiography showed that mitral valve volume was significantly larger in patients with mitral valve stenosis than in normal subjects (9.0 +/- 2.2 and 4.5 +/- 0.7 ml, respectively, p < 0.001). When patients with mitral valve stenosis were divided into the SR and AF groups, mitral valve volume was found to be significantly larger in the AF group than in the SR group (9.76 +/- 2.2 ml. and 7.72 +/- 1.5 ml, respectively, p < 0.01) and patients in the AF group tended to be older (p < 0.05) with larger left atrial diameter (LAD) (p < 0.01). However, MVA between the two groups showed no statistical significance (1.1 +/- 0.43 and 1.0 +/- 0.34 cm2, respectively, p > 0.2). When the study subjects were divided into two groups (< 50 and > or = 50 years) according to age, the comparison of mitral valve volume between these two groups (9.37 +/- 2.18 and 8.56 +/- 2.14 ml, p > 0.2) showed no statistical significance.

CONCLUSIONS

Quantitative 3-D echocardiography can be applied for the measurement of mitral valve volume in vivo. Patients with rheumatic mitral valve stenosis with atrial fibrillation have a propensity to have a larger mitral valve volume and are older than the patients with sinus rhythm; however, the age per se does not seem to be a cause for larger mitral valve volume.