[Up-regulation of DLK1 in non-small cell lung cancer and the relevant molecular mechanism]

OBJECTIVE

To explore the expression of delta-like 1 homolog (DLK1) gene in non-small cell lung cancer (NSCLC) and its regulatory mechanism.

METHODS

The expression levels of DLK1 protein in 204 NSCLC tissues were examined by immunohistochemical (IHC) staining, and the correlation between DLK1expression and clinicopathological features was analyzed. Bisulfate sequencing PCR (BSP) of DNA samples from the tumor tissues of 18 NSCLC patients was performed to evaluate the DNA methylation status of CpG island in the DLK1 promoter region, and also compared with the corresponding IHC staining of DLK1 protein in the same samples.

RESULTS

Among the 102 squamous cell carcinoma (SCC) tissue specimens and their adjacent normal bronchial epithelia, DLK1 was up-regulated in 72 and 37 samples, respectively (P=0.001), and among 102 adenocarcinomas (ADC) tissues and their adjacent alveolar tissues, DLK1 was up-regulated in 77 and 7 samples, respectively (P<0.001). In addition, overexpression of DLK1 was significantly associated with histological type, clinical stage and tumor size of NSCLC (P<0.05 for all). The expression of DLK1protein was inversely correlated with its promoter methylation (P<0.05).

CONCLUSION

DLK1 expression is up-regulated in NSCLCs, which may be due, at least in part, to the DNA hypomethylation in the promoter region of theDLK1 gene.

Comparison of Open-Cell Stent and Closed-Cell Stent for Treatment of Central Vein Stenosis or Occlusion in Hemodialysis Patients

Background

Central vein stenosis or occlusion is a common complication that can lead to significant morbidity and dysfunction of access in the hemodialysis patient. More lesions can develop over time, and preserving access becomes a challenge as life expectancy of the hemodialysis patient increases.

Objectives

The goal was to compare long-term results and determine the outcomes of open-cell stent versus closed-cell stent for central vein stenosis or occlusion in hemodialysis patients.

Patients and Methods

From 1997 to 2015, in 401 hemodialysis patients, stent placement for central vein stenosis or occlusion was performed if balloon angioplasty was unsatisfactory, due to elastic recoil or occurrence of restenosis within 3 months. When thrombus was present, primary stenting was performed. A total of 257 open-cell stents and 144 closed-cell stents were used. Angiographic findings including lesion site, central vein stenosis or occlusion, and presence of thrombosis and complication were evaluated. Primary patency rate and mean patency rate of the stent were compared between two stent groups by Kaplan-Meier survival analysis.

Results

For the open-cell stent group, 159 patients were diagnosed as central vein stenosis and 98 were occlusion. For the closed-cell stent group, 78 were stenosis and 66 were occlusion. There were two complications for central migration and two for procedure-related vein rupture. Open-cell stents and closed-cell stents had mean patency rates of 10.9 ± 0.80 months and 8.5 ± 10.87 months, respectively (P = 0.002).

Conclusion

The open-cell stent is effective and its performance is higher than that obtained with the closed-cell stent for treating central vein stenosis or occlusion in hemodialysis patients.

Diagnostic yield of capsule endoscopy in ulcerative colitis and inflammatory bowel disease of unclassified type (IBDU)

BACKGROUND AND STUDY AIMS

Capsule endoscopy is increasingly reported as an important diagnostic procedure in patients with known or suspected Crohn's disease, but its clinical utility in patients with ulcerative colitis or unclassified type inflammatory bowel disease (IBDU) is unclear. The aim of our study was to determine the diagnostic yield of capsule endoscopy for small-bowel disease in patients with ulcerative colitis and IBDU.

PATIENTS AND METHODS

All data from patients with a history of ulcerative colitis or IBDU who underwent capsule endoscopy between October 2001 and August 2005 were analyzed for procedure indications and findings. Images were reviewed by an experienced capsule endoscopist. The finding of multiple ulcerations (three or more) on capsule endoscopy was classified as diagnostic of small-bowel Crohn's disease.

RESULTS

120 patients had undergone 122 capsule endoscopy procedures. Overall, 19 of 120 patients (15.8 %) had capsule endoscopy findings consistent with the diagnosis of Crohn's disease. The proportion of patients with small-bowel disease was significantly higher among patients with a history of colectomy (7 of 21 patients, 33 %) compared with those without colectomy (12/99, 12 %) ( P = 0.04). Among patients with positive findings on capsule endoscopy, 18 had also previously undergone a small-bowel follow-through study and only one showed findings consistent with Crohn's disease.

CONCLUSIONS

Many patients with a diagnosis of ulcerative colitis and atypical features or IBDU may have small-bowel findings on capsule endoscopy that are consistent with Crohn's disease. Capsule endoscopy should be considered in ulcerative colitis patients with atypical clinical features particularly after colectomy.

Superficial endobronchial lung cancer: radiologic-pathologic correlation

OBJECTIVE

To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology.

MATERIALS AND METHODS

This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared.

RESULTS

Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.

CONCLUSION

CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

[Inhibitory effects of N-(4-hydroxylphenol) retinamide on transformed human bronchial epithelial cells in vitro and reconstructed human bronchial epithelium in vivo]

Precancerous lesion is one of most important steps in tumorigenesis. It has been shown that retinoids have reliable effects on controlling many kinds of animal tumor and malignant tumor cell lines in vitro, but there is no laboratory report on the biological effect of retinoids on the precancerous lesion of human lung cancer. In this study the methods including of cell serum-free culture, precancerous model of human bronchial epithelium reconstructed in rat trachea/xenotransplanted in nude mice, flowcytometry, immunohistochemistry, TUNEL and pathological observation have been used to study the biological effects of N-(4-hydroxylphenol) retinamide (4-HPR), one new kind of retinoids, on transformed human bronchial epithelial cells in vitro and premalignant human bronchial epithelium in vivo. The results showed that in the study in vitro, the proliferation of transformed human bronchial epithelial cells, the ratio of cells in S phase, and the percentage of cells that positively react to antibody Ki-67 and mpm-2 were inhibited, but apoptotic cells were induced significantly by 4-HPR exposure. At the experiment in vivo, both growth rates and precancerous grades of the reconstructed human bronchial epithelium were reduced, and apoptotic cells were also observed in epithelium after 4-HPR treatment. The results suggested that 4-HPR is one of hopeful chemopreventive medicines to lung cancer.

Molecular cytogenetic alterations in the early stage at human bronchial epithelial cell carcinogenesis

Lung carcinogenesis is a multi-step process involving activation of oncogenes and inactivation of tumor suppress genes. Many molecular and cytogenetic alterations occur in the early stages of carcinogenesis. We have developed an effective culture system for human bronchial epithelial cells and lung cancer cells. Four immortalized human bronchial epithelial cell lines were established by transfecting the epithelial cells with plasmid DNA containing the early region of SV40. Some molecular and cytogenetic alterations, such as 3p-, 2q-, 9p-, c-myc translocation t(8;14) (q23; q32), were found in one immortalized bronchial epithelial cell line M when approaching malignant transformation. An increase in cell proliferation and decrease of apoptosis were noted in the late passages of the immortalized cell line M. Some molecular cytogenetic alterations were also observed in human primary non-small cell lung cancers. Molecular cytogenetic alterations during the early stage of carcinogenesis of human bronchial epithelial cells may be useful as biomarkers for both diagnosis and intermediate endpoint of chemoprevention of lung cancer.

[Preliminary study on the antimutagenesis of vegetables and fruits]

Possible antimutation of 108 preparations of 91 kinds of vegetables and fruits on Salmonella typhimurium TA98 and TA100 mutants was tested. 4-nitroquinoline-N-oxide (4 NQO), N-methyl-N-nitro-N-nitrosoguanidine (MNNG), aflatoxin B1 (AFB1) and benzo (a) pyrene (BaP) were used as mutagens. The results showed that 67 (62%) preparations had antimutagenic action in vitro to different degrees. 9.6% of all preparations showed inhibition action on 4 NQO in TA100 mutant and 12.3%, in TA98, 5% on MNNG in TA100, 38% on AFB1 in TA100 and 45.1% in TA98, 28.9% on BaP in TA100. This experiment provides a scientific basis to the study of food resources as prevention of carcinogenesis.