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简介：AIM:ToanalyzetheassociationbetweenHelicobacterspp.andsomecommongutbacteriainpatientswithcholecystitis.METHODS:Anested-polymerasechainreaction(PCR),specificto16SrRNAofHelicobacterspp.wasperformedonparaffin-embeddedgallbladdersamplesof100cholecystitisand102controlcases.ThesampleswerealsoanalyzedforsomecommongutbacteriabyPCR.Positivesamplesweresequencedforspeciesidentification.RESULTS:HelicobacterDNAwasfoundinsevenoutof100casesofacuteandchroniccholecystitis.SequenceanalysisdisplayedHelicobacterpullorum(H.pullorum)insixcasesandHelicobacterpyloriinone;H.pullorumwasonlyfoundincaseswithmetaplasia.Controlsam-pleswerenegativeforHelicobacterspp.andsomecommongutbacteria.Therewasasignificantdifference(P=0.007)betweencholecystitisandcontrolsamplesforHelicobacterDNA.CONCLUSION:ApossiblerelationshipwasdetectedbetweenHelicobacterDNAandcholecystitis.Furtherserologicalandimmunohistochemicalstudiesareneededtosupportthesedata.

简介：Thisarticlediscussestheadequatetreatmentofearlygallbladdercancer(T1a,T1b)andisbasedonpublishedstudiesextendingovernearly3decades.Randomizedstudiesandmetaanalysescomparingdifferentsurgicaltreatmentsdonotexist.Theliteratureshowsthatinupto20%ofpatientslymphnodemetastasisarefoundinT1bgallbladdercancer.Duetohighmalignancywithearlyangiolymphaticspreadandresistancetochemotherapyandradiationontheonehand,andtherelativelowoperativeriskofextendedcholecystectomy(cholecystectomyandregionallymphadenectomy)ontheotherhand,webelievethatthisprocedureismandatoryinearlygallbladdercancer.

简介：AIMTocomparesurvivalandrecurrenceinhepatocellularcarcinoma（HCC）patientswhodidordidnotreceiveadjuvanttransarterialchemoembolization（TACE）.METHODS：Aconsecutivesampleof229patientswhounderwentcurativeresectionbetweenMarch2007andMarch2010inourhospitalwasincluded.Ofthese229patients,91（39.7%）underwentcurativeresectionfollowedbyadjuvantTACEand138（60.3%）underwentcurativeresectionalone.Inordertominimizeconfoundsduetobaselinedifferencesbetweenthetwopatientgroups,comparisonswereconductedbetweenpropensityscore-matchedpatients.SurvivaldataandrecurrencerateswerecomparedusingtheKaplan-Meiermethod.IndependentpredictorsofoverallsurvivalandrecurrencewereidentifiedusingCoxproportionalhazardregression.RESULTS：Among61pairsofpropensityscorematchedpatients,the1-,2-,and3-yearoverallsurvivalrateswere95.1%,86.7%,and76.4%intheTACEgroupand86.9%,78.5%,and73.2%inthecontrolgroup,respectively.Atthesametime,theTACEandcontrolgroupsalsoshowedsimilarrecurrenceratesat1year（13.4%vs24.8%）,2years（30.6%vs32.1%）,and3years（40.1%vs34.0%）.MultivariateCoxregressionidentifiedserumalpha-fetoproteinlevel≥400ng/mLandtumorsize〉5cmasindependentriskfactorsofmortality（P〈0.05）.CONCLUSION：AspostoperativeadjuvantTACEdoesnotimproveoverallsurvivalorreducerecurrenceinHCCpatients,furtherstudyisneededtoclarifyitsclinicalbenefit.

简介：尽管非小的细胞肺癌症(NSCLC)能转移到几乎任何东西器官，到有重要临床的表明的胆囊的转移是相对稀罕的。这里，我们报导作为尖锐胆汁介绍的NSCLC的胆囊转移的一个案例。在恰好上面的象限和发烧疼痛地介绍的一个79岁的人。胸和腹部的计算断层摄影术(CT)扫描在胆囊变厚的肺和不规则的墙的恰好更低的脑叶显示出一个cavitary团。肺团的开的胆囊炎和针活体检视被执行。胆囊的组织学的检查揭示了显示象针活体检视估计的肺团的一样的形态学的中等区分的有鳞的房间癌。胆囊和肺织物的随后的immunohistochemical检查证明肿瘤房间为P63是积极的但是为cytokeratin否定7，cytokeratin20并且甲状腺抄写factor-1。胆囊的第二个主要肿瘤被immunohistochemical方法排除，并且最后的病理学的诊断是NSCLC的胆囊转移。尽管发生是极其稀罕的，尖锐胆汁能与肺癌症转移联合发生到胆囊。

简介：AIMToinvestigatetheimpactofsurgicalproceduresonprognosisofgallbladdercancerpatientsclassifiedwiththelatesttumor-node-metastasis（TNM）stagingsystem.METHODS：Aretrospectivestudywasperformedbyreviewing152patientswithprimarygallbladdercarcinomatreatedatPekingUnionMedicalCollegeHospitalfromJanuary2003toJune2013.Postsurgicalfollow-upwasperformedbytelephoneandoutpatientvisits.ClinicalrecordswerereviewedandpatientsweregroupedbasedontheneweditionofTNMstagingsystem（AJCC,seventhedition,2010）.Prognoseswereanalyzedandcomparedbasedonsurgicaloperationsincludingsimplecholecystectomy,radicalcholecystectomy（orextendedradicalcholecystectomy）,andpalliativesurgery.Simplecholecystectomyis,bydefinition,resectionofthegallbladderfossa.Radicalcholecystectomyinvolvesawedgeresectionofthegallbladderfossawith2cmnonneoplasticlivertissue;resectionofasuprapancreaticsegmentoftheextrahepaticbileductandextendedportallymphnodedissectionmayalsobeconsideredbasedonthepatient＇scircumstance.Palliativesurgeryreferstocholecystectomywithbiliarydrainage.DataanalysiswasperformedwithSPSS19.0software.Kaplan-MeiersurvivalanalysisandLogranktestwereusedforsurvivalratecomparison.P〈0.05wasconsideredRESULTS：Patientsweregroupedbasedonthenew7theditionofTNMstagingsystem,including8casesofstage0,10casesofstageⅠ,25casesofstageⅡ,21casesofstageⅢA,21casesofstageⅢB,24casesofstageⅣA,43casesofstageⅣB.Simplecholecystectomywasperformedon28cases,radicalcholecystectomyorexpandedgallbladderradicalresectionon57cases,andpalliativeresectionon28cases.Thirty-ninecaseswerenotoperated.Patientswithstages0andⅠdiseasedemonstratednostatisticalsignificantdifferenceinsurvivaltimebetweenthosereceivingradicalcholecystectomyandsimplecholecystectomy（P=0.826）.TheprognosisofstageⅡpatientswithradicalcholecystect

简介：AbstractBackground:Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China.Methods:This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.Results:Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350–46,512) new cases and 47,278 (95% UI: 32,889–57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220–41,231) deaths, and 763,584 (95% UI: 566,755–920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6–1.0%), 1.3% (95% CI: 1.1–1.5%), 0.4% (95% CI: 0.2–0.6%), and 0.2% (95% CI: 0.1–0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily.Conclusions:GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.

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简介：AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.

简介：AbstractBackground:Topoisomerase II alpha (TOP2A) has been reported to play a crucial role in the tumorigenesis of various cancer types. However, the biological role of TOP2A in gallbladder cancer (GBC) remains unknown. The current study aimed to explore the function and potential mechanism of TOP2A in GBC.Methods:Based on Gene Expression Profiling Interactive Analysis data, we found TOP2A was significantly up-regulated in GBC tissues and resulting in shorter overall survival. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to detect the expression of TOP2A in 45 pairs of GBC tissues and adjacent non-tumor tissues. In vitro, cell proliferation, migration, and invasion ability were examined by cell counting kit-8 and transwell assay, respectively. Epithelial-mesenchymal transition (EMT) related and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway-related markers were measured by Western blotting. Xenograft model assay was performed to evaluate the effect of TOP2A in vivo.Results:TOP2A was found up-regulated in GBC (tumor vs. normal, 12.62 vs. 0.34) and correlated with the late tumor node metastasis stage (P = 0.0032), present of lymph node metastasis (P = 0.0273), and poor prognosis in GBC patients (log-rank P = 0.028). In vitro and in vivo assays showed that knockdown of TOP2A notably inhibited cell proliferation, migration, invasion, EMT process, and tumor growth in GBC. In addition, TOP2A down-regulation significantly decreased the protein levels of phosphor (p)-PI3K, p-Akt, and p-mTOR.Conclusion:Our study demonstrates that TOP2A was overexpressed in GBC and associated with poor prognosis in GBC patients. TOP2A promotes GBC cell proliferation, migration, invasion, EMT process, and tumor growth through activating PI3K/Akt/mTOR signaling pathway, and may serve as a novel prognostic biomarker and therapeutic target for GBC.