Biomedical subjects

Liang-Shun Wang

Publications and source records attributed to Liang-Shun Wang.

30 records · Page 2Linked to original sources

PubMed2004

Pulmonary metastasectomy for hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is seldom resectable due to advanced status. Even though hepatectomy is feasible, a large proportional of patients may still develops extrahepatic recurrence. Pulmonary metastasis is the most common site of extrahepatic spread. Few articles have discussed the benefit of resection for lung metastasis after curative hepatectomy. We evaluated the general information and the result of lung resection for patients having lung metastasis after curative resection of HCC. METHODS: Six patients who underwent pulmonary metastasectomy for HCC at Taipei Veterans General Hospital between August 1995 and May 2004 were enrolled in the study. All of them had received the hepatectomy for primary HCC. The demographic information of patients, the site and number of extrahepatic recurrence, the method of surgical intervention and the outcome after surgery were retrospectively reviewed. RESULTS: There were 4 men and 2 women with the mean age of 47.3 years. All of them were HBV carriers. Five patients had multiple pulmonary metastases removed by wedge resection. Two patients had bilateral lung metastases upon diagnosis of extrahepatic recurrence. The mean duration of follow-up after hepatic resection was 75.0 +/- 25.1 months (32 to 104 months). The mean survival after pulmonary resection was 47.2 +/- 34.3months (1 to 94 months). Four patients are still alive and free of the disease. One patient is alive but with the disease. One patient who refused further aggressive treatment after resection of lung metastasis died of the disease 40 months after lung resection, 77 months after hepatic resection. CONCLUSIONS: Lung resection for the pulmonary metastasis of HCC can result in a favorable long-term survival when there is no other intrahepatic or extraphepatic recurrence of HCC. For patients with multiple lung metastases in different lobes or different lungs, aggressive surgical resection is recommended if complete resection can be achieved.

Adult↗

PubMed2003

Clinicopathologic significance of cyclooxygenase-2 overexpression in esophageal squamous cell carcinoma.

BACKGROUND: Esophageal cancer is one of the most aggressive malignancies in the world, and whether multiple therapeutic modalities could improve long-term survival remains controversial. Recent studies have shown an increase of cyclooxygenase-2 (COX-2) expression in various malignancies, but its clinicopathologic role in esophageal squamous cell carcinoma (ESCC) remains unclear. METHODS: From 1993 to 1997, tissue samples from 96 patients with ESCC who underwent esophagectomy at our institution were collected for analysis. Cyclooxygenase-2 expression was examined by immunohistochemical staining, and further confirmed by Western blot analysis on six frozen tissues. Clinicopathologic data were analyzed to verify the significance. RESULTS: Cyclooxygenase-2 immunoreactivity was detected in 59 of 96 ESCC specimens (61%), and COX-2 overexpression (COX-2 high) was observed in 49% (47 of 96) of ESCCs. Statistical differences between COX-2 high and COX-2 low were found with respect to the status of distant metastasis (M factor) (p = 0.035) and tumor stage (p = 0.04). The survival was not significantly different between patients with and without COX-2 overexpression (p = 0.43). Using the Cox regression analysis, only the N factor (p = 0.0034) and M factor (p = 0.0325) were independent prognostic factors. CONCLUSIONS: Our results showed that in patients with ESCC, COX-2 overexpression was significantly correlated with fewer metastases and less advanced stage, but had no impact on survival. The status of local or distant lymph node metastasis was the most important prognostic factor. The biological role and pathophysiologic regulation of COX-2 overexpression in ESCC deserve further investigation.

Adult↗

PubMed2003

High cyclooxygenase-2 expression in cervical adenocarcinomas.

OBJECTIVE: The purpose of this study was to examine the relationships between cyclooxygenase-2 (COX-2) expression and prognostic factors in cervical carcinomas. METHODS: We studied COX-2 expression in 53 women with cervical cancers, including 35 squamous cell carcinomas (SCCs), 1 adenosquamous cell carcinoma (ASCC), and 17 adenocarcinomas (ACs), using commercially available polyclonal antibodies on Formalin-fixed, paraffin-embedded tissues. Normal cervical tissues were obtained as from other patients with uterine myomas treated with a total hysterectomy (n = 16). The immunoreactivity was quantified using an immunohistochemical scoring system that approximates the use of an image analysis-based system. RESULTS: Twenty-two cervical cancer tissues (41.5%), including 10 SCCs and 12 ACs, expressed COX-2 at a moderate to strong level, which significantly, differed from the negligible expression found in the control group of 16 normal cervical tissues (P = 0.001). Different cell types showed significantly different expression levels of COX-2 (SCC at 28.6% vs AC at 70.6%, P = 0.004). The presence of deep stromal invasion (n = 40) showed a significant inverse relationship to COX-2 expression (32.5% vs 69.2%, P = 0.02). The expression of COX-2 in well-differentiated carcinomas was significantly increased compared to that in moderately and poorly differentiated carcinomas (72.7% vs 33.3%, respectively, P = 0.018). CONCLUSIONS: Overexpression of COX-2 was found in both SCC and AC, but SCCs showed infrequent and low expression. These findings suggest that increased COX-2 expression may play an important role in cervical adenocarcinomas.

Adenocarcinoma↗

PubMed2003

Long-term results of pathological stage I non-small cell lung cancer: validation of using the number of totally removed lymph nodes as a staging control.

OBJECTIVE: The number of totally removed lymph nodes during thoracotomy was used alternatively to represent the quality of lymphadenectomy in patients with pathologic stage I non-small cell lung cancer (NSCLC). We combined this new parameter with other well-established prognostic factors and performed multivariate survival analyses to validate its usage as a stage control. METHODS: Three hundred and twenty-one patients who underwent complete surgical resection for stage I NSCLC were reviewed retrospectively. Aside from the number of lymph nodes removed during thoracotomy, other well-known clinical and histopathological factors were also included as possible prognostic factors for analysis. Two survival analyses, overall death and cancer-related death as study end-point, were performed, using the Kaplan-Meier method and multivariable Cox's proportional hazard regression analysis. Stepwise method of variable selection was employed to choose the 'best' Cox proportional hazard model in each survival analysis. RESULTS: The overall 5- and 10-year survival rates were 48 and 35%, and the cancer-related 5- and 10-year survival rate was 63.3 and 58.3%, respectively. The number of totally removed lymph nodes during thoracotomy, tumor size and smoking history in multivariable analysis significantly affected both overall and cancer-related survival rates. Cell type of adenocarcinoma or large cell carcinoma was associated with a worse cancer-related survival compared with other histological types. CONCLUSIONS: The quality of lymphadenectomy, represented quantitatively by the number of totally removed lymph nodes during thoracotomy, may impact on a more accurate tumor stage, and will affect the survival rate for patients with stage I NSCLC as well as other well known clinical and histopathological factors.

Adult↗

PubMed2003

Atypical thymic carcinoid and malignant somatostatinoma in type I multiple endocrine neoplasia syndrome: case report.

Thymic carcinoid and malignant somatostatinoma are both rare, and their concurrent presence in multiple endocrine neoplasia type 1 (MEN-1) has never been reported in the English literature to date. We present a patient with thymic carcinoid and malignant somatostatinoma in association with MEN-1. The patient eventually died of pulmonary aspergillosis and respiratory failure. Autopsy showed a 16 x 10 x 8-cm thymic carcinoid tumor, parathyroid and adrenal gland hyperplasia, and malignant somatostatinoma of the pancreas with a metastatic tumor over the splenic hilum.

Adrenal Glands↗

PubMed2003

The role of mediastinoscopy in the evaluation of thoracic disease and lung cancer.

BACKGROUND: Mediastinoscopy is a widely used technique in the diagnosis of mediastinal disease and the staging of bronchogenic carcinoma. Its efficacy in the preoperative staging of lung cancer is well-established, with a procedural sensitivity of greater than 90% and specificity of 100%. Mediastinoscopy can also establish the diagnosis in greater than 90% of mediastinal disease. We conducted a retrospective study of mediastinoscopy performed at our institution between 1998 and 2001 to evaluate the safety and efficacy of mediastinoscopy. METHODS: We collected 100 consecutive mediastinoscopies performed in Thoracic Division of Taipei Veterans General Hospital between 1998 and 2001. The indications for mediastinoscopy included mediastinal mass or lymphadenopathy and the staging of lung cancer. Some patients had the undetermined lung mass with enlarged mediastinal lymph node. RESULTS: There were 69 men and 31 women aged from 13 to 87 (mean 60.9). Sixty-seven patients had mediastinoscopy for the staging of lung cancer, 29 patients for diagnosis of mediastinal mass or lymphadenopathy, and 4 patients for undetermined lung mass with mediastinal lymphadenopathy. Among the patients with mediastinal disease, sarcoidosis was diagnosed in 13 patients, and lymphoma in 5 patients. N2 or N3 nodal metastasis was revealed in 38 of 67 patients who had lung cancer. Fifteen patients with negative mediastinoscopy proceeded to thoracotomy for tumor resection. Seventeen patients received neoadjuvant chemotherapy followed by resection. There were three complications, all due to bleeding, and no mortality. CONCLUSIONS: Mediastinoscopy is a safe and effective procedure for the diagnosis of mediastinal disease and the staging of lung cancer. In cases of lung cancer, mediastinoscopy can provide more accurate evaluation of mediastinal lymph node metastasis than conventional diagnostic tools like computed scan or magnetic resonance image with low morbidity and mortality.

Adolescent↗

PubMed2003

Surgical results of squamous cell carcinoma of the esophagus in young patients.

BACKGROUND: Squamous cell carcinoma of the esophagus (ESCC) is one of the ten most common cancers in Taiwan. Surgical resection is the mainstay of the treatment. Young patients with ESCC are reported to have poor surgical outcome. This retrospective and comparative study is to evaluate the clinicopathologic difference and survival between young and elderly patients. METHODS: From January 1985 to December 2000, totally 797 patients with esophageal cancer received esophagectomy with reconstruction at our institution. Among them, 12 patients who received neoadjuvant concurrent chemo-radiotherapy followed by esophagectomy were excluded from this study. The other 785 patients were divided into two groups. Group I included 67 patients aged 50 or younger (8.5%) and group II included 718 patients aged over 50 years (91.5%). The clinical data were collected by chart review and follow-up data were collected through outpatient department record or telephone contact. These two groups were analyzed and compared regarding sex ratio, exposure to tobacco or alcohol, surgical mortality rate and 5-year survival rate. RESULTS: There was no difference in gender distribution between young and old patients groups. More patients in the young patients group had the habits of alcohol and tobacco consumption than in the elder patients group. The surgical (30-day) mortality was 2.98% in the young patient group, and 5.43% in the elder group. The 5-year survival rate was better in young patients group than in elder patients group but there was no statistical significance. Survival in young patients group was significantly related to TNM staging system. CONCLUSIONS: More young patients with ESCC had the habit of smoking and drinking. There was no statistical difference between the groups in clinical variables, surgical mortality and survival. The survival rate was significantly related to the TNM tumor stage.

Age Factors↗

PubMed2002

Clinical significance of interleukin-6 and interleukin-6 receptor expressions in oral squamous cell carcinoma.

BACKGROUND: Recent studies showed that interleukin-6 (IL-6) played a role in tumor development. However, available information about the prognostic significance of IL-6 and IL-6 receptors (IL-6R) for oral squamous cell carcinoma (OSCC) is limited. METHODS: Eighty-six patients with OSCC were enrolled. Immunohistochemical staining was used to determine IL-6R expression and in-situ hybridization for IL-6 mRNA transcripts in surgical specimens. Clinicopathologic correlation was evaluated by chi-square test and survival by log rank test. RESULTS: Expression rates of IL-6R and IL-6 mRNA transcripts in tumor specimens were 73.3% and 54.7%, much higher than those in nontumor mucosa (p <.001). IL-6R overexpression was associated with larger tumors and more advanced histologic grade (p <.05). The presence of IL-6 mRNA transcripts was inversely correlated with distant metastasis, lymph node involvement, and second primary SCC (p <.05) and predicted better survival (p =.007). CONCLUSIONS: IL-6-IL-6R coexpression was rather high in OSCC, and IL-6 mRNA transcript expression might influence patient survival. The biologic role of IL-6-IL-6R coexpression in OSCC needs additional investigation.

Adult↗

PubMed2002

Detection of Epstein-Barr virus genome within thymic epithelial tumours in Taiwanese patients by nested PCR, PCR in situ hybridization, and RNA in situ hybridization.

Epstein-Barr virus (EBV) is known to be associated with a variety of tumours, including Burkitt's lymphoma, nasopharyngeal carcinoma, and some carcinomas of other organs with similar lymphoepithelioma-like features. The association between EBV and thymic epithelial tumours is inconclusive, as reports in this regard are not entirely consistent and the methods employed are of different sensitivity and specificity. This study examined 78 thymomas and 21 thymic carcinomas in Taiwanese patients, to detect the viral genome at both DNA and RNA levels. The tissue blocks were first screened by nested polymerase chain reaction (PCR) targeting on the first tandem internal repeats. The positive cases were further submitted for viral localization by in situ PCR insitu hybridization (ISH) and Epstein-Barr-encoded RNA-1 (EBER-1) ISH. None of the thymomas showed a detectable EBV genome. Eight thymic carcinomas were positive for EBV by nested PCR, of which six displayed nuclear signals within the tumour cells by in situ PCR ISH and/or RNA ISH, one displayed signals within the lymphocytes, and one showed no discernible in situ signals. Most of them exhibited a lymphoepithelioma-like morphology. These results show that nested PCR is a sensitive method for screening the EBV genome in thymic epithelial tumours. In situ PCR ISH is reliable for localization of the virus, in addition to EBER-1 RNA ISH. Thymomas are not related to EBV, even in this endemic area. Thymic carcinomas, especially the lymphoepithelioma-like thymic carcinomas, are more often associated with the virus.

Adult↗

PubMed2002

Adenoid cystic carcinoma of the trachea and bronchus--a clinicopathologic study with DNA flow cytometric analysis and oncogene expression.

OBJECTIVE: Adenoid cystic carcinoma (ACC) of the tracheobronchial tree is quite uncommon. The clinicopathologic analysis and the therapeutic outcomes of tracheobronchial ACC have been reported earlier. However, their biological behavior should differ from other tracheal neoplasms. Thus, DNA flow cytometric analysis and biomarkers of p53, HER-2/neu and COX-2 for tracheobronchial ACC were investigated in order to evaluate their clinicopathological significance. METHODS: Between 1985 and 1999, nine patients with tracheobronchial ACC were included for the study. All the patients had pathologically confirmed ACC. Five were male and four were female. Eight patients underwent surgical resections. Seven paraffin embedded tumors from six patients were available for DNA flow cytomeric analysis and immunohistochemical staining of p53, HER-2/neu and COX-2. RESULTS: Histologically, nine pathologic specimens from eight surgical patients (including one patient received operation twice) showed one grade I, five grade II and three grade III. The mitotic activity, lymphatic invasion and vascular invasion were more frequent in advanced grading tumor. The higher grade tumors seemed to be associated with a higher synthetic phase fraction (SPF). Immunohistochemically, except for one grade II tumor showing positive expression of HER-2/neu, all the seven tumorous samples revealed negative expressions of p53, COX-2 and HER-2/neu. The patient with positive HER-2/neu tumor had distant metastases 4 years after surgery. CONCLUSIONS: Complete surgical resection may provide best survival for tracheobronchial ACC. The DNA ploidy and SPF may correlate with tumor grading or metastasis. The overexpressions of HER-2/neu, p53 and COX-2 may impact the prognosis in patients with stage I non-small cell lung cancer, but did not express difference in our patients.

Adult↗

PubMedDate not supplied

The elevated serum interleukin-6 correlates with the increased serum butyrate level in patients with nasopharyngeal carcinoma.

We investigated the clinical significance and regulation of serum interleukin-6 (IL-6) in patients with nasopharyngeal carcinoma (NPC). Serum IL-6 levels of 314 NPC patients and 202 healthy individuals were determined. Of the NPC patients, 69.1% (217/314) showed higher IL-6 levels than that of normal average (2.76+/-2.06 pg/ml). Elevation of IL-6 correlated with the advanced disease and the adverse prognosis of NPC patients. By employing in situ hybridization technique, IL-6 mRNA was detected in the tumor cells of NPC patients with high serum IL-6 levels. Concurrently, serum levels of butyrate were determined in 147 NPC patients and 52 healthy individuals by gas chromatography. Patients with elevated serum butyrate concentrations (4.2+/-2.2 micro M) also had significantly higher IL-6 levels (29.14+/-5.17 pg/ml). No detectable serum butyrate was measured in the healthy individuals. In order to investigate the direct relationship between butyrate and IL-6, n-sodium butyrate (n-BT) was added to the NPC cells in an in vitro study, and marked increase of IL-6 expression was detected in n-BT-treated cells. Our results suggested that tumor cells could be an important source of elevated serum IL-6 in patients with NPC and that IL-6 level in NPC patients was proportional to the serum butyrate concentration. In vitro, IL-6 expression in NPC cells could be up-regulated by butyrate.

Biomarkers, Tumor↗

PubMedDate not supplied

Expression of dihydrodiol dehydrogenase and resistance to chemotherapy and radiotherapy in adenocarcinoma cells of lung.

BACKGROUND: The cytoplasmic enzyme dihydrodiol dehydrogenase (DDH) plays an important role in the detoxification process. Recently, the overexpression of DDH was detected in non-small cell lung cancer (NSCLC) cells and patients with DDH overexpression were shown to have a significantly higher incidence of early tumor recurrence and distant metastasis. In this study, the correlation between DDH expression and resistance to cisplatin, adriamycin and radiotherapy in NSCLC was examined. MATERIALS AND METHODS: Seven lung adenocarcinoma cell lines (H23, H838, H1437, H1648, H2009, H2087 and H2126) were used in the study. The DDH level was determined by reverse transcription polymerase chain reaction and immunoblotting. Drug- and radiation-mediated cytotoxicity was measured by clonogenic assay. DDH isoforms (DDH1, DDH2 and DDH3) were transfected into H23 cells that did not express DDH to examine their effects on drug and radiation resistance. RESULTS: DDH-overexpressed adenocarcinoma cells exhibited a much higher resistance to doxorubicin, cisplatin and irradiation than cells with lower DDH expression. The DDH2- and DDH1-transfectants showed higher drug and radiation resistance than the DDH3-trasnfectant. CONCLUSION: Resistance to both anticancer drugs and irradiation in lung adenocarcinoma cells was closely associated with DDH activity. DDH1 and DDH2 were the main isoforms responsible for these effects.

Adenocarcinoma↗