Differential Expression of Vascular Endothelial Growth Factor (VEGF) and VEGF Receptors in the Sequence of Hyperplastic Polyp, Serrated Adenoma and Adenocarcinoma of Colorectum

AIM: The aim of this study was to investigate the role for vascular endothelial growth factor (VEGF) and its receptors, VEGFR-1 and -2, in the hyperplastic polyp (HP)- serrated adenoma (SA)-adenocarcinoma (AC) sequence of the colorectum.Methods: Thirty-six HPs, 33 SAs and 7 ACs (which contained HP and/or SA) were immunohistochemically examined for the expression of VEGF, VEGFR-1, and VEGFR-2.Results: VEGF protein was expressed in the cytoplasm of SA and AC tumor cells, and VEGFR-1 and VEGFR-2 were expressed both in the cytoplasm and on the membrane of these tumors, while there was faint or no expression of VEGF, VEGFR-1 and VEGFR-2 in HPs. Immunohistochemical staining revealed that 8.3% (3 of 36) HPs, 87.9% (29 of 33) SAs and 100% (7 of 7) ACs were positive for VEGF; 2.8% (1 of 36) HPs, 97.0% (32 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-1; 16.7% (6 of 36) HPs, 100% (33 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-2. The expression of VEGF, VEGFR-1 or VEGFR-2 was statistically correlated with the sequence of HP, SA and AC (P < 0.0001, respectively) Conclusion: Our results suggest that the VEGF pathway may play an important role in the HP-SA-AC sequence

Apical membrane localization of glycogen synthase kinase 3beta protein in normal colon epithelium and aberrant distribution in colorectal cancer.

Glycogen synthase kinase 3beta (GSK-3beta) was subsequently shown to function in a wide range of cellular processes. GSK-3beta is a multifunctional serine/threonine kinase which performs a role in several signaling pathways including Wnt signal transduction. Recently, the activity of membrane-localized GSK-3beta has been shown to be crucial for initiation of Wnt cascade. In our study, the membrane localization of GSK-3beta was found on the apical membrane of normal epithelium, where co-localized and directly bound with MUC1. In colorectal cancer, depolarized cells showed the aberrant distribution of GSK-3beta on the cellular membrane with beta-catenin nuclear accumulation. The aberrant distribution of the membrane-localized GSK-3beta may contribute to the development of colorectal cancer

Differential Expression of Vascular Endothelial Growth Factor (VEGF) and VEGF Receptors in the Sequence of Hyperplastic Polyp, Serrated Adenoma and Adenocarcinoma of Colorectum

AIM: The aim of this study was to investigate the role for vascular endothelial growth factor (VEGF) and its receptors, VEGFR-1 and -2, in the hyperplastic polyp (HP)- serrated adenoma (SA)-adenocarcinoma (AC) sequence of the colorectum.Methods: Thirty-six HPs, 33 SAs and 7 ACs (which contained HP and/or SA) were immunohistochemically examined for the expression of VEGF, VEGFR-1, and VEGFR-2.Results: VEGF protein was expressed in the cytoplasm of SA and AC tumor cells, and VEGFR-1 and VEGFR-2 were expressed both in the cytoplasm and on the membrane of these tumors, while there was faint or no expression of VEGF, VEGFR-1 and VEGFR-2 in HPs. Immunohistochemical staining revealed that 8.3% (3 of 36) HPs, 87.9% (29 of 33) SAs and 100% (7 of 7) ACs were positive for VEGF; 2.8% (1 of 36) HPs, 97.0% (32 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-1; 16.7% (6 of 36) HPs, 100% (33 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-2. The expression of VEGF, VEGFR-1 or VEGFR-2 was statistically correlated with the sequence of HP, SA and AC (P < 0.0001, respectively) Conclusion: Our results suggest that the VEGF pathway may play an important role in the HP-SA-AC sequence

A pilot study to assess the safety and usefulness of combined transurethral endoscopic mucosal resection and en-bloc resection for non-muscle invasive bladder cancer

Background: Transurethral resection (TUR) is the standard operation used for non-muscle invasive bladder cancer (NMIBC). Although most solid tumors are principally removed via single block resection without incising the mass, disruption of the lesion is unavoidable in traditional TUR. Furthermore, pathological diagnosis is often difficult due to heat-related denaturation of tissues in TUR. Although transurethral en-bloc resection is useful for judging tumor invasion, it is associated with a prolonged operative duration. We attempted to show the safety and usefulness of combined endoscopic mucosal resection (EMR) and en-bloc resection in NMIBC patients. Methods: We investigated 39 patients with clinical NMIBC who were treated using our original EMR?+?en-bloc resection technique, which involved removal of the tumor mass that protruded from the mucosa, using a polypectomy snare similar to that used for EMR. The residual lesion was removed using en-bloc resection. The operative period, duration of hospitalization, and recurrence rates were compared with those of conventional TUR (n?=?31). Results: The mean (standard deviation, range) time interval for EMR and total operative duration were 1.6 (1.1, 1?5) min and 18.3 (10.5, 3?48) min, respectively. The total operative duration was comparable to that of TUR (17.3?min, p?=?0.691). The mean duration of catheterization in the EMR?+?en-bloc resection group (4.2?days) was also similar to that in the TUR group (3.7?days; p?=?0.285). No severe complications were observed with EMR?+?en-bloc resection. The pathologists were able to determine tumor invasiveness with considerable certainty in all specimens obtained via the EMR?+?en-bloc procedure than via TUR, and the difference in the ease of diagnosis was statistically significant (p?=?0.016). Recurrence rates were comparable (p?=?0.662) between the EMR?+?en-bloc (15.4%) and TUR groups (19.4%). Conclusions: Our results demonstrated that the EMR?+?en-bloc resection technique is feasible, safe, and useful for treating patients with NMIBC. Furthermore, this technique helps provide a more accurate pathological diagnosis

Laparoscopic resection of a gastrointestinal stromal tumor larger than 5 cm: Report of a Case

A 46-year-old woman was admitted to our hospital and was diagnosed with a gastric submucosal tumor at the medical examination. Upper endoscopic examination revealed a submucosal tumor in the lower body of the stomach. Abdominal computed tomography (CT) revealed a large tumor of dimensions 51 × 32 mm in the lower body of the stomach with a mixed appearance: a solid part exhibiting a contrast effect and a cystic part exhibiting no contrast. Endoscopic ultrasonic fine needle aspiration biopsy (EUS-FNAB) was performed, and a gastrointestinal stromal tumor (GIST) was diagnosed by immunohistopathological examination. Laparoscopic surgery with five ports was performed for resection. After securing the safety margin the tumor was resected circumferentially using an ultrasonically activated device (USAD). Resection entailed a significant portion of the gastric wall. During surgery, a support yarn hooked in the minor axis direction, and the defect was closed using an automatic suturing device three times. According to the third edition of the GIST clinical practice guidelines, indications for laparoscopic resection of GISTs over 5cm have been relaxed. It was considered that careful laparoscopic resection would be possible even though this was a large GIST exceeding 5 cm

Laparoscopic resection of a gastrointestinal stromal tumor larger than 5 cm: Report of a Case

A 46-year-old woman was admitted to our hospital and was diagnosed with a gastric submucosal tumor at the medical examination. Upper endoscopic examination revealed a submucosal tumor in the lower body of the stomach. Abdominal computed tomography (CT) revealed a large tumor of dimensions 51 × 32 mm in the lower body of the stomach with a mixed appearance: a solid part exhibiting a contrast effect and a cystic part exhibiting no contrast. Endoscopic ultrasonic fine needle aspiration biopsy (EUS-FNAB) was performed, and a gastrointestinal stromal tumor (GIST) was diagnosed by immunohistopathological examination. Laparoscopic surgery with five ports was performed for resection. After securing the safety margin the tumor was resected circumferentially using an ultrasonically activated device (USAD). Resection entailed a significant portion of the gastric wall. During surgery, a support yarn hooked in the minor axis direction, and the defect was closed using an automatic suturing device three times. According to the third edition of the GIST clinical practice guidelines, indications for laparoscopic resection of GISTs over 5cm have been relaxed. It was considered that careful laparoscopic resection would be possible even though this was a large GIST exceeding 5 cm