Sheng-Hsuan Chen

Overexpression of protein kinase cα mRNA may be an independent prognostic marker for gastric carcinoma

The variability of the prognosis of gastric carcinoma drives extensive researches for novel prognostic markers. The aims of this study were to correlate the expression of protein kinase Cα (PKCα) mRNA with clinicopathological parameters and to evaluate the significant value of PKCα in gastric carcinoma prognosis.

Clinicopathological Correlation and Prognostic Significance of Protein Kinase Cα Overexpression in Human Gastric Carcinoma

Objectives This study investigated the PKCα protein expression in gastric carcinoma, and correlated it with clinicopathological parameters. The prognostic significance of PKCα protein expression in gastric carcinoma was analyzed. Methods Quantitative real-time PCR test was applied to compare the PKCα mRNA expression in tumorous and nontumorous tissues of gastric carcinoma in ten randomly selected cases. Then PKCα protein expression was evaluated in 215 cases of gastric carcinoma using immunohistochemical method. The immunoreactivity was scored semiquantitatively as: 0u200a=u200aabsent; 1u200a=u200aweak; 2u200a=u200amoderate; and 3u200a=u200astrong. All cases were further classified into two groups, namely PKCα overexpression group with score 2 or 3, and non-overexpression group with score 0 or 1. The PKCα protein expression was correlated with clinicopathological parameters. Survival analysis was performed to determine the prognostic significance of PKCα protein expression in patients with gastric carcinoma. Results PKCα mRNA expression was upregulated in all ten cases of gastric carcinoma via quantitative real-time PCR test. In immunohistochemical study, eighty-eight out of 215 cases (41%) of gastric carcinoma revealed PKCα protein overexpression, which was statistically correlated with age (Pu200a=u200a0.0073), histologic type (P<0.0001), tumor differentiation (Pu200a=u200a0.0110), depth of invasion (Pu200a=u200a0.0003), angiolymphatic invasion (Pu200a=u200a0.0373), pathologic stage (Pu200a=u200a0.0047), and distant metastasis (Pu200a=u200a0.0048). We found no significant difference in overall and disease free survival rates between PKCα overexpression and non-overexpression groups (Pu200a=u200a0.0680 and 0.0587). However, PKCα protein overexpression emerged as a significant independent prognostic factor in multivariate Cox regression analysis (hazard ratio 0.632, Pu200a=u200a0.0415). Conclusions PKCα protein is upregulated in gastric carcinoma. PKCα protein expression is statistically correlated with age, histologic type, tumor differentiation, depth of invasion, angiolymphatic invasion, pathologic stage, and distant metastasis. The PKCα protein overexpression in patients with gastric carcinoma is a significant independent prognostic factor in multivariate Cox regression analysis.

Regression of Multiple Liver Adenomas after Withdrawal of Oral Contraceptives in a Hepatitis C Virus Carrier

We report on a case of multiple liver adenomas in a hepatitis C virus (HCV) carrier. A 40-year-old woman was asymptomatic and has been taking oral contraceptives continuously for 15 years. Abdominal ultrasonography revealed multiple iso-and hypoechoic tumors in both lobes of the liver. Enhanced computed tomography (CT) and magnetic resonance imaging demonstrated multiple hypervascular tumors in the lives; with the biggest one at segment Ⅳ, which measured 7cm in diameter. Cellar angiography revealed multiple hyervascular tumor staining of varying sizes in the liver. Histologically, the tumor showed features typical of a liver cell adenoma with no evidence of malignant transformation. These tumors progressively decreased in size and number after the patient discontinued the use of oral contraceptives. Eighteen months after the initial diagnosis, these tumors had almost completely disappeared on follow-up abdominal ultrasonography. We suggest that in an asymptomatic patient with contraceptives-related multiple liver adenomas, discontinuing the use of oral contraceptives is one of the choices of treatment, and close follow-up by ultrasonography or CT is mandatory.

Dual Infection with Non-Self-Limited Cytomegalovirus and Shigella of the Colon in Non-Immunocompromised Patient: Report of a Case

Cytomegalovirus infections are usually found in immunocompromised persons and rarely present in those who are immunocompetent. We report a case of an elderly man presenting with watery diarrhea, abdominal pain, and fever for one month. Infection of Shigella flexneri was proved by stool culture at first. Clinical symptoms did not improve with antibiotics treatment. In contrast, diffuse abdominal distention and megacolon developed. Then the diagnosis of CMV colitis was made by colonoscopy with mucosal biopsy. Treatment with Ganciclovir (10 mg/kg/day I.V. in 2 divided doses) for 2 weeks resulted in resolution of clinical symptoms with no noticeable side effects. There was no relapse during 6 months follow-up. We report, to our knowledge, the second case of dual infection of the colon with CMV and Shigella in an immunocompetent patient and the first non-self-limited example.