简介：Transforminggrowthfactor-β(TGF-β)isakeyfactorincancerdevelopmentandprogression.TGF-βcansuppresstumorigenesisbyinhibitingcellcycleprogressionandstimulatingapoptosisinearlystagesofcancerprogression.However,TGF-βcanmodulatecancer-relatedprocesses,suchascellinvasion,distantmetastasis,andmicroenvironmentmodificationthatmaybeusedbycancercellstotheiradvantageinlatestages.Correspondingmechanismsincludeangiogenesispromotion,anti-tumorimmunitysuppression,andepithelial-to-mesenchymaltransition(EMT)induction.ThecorrelationbetweenTGF-βexpressionandcancerprognosishasalsobeenextensivelyinvestigated.ResultssuggestthatTGF-βpathwaycanbetargetedtotreatcancer;assuch,thefeasibilityofthistreatmentisinvestigatedinclinicaltrials.

简介：Objectives:ToexploretheprognosticrelevanceofthenumberandratioofmetastaticlymphnodesinresectedCarcinomaoftheampullaofVater(CAV).Methods:Theclinicaldataof155patientswhounderwentpancreaticoduodenectomy(PD)forcanceroftheampullaofVaterbetweenJanuary1990andDecember2010wereretrospectivelyanalyzed.KaplanMeiermethodwasusedinsurvivalanalysisandLogrankmethodincomparison.MultivariateanalysiswasperformedusingCoxproportionalhazardsmodel.Results:Amongthese155patients,thein-hospitalmortalityratewas4.5%,lymphnodepositivediseasewas21.3%,andthe5-yearsurvivalratewas51.6%.Patientswithalymphnoderatio(LNR)>20%weremorelikelytohavetumordifferentiation,depthofduodenalinvolvement,depthofpancreaticinvasion,T-stageandTNM-Stage.ThenumberofthemetastaticlymphnodesisimportantprognosticfactorsoftheCAV.Univariateanalysisshowedthatthefactorsassociatedwiththeprognosisincludedtumorsize(P=0.036),tumordifferentiation(P=0.019),LNR(P=0.032),numberofmetastaticlymphnodes(P=0.024),lymphnodemetastasis(P=0.03),depthofpancreaticinvasion(P=0.001),T-stage(P=0.002),TNMstage(P=0.001),elevatedCA19-9(P=0.000),andjaundice(P=0.021).Multivariateanalysisshowedthatthefactorsassociatedwiththeprognosiswerethenumberofmetastaticlymphnodes(P=0.032;RR:1.283;95%CI:1.022-1.611),tumorsize(P=0.043;RR:1.736;95%CI:1.017-2.963),andelevatedCA19-9(P=0.003;RR:3.247;95%CI:1.504-7.010).Conclusions:LNRisausefulfactorforpredictingtheprognosisoftheradicaltreatmentforCAV,whereasthenumberofmetastaticlymphnodesisthemostimportantfactor.Furtherresearchonthelocations,number,andLNRwillbeclinicallymeaningfultoimprovesurvivalinpatientswithCAV.

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