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Purpose: Intrahepatic cholangiocarcinoma (ICC) has various characteristics according to anatomical, histologic classifications, and its prognoses are different. This study aimed to compare oncologic outcomes according to tumor location (second bile duct confluence) and evaluate the effect of adjuvant chemotherapy. Methods: Clinical data of 318 patients who underwent curative resection for ICC was reviewed. Central type ICC (C-ICC) and peripheral type ICC (P-ICC) were defined when the tumor invades the intrahepatic secondary biliary confluence and when located more peripherally, respectively. Results: A larger tumor size, higher rate of elevated CA 19-9 level, vascular invasion, R1 resection, advanced T stage, and lymph node metastasis were found in C-ICC. C-ICC had poorer overall survival (median, 33 months vs. 58 months; P = 0.001), and the difference was more prominent in the early stage. C-ICC had a higher recurrence rate (68.7% vs. 55.1%, P = 0.014); otherwise, there was no difference in the recurrence patterns. There were no survival benefits of adjuvant chemotherapy in the entire cohort, but there were benefits in advanced stages (T3-4, N1 stage), especially in C-ICC. Conclusion: C-ICC has more aggressive tumor characteristics and poor survival compared to P-ICC. Adjuvant chemotherapy seems to have survival benefits in the advanced stages, especially in the central type.
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BACKGROUND: Panax ginseng (i.e., ginseng) root is extensively used in traditional oriental medicine. It is a modern pharmaceutical reagent for preventing various human diseases such as cancer. Ginsenosides-the major active components of ginseng-exhibit immunomodulatory effects. However, the mechanism and function underlying such effects are not fully elucidated, especially in human monocytes and dendritic cells (DCs). METHODS: We investigated the immunomodulatory effect of ginsenosides from Panax ginseng root on CD14(+) monocytes purified from human adult peripheral blood mononuclear cells (PBMCs) and on their differentiation into DCs that affect CD4(+) T cell activity. RESULTS: After treatment with ginsenoside fractions, monocyte levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 increased through phosphorylation of extracellular signal-regulated kinase (ERK)1/2 and c-Jun N-terminal kinase (JNK), but not p38 mitogen-activated protein kinase (MAPK). After treatment with ginsenoside fractions, TNF-α production and phosphorylation of ERK1/2 and JNK decreased in lipopolysaccharide (LPS)-sensitized monocytes. We confirmed that DCs derived from CD14(+) monocytes in the presence of ginsenoside fractions (Gin-DCs) contained decreased levels of the costimulatory molecules CD80 and CD86. The expression of these costimulatory molecules decreased in LPS-treated DCs exposed to ginsenoside fractions, compared to their expression in LPS-treated DCs in the absence of ginsenoside fractions. Furthermore, LPS-treated Gin-DCs could not induce proliferation and interferon gamma (IFN-γ) production by CD4(+) T cells with the coculture of Gin-DCs with CD4+ T cells. CONCLUSION: These results suggest that ginsenoside fractions from the ginseng root suppress cytokine production and maturation of LPS-treated DCs and downregulate CD4(+) T cells.
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OBJECTIVES: The goal of this study was to identify cytokines that may predict high-risk HPV clearance or persistence in untreated patients with mild dysplasia or less of the uterine cervix. METHODS: A prospective analysis was performed on 57 patients who harbored high-risk HPV with histologically verified mild dysplasia or less between May 2005 and March 2006. All patients underwent follow-up evaluation at 12 months. Real-time PCR was used to quantify interferon-gamma (IFN-gamma), interleukin-10 (IL-10), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) transcripts. Hybrid Capture II testing was used to detect HPV DNA. RESULTS: Among the 57 patients that were untreated with mild dysplasia, or less, 46 (80.7%) had no detectable HPV after 12 months of follow-up. Univariate analysis showed that a negative HPV test, of untreated mild dysplasia or less, occurred in 93.3% (28/30) of patients who were IFN-gamma-positive and in 66.7% (18/27) of patients who were IFN-gamma-negative (P=0.0109). Other factors such as age, lesion grade in the colposcopic biopsy, IL-10, IL-6, TNF-alpha, day of menstrual cycle, smoking, and use of oral contraceptives were not significantly associated with high-risk HPV negative or positive results after 12-months of follow-up in patients with untreated mild dysplasia or less. The multivariate logistic regression analysis showed that only IFN-gamma-positive results were significantly associated with clearance of high-risk HPV after 12 months of follow-up (OR: 8.26; 95% CI: 1.24-54.94). CONCLUSIONS: These results suggest that intralesional IFN-gamma may be a prognostic marker for clearance of high-risk HPV.