In conclusion, constitutive activation of ERBB3-dependent signaling driven by an NRG1/ERBB3 autocrine mechanism is strongly associated with microscopic vascular invasion, early recurrence, and poor prognosis of HCC. ERBB3-dependent signaling plays a crucial role in the regulation of tumor invasion and metastasis of HCC rather than tumor CP 868596 initiation and growth. ERBB3 is a marker indicating microscopic vascular

invasion and a predictor for the early recurrence of HCC. ERBB3-dependent signaling is a candidate target for the treatment of microscopic intrahepatic invasion and for the prevention of HCC recurrence. The authors are grateful to Professor Yun-Fan Liaw for his comments on this study and to Miss Shao-Jung Erlotinib chemical structure Lo for her technique assistance. They also thank the Taiwan Liver Cancer Network

for providing some of the clinical samples for this study and the National RNAi Core of Taiwan for providing the lentivirus-based shRNA clones. Additional Supporting Information may be found in the online version of this article. “
“Background and Aims:  The change of therapeutic strategy for large colorectal tumors after the introduction of endoscopic submucosal dissection (ESD) has not yet been clarified. The aim of this study was to estimate the impact of ESD as an initial treatment strategy. Methods:  A questionnaire was administered to nine expert panelists in colorectal ESD. The questionnaire used retrospective data from consecutive case series. Forty-seven cases of early colorectal tumors (≥ 20 mm) were included. Endoscopic growth types were 25 laterally-spreading tumors (LST) of granular type (G), 15 LST of non-granular types (NG), and seven protruded types. Pathological diagnoses included 15 adenomas (Ad), 18 intramucosal cancers (M), three submucosally-shallow invasive

cancers (< 1000 µm) (SMs), and 11 submucosally-deep invasive cancers (≥ 1000 µm) (SMd). The expert panelists completed questionnaires about recommended initial treatment under suppositions of before and after the introduction of ESD. Over-surgery was defined as surgery for Ad, M, and SMs. Non-curative endoscopic resection (ER) MCE was defined as ER for SMd. Results:  After the introduction of ESD, the reduction in the over-surgery rate was estimated at 10.8% for Ad, M, and SMs, and the increase in the non-curative ER rate was estimated at 27.2% for SMd. By endoscopic growth type, the reduction of over-surgery rates for LST–NG, LST–G, and protruded type was 15.5%, 10.5%, and 2.2%, respectively. Conclusions:  The endoscopists changed their therapeutic strategy for large colorectal tumors to reduce over-surgery, especially in LST–NG, demonstrating the impact of ESD.